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What does it mean to be trauma-informed?
The dearth of evidence on trauma and trauma-informed approaches in communication sciences and disorders is the professional issue we never knew we had, but adoption of this approach can reframe our perspectives on therapy and improve clinical care.
December 11, 2022
Most of us aren’t sure what exactly trauma-informed care means. It turns out that as a profession, we are woefully uninformed on this topic. Those of us who have had some training often lack confidence in our skills and the support we have to implement it. Below, we’ll review the basics and share resources, based on research and expert commentary from scientists in our field.
It means critically reframing your perspective of the world around you.
Champine and colleagues found that trauma-informed individuals:
Check out their paper for focus group responses on what it means to be trauma-informed.
To understand how this looks on a larger scale, Gayaldo and Gladfelter’s commentary directs us to resources outside of our field, such as the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA describes trauma as a pervasive public health problem resulting from adversity. Because trauma is ubiquitous, SAMHSA proposes a trauma-informed approach that would be appropriate to use in behavioral health systems, child welfare systems, medical and educational systems, and the criminal justice system.
According to SAMHSA, a program, organization, or system that is trauma-informed:
Rupert and Bartlett recognize the important role that SLPs play in the lives of children experiencing maltreatment and trauma. First, we are mandated reporters. Additionally, in our scope as communication specialists, we work to strengthen child and caregiver interactions and attachment—protective factors for children experiencing trauma—through the improvement of social-emotional, executive function, and communication skills. Rupert and Bartlett note that many SLPs lack education and training on trauma and attachment, and don’t have access to evidence-based recommendations regarding trauma inquiry or screening. In their survey study, they found that most of our understanding of trauma is limited to maltreatment such as neglect or abuse. We also tend to think of attachment in a binary way; either it is or isn’t there, when in fact, attachment can be secure, avoidant, ambivalent/anxious, or disorganized, with all types having implications for a child’s development.
Download a printable PDF version of this graphic here.
The good news is that SLPs want to understand how trauma affects communication development and understand the relevance of trauma to our work. This is a challenge, according to Gayaldo and Gladfelter, because although one in seven children are exposed to maltreatment, our literature has very little evidence base on the subject. Keep in mind that the aforementioned prevalence means that maltreatment is a risk factor for communication disorders more common than autism spectrum disorder and developmental language disorder. It also pretty much guarantees that SLPs will have students on their caseloads who have been exposed to maltreatment or trauma.
Note: Be on the lookout for another deep dive into trauma-informed care and implications for dismantling ableism! In the meantime, members can look back at other research reviews on childhood trauma (here and here), trauma-response behaviors (here), and coaching caregivers to find opportunities for responsiveness and attunement (here and here).
Champine, R. B., Hoffman, E. E., Matlin, S. L., Strambler, M. J., & Tebes, J. K. (2022). “What does it mean to be trauma-informed?”: A mixed-methods study of a trauma-informed community initiative. Journal of Child and Family Studies https://doi.org/10.1007/s10826-021-02195-9 [open access]
Gayaldo, S., & Gladfelter, A. (2022). Prevalence versus evidence: A closer look at the research available for serving children exposed to maltreatment and a response to Hyter’s call for trauma-informed care. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2022_ajslp-21-00380 [available to ASHA members]
Roberson, M. M., & Lund, E. (2022). School-based speech-language pathologists’ attitudes and knowledge about trauma-informed care. Language, Speech, and Hearing Services in Schools https://doi.org/10.1044/2022_lshss-21-00172 [available to ASHA members]
Rupert, A., & Bartlett, D. (2022). The childhood trauma and attachment gap in speech-language pathology: Practitioner's knowledge, practice, and needs. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2021_ajslp-21-00110 [available to ASHA members]
We pride ourselves on ensuring expertise and quality control for all our reviews. Multiple TISLP staff members and the original journal article authors are involved in the making of each review.
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