Trauma-informed care in early intervention: Providers' barriers, boundaries, and needs

Young children who receive early intervention (EI) services are at increased likelihood of having experienced trauma, as trauma is most common in the birth-to-three age range, especially for children with disabilities. Little is known about EI services for trauma-impacted children and families. Previous research suggested that EI providers are unprepared to support trauma. Thus, we conducted qualitative interviews with 14 EI providers in one US state to understand the barriers and needs related to trauma-informed care (TIC). We organized our findings so that each theme is nested in a system from social ecological theory. The six themes included macrosystem (the system is unequipped, lack of role clarity), exosystem (providers need specific training), mesosystem (gatekeeping, family-provider dynamics), and microsystem (EI providers' well-being and comfort). Implications include the need for a top-down approach to TIC in EI and clarification of the roles of various EI disciplines in implementing TIC.