Neurodevelopmental disabilities (NDDs) are conditions present from birth or early childhood which affect how individuals perceive, make sense of, and interact with the world. The most common are attention-deficit hyperactivity disorder (ADHD) and autism. Many individuals with NDDs have social-communication differences, difficulties recognizing risks, and behaviors that are stigmatized by society. Accordingly, many have poor attachment with caregivers, are rejected by peers, and are perceived by predators as uniquely vulnerable. This leads to high rates of complex trauma, including child maltreatment, bullying, assault, and intimate partner violence. Differences in cognition, disability-related stressors, emotional health comorbidities, and lack of support subsequently increase the risk of posttraumatic stress and dissociation.
Unfortunately, the overlap of NDDs with posttraumatic stress disorder and dissociation is under-recognized. In some cases, NDD symptoms are misperceived as arising entirely from trauma -- such as attention-deficit and hyperactivity symptoms being attributed solely to childhood physical abuse -- which may cause confusion and frustration when trauma therapy alone fails to resolve core symptoms. If a NDD is already diagnosed, it is not uncommon for all other symptoms to be attributed to this diagnosis, and clinicians are often particularly hesitant to consider that trauma and dissociation are relevant. A major concern is the lack of training or professional support for proper screening, especially for clients who are non-verbal or otherwise impaired in reporting about their experiences. Even when a clinician recognizes that a NDD client has been traumatized and is struggling with dissociation, there are few existing resources to assist with treatment.
This presentation will review what is known about experiences of trauma, posttraumatic stress, and dissociation for individuals with NDDs. It will then discuss how clinicians can improve their ability to recognize when a developmentally disabled client could benefit from treatment for trauma or dissociation. Finally, treatment considerations will be addressed. This includes a discussion of the neurodiversity framework, which can protect against shame by emphasizing the right to exist in ways that differ from socially imposed norms. In-line with the presenters' professional experience, special attention will be paid to autistic adults.
Learning Objectives:
At the conclusion of this session participants will be able to:
Discuss at least two reasons why neurodevelopmentally disabled individuals are vulnerable to complex trauma, posttraumatic stress, and dissociation
Identify at least three signs that a neurodevelopmentally disabled client has experienced trauma or is struggling with posttraumatic stress or dissociation
Identify at least two ways that neurodevelopmental disorders may affect the presentation of a dissociative disorder
Describe at least three treatment modifications or considerations that may be relevant for clients with NDDs