Utilizing Trauma-Informed Practices in Pediatric Pelvic Floor Therapy

Trauma-informed care has become a pivotal topic in healthcare, especially amidst today’s growing mental health crisis. For pediatric pelvic floor therapists, understanding trauma is essential, yet it requires a unique perspective when working with children. Their experiences, often compounded by medical trauma or stress, require a compassionate approach that acknowledges both their physical and psychological needs.

By becoming trauma-informed, pediatric therapists can create safe, supportive spaces that foster resilience and healing for young patients and their families.

Trauma is more than a single event—it’s experiences that leave lasting impressions on a child’s emotional, physical, and even spiritual well-being. Trauma encompasses harmful events or circumstances that disrupt development and can shape behaviors, relationships, and health outcomes for years to come.

Trauma-informed care offers a framework for understanding and integrating the ripple effects of trauma. As a trauma-informed provider, you should be able to acknowledge trauma’s impact and create a supportive environment for your patients. As pediatric therapists, this means incorporating trauma awareness into care without attempting to treat or resolve the trauma itself.

Children seeking pelvic floor therapy may present with challenges linked to trauma, including toileting concerns, emotional dysregulation, or physical pain. Many of these challenges are exacerbated in children who have experienced medical trauma—situations involving serious illness, painful procedures, or prolonged hospital stays. These experiences can leave lasting impressions, heightening their stress responses and complicating recovery.

Addressing these issues requires more than technical expertise; it demands a compassionate approach that considers the child’s history and psychological state.

The key objectives of trauma-informed care in therapy are to:

• Prevent trauma and build resilience
• Intervene effectively for those exposed to trauma, including caregivers, siblings, and healthcare workers
• Provide support for children who demonstrate trauma-related symptoms while promoting overall well-being

You can use these goals to guide your therapeutic process and help facilitate healing and growth in high-risk pediatric populations.

Understanding high-risk pediatric populations can help you anticipate and address the specific challenges these children may face in the clinical setting. Awareness of a child’s social determinants of health is also critical to providing comprehensive care. You can learn more about these high-risk populations in my online mini course Pediatric Trauma-Informed Care, Child Abuse, and Adolescent Suicide and learn how these kids are more likely to experience trauma.

Let’s take a look at the effects of trauma on children, specifically.

While all human brains (both children and adults) are neuroplastic, children’s brains are immature and extremely impressionable. Therefore, they are more susceptible to the harmful effects of negative events or interactions.

Trauma disrupts brain development and function. The key structures impacted include:

• Amygdala: Overactivity increases stress and fear responses.
• Hippocampus: Underactivity impacts memory and learning.
• Prefrontal Cortex: Reduced accessibility limits decision-making and emotional regulation.

These brain changes can lead to chronic dysregulation of the immune system, resulting in symptoms like fatigue, sickness, and cognitive challenges. Excessive or frequent activation of the stress response leads to long-term changes and dysregulation of the neuroendocrine system. Epigenetic modifications can further perpetuate stress responses into adulthood.

Children exposed to trauma may display a wide range of symptoms, including, but not limited to:

• Emotional dysregulation
• Sleep disturbances
• Toileting concerns
• Cognitive and developmental delays

Screening for these symptoms involves a holistic approach that includes gathering comprehensive histories, observing behaviors, and engaging in sensitive dialogue with families.

Let’s dive into how you can do this.

You’ve learned how to improve your awareness in the previous sections. Children NEED safe, stable, and nurturing relationships that act as a buffer against adversity. Predictable, compassionate environments help children feel secure.

Understand what fosters resilience and how to promote it. Kids in therapy often feel like they have done something wrong. You can help shift their perspective and alleviate the guilt. Through demonstrating empathy and other methods, you can become a trusted source of safety for the child. Therapists should aim to emphasize patient and family resilience.

The depth of your awareness and readiness should extend far beyond the content of this blog post. Check out my Mini Course to learn the nuances of trauma’s effects on children.

Screen for trauma affecting both the child and the family. Screening tools can help identify symptoms such as sleep or eating issues, toileting challenges, and emotional distress. I provide you with all the support material you need to screen effectively in my online Mini Course.

Pay attention to their medical histories, as children with medical trauma often exhibit unique stressors. Making sure the child is comfortable during your assessment and treatment holds more weight than sometimes the treatment itself. Kids need to know they are in a safe and welcoming environment.

Always prioritize safety by addressing critical concerns like abuse, neglect, and youth suicide. I’ll dive into these topics in future blog posts, coming in the next couple months.

Families can often feel overwhelmed when first beginning therapy, especially if they’ve been through multiple healthcare providers for chronic bowel and bladder issues. Engage families in discussions about their fears and ask about a child’s triggers and coping mechanisms.

Identify and address both sensory and emotional triggers. Educate families on recognizing these triggers and establishing strategies to mitigate their impact.

Encourage caregiver involvement in therapy. Collaboration between therapists, families, and other healthcare providers ensures comprehensive support. Addressing social determinants of health also contributes to lasting resilience.

Promote psychoeducation to help families understand the physiological and psychological effects of trauma. Exploring these topics can be difficult for parents, but you can help families by opening up these conversations.

By embracing trauma-informed care, pediatric pelvic floor therapists can address the complexities of trauma while promoting resilience and recovery. This holistic approach not only alleviates physical symptoms but also nurtures emotional and psychological well-being. As a pediatric pelvic floor therapist, your commitment to understanding and responding to trauma lays the foundation for a brighter future for your young patients and their families.

Get started today, and learn more about how to implement trauma-informed care in your pediatric pelvic floor therapy practice, in my new online mini course Pediatric Trauma-Informed Care, Child Abuse, and Adolescent Suicide.