Trauma in Children with Neurodevelopmental Disorders: Autism, Intellectual Disability, and Attention-Deficit/Hyperactivity Disorder

Abstract

Current evidence indicates that having a neurodevelopmental disorder (NDD), such as autism spectrum disorder, intellectual developmental disorder, and attention-deficit/hyperactivity disorder, increases the odds that a child will be exposed to maltreatment and other adverse events. Early trauma such as physical neglect or exposure to violence during early developmental periods may lead to the development of NDD symptoms. Recent longitudinal twin studies suggest NDD and child maltreatment run together in families as a set of genetic traits, hence the importance of routine screening of co-occurring trauma and NDD. The diagnostic complexities of co-occurring trauma-related symptoms and NDD are explored. This is a new and as-yet understudied area with a history of methodological inadequacies, including errors in classification and overreliance on convenience samples without comparison groups of typically developing children. Assessment is complicated by diagnostic overshadowing bias and gaps in the availability of measures to assess traumatic experience in children with developmental and language delays. There is a particular need for self-report measures that are engaging and comprehensible for children with varying language and cognitive capacities. Web-based electronic assessment tools and their application to this population of children are discussed. Current evidence-based trauma treatment models are briefly reviewed with an emphasis on the adaptation of Trauma-Focused Cognitive Behavior Therapy for use with children who have autism and other NDDs.