Infants and young children are vulnerable to multiple types of trauma, including neglect and sexual, physical, and emotional abuse. Some believe that young children are not impacted by trauma and that, if they are, they will simply "grow out of it."

Continuing research, however, clearly demonstrates that trauma can alter young children's neurobiological development and place them at risk for behavioral, social, emotional, linguistic, and cognitive problems across the lifespan. Despite these alarming findings, there is increasing evidence that early interventions can foster recovery and enhance resilience.

Joy Osofsky, Phillip T. Stepka, and Lucy S. King distill the vast literature on childhood trauma in this concise guide that reviews what effects these traumatic experiences can have and which treatments are best suited for addressing them. They provide a detailed framework for selecting the most appropriate intervention based on specific criteria.

Vivid case examples teach clinicians how to apply these treatments in real scenarios and support parents and caregivers as key attachment figures and sources of security in a child's life.

Table of Contents

Series Foreword
Anne P. DePrince and Ann T. Chu


Introduction: Recognizing the Impact of Trauma Exposure on Young Children

  1. The Impact of Early Trauma on Development
  2. Child–Parent Psychotherapy
  3. Attachment and Biobehavioral Catch-Up Intervention
  4. Parent–Child Interaction Therapy
  5. Considerations in Choosing a Treatment That Works

Afterword: Conclusions and Future Directions

Appendix: Key Points on the Impact of Early Trauma on Development



About the Authors

Author Bios

Joy D. Osofsky, PhD, Paul J. Ramsay Chair of Psychiatry and a professor of pediatrics and psychiatry at Louisiana State University Health Sciences Center (LSUHSC) in New Orleans, is both a clinical and developmental psychologist. She is director of the LSUHSC Harris Center for Infant Mental Health.

Among her scholarly achievements, Dr. Osofsky has written or edited nine books, including the Handbook of Infant Development and Clinical Work With Traumatized Young Children, and is coeditor of the WAIMH Handbook of Infant Mental Health.

Dr. Osofsky is past president of ZERO TO THREE: National Center for Infants, Toddlers and Families and the World Association for Infant Mental Health.

In 2016, she wrote the first chapter on infant mental health in the Handbook of Clinical Psychology.

She has played a leadership role in the Gulf Region in developing response and recovery efforts following Hurricane Katrina and the Deepwater Horizon oil spill.

In 2007, Dr. Osofsky received the Sarah Haley Memorial Award for Clinical Excellence from the International Society for Traumatic Stress Studies, for trauma work. In 2010, she was honored with a Presidential Commendation from the American Psychiatric Association for her work in the aftermath of Hurricane Katrina. Dr. Osofsky was recognized with the 2014 Reginald Lourie Award for leadership in the field of infant mental health and outstanding contributions to the health and welfare of children and families.

She does research, intervention, and clinical work with infants, children, and families exposed to community and domestic violence, maltreatment, trauma, and disasters and is the clinical consultant for Safe Babies Court Teams for ZERO TO THREE.

Dr. Osofsky is currently the coprincipal investigator for the Terrorism and Disaster Coalition for Child and Family Resilience, a National Child Traumatic Stress Network Center initiative funded by the Substance Abuse and Mental Health Services Administration. She serves a key role in helping state and national legislators and policymakers understand the behavioral health needs of children, especially young children.

Phillip T. Stepka, PsyD, is an assistant professor of clinical psychiatry at LSUHSC and serves as a member of the teaching faculty for the Harris Center for Infant Mental Health. His interests include trauma throughout the lifespan, child maltreatment, infant mental health, fetal alcohol effects and syndrome, pervasive developmental disorders, sexual abuse and sexual behavior problems, and risk and resiliency factors in military families.

Dr. Stepka serves as project coordinator for the LSUHSC site for the Substance Abuse and Mental Health Services Administration-funded Early Trauma Treatment Network, a center in the National Child Traumatic Stress Network. He is a child–parent psychotherapy national trainer and consults on adaptations of other evidence-based practices for young children across the country.

Dr. Stepka provides evaluative, therapeutic, and consultation services to military children, their families, and educators at the Belle Chasse Naval Air Station/Joint Reserve Base in South Louisiana. He also collaborates with the military's Family Advocacy Program in developing and implementing resilience-building interventions for young children with deployed caregivers and providing multidisciplinary treatment to military families affected by abuse, neglect, and domestic violence.

Lucy S. King, BA, is currently a PhD student in the Department of Psychology at Stanford University, where she studies the impact of environmental adversity on psychobiological development from the first months of life through adolescence. Her areas of interest include novel methods for measuring positive and negative aspects of the early environment and the effects of caregiving behavior on the development of stress response systems.

She has previously held research positions in the Department of Psychiatry at Boston Children's Hospital and at Louisiana State University Health Sciences Center.

Ms. King has published and presented peer-reviewed research clarifying the associations between caregiving, early stress exposure, and biological reactivity and regulation in infancy and childhood. She has also conducted research on developmental psychopathology in children and adolescents exposed to natural and technological disasters.

She is the recipient of a Graduate Research Fellowship from the National Science Foundation.

Reviews & Awards

Especially useful to clinicians and clinicians in training who serve parents and very young children affected by trauma.

Children under age 5 are traumatized at a higher rate than any other age group, but professionals are often at a loss about how to help them. This remarkable volume expands our understanding of how young children are affected by trauma, the treatments that work, and the developmental and relational issues in their application. A timely, essential resource.
—Ross A. Thompson, PhD
Distinguished Professor of Psychology, University of California, Davis

With a laser focus on young children who have experienced the worst kind of adversity, Osofsky, Stepka, and King move beyond imparting knowledge about how trauma affects early development to offering insights about what we can do for affected children and families. They highlight three evidence-based trauma interventions that practitioners can integrate into their own work. This is an important read for clinical, early childhood, and child welfare professionals alike, and for all who are concerned about young children exposed to trauma.
—Brenda Jones Harden, PhD
Professor, Institute for Child Study, HDQM; Director, Prevention and Early Adversity Research Laboratory, University of Maryland, College Park