Autism and Trauma: A theoretical paper addressing vaccine avoidance due to fear of autism

Abstract

Despite the numerous studies indicating that autism is not caused by vaccines, there are still those who insist that autism is the result of vaccination and that their child was harmed by vaccinations. Explaining the safety of vaccinations has not proven successful in addressing this pernicious theory and in many parts of the country vaccination rates have fallen. Furthermore, telling a concerned parent that vaccines are safe in response to anxiety that a child “seems different” after a vaccination is dismissive and often results in a loss of trust in the medical establishment. This paper seeks to provide an explanation for the symptoms some individuals report seeing in their children post vaccination. Utilizing current research on trauma and the intense world theory, I would like to propose that the negative reactions/changes sometimes seen after a vaccination are not due to the vaccines themselves but rather a trauma response to the act of receiving the vaccine i.e. medical trauma. Parents and others who work with children need to be educated on trauma. This is especially important for those children with sensitive nervous systems such as found in the autistic, HSP (highly sensitive person), and SPD (sensory processing disorder) populations.

Keywords: autism, trauma, vaccines, intense world theory

Theory

Utilizing current research on trauma and the intense world theory, I would like to propose that the negative reactions/changes sometimes seen in an infant/child after a vaccination are not due to the vaccines themselves but rather a trauma response to the act of receiving the vaccine i.e. medical trauma. Hospitalization/medical trauma refers to a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences. My theory is that the process of receiving medical care is more overwhelming to certain populations that have sensitive nervous systems such as autistic children, highly sensitive children (HSP), and children with sensory processing disorder (SPD). I would argue that autistic individuals (see below for in-depth analysis), HSP individuals (who are by definition more sensitive to environmental stressors) and individuals with SPD (a neurological condition that impacts how pain and other sensory information from the 8 senses are processed and responded to) are at a higher risk of being affected by trauma which includes medical traumas such as vaccines given without trauma informed pain management.[1] Thus, the majority of children “damaged by vaccines” are in actuality autistic and/or traumatized children who, suffering from an overload of toxic stress and trauma, shutdown during a crucial developmental period as a protective mechanism. This shut down, in turn, is what produces the changes in behavior and developmental delays some individuals report seeing in their children post vaccination.

What I’m proposing (trauma based prevention and treatment of vaccine reaction) will likely be true for most children but it is unlikely it will be true for every single child. Some children might have a mitochondrial condition that is triggered by vaccinations (for example), and while I certainly believe we should do all we can to screen for those children, I don’t think we should scrap vaccinations altogether because there is a minute possibility of a negative reaction. Furthermore, the potentiality of a medical trauma does not mean we refrain from giving vaccines. The return of polio, whooping cough, and measles (along with other diseases) is not worth the avoidance of what is a potential trauma. Rather, doctors should follow trauma informed pain management[1] when giving vaccinations and other medical care.

Prior to the vaccination, care should be taken that the caregiver and the infant/child aren’t stressed (calm, non-hectic day with time spent afterwards in a safe calm environment).[2] It is important to note that “the adult’s first task is to attend to (their) own emotional state, since it’s only in the adult’s calm, competent, and reassuring presence that children find the space to resolve their tensions.” Mate (2007, pp. XIV) If caregivers notice signs of trauma in their child post-vaccination, body-based modalities such as massage, Eye Movement Desensitization and Reprocessing (EMDR), and somatic experiencing should be utilized to help move stuck trauma and stress from the body.[3] This advice is given with the understanding that not everyone in this society has the privilege to prioritize their health care. For many just finding time to make multiple doctor appointments is challenging enough (transportation issues, taking time off work etc.). I believe society should be changed so that everyone has the time and resources to take care of their health and their loved one’s health.[2] Research has shown that a key component of health is addressing trauma.[4] Overall, the goal should not be the complete and utter avoidance of trauma but rather minimizing, mitigating, and healing traumas effects and developing resiliency. It is also important to educate the general public on trauma- how it looks in both adults and infants/children and how to address trauma if it presents itself.

I believe there needs to be more extensive trauma screening and awareness and that children who show a sensitive nervous system need to be treated with extra consideration. Rather than telling ourselves that our infants need to be toughened up, we need to recognize that strength comes from gentle present loving care and that denying pain relief and trauma treatments inhibits growth (emotional, spiritual, and physical).[5] Finally, we need to support families- so that caregivers can be calm present and loving- and welcome all individuals. Part of the fear of autism is the fear of the flawed child, the disabled or different child. By changing the narrative- around children, autism, sensitivity, difference, parenting, families- we make it less scary or bad to have different or disabled children which in turn removes the pressure for a cure. I believe we create our shared reality and that by building new narratives we can build a new reality. I hope with this paper to offer a new narrative on vaccines and autism and to help raise awareness of trauma.

Viewpoint

Before I delve into an in-depth exploration of trauma and autism, I’d like to take a moment to invite the reader to see the world through an infant’s eyes. Infants don’t have the ability to cognitively understand what is happening to them, they have a greater sensitivity to pain, and they don’t have the tools to self-regulate or manage/soothe their pain. These three facts mean infants have a greater sensitivity to trauma both big T traumas such as major accidents and abuse and little t traumas i.e. everyday stresses such as overstimulating environments.

“A ‘minor’ fall, for example, can become traumatic if the child is not supported in processing it in a healthy way and especially if (they are) shamed for ‘over-reacting’ or labeled as ‘too sensitive.’ An elective medical procedure can also have long-term negative effects if the child is not adequately supported and prepared, and if (their) reactions are not empathically received.” Mate (2007, pp. XV)

Even if a baby looks like they’ve calmed down they might not have fully returned to baseline (see Figure 1. Symptoms of Un-Discharged Traumatic Stress). In other words, some tension (residual trauma) may still be present in the body.[6] Due to their undeveloped nervous, motor, and perceptual systems, prenatal infants, newborns, and very young children are at the most risk from stress and trauma.

Now imagine a baby in this society.[2] A very sensory overstimulating society with terrible parental leave policy, deep economic inequality, and a mess of a health care system all of which creates a lot of unnecessary stress and trauma for both the infant and the caregivers. Current research on ACE (adverse childhood experience) scores[4] indicates that moderate to high ACE scores are common in our society. Current research suggests that two-thirds of adults have at least one ACE and that two-thirds of children have experienced a potentially traumatic event in the last year. In adults and children, the body responds to a perceived threat- whether its overly harsh lights, physical abuse, or a sudden fall- by releasing adrenaline and cortisol which activates the motivation to freeze, flee, or fight. This results in heart rate and breathing speeding up (in case we need more oxygen to facilitate running/fighting the threat), our digestion slowing down (blood is redirected to the limbs to facilitate running/fighting), and there is also a slowdown in the immune system as well in cellular repair and growth (all resources being focused on running, fighting, or freezing). If the energy called up in response to the threat isn’t fully discharged the residual energy will remain in the body which leads the body to feel like it’s still facing a threat even after the threatening event has passed. Our bodies cannot function optimally when stuck in the middle of the stress cycle.

With this in mind, let’s say along the path of life things happen that put the infant’s nervous system out of equilibrium i.e. the excess energy called up by the freeze, flight, fight process doesn’t get fully discharged and instead stays trapped in the body thus creating the potential for traumatic symptoms. Each time the body isn’t able to complete the stress cycle the infant doesn’t fully return to baseline and each subsequent stress cycle moves the infant further from baseline. It is important to note that while an event may disappear from conscious memory the body does not forget. Rather, “there is a physiological imperative to complete the incomplete sensory-motor impulses that were activated before the body is able to return to a state of relaxed alertness.” Levine (2007, pp. 9) In other words, the body wants to complete the stress cycle and cannot return to baseline (relaxed alertness) until the cycle is completed.[6]

Imagine the doctor’s office through the eyes of an infant: lighting (gentle versus harsh lighting) along with other aspects of the physical environment, the day (or week) may have been hectic, hearing the distress of other infants and children (triggering empathetic distress)[7] and the tension telegraphed by the parent (unconscious stress of being in a doctor’s office due to conditioning, stress of parking, making the appointment etc.). Now add getting a shot, which doesn’t feel comfortable. Ideally, one would have a doctor that is trained in trauma informed care (breastfeeding, keeping the child close to the caregiver etc.) but many doctors don’t follow guidelines on pain procedures. [1] Now imagine that tiny infant- already stressed from everything around them- separating them from their caregiver and laying them down alone on a table. Infants under 8 weeks can only see 8-12 inches in front of them and before 8 months infants don’t have object permanence (the awareness that things out of sight still exist). These two facts mean that when the caregiver is out of sight and physically distant, they seem to have literally disappeared, which is frightening for young infants. If an infant, who can’t run away or fight back, withdraws in order to cope with the overstimulating environment-whether it’s the doctors office or a crowded grocery store- they might miss the “sensitive period” i.e. the developmental phase during which the brain is especially responsive to (and rapidly assimilates) external stimulation. This shut down can cause lifelong problems. Taking all that into account one can see how that event (receiving a vaccination) could be the tipping point for a dysregulated nervous system which can get stuck either on the gas (sympathetic flight or fight) or on the brakes (parasympathetic freeze)- see graph in footnotes. According to the intense world theory, the autistic brain has hyper-responsive sensory, memory, and emotional systems. This means that autistic babies are more sensitive to their environments and are more easily overwhelmed by overstimulating environments (such as the doctors office or the grocery store). Thus, if we have an autistic infant, add in an off-kilter nervous system and intense world theory and the end result may be autism that might have presented as less severe (more of the gifts preserved and less severe side effects) if trauma mitigation and healing had been utilized after the vaccination.

Trauma/Autism Overview

Current research shows that traumatic experiences can cause lifelong alternations in brain chemistry and body physiology. [4] Trauma is any event that overwhelms the nervous systems resources and ability to regulate. Trauma results when the energy called up to address a perceived threat is thwarted from completing its cycle. [6] Research has shown that stress and trauma negatively impact quality of life and quality of relationships and make it more difficult to relate to others (engage in social behavior) and maintain relationships.


In both adults and children, when faced with a threat or danger that exceeds the nervous system's ability to cope, certain

“distinguishing signs appear soon after the event. They are: 1) hyperarousal, 2) constriction, 3) dissociation, and 4) feelings of numbness and shutdown (or freeze), resulting in a sense of helplessness and hopelessness. These reactions represent universal symptoms… All children, but especially infants and the very young, show symptoms that are distinctively different from those of adults. This is due to a combination of factors including brain development, level of reasoning and perceptual development, incomplete personality formation and dependency, as well as attachment to their adult caregivers. Together with restricted motor and language skills, children have limited capacities to respond or cope. In addition to having a grown-up brain, adults have the freedom to access resources that reduce stress and anxiety…children, on the other hand, are totally dependent on their grown-ups to read and meet their needs for safety, support, nurturance, self-regulation, and reassurance.” Levine (2007, pp. 40)

The younger the brain, the more sensitive it is to repeated stress and trauma. “Chronic and repeated trauma experiences may lead to complex trauma and [can] compromise all areas of child development [including] neurodevelopment, identity formation, cognitive processing, body integrity, and ability to self-regulate affect and behavior.” Allen (2015, pp. 101T)

It is important to keep in mind that

“some trauma symptoms are normal responses to overwhelming circumstances. The heightened arousal energy together with shutting down (when there is no escape) are biologically hard-wired survival mechanisms. However, this protective system is meant to be time-limited; our bodies were designed to return to a normal rhythm soon after the danger ends…when the intense survival energy that was summoned to defend us during a perceived threat does not get used up, we continue to experience life as if the threat is still present.” Levine (2007, pp. 41)

Thus

“trauma symptoms develop when the physiological mechanism for self-protection, set into motion for escape, are thwarted (prevented for any number of reasons, either physical or through conflicts). In other words, the child or adult did not get to accomplish the full cycle of: 1) utilizing the chemical and hormonal program, 2) energizing the sensory-motor activities of protection, orientation, and defense, then 3) discharging the excess activation, and finally, 4) returning to a relaxed alertness or physiological homeostasis.” Levine (2007, pp. 72)

How likely one is to develop traumatic symptoms is related to the level of shutdown(freeze) the individual experiences as well as to the undischarged energy that was originally mobilized in the freeze, flight, fight response. Levine (2007, pp. 7) Further, “the extent of the effects of trauma is a complex interaction of genes, psychosocial environment, critical periods vulnerability and resilience.” Palay (2012) Thus “while the magnitude of the stressor is clearly an important factor, it does not define trauma. This is because trauma is not in the event itself: rather, trauma resides in the nervous system.” Levine (2010, pp. 4) It is when unresolved emotions triggered by adverse events are not allowed to complete their cycle that creates the long-term negative impacts associated with experiencing or witnessing a traumatic event. With trauma the self-protective survival process has gone haywire and thus children and adults need support to release this highly-charged state and return to a relaxed alert state and physiological homeostasis.[6]

At-risk children include children who had physical exposure to a traumatic event, children who witnessed a traumatic event, who were near the location of a disaster or incident, who had pre-existing mental health issues, whose caregivers experienced emotional difficulty, who had preexisting or consequent family life stressors such as divorce or loss of job, those with previous loss or trauma experiences, and children with a limited support network. Various factors influence a child's ability to respond appropriately and complete the cycle outlined above. These include the event itself (intensity of the event, whether there were multiple events, if the event was prolonged), the child’s physical characteristics (which include age, overall fitness, and constitution which is a combination of genetics, temperament, and early environment), external resources available to the child such as a secure attachment to a safe adult and healthy outlets for stress, the child’s skills/capabilities (such as developmental level) and the quality of the care the child receives immediately after the frightening incident. Levine (2007, pp. 72) Another influencing factor is the number of traumatic events to which a child is exposed.

Some factors that can cause trauma are hospitalization/medical trauma, experiences of abuse (physical, verbal and sexual), traumatic natural disasters/events, being a refugee of war or terrorism, community and school violence, neglect (physical and emotional), traumatic grief and death, and witnessing domestic violence.

Trauma in children can manifest in a multitude of ways such as hyperactivity, sleep problems such as nightmares or refusing to go to sleep, dissociation and flashbacks, being hypervigilant, repetitive play, emotional numbing, regressive behaviors such as bed-wetting or thumb sucking, self-harm, difficulty with regulating emotions and arousal, and development of sensory triggers. The child may seem spacey/detached/distant and may display avoidance of things that remind them of the traumatic event and may withdrawal from friends and social activities i.e. show avoidance of intimacy and aversion of physical and emotional closeness that leads to feelings of vulnerability. It is important to keep in mind that since infants and children are “less able to defend themselves, they are more vulnerable than adults to retaining an excess of this highly-charged arousal energy.” Levine (2007, pp. 41) This means that children need specific directed help from adults to discharge this excess energy and return to a relaxed state of alertness. Without this guidance, the unresolved energy will find expression in a wide array of behaviors and symptoms as listed above.

Children who have experienced trauma are vulnerable to living in a dysregulated state of arousal. Frequently, accompanying this dysregulation are symptoms of sensory sensitivity, such as hypersensitivity to sounds, touch, and movement. These symptoms in trauma can be accompanied by experiences of freeze/flight/fight. With improved arousal regulation in the context of a safe relationship children show better identification and expression of basic needs (e.g. thirst, touch), greater cognitive organization, improved verbal communication, increased symbolic play in younger children, improved problem solving, greater expression of feelings, greater self-observation and increased social engagement.

In order to mitigate and heal the effects of trauma or chronic high levels of stress we must reduce the stress the individual is experiencing[2] and help move any residual trauma out of the body. Held trauma can be seen in hypertonic muscles and chronic health concerns such as insomnia, headaches, tight/restricted psoas (pelvic issues), and nervous system dysfunction. In order to reduce stress, it’s important to recognize that many things may cause toxic levels of stress, especially for neurologically fragile children or those with sensitive nervous systems (such as with autism, HSP or SPD). There are big T traumas such as physical or sexual abuse and there are the frequent little t traumas or stress causing conditions that accumulate over time. It is also important to note that a common protective strategy in young children is to run toward their adult attachment figure, thus for a child to resolve a trauma there needs to be a safe emotionally stable adult available for the child to turn to.

Current research indicates that trauma symptoms and autistic symptoms look similar. [8] Further, it is recognized that certain populations, such as autistics, are more sensitive to potential traumas and stressors such as receiving vaccines and other medical procedures. In the case of autism, this is due to greater nervous system sensitivity, difficulty with emotion regulation, social isolation and communication difficulties (infants can’t verbally communicate their needs, some older children are nonverbal and even if the child is verbal may not have the ability to accurately report or convey their internal emotional state to others). Issues around language and emotion also affect verbal expression and process, both of which play a key part in most therapies for trauma in children. Further, sensory issues are very common in the autistic population and there is evidence that autistic individuals respond more intensely to stimuli.

Even if the autistic child isn’t faced with a significant stressor (such as ongoing physical abuse) there are all the small stressors such as the daily stress of feeling overwhelmed, the stress from lacking control over ones’ daily life (where you live, what you do every day etc.), sensory stressors, the stress of feeling different and not being able to do what other people can do. These small stressors add up to a nervous system that is closer to overwhelm. The younger the brain the more sensitive it is to repeated stress and trauma. One theory on autism, the intense world theory, postulates that sensory overload shuts down the brain during crucial periods of development resulting in the social and emotional delays present in autism. This is not to say that autism would not be present if this sensory overwhelm had not occurred rather the idea is that “early intervention to reduce or moderate the intensity of an autistic child’s environment might allow their talents to be protected while their autism-related disabilities are mitigated or, possibly, avoided.” Szalavitz (2013)

Autism is both a neurological developmental disability and an example of human variation (neurodiversity) that affects how an individual experiences the world around them. Difficulty with staying well regulated emotionally and physiologically is a core feature of autism. Autism is present throughout life from infancy to adulthood. Currently, scientists believe that both genetics and environment play a role in autism. Autism is not a recent invention. Autistic individuals have always been with humanity.


Autism is a spectrum. I personally conceptualize autism as a paint wheel.[9] No two autistic people are alike same as with allistic (non-autistic) individuals. While autistic individuals may share similar characteristics, each are individuals with their own personalities and interests as well as unique neurological and psychological profiles.The wide range of characteristics associated with autism precludes the idea of a singular approach when it comes to designing support.


Research has clearly shown that key to optimal functioning for all individuals, especially those with sensitive nervous systems such as with autism, is addressing trauma[4]. Ongoing research regarding body-based healing methods (such as EMDR, massage, or somatic experiencing) have indicated their effectiveness at addressing trauma trapped in the body (often resulting in the resolution of stubborn health concerns).[3] It is imperative that we not only continue our research into trauma and autism but that we begin to incorporate what current research indicates about trauma and autism into our daily lives and into how we provide medical care such as vaccinations.



Footnotes

1. https://www.ncbi.nlm.nih.gov/books/NBK207195/ (Trauma Informed Care)

https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/healthy-foster-care-america/Pages/Trauma-Guide.aspx

Most pediatricians and emergency department professionals agree that psychosocial issues are important,(59,60) and the scientific basis for the effect of stress and life experiences on long-term health resonates well with clinicians. However, research suggests that many health care professionals underestimate the prevalence of psychological problems among children (61,62) are unaware of available tools to assess the risk for PTSS (61) and report inadequate knowledge and skills related to assessing mental health problems and PTSS in children. (60,62) Only 1 in 10 pediatricians frequently assess or treat PTSSs,(62) and only a small proportion of emergency department professionals report giving any verbal guidance (18%) or written information (3%) about PTSSs to children and their families.(61) Moreover, among US level 1 trauma centers, there is marked variability in the implementation of psychosocial services, with only 20% reporting specialized PTSS screening and intervention services for children and families.63 These findings underline the importance of organizational readiness, assessment of unique organizational characteristics, and shifts in culture to facilitate trauma-informed care.(64-66) (italics indicate footnotes) http://ohioaap.org/wp-content/uploads/2016/08/Marsac_Trauma.pdf

http://www.sciencedirect.com/science/article/pii/S0899588517300084 Effective Management of Pain and Anxiety for the Pediatric Patient in the Emergency Department

https://www.ncbi.nlm.nih.gov/pubmed/24885559 Too many crying babies: a systematic review of pain management practices during immunizations on YouTube.

https://www.ncbi.nlm.nih.gov/pubmed/?term=crying+immunization

https://www.ncbi.nlm.nih.gov/pubmed/28051876 Efficacy of Breastfeeding on Babies' Pain During Vaccinations.

2. I do not wish this paper to be read as a reprimand of parents. I believe parents are doing the best they can with the tools they have. One crucial tool for overall health and parenting is trauma awareness and, if needed, trauma healing. Being able to address your trauma requires access to health care, education, and time. In our society, the ability to receive adequate education or health care (physical and emotional) for yourself or your child is very much dependent on where one lives and what one’s socio-economic status is. One cannot assume that an individual has the finances to pay for therapy (assuming there are competent therapists nearby), access to the internet, or access to a well-stocked library near them. In regards to time, most individuals are trapped in survival mode working constantly to maintain access to shelter, food, and other resources leaving them without the time or energy to address attachment issues, trauma and other health concerns. Thus, if a parent never learned how to self-regulate how can they help their child learn to self-regulate? This is especially true if there is a paucity of parenting support services where the parent lives. Again, this is not a condemnation of the parent but a condemnation of society for not providing adequate support and guidance for all families. Support for parents should be offered equally to all and raising the next generation should shift from being an individual pursuit to a community activity. I envision a society where instead of judgment and scorn, families find support and open welcoming arms.

What is important to keep in mind is that parenting in this society is challenging for a range of reasons such as a shredded social safety net (no parental leave, lack of flexible work, lack of safe quality child care), significant economic inequality along with the largely unspoken zeitgeist that wealth indicates moral character while poverty indicates moral weakness (i.e. the pull yourself up by your bootstraps mentality that forgets that not everyone is born with boots—much less the same quality of boots), lack of medically accurate non-shaming sexual and romantic education that includes accurate depictions of pregnancy/birth/miscarriage/abortion, lack of emotional support networks, and a hyper individualist culture that views childrearing as a private (not communal) enterprise placing the full weight of taking care of a child on 1 or 2 individuals shoulders.

From my research, I do not believe that humans are designed for how our culture dictates childcare should look like i.e. two people alone in charge of not only caring for a newborn but are also each other’s only or primary emotional support. At the same time there is the expectation of working a full time job—preferably with one working full-time and the other staying home (in our culture it is assumed that the female will stay at home). With current economic realities (student loans, cost of living rising while wages remain stagnant/not growing at the same pace as cost of living, etc.) many families require that both caregivers work either full or part-time to stay somewhat afloat. In a just society, work would be flexible so that people can actually be parents instead of struggling to maintain access to food, shelter, and healthcare. We do not live in a just society and it would be prudent to keep that in mind before leaping to judgment when it comes to parenting. In an ideal world, everyone would be able to provide healing and support for the infant before and after a vaccination. Again, we do not live in an ideal world but we can work to create a just world rather than assuming our current reality of deep inequality is somehow “natural”.

http://www.jpeds.com/article/S0022-3476(17)30218-4/fulltext Systematic Review and Meta-Analysis: Fussing and Crying Durations and Prevalence of Colic in Infants

https://www.nytimes.com/2017/03/23/upshot/americans-agree-on-paid-leave-but-not-on-who-should-pay.html

https://www.nytimes.com/2017/04/20/upshot/how-child-care-enriches-mothers-and-especially-the-sons-they-raise.html?_r=0

https://www.nytimes.com/2017/07/25/upshot/how-home-visits-by-nurses-help-mothers-and-children-especially-boys.html

“Our stressors are lower intensity and longer duration-“chronic stressors”…in contrast to “acute stressors,” like straightforward predation. Acute stressors have a clear beginning, middle, and end; completing the cycle- running, surviving, celebrating- is inherently built in. Not so with chronic stressors. If our stress is chronic and we don’t take deliberate steps to complete the cycle, all that activated stress just hangs out inside us, making us sick, tired, and unable to experience pleasure with sex (or with much of anything else)…Our emotion-dismissing culture is uncomfortable with Feels. Our culture says that if the stressor isn’t right in front of us, then we have no reason to feel stressed and so we should just cut it out already. As a result, most peoples idea of “stress management” is either to eliminate all stressors or to just relax, as if stress can be turned off like a light switch… even without medication and an emotion-dismissing culture, our ultra social human brains are really good at self-inhibition, stopping the stress response midcycle because, “Now is not an appropriate time for Feels” we use this self-inhibition in order to facilitate social cooperation-i.e. not freak anybody out. But unfortunately, our culture has eliminated all appropriate times for Feels. We’ve locked ourselves, culturally, into our own fear, rage, and despair. We must build time, space, and strategies for discharging our stress response cycles.” Nagoski (2015, pp. 120-121)

“Stressors of all kinds are constantly impinging on our autonomic nervous system. Too much noise, visual stimulus, crowds, refined sugar, commuting, waiting to get served, pollutants, the news, are just some of the stressors that we must cope with every day.” https://www.psychologytoday.com/blog/self-reg/201608/caught-in-stress-cycle

3.

http://onlinelibrary.wiley.com/doi/10.1002/jclp.10068/full Eye movement desensitization and reprocessing (EMDR): Information processing in the treatment of trauma

http://link.springer.com/article/10.1007/s00787-014-0572-5 Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial

http://www.tandfonline.com/doi/full/10.1080/19361521003761325?src=recsys Effectiveness of MASTR/EMDR Therapy for Traumatized Adolescents

http://journals.lww.com/burncareresearch/Abstract/2001/03000/Childrens__Distress_During_Burn_Treatment_Is.21.aspx

http://journal.frontiersin.org/article/10.3389/fpsyg.2015.00093/full#h4 Somatic experiencing: using interoception and proprioception as core elements of trauma therapy

4. https://acestoohigh.com/aces-101/

https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime

5. “Parent toughness toward babies is celebrated as “not spoiling the baby.” Wrong! These ideas are based on a misunderstanding of how babies develop. Instead, babies rely on tender, responsive care to grow well—with self-control, social skills and concern for others.” https://www.psychologytoday.com/blog/moral-landscapes/201701/be-worried-about-boys-especially-baby-boys

https://www.youtube.com/watch?v=YcQg1EshfIE Monkeys and Morality: Crash Course Psychology #19

https://www.psychologytoday.com/blog/the-athletes-way/201304/the-neuroscience-calming-baby

6. “That is the complete stress response cycle, with beginning (“I’m at risk!”), middle (action), and end (“I’m safe!”).” Nagoski (2015, pp. 115)

“Emotions are physiological cascades that want to complete their cycles, and they will complete those cycles when you allow them to.” Nagoski (2015, pp. 129)

7. https://www.youtube.com/watch?v=l7AWnfFRc7g RSA ANIMATE: The Empathic Civilization

http://psycnet.apa.org/psycinfo/1971-28677-001 Newborn's response to the cry of another infant.

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0065292 Rudimentary Sympathy in Preverbal Infants: Preference for Others in Distress

8. “Some children with autism also have “Big T” trauma. Some traumatized children look autistic, but aren’t. Autism can be stressful and traumatic in itself. Not all autistic symptoms represent Big T trauma. Not all traumatic symptoms will mimic autism spectrum. However, we know there is overlap in how they appear, because they are related to the same systems in the brain. We know that interventions that calm a traumatized brain will calm (or at least will not harm) an autistic brain. We know that some individuals, whether by virtue of their autism disorder or not, will actually experience abuse and other traumatic events. Finally, we know that having an autism spectrum or other developmental disability creates everyday stresses and anxiety that can cause the same cumulative effects. For all these reasons, we need to assume that every child on the spectrum carries some load of toxic stress. We should make trauma-informed interventions a universal precaution. In healthcare settings, universal precautions translate to simple steps: treat everyone as if he or she has a communicable disease. Wear gloves, clean bodily fluids with bleach and so on. If the patient is sick, these precautions keep others safe, and if he or she isn’t sick, these measures won’t hurt them or interfere with other treatment. Trauma-informed care should be used the same way. Treat every child as if toxic stress is a potential factor, and that feeling safe and in control are of paramount importance. For children overloaded with stress, this will be critical; a child who does not have significant levels of stress will still respond well and not be harmed in any way. Finally, we should offer children with suspected significant trauma treatment that takes into account the autism symptoms that may be idiosyncratic or off-putting in typical treatment settings, and work through the autism symptoms to address the trauma.” Palay (2012, pp. )

https://www.ncbi.nlm.nih.gov/pubmed/8282677

9. https://themighty.com/2016/05/rebecca-burgess-comic-redesigns-the-autism-spectrum/

https://graphicexplanations.info/2013/09/13/understanding-the-spectrum-in-autistic-spectrum/

https://www.theatlantic.com/health/archive/2015/11/what-does-the-autism-spectrum-look-like/413659/

http://nymag.com/scienceofus/2015/09/problematic-obsession-with-curing-autism.html

https://www.nytimes.com/2014/03/09/magazine/reaching-my-autistic-son-through-disney.html?ref=magazine&_r=0

https://www.youtube.com/watch?v=_MBiP3G2Pzc (ted talk The Forgotten History of Autism)

http://www.thinkingautismguide.com/2015/02/this-just-in-being-alive-causes-autism.html

10. https://www.nytimes.com/2017/01/28/opinion/sunday/the-normalization-trap.html?_r=0

“Numerous experiments have shown that “what we understand to be acceptable for us-and in a sense what we understand to be the “truth” around us- is defined through our interactions with other people…(Kurt)Lewin had a name for this idea: “social reality.” When many people around us feel that a certain thing is right or true-whether it concerns the combat-readiness of a division, the propriety of eating cow hearts…-that group belief becomes, for each of us, an idea that we, too, take as fact.” Manjoo (2008, pp. 52-53)

“Every culture possesses what Edward Shorter, a medical historian at the University of Toronto, calls a “ ‘symptom repertoire’—a range of physical symptoms available to the unconscious mind for the physical expression of psychological conflict.””

http://www.newyorker.com/magazine/2017/04/03/the-trauma-of-facing-deportation

Figure 1. Symptoms of Un-Discharged Traumatic Stress

Biography

Allen, T. (2015). Touch Therapy for Liddle Kidz with Trauma. Liddle Kidz Foundation.

Aviv, R. (2017). The Trauma of Facing Deportation. Retrieved from http://www.newyorker.com/magazine/2017/04/03/the-trauma-of-facing-deportation

Lai, M. C., Anagnostou, E., Wiznitzer, M., Allison, C., & Baron-Cohen, S. (2020). Evidence-based support for autistic people across the lifespan: maximising potential, minimising barriers, and optimising the person-environment fit. The Lancet. Neurology, 19(5), 434–451. https://doi.org/10.1016/S1474-4422(20)30034-X

Levine, P. A., & Kline, M. (2007). Trauma Through a Child’s Eyes: Awakening the Ordinary Miracle of Healing. North Atlantic Books. (Mate quotes from the introduction)

Manjoo, F. (2008). True Enough: Learning to Live in a Post-Fact Society. Wiley.

Marsac, M. L., Kassam-Adams, N., Hildenbrand, A. K., Nicholls, E., Winston, F. K., Leff, S. S.,

& Fein, J. (2015). Implementing a Trauma-Informed Approach in Pediatric Health Care Networks. JAMA Pediatrics, 170(1), 70-77.

Nagoski, E. (2015). Come as You Are. Simon & Schuster Paperbacks.

Narvaez, D. (2017). Be Worried About Boys, Especially Baby Boys. Retrieved from https://www.psychologytoday.com/blog/moral-landscapes/201701/be-worried-about-boys-especially-baby- boys

Palay, L. (2012). Autism and Trauma: Calming Anxious Brains. Retrieved from http://www.aldridgepalay.com/Article%20Autism%20and%20Trauma.html

Shanker, S.(2016). Caught in a Stress Cycle. Retrieved from https://www.psychologytoday.com/blog/self- reg/201608/caught-in-stress-cycle

Szalavitz, M. (2013). The Boy Whose Brain Could Unlock Autism. Retrieved from https://medium.com/matter/the-boy-whose-brain-could-unlock-autism-70c3d64ff221#.wryvndwas

Further resources

http://journal.frontiersin.org/article/10.3389/fnhum.2010.00224/full#h8 The Intense World Theory – a unifying theory of the neurobiology of autism

http://thescientificparent.org/vaccines-101-too-much-too-soon/ (This a good overview of what vaccines are and answers some common questions that come up)

Bliss, E. (2015) On Immunity: An Inoculation. Graywolf Press.

http://www.tandfonline.com/doi/abs/10.1080/20473869.2017.1305139 Massage efficacy in the treatment of autistic children – a literature review

https://www.esciencecentral.org/journals/one-and-twoyear-outcomes-of-treating-preschool-children-with-autism-with-a-qigong-massage-protocol-an-observational-followalong-st-2327-5162-1000216.php?aid=75065

http://www.ijtmb.com/index.php/ijtmb/article/view/227 Treatment of Tactile Impairment in Young Children with Autism: Results with Qigong Massage

https://www.amtamassage.org/articles/3/MTJ/detail/3642?utm_campaign=mtj&utm_source=facebook&utm_medium=social&utm_content=autism Breaking Through: Massage + Autism

Levine, P. A., & Kline, M. (2008) Trauma-Proofing Your Kids: A Parent's Guide for Instilling Confidence, Joy, and Resilience. North Atlantic Books. (Note: this books discussion of childhood sexuality/development of sexuality is a bit outdated and only somewhat accurate for a small percentage of individuals in certain family dynamics)

http://www.nctsn.org/resources/audiences/parents-caregivers

https://www.youtube.com/watch?v=-mpbBAQvrKM (ted talk The Power of Addiction and The Addiction of Power)

https://www.youtube.com/watch?v=8nz2dtv--ok The Growth of Knowledge: Crash Course Psychology #18

http://www.thedirtynormal.com/blog/2010/06/21/attachment-styles-a-primer/

https://www.youtube.com/watch?v=apzXGEbZht0 Still Face Experiment: Dr. Edward Tronick

https://mindhacks.com/2017/02/28/hormones-brain-and-behaviour-a-not-so-simple-story/

Why are boys at risk? To address this question, I use the perspective of regulation theory to offer a model of the deeper psychoneurobiological mechanisms that underlie the vulnerability of the developing male. The central thesis of this work dictates that significant gender differences are seen between male and female social and emotional functions in the earliest stages of development, and that these result from not only differences in sex hormones and social experiences but also in rates of male and female brain maturation, specifically in the early developing right brain. I present interdisciplinary research which indicates that the stress-regulating circuits of the male brain mature more slowly than those of the female in the prenatal, perinatal, and postnatal critical periods, and that this differential structural maturation is reflected in normal gender differences in right-brain attachment functions. Due to this maturational delay, developing males also are more vulnerable over a longer period of time to stressors in the social environment (attachment trauma) and toxins in the physical environment (endocrine disruptors) that negatively impact right-brain development. In terms of differences in gender-related psychopathology, I describe the early developmental neuroendocrinological and neurobiological mechanisms that are involved in the increased vulnerability of males to autism, early onset schizophrenia, attention deficit hyperactivity disorder, and conduct disorders as well as the epigenetic mechanisms that can account for the recent widespread increase of these disorders in U.S. culture. I also offer a clinical formulation of early assessments of boys at risk, discuss the impact of early childcare on male psychopathogenesis, and end with a neurobiological model of optimal adult male socioemotional functions. https://www.ncbi.nlm.nih.gov/pubmed/28042663

https://sensitivityuncensored.com/2016/08/19/youre-highly-sensitive-really-mean/

https://sensitivityuncensored.com/2016/08/23/holding-space-highly-sensitive-child/

https://www.nytimes.com/2015/10/20/science/babies-take-months-to-link-touches-to-what-touches-them.html

Some Information about the human sensory system and sensory processing disorder

Humans have eight senses: touch, smell, vision, hearing, taste, proprioception, vestibular and the interoceptive sense.* We take in information about our environment through our 8 senses. When our sensory system is compromised either due to sensory processing disorder or temporary illness such as a head cold this impacts our ability to adequately respond to and engage with our environment. The ability of the brain to organize sensory input varies from individual to individual. For most sensory processing is done automatically and taken for granted. For those with SPD sensory processing is impaired.

Sensory processing disorder (SPD) is a condition where the sensory signals don’t get organized into appropriate responses. A. Jean Ayres- an occupational therapist who developed the theory of SPD and created evaluation procedures and intervention strategies for SPD- described SPD as a neurological traffic jam that prevents certain parts of the brain from receiving the information needed to interpret sensory information from the environment correctly. Thus, an individual with SPD has difficulty processing and acting upon information received through the 8 senses, which creates challenges in preforming everyday tasks. If the brain does not correctly process and respond to sensory information then the individual will not be able to perceive and properly make use of the information from their senses and will not be able to interact with their environment optimally.

“Motor clumsiness, behavioral problems, anxiety, depression, school failure, and other impacts may result if the disorder is not treated effectively. One study (Ahn, Miller, Milberger, McIntosh, 2004) shows that at least 1 in 20 children’s daily life is affected by SPD. Another research study by the Sensory Processing Disorder Scientific Work Group (Ben-Sasson, Carter, Briggs-Gowen, 2009) suggests that 1 in every 6 children experiences sensory symptoms that may be significant enough to affect aspects of everyday life functions. Symptoms of Sensory Processing Disorder, like those of most disorders, occur within a broad spectrum of severity. While most of us have occasional difficulties processing sensory information, for children and adults with SPD, these difficulties are chronic, and they disrupt everyday life.” http://www.spdfoundation.net/about-sensory-processing-disorder/

The signs of sensory dysfunction are numerous and often overlap with other conditions. Some common ones include avoidance of certain textures/sounds/games etc., being clumsy, tiring easily, hyperactivity/hypoactivity, spinning and other repetitive purposeful movements, anxiety, aggression, having difficulty interpreting sensory information and responding appropriately to it, difficulty with social interaction, fear of everyday objects or activities such as stairs or swings, and difficulty with concentration. http://sensoryprocessingchallenges.com/images/Sensorytoolhome.pdf

*Proprioceptive is the body awareness sense. It tells the mind where the body begins and ends and is linked to the tactile and vestibular system. This sense gives us information about how much force to use and through which line of motion to move while doing activities such as picking up a glass of water.

Vestibular is the movement and balance sense which gives us information about where our head and body are in space and allows us to stay up right while we sit, stand, and walk. This sense is involved in the body’s sense of balance and awareness of space, gravity and movement. A malfunctioning vestibular system creates the feeling of being “lost in space”.

Interoception is an internal body sense that senses essential regulation responses such as hunger, breathing, heartrate, and respiration in the body. If the interoception system is impaired this can make it difficult to understand emotional reactions- a well-known example would be when people mistake the symptoms of a panic attack for a heart attack. Their brain can’t explain the sensory input-racing heart etc.- so it thinks its dying and freaks out even more.

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