Annual Research Review: Interventions for young children exposed to trauma

The landscape of trauma-focused interventions for young children has evolved significantly, though substantial gaps remain. Early childhood trauma exposure occurs during sensitive periods of brain development with potential lifelong consequences. However, these periods also present unique opportunities for intervention to redirect trajectories toward positive outcomes. Rapid neurodevelopmental changes across early childhood necessitate interventions specifically designed for evolving capacities rather than simply "scaled down" versions of adult treatments. A review focused exclusively on evidence-based interventions for young children is needed. This review represents a synthesis of the literature informed by our clinical and research expertise. We review interventions that (1) target trauma symptoms as primary outcomes, (2) were designed for children ages 0-8 years, (3) include substantive caregiver involvement, and (4) have empirical support from published randomized controlled trials or well-designed quasi-experimental studies. Our review revealed a tiered evidence base for young children, with the strongest support for interventions targeting specific age groups: Child-Parent Psychotherapy for infants and toddlers, Preschool PTSD Treatment for preschoolers, and Trauma-Focused CBT for early elementary children. Critical gaps include limited interventions for children under age 3, sparse evidence for interventions targeting noninterpersonal trauma, assessment challenges, particularly with longitudinal measurement across developmental transitions, and insufficient implementation research on disseminating interventions in community settings. By continuing to refine effective trauma interventions for our youngest children, we can alleviate immediate suffering and potentially prevent decades of associated difficulties across the lifespan. Future research priorities should include expanding the evidence base for existing interventions through well-powered trials with diverse samples, developing and testing preventive interventions delivered following potentially traumatic events, adapting established interventions for under-studied trauma types, and implementation research to support widespread adoption in real-world settings.