Putting Your Trauma Lens On

UMMS Affiliation

Department of Pediatrics, Division of Child Protection; Foster Children Evaluation Services; Child Protection Program, UMass Memorial Children's Medical Center

Publication Date


Document Type



Mental and Social Health | Pediatrics | Psychiatry and Psychology | Psychological Phenomena and Processes | Trauma


Trauma in childhood is now understood to cause long-term effects on the brain and body. The pediatric provider, using a "trauma lens," which constitutes observing a child's attachment, resilience, and stress response, is well poised to identify and support children and families at risk. Fortunately, resilience is a dynamic process that can be learned, enhanced, and supported. Familiarity with the most common symptoms of traumatic stress will help the medical provider quickly recognize which children are impacted or FRAYED (Fits, Frets, and Fear; Regulation disorders; Attachment problems; Yawning and Yelling; Educational and developmental delays; Defeat and Dissociation). Once symptoms are identified, the caregiver can "focus" on attachment and resilience skills, the THREADS (Thinking and learning brain, with opportunity for continued growth; cognitive development; Hope, optimism, faith, belief in a future for one's self; Regulation [self-regulation, self-control]; Efficacy, or knowing one can impact their environment and situation; Attachment, secure; Development, or mastery of age-salient developmental tasks; Social context or the larger network of relationships in which one lives and learns) that can be woven together to promote resilience. Guiding families with empathy and positive regard, the medical provider can help the child and family rebuild resilience skills. Organizing practical guidance around the "3 R's"-Reassuring, Restoring routines, and Regulating-is a roadmap to recovery.

DOI of Published Version



Pediatr Ann. 2019 Jul 1;48(7):e269-e273. doi: 10.3928/19382359-20190618-01. Link to article on publisher's site

Journal/Book/Conference Title

Pediatric annals

Related Resources

Link to Article in PubMed

PubMed ID