Smith College Studies in Social Work, 84:292–309, 2014 Copyright © Taylor & Francis Group, LLC ISSN: 0037-7317 print/1553-0426 online DOI: 10.1080/00377317.2014.924251 Trauma’s Neurobiological Toll: Implications for Clinical Work With Children KAREN ZILBERSTEIN A Home Within, Northampton, Massachusetts, USA Traumatic stress in childhood exacts a particularly high developmental toll. When traumatic experiences start early, con- tinue chronically, and/or occur in conjunction with inadequate caretaking, neurobiological consequences intensify. Implicated brain regions include those mediating stress reactions, emotional arousal and regulation, attention, inhibition, impulse control, and various types of memory. To address those issues psychotherapeu- tically, treatment must comprehensively target underdeveloped or damaged neural networks. This article reviews current knowl- edge of the neurobiological and developmental affronts caused by traumatic stress during childhood and examines the various treat- ments and treatment implications for psychotherapeutic work with children. KEYWORDS trauma, traumatic stress, child development, attachment, neurobiology INTRODUCTION Severe and prolonged traumatic stress, experienced in childhood, often exacts a developmental toll. Trauma disrupts neurobiological maturation by provoking alterations in emotional, behavioral, interpersonal, cognitive, sensory, and biological areas of functioning (Ford, 2009). When traumatic experiences occur in conjunction with inadequate caretaking, so that the attachment figure either serves as the source of fear and/or cannot help the child cope, the disruptive, dysregulating effects increase exponentially Received 2 May 2014; accepted 2 May 2014. Address correspondence to Karen Zilberstein, MSW, 8 Trumbull Road #205, Northampton, MA 01060, USA. E-mail: ekaren@me.com 292 Downloaded by [Karen Zilberstein] at 14:28 08 August 2014