Trauma‑Informed Supports for People with Intellectual and Developmental Disabilities – Part 1

Trauma‑Informed Supports for People with Intellectual and Developmental Disabilities

Part 1 of a two‑part series – March 2026

Session Overview & Logistics

• Date & Time: 9 a.m. – 12 p.m.
• Host: Illinois Crisis Prevention Network (ICPN).
• Housekeeping (Danielle Daly, ICPN):
• Participants muted, cameras disabled.
• Chat box used for comments, questions, and resource sharing.
• Questions addressed during scheduled 10‑minute breaks.
• Announcements: Upcoming ICPN workshops, past recordings on YouTube, and the seventh annual conference (Springfield – Mar 28; Naperville – Mar 29).
• Continuing‑Education‑Units (CEUs): Emailed within 14 days; contact Danielle if not received.

Presenter Introduction

• Dr. Karen Harvey opened by thanking attendees for persisting through the pandemic and stressing the need for self‑care (“we can’t take care of anybody else if we’re not taking care of ourselves”).
• She framed grief as a public‑health issue (citing Dr. Tony Miles) and warned against applying the classic “Kübler‑Ross stages of grief” to bereaved individuals, noting those stages were meant for the dying, not the mourners.

The COVID‑19 Pandemic as a Collective Trauma

• Described as “its own kind of trauma” affecting people with IDD, families, and staff.
• Three phases identified:
• Fear – e.g., washing groceries, avoiding surfaces.
• Isolation – loss of community activities, day‑program closures, separation from friends and family.
• Anxiety & Fatigue – reluctance to re‑engage, exhaustion from prolonged stress.
• Dr. Harvey shared anecdotes from group‑therapy work (July 2020 – June 2021) and workshops in New Jersey, New York, and North Dakota, illustrating job loss, program closures, and grief among people with IDD.

Grief, Loss, and the Need for Support

• Many people with IDD lost jobs, friends, family members, and staff during the pandemic.
• Example: A New Jersey house‑manager lost a long‑time colleague—the state’s first COVID death—leaving residents with unaddressed grief.
• Behavioral manifestations of grief (when unrecognized) included aggression, property destruction, and refusal.

Major Sources of Trauma for People with IDD

Biological Impact of Trauma

• Trauma affects three major brain systems:
• Brainstem – basic life functions.
• Limbic system (amygdala, hippocampus) – fight/flight/freeze and emotional memory.
• Neocortex – rational thinking and planning.
• Chronic trauma can enlarge the amygdala (heightened threat detection) and shrink the hippocampus (working memory), mirroring findings in children from war‑torn Bosnia and those raised in violent environments.
• The mirror‑neuron system is essential for early social learning; neglect disrupts this system, leading to lasting cognitive deficits.

Understanding Trauma Responses

Dr. Harvey outlined the four PTSD symptom clusters with concrete examples:

1. Re‑experiencing – intrusive memories, nightmares, flashbacks (e.g., a client repeatedly hearing a staff member’s voice that reminded them of past abuse).
2. Avoidance – refusing medical appointments or social events due to fear of being touched or harmed.
3. Negative alterations in cognition/mood – pervasive shame, hopelessness, or a sense of impending doom.
4. Arousal – hyper‑vigilance, irritability, aggression (often misread as “manipulative” behavior).

Additional trauma‑related behaviors discussed:

• Fawning – excessive people‑pleasing to avoid harm.
• Self‑harm – coping with intense emotional stress or feeling trapped.
• Property destruction – often a manifestation of fear rather than intent to harm.

The Triangle of Post‑Traumatic Recovery

These three elements constitute the “post‑traumatic recovery triangle” and were presented as the core framework for healing.

Defining Safety

• Physical & Emotional Dimensions: “I’m going to be okay, no one is going to hurt me, and I know the other person’s intentions are good.”
• Even with drills and protocols, safety is compromised if staff mock, threaten, or isolate individuals.

Importance of Connection & Empowerment

• Isolation erodes hope and hampers recovery.
• Cult‑like dynamics (as described by Judith Herman) – abusers isolate victims, restrict contact with family, and limit choices – mirror many trauma environments.
• Empowerment requires genuine options (e.g., allowing a client to choose a staff member for a medical visit) rather than token choices.

Understanding Self‑Harm

• Coping Mechanism: A 2015 literature review (Ford & Gomez) described self‑harm as an attempt to manage intense emotional stress or feelings of being trapped.
• Illustrative case: A client with “cauliflower ears” and facial scars from repeated self‑injury after enduring abuse and a “fight club” atmosphere in his residence.
• Assessment tip: Whenever self‑harm is observed, look for current or past abuse as a possible underlying factor.

The Illusion of Knowledge

• Quote from Stephen Hawking: “The greatest enemy of knowledge is not ignorance, it’s the illusion of knowledge.”
• The speaker reflected on personal experience of assuming they understood a client’s behavior, only to realize the assumption was false.
• Lesson: Avoid jumping to conclusions; instead, ask how you can support the person and what they need to feel safe.

Survival Mechanisms and Behavioral Issues

• Many challenging behaviors originate as survival strategies developed in response to bullying, exclusion, or other adverse experiences.
• These behaviors may have once protected the individual, even if they are now maladaptive.
• The recommended shift is from “fixing” the person to providing safety and support.

Practical Approaches to Support Healing

• Safety First: Identify each person’s triggers and create environments that minimize them.
• Connection: Foster genuine relationships; isolation worsens trauma.

• Empowerment: Offer real choices and respect autonomy.

• Expressive Therapies: Music, art, movement, collage, and similar modalities provide safe outlets for expression.

• Interviewing People with Trauma:

• Convey deep respect (“I can imagine how hard it must have been”).

• Avoid opening trauma without being able to provide support.

• Explaining Death: Use group grief sessions where individuals can share and hear peers’ experiences; avoid one‑on‑one explanations that may retraumatize.

• Gathering Trauma History from Non‑Verbal Individuals:

• Prioritize safety and reassurance (“bad things won’t happen here”).

• Do not force direct trauma discussion that could trigger the person.

• Staff Involvement in Therapy:

• Ask therapists if staff can attend a brief portion of each session (e.g., 15 minutes) to act as a bridge, without requiring the client to disclose anything.

• This collaborative approach can make therapy more effective while protecting confidentiality and safety.

• Navigating Mandatory Reporting: Therapists may report suspected abuse to Child Protective Services; staff must balance advocacy with the client’s wishes.

Case Illustrations (Behavior‑Plan Lessons)

• James – Non‑compliant client; initial reinforcement (soda, money) failed until a genuine romantic relationship with a peer (Sarah) provided motivation, leading to improved hygiene and eventual marriage.
• Philip – North Dakota workshop participant; after sharing his pandemic experience, he concluded with “Live life to the fullest.”
• Judy – Labeled “fire‑setter”; recognizing teasing and past sexual abuse as triggers led staff to change her living situation, reducing destructive behavior and enabling a healthy relationship.
• Dan – Frequent aggression; the trigger was a staff member who resembled a past abuser; removing that visual cue stopped the aggression.

Resources & Tools

• Free materials (workbooks, assessment tools, storybooks) are available at karenharvey.org.
• Upcoming book: “Trauma and Healing” (targeted at therapists but useful for all providers).
• Emphasis on bridging mental‑health professionals and direct‑support staff: involve staff in the final moments of a therapy session so they feel part of the treatment team.

Q&A Highlights

• Self‑harm & Abuse: Reiterated that self‑harm often signals underlying abuse.
• Non‑Verbal Trauma Histories: Emphasized safety first; avoid direct trauma questioning that could re‑trigger.
• Therapy Honesty: When a client is not honest with their therapist, involve staff in a limited, supportive capacity to improve trust and outcomes.
• Case of a Senior with Type 1 Diabetes: Client frequently left school without explanation, suggesting an unaddressed issue; therapy and a safe space were recommended.

The pandemic created a collective trauma for people with IDD, intensifying fear, isolation, and fatigue, while the population already faces a spectrum of heightened trauma risks such as abuse, neglect, and loss of autonomy. Trauma reshapes brain structures, enlarging threat detection centers and shrinking memory regions, which underlies many challenging behaviors that are often survival strategies. Recovery hinges on the three pillars of safety, connection, and empowerment, forming a recovery triangle that guides healing. Practical support must prioritize safe environments, genuine relationships, real choices, expressive therapies, and collaborative staff involvement in treatment while respecting confidentiality. By shifting focus from fixing individuals to providing consistent safety and support, providers can better address the complex needs of those with intellectual and developmental disabilities.