Childhood Trauma & Resilience

Heather C. Forkey, MD, FAAP, is an Associate Professor of Pediatrics and Pediatric Vice Chair for Wellness at the University of Massachusetts Medical School, and Division Director for the Child Protection Program and Foster Children Evaluation Service (FaCES) of the UMass Memorial Children’s Medical Center. She also serves as the Medical Director of Lifeline4Kids at University of Massachusetts Medical School. In addition to her clinical work, Dr. Forkey has been the recipient of local and federal grants to address issues of children in foster care and to translate promising practices to address physical and mental health needs of children who have been traumatized. She has published and presents nationally and internationally on the topics, and serves in leadership roles for the National Child Traumatic Stress Network and American Academy of Pediatrics on issues related to foster care and child trauma. Jessica L. Griffin, PsyD, is an Associate Professor of Psychiatry and Pediatrics at the University of Massachusetts Medical School (UMMS), where she has been a faculty member since 2006.  Dr. Griffin is a nationally recognized expert in Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), trauma, and relationships. She has trained and provided consultation for thousands of clinicians across the United States. With funding from SAMHSA/NCTSN in 2012, as Principal Investigator and Executive Director, she developed the UMMS Child Trauma Training Center, with a focus on training, treatment, and resolving access issues for youth who have experienced trauma. Within this initiative, Dr. Griffin created and piloted a highly innovative centralized referral system, LINK-KID, targeted at decreasing wait-times for youth and families to trauma-focused evidence-based treatments. Due to LINK-KID’s early successes, she and her team expanded LINK-KID to what is now a statewide capacity, serving trauma victims throughout the Commonwealth of Massachusetts. To date, under her direction, the center has trained over 45,000 professionals in trauma-informed care and trauma-responsive practices and successfully referred over 4,000 youth into evidence-based treatment models. In April of 2020, Dr. Griffin was awarded a multi-year, multi-million dollar grant to develop the national Resilience through Relationships Center, housed at the University of Massachusetts Medical School aimed at supporting parents, caregivers, and children exposed to trauma.   Dr. Griffin is a clinical and forensic psychologist with a specialty in trauma and relationships. She has extensive expertise in childhood maltreatment, attachment and relationships, psychological evaluation, and divorce and custody matters. She presents regularly at the local, national, and international level on topics related to childhood trauma, relationships, TF-CBT, and forensic evaluation of children and families and has published journal articles and book chapters on a variety of topics related to trauma and relationships. Dr. Griffin has received numerous awards for her work and has been featured on NPR, Fox News, the Insider, iHeartRadio, the New York Post, ENews, the Daily Mail, Reader’s Digest, Forbes, Business Insider and other media outlets and has appeared on television, serving as an expert and consultant on several television docuseries about relationships, marriage, and divorce on A&E’s Lifetime Television network. She is the CEO of LoveBuilder, a relationship company, which provides educational online courses to couples, singles, and parents. Dr. Moira Ann Szilagyi, President-elect of the American Academy of Pediatrics (AAP), is a primary care pediatrician, Professor of Pediatrics, Division Chief of Developmental-Behavioral Pediatrics and Interim Division Chief of General Pediatrics at UCLA where she is also the Peter Shapiro Term Chair for Enhancing Children’s Developmental and Behavioral Health in Pediatrics. Dr. Szilagyi was Professor of Pediatrics at the University of Rochester from 1990 to 2014 and Medical Director of Starlight Pediatrics, an integrated-care medical home for children in foster/kinship care. Her broad experience includes primary care for vulnerable populations, suburban private practice, education of trainees, leadership of several multi-system collaborative partnerships to improve care for vulnerable children, research on evidence-based screening and the integration of mental health into primary care, and a long history of advocacy at the federal, state and local levels. Dr. Szilagyi has held numerous AAP leadership positions, chairing the AAP NY-District II Task Force on Foster Care and the national Council on Foster Care, Adoption and Kinship Care. She is editor of Fostering Health (the manual for providers and systems) and has authored several AAP policy statements and clinical and technical reports on child welfare-involved children. She is Principal Investigator of an AAP case-based online educational program to help pediatricians integrate trauma-informed care into practice. Dr. Szilagyi sees patients in L.A. County’s foster care system.

Introduction
Part I: Building the Resilient Child
1. Brain Development: Early Childhood Through Adolescence
2. Promoting Resilience
3. Attachment
4. Parenting
5. Cultural Connections
Part II: Effects of Adversity and Trauma
6. Pathophysiology of Trauma
7. How Trauma Can Manifest in Children and Teens
Part III: Responding to Trauma
8. Engagement
9. Patient Evaluation and Differential Diagnosis
10. Surveillance and Screening
11. Pediatric Management
12. The Intersection of Trauma and Culture
13. Supporting the Caregiver
14. Integrated Care
15. The Role of Medication
Part IV: Supporting the Clinician and Pediatric Settings
16. Burnout and Secondary Traumatic Stress
17. Trauma-Informed Systems of Care

Conclusion

Appendixes: Selected Handouts by Topic
Appendix A. Promoting Resilience Handouts
Appendix B. Attachment Handouts
Appendix C. Parenting Handouts
Appendix D. Cultural Connections Handouts
Appendix E. Signs and Symptoms of Trauma Handouts
Appendix F. Engagement Handouts
Appendix G. Pediatric Management Handouts
Appendix H. Medication Handouts