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Tuesday, 6 October 2015

Is childhood trauma a disability?

A landmark court ruling in the United States has found that children who experience trauma and multiple adversities could be considered to have a disability. Importantly, the judge in this case identified that not all children affected by trauma end up being disabled by their experiences of trauma, but that some children certainly do.

These findings have come out of a court case that has seen a class action taken by students of a high school, claiming that as the school was not trauma informed and trauma sensitive, their needs were not met and they were disadvantaged within this system. They claim that the school did not recognise that the behavioural, emotional and learning difficulties they were facing were caused by their exposure to trauma and adversity and that the school could have done more to meet their needs.

This is certainly an interesting development in the current response to children exposed to trauma and adversity. The research clearly indicates that for some children who experience repeated exposure to trauma and adversity early in life and are without opportunities for safety and adequate care, there are changes within the architecture of the brain that lead to learning difficulties and emotional health difficulties across the lifespan. This research has led to many services that work with children to become, at the least trauma informed, through to trauma sensitive and trauma focused. 

In thinking further about the long term impact of child trauma and adversity, we can turn to recent Australian research that has looked at the impact of physical abuse, sexual abuse, emotional abuse and neglect on adverse health outcomes across the lifespan: 

"Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment."

Long-term mental health conditions are often associated with disability, that is, with a long term impairment in several areas of functioning in the person's life. According to the UK government, a mental health condition is considered to be a disability if it has a long term effect on your normal day to day activity and in Australia mental health conditions are included under the National Disability Insurance Scheme

The pertinent question really is, would it be helpful for those who have experienced significant trauma and adversity as a child to be identified as having a disability? This is not a question that is easy to answer, though it is clear that if there was greater recognition of the impacts of these experiences, there may be greater access to funding and appropriate assistance. This may see some of the impacts, especially in the area of learning and emotional health, be addressed earlier on and more effectively, which would certainly be beneficial both in the short and the long term.

Through the Royal Commission into Institutional Responses to Child Sexual Abuse we have had a rare glimpse into the long term impacts that childhood trauma can have. As one courageous man Grahame Rundle has told the Commission:

"The truth is that we don't ever forget and get over it,

Once your childhood is taken from you, it's gone forever."