Treating Traumatized and Dissociative Neurodevelopmentally Disabled Clients

This session is available for 6.00 APA and ASWB credits.

Abstract
Neurodevelopmental disabilities (NDDs) are conditions present from birth or early childhood which affect how individuals perceive, make sense of, and interact with the world. Two of 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 workshop will review what is known about experiences of trauma, posttraumatic stress, and dissociation for individuals with NDDs. Signs of posttraumatic stress and dissociation, overlapping symptoms, and potentially unique presentations will be discussed. Attendees will be encouraged to reflect individually and in groups on what they know about treatment for traumatized and dissociative individuals with NDDs, what might complicate treatment, and how to make use of client strengths. Case examples and roleplaying will be used to address specific treatment considerations for working with clients with NDDs. In-line with the presenters' professional experience, special attention will be paid to autistic adults.