Posttraumatic stress disorder (PTSD) has been in the news frequently as veterans from the wars in Iraq and Afghanistan return home. many of these individuals suffer lasting effects from the trauma they experienced and witnessed.PTSD is an anxiety disorder that may occur after exposure to a traumatic event that threatens the physical integrity of self and/or others and in which one’s response involves intense fear, helplessness, and horror. The disorder is characterized by reexperiencing the traumatic event, avoidance of stimuli associated with the trauma, numbing of general responsiveness, and increased arousal.  The trauma does not have to be war-related; it may be a car accident, sexual  or physical assault, natural disaster, fire, abuse, or other type of trauma.Children and adolescents may also experience PTSD although it often looks quite different in them. whereas, the diagnosis of PTSD focuses on an isolated traumatic event with subsequent responses to specific triggers, for many children trauma is chronic and involves interpersonal relationships. in some cases, the trauma is perpetrated by the individual(s) who are supposed to love and protect the child. Very different reactions may be seen in children who experience multiple, chronic traumatic events from those who experience a single, isolated traumatic event.in fact, there is ongoing discussion about the validity of the PTSD diagnosis criteria for children and adolescents. The Complex Trauma Taskforce of the National Child Traumatic Stress Network is proposing the diagnosis of “developmental trauma disorder” for children and adolescents who experience early, chronic, and severe trauma.Developmental trauma disorder may be seen in children after repeated exposure to “developmentally adverse interpersonal trauma.” Symptoms include emotional and physiological dysregulation, developmental delays, sensory integration problems, attention problems, impulsive behaviors, low self esteem, and interpersonal problems. Psychiatrist Dr. Bessel van der Kolk, from Boston University Medical Center and a member of the Complex Trauma Taskforce, has been a leader in the development of the diagnosis of developmental trauma disorder. he described the problem: “Because children’s brains are still developing, trauma has a much more pervasive and long-range influence on their self-concept, on their sense of the world and on their ability to regulate themselves.” [DeAngelis, T. (2007). a new diagnosis for childhood trauma? [Electronic version]. Monitor on Psychology, 38(3), 32.]Foster parents and adoptive parents often see the effects of chronic and interpersonal trauma played out in the behaviors and emotions of children living in their homes. These problems can create overwhelming challenges for the adults trying to help these children.too often medications are used to treat the symptoms of complex trauma including attention deficit disorder, cognitive and behavioral problems, and antisocial behaviors. These medications treat isolated symptoms and fail to address the larger problem. Other interventions such as cognitive behavioral therapy and traditional psychotherapy are limited in their effects because they do not work to change the brain. Dr. van der Kolk describes these piecemeal efforts as “losing sight of the forest in favor of one tree.”more helpful responses are described by Cathy Malchiodi, art therapist, author, and expert in treating trauma in children and adolescents. in her article “Developmental Trauma Disorder: what Trauma Specialists need to Know”, she identified the following interventions:•    Establishing a sense of safety for the child Continued…

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