What is the impact of trauma in early childhood on tactile processing and development?

We were asked the question: What is the impact of trauma in early childhood on tactile processing and development? Here are some thoughts….

Trauma can happen at any time including in the preterm infant. Many of us will experience trauma at some point in our lives.  We are designed to cope with stress, stress is part of everyday life, but when stress tips over into trauma, trauma shapes us. Our behavioural responses target life preservation rather than adaptation.

“Trauma results from an event, series of events, or set of circumstances that are experienced by an individual as physically or emotionally harmful or threatening; it has lasting, adverse effects on the individual’s functioning as well as physical, social, emotional, and/or spiritual well-being”.  

Trauma overwhelms the resources we have for coping, and it often ignites the “fight, flight or freeze” reaction at the time of the event, as well as into the future.

(SAMHSA’s Concept of Trauma and Guidance for a Trauma Informed Approach 2014)

In humans our neurobiology is very open to being moulded by our surroundings; it adapts itself to survive and feel safe in the prevailing environment. It uses this experience to build a brain that anticipates what will be required in the future. This is especially the case in early development when it is laying down the foundations and scaffolding for future brain development. From 0-2 there are many critical and sensitive periods during which time crucial functions are being established and when neural circuits are more sensitive to influence.  Like all sensations, tactile experiences in this timeframe are more easily encoded into our neuro software providing instructions as to how to deal with touch experiences going forwards.

Early tactile and interoceptive signals provide moment-by-moment mapping of our internal and external landscape across both the unconscious and the developing conscious levels of our brain. Ascending pathways for pain as far as the thalamus are established by 23/24 weeks. The descending modulating pathways will mature much later across the first year of life. This means that pain is more difficult to modulate at this ealy stage of development.

In response to stressful events, e.g. pain, stress responses will be initiated and will adapt the developing neurology to be ready for future painful experiences. For example, our amygdala and insula activity increases and our hippocampal activity decreases. Our neurobiology becomes primed for threat and we illicit threat behaviours quickly and unconsciously.

Within the NICU unit there are many environmental stressors including frequent painful procedures, sensory overwhelm across several sensory systems and isolation from parental contact all of which create stress responses that are likely to overwhelm and therefore tip into trauma. In early life there is an understanding now that several adverse childhood experiences (ACES) can alter the developing neurobiology and predispose it to later physical and mental health challenges.

Based on S. Porges Polyvagal Theory, our threat/ stress responses are:

  • Sympathetic responses: mobilise (fight/flight), heightened sensory awareness across all sensory systems, increased heart rate etc
  • Parasympathetic (dorsal vagus) mediated response: shutdown, reduced mobility, reduced responses to sensory stimuli, reduced heart rate etc.   

Prolonged stress and trauma events, especially in early life, impact future cortisol levels, reduce thalamic volumes (somatosensory thalamus),  maturation of the brain with decreased frontal and parietal brain width and altered diffusion and functional connectivity in the temporal lobes.

(McPherson C, et al. The influence of pain, agitation, and their management on the immature brain. Pediatr Res. 2020)

In keeping ourselves safe in the moment we are also looking to keep ourselves safe in the future. We write a neurobiological autobiography that we use as an instruction book for navigating the future. It becomes our sounding board for how we should interpret internal and external sensory cues going forwards.

For a trauma encoded neurobiology, a touch experience will be perceived as a threat to wellbeing, be painful or even life threatening, even when in a safe space. This is when our responses mismatch the environmental situation.  We become hypervigilant, keeping a look out for possible threats. We are quick to adopt fight/flight/freeze and potentially numbing behaviours that are not appropriate to the environmental cues in the moment and are not conducive to building close supportive relationships.

The adults interpreting these behaviours may not draw the connection between child’s trauma history and current presenting problems. They may not read the behaviours as stress responses but as sensory over or under responsiveness or defiance.

When we over responded, our behaviours may then be labelled as ‘tactile defensive’. Or, when we fail to respond at all, we appear to have an extremely high pain threshold or sensory shutdown.

Trauma based behaviours can lead to increased likelihood of infant and child mental health labels of ADHD, ODD, depression and anxiety being given.

Responding in a mismatched way also creates its own anxiety in the child.

For us to learn about ourselves and the world we need to feel safe and be supported to explore. To make use of our tactile system as a means of learning about the world, we need to be in physical contact with others and objects. If our neurobiology sees touching or being touched as a threat, we will not engage in the typical social connections needed to bond with others.  Nor will we explore with our hands and mouth objects or the world around us. We will push away and deprive our neurobiology of the sensory food it both requires and is expecting for positive adaptive development.

We all come with our own unique genetic factors that means we can all be impacted differently by similar adverse early life environments. However, there is a growing awareness that early overwhelm of the stress response system can have considerable and long-term impact on development and mental and physical health and wellbeing.

If we assume that early tactile overload or deprivation will cause future vulnerabilities, then we can be proactive in promoting protective factors in our work with babies and families.

Our early tactile system can be a vehicle of protection. Caregiver environments, especially offering skin to skin, alter the development of the autonomic system and supports faster resolution of stress, so reducing the likelihood of a trauma event occurring and facilitating brain adaptation that will support a sense of safety and a springboard for exploration.  

Question: Does trauma in early childhood impact tactile processing and development?

Yes, it does. A traumatic event may start with the tactile system! With either excessive painful, or total lack of positive emotional or touch experiences.

Overloading the stress response system will build a brain that looks for tactile threat rather than tactile safety. Keeping safe in the face of perceived threats will alter social and environmental engagement, depriving the brain of the positive tactile experiences that support regulation, connection and learning.

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