Traumatic Experiences and Major Life Stressors in Children and Youth With Neurodevelopmental Disorders

Traumatic experiences adversely affect mental health; children with neurodevelopmental disorders (NDDs) may be more vulnerable to these adverse effects. The objective of this study was to examine the prevalence, types, and clinical correlates of traumatic experiences and major life stressors in children and youth with NDDs.

A longitudinal retrospective cohort study was conducted using electronic medical records from a large tertiary program supporting children and youth diagnosed with autism or intellectual disability and persistent behavioural or mental health concerns. Those with and without a documented history of trauma/major stressors were compared regarding clinical and demographic characteristics; longitudinal associations with crisis service utilization were examined using survival models.

Of 389 individuals (94% autism, 40% intellectual disability; 17% female; mean age 10.7 ± 3.1 years), 58 (15%) had a recorded trauma/major stressor, most commonly physical assault/abuse (3%) or family member death/estrangement (3%). Those with prior trauma/stressors were less likely to be female (5% vs. 19%, p = 0.01) or minimally-verbal (22% vs. 53%, p < 0.001); they had more suicidality (29% vs. 13%, p = 0.009), aggression (91% vs. 78%, p = 0.01), crisis service utilization (57% vs. 32%, p = 0.002), and psychotropic polypharmacy (3 vs. 2 medications, p < 0.01). Older age, past crisis service use, financial strain, and more allied health supports, but not past trauma/stressors, were associated with subsequent crisis service use.

Children and youth with NDDs and a history of traumatic experiences or major life stressors had more mental health and behavioural symptoms. Trauma and major stressors may be clinically under-identified in those with minimal verbal communication.