Child Trauma and Trauma Informed Care

June 1, 2019

Jason Lang, Ph.D.

Child Health Development Institute (CHDI)


  • Childhood trauma exposure is a public health concern
  • Most U.S. children are exposed to trauma or adverse childhood experiences (ACES), including violence, physical/sexual abuse, accidents, neglect, parent mental illness, etc.)
  • Most childhood trauma exposure is unreported; screening can improve early identification of children
  • Childhood trauma exposure is associated with problems with physical and mental health, suicide, substance abuse, school performance, and employment through adulthood
  • The costs for children maltreated in a single year are estimated to be $124 billion in future healthcare and social service costs
  • “Trauma-informed care” or a “trauma-informed approach” refers to strategies that a state, organization, system, or program can use to prevent, identify, and intervene early for children who may be exposed to trauma
  • Trauma-informed care is relevant to, and has been applied in, all child-serving settings, including behavioral health, child welfare, pediatrics, juvenile justice, education, law enforcement, early care and education, and home visiting
  • Trauma-informed care strategies include:
    • Workforce development/staff training and support
    • Screening and assessment to improve early identification of children
    • Access to evidence-based trauma-focused prevention and intervention programs
    • Organizational and policy changes to reflect research about trauma and consumer input
  • Barriers to implementation of trauma-informed care strategies include:Limited local/in-house expertise in childhood trauma
    • Limited funding to support training and implementation activities
    • High rates of staff turnover

Key Resources

  • This brief summarizes child trauma and the National Child Traumatic Stress Network (NCTSN)
  • Recent legislation related to trauma-informed approaches
  • Recent GAO report on Children Affected by Trauma
  • This brief describing CT’s trauma-informed child welfare system