Your local office:

Effects of Complex Trauma on Children

Complex trauma is defined as experiencing, or being exposed to, multiple traumatic events by caregivers who are supposed to provide children with safety and security and do not, and the impact those events have had on a child’s immediate and long-term well-being1.

Children who have experienced ongoing abuse or neglect have been exposed to complex trauma. Generally, when children experience a traumatic event—such as a natural disaster, loss of a loved one, or an accident that results in physical injury—the most significant factor in their healthy recovery is the consistent and loving presence of their caregiver(s).

This is one of the reasons why complex trauma can be so damaging to children. Not only are they experiencing multiple traumatic events, but the people they would typically depend on to get through it are the perpetrators themselves. The impact that complex trauma has on a child’s life depends on a number of factors. But there is some good news: your child is not limited by his past traumas. There are a number of things you can do to help him recover from complex traumas that occurred prior to his adoption.

In general, when a child is exposed to complex trauma, seven areas of functioning are affected2:


A child’s ability to trust other adults is compromised when she experiences ongoing abuse or neglect at the hands of her primary caregivers, or when her caregivers are unable or unwilling to protect her from ongoing abuse or neglect. Children learn fear and self-reliance instead of safety and trust. They develop self-protective behaviors that can later create obstacles to building healthy relationships, even in safe environments.


Over time, the stress of experiencing multiple traumas changes brain development. The areas of the brain that control our ability to think rationally and make good choices in stressful situations are affected. A child’s ability to identify and manage feelings and to use language to express feelings is also affected. Children who have been exposed to complex trauma also have higher levels of stress hormones, even when their bodies are at rest. This means that the trauma has caused their brains to be “re-wired” as though they are in a constant state of high alert. They remain ready to protect themselves from danger in an instant through aggression (fight), withdrawal (flight), or dissociation (freeze).

An adopted child who has gone through complex trauma.

Affect Regulation

When children do not have a role model for healthy ways to express emotions, or when the stress of multiple traumas impacts their brain, they often have difficulty identifying, managing, and expressing their own emotions. Children can become highly sensitive to the emotions of other people but lose the ability to identify their own emotions. They may have problems maintaining their boundaries with other people, or feeling and understanding their own emotions.


Dissociation is when a child shuts down by trying to forget certain experiences or attempting to eliminate certain sensations when they become overwhelmed. Frequently used by children who have experienced complex trauma, dissociation is used as a coping strategy to avoid becoming overwhelmed by the trauma. Dissociation can occur even after a child is removed from his abusive or neglectful environment, when there is a trigger that reminds him of the trauma he has experienced.

Behavioral Regulation

Children who have experienced complex trauma may have difficulty managing some of their behaviors during periods of stress or intense emotion. They may even re-enact behaviors related to their abuse as a way to try to gain control over them. These behaviors are coping mechanisms that were developed as a way to avoid the pain of their traumas. With loving guidance, children can learn to replace these behaviors with healthy ones once they feel safe.


Traumatic experiences, especially those that involve chronic neglect, are damaging to a child’s ability to think and learn. Children who experienced chronic neglect may have trouble with understanding and expressing themselves with words, focusing their attention, problem-solving or reasoning.


Children who experience ongoing abuse and neglect from the people who are supposed to love and care for them may have convinced themselves that they deserved the abuse or neglect or may feel unworthy. In these cases, the child may see himself as unlovable, ineffective, helpless, and worthy of rejection. There is often a high degree of self-blame for any negative events that happen in their lives.


1Cook, A., Blaustein, M., Spinazzola, J., & van der Kolk, B. (Eds.) (2003). Complex trauma in children and adolescents. National Child Traumatic Stress Network


Helpful Resources

ADOPTSSM Child Trauma Assistance program Provides information about portions of Bethany Christian Services’ ADOPTSSM program that treats children who have experienced complex trauma.

The American Academy of Pediatrics has created “Understanding the Behavioral and Emotional Consequences of Child Abuse” for pediatricians who are unfamiliar with the effects of trauma on children’s health and development. This may be a helpful tool for you to share with your child’s pediatrician.

Going and Growing Through Grief and Loss: Parenting Traumatized Adopted Children (by Dee A. Paddock; available online from Foster Care & Adoptive Community

From the National Child Traumatic Stress Network (NCTSN):

The Invisible Suitcase: Behavioral Challenges of Traumatized Children Discusses the impact of abuse and neglect on children’s behaviors in a new family and offers helpful information on “compassion fatigue” that adoptive parents often experience and steps you can take to help yourself.

Complex Trauma in Children and Adolescents (editors: Alexandra Cook, Ph.D., Margaret Blaustein, Ph.D., Joseph Spinazzola, Ph.D., and Bessel van der Kolk, M.D.) Provides an in-depth discussion of complex trauma in children and adolescents, including areas of functioning that are impaired, protective factors, and components of effective treatment

What to Do if Your Child Discloses Sexual Abuse Children who have experienced sexual abuse often do not reveal the fact that it occurred until after an adoptive placement. Parents often struggle to process the shock of this news and feel at a loss for knowing how to help their child. This paper and Understanding and Coping with Sexual Behavior Problems in Children: Information for Parents and Caregivers offer helpful suggestions.

From the Child Trauma Academy

Principles of Working with Traumatized Children: Special Considerations for Parents, Teachers, and Caregivers (by Bruce D. Perry, MD, Ph.D.)

Bonding and Attachment in Maltreated Children (by Bruce D. Perry, MD, Ph.D.) Discusses the impact of chronic neglect on a child’s development and ways to nurture healing and healthy development.