What is trauma-informed care?

Trauma-informed care (TIC) is an approach that recognizes the widespread impact of trauma on individuals and seeks to create safe, supportive environments to promote healing and recovery. It focuses treatment on the whole person by understanding how adverse experiences affect health, behavior, and communication.

It is often summarized as the act of asking “What happened to you?” instead of “What’s wrong with you?” We take that one-step further and say that being trauma informed also means understanding the nuanced and complex possible answers to that question through ongoing education as well as a habit of deconstructing our learned implicit biases.

Why is trauma-informed care important in speech-language pathology?

Children and adults who have experienced trauma are at greater risk of communication disorders. Trauma can affect language development, social interaction, and the ability to engage in therapy. Speech-language pathologists (SLPs) play a crucial role by not only addressing speech and language concerns but by fostering environments that help individuals feel heard, safe, and in control of their recovery.

Additionally, as communication is such a vital aspect of speech-language services, SLPs can be the first person a client tells about traumatizing events in their life. Understanding how to validate and normalize the client’s feelings and actions is critical for regaining a sense of safety for that client. SLPs also need to recognize and process the emotional impacts of these encounters in themselves to reduce burnout and the chances of developing secondary traumatic stress (e.g., vicarious trauma, compassion fatigue, trauma exposure response).

How does trauma affect communication and language?

Trauma’s impacts on communication and language development include:

• Neurobiological Effects: Trauma can alter brain development and functioning, directly affecting language processing, memory, and social interaction skills.

• Emotional Regulation: Traumatic experiences may cause emotional dysregulation, anxiety, or withdrawal, making it harder for patients to participate fully in communication tasks.

• Behavioral Responses: Individuals who have experienced trauma may demonstrate avoidance, defensiveness, or increased reactivity when engaging in conversations, particularly in clinical settings.

Additionally, trauma often diminishes internal motivation, leaving a person feeling disconnected, discouraged, or overwhelmed. This often hampers their drive and sense of purpose. It can also impair social connection by making it harder to trust others due to fear and anxiety. Thus, the person impacted by trauma may withdrawal socially, making it harder to communicate and read social cues.

Can children with speech-language delays without trauma still benefit from trauma-informed care?

Yes! Children with speech or language delays often feel vulnerable and have difficulty connecting with their peers. Additionally, they may develop some anxiety around communication due to failed attempts to connect socially. Trauma-informed care helps reduce anxiety, build trust, and foster confidence, making communication therapy more effective and less overwhelming.

How are neurodivergent-affirming speech-language services related to trauma-informed care?

Neurodivergent-affirming speech-language services are, by necessity, trauma-informed. They strive to honor clients’ authentic selves, promote well-being, and prevent both explicit and implicit retraumatization that often occur in more traditional, compliance-based (i.e., “do what I say because I’m the authority”) practices.

You can think of neurodivergent-affirming services as one example how to apply trauma-informed care to a specific area of service.

What are the benefits of trauma-informed communication therapy?

• Helps clients feel comfortable communicating: Understanding trauma helps professionals establish an environment of trust and emotional safety..

• Increases active participation: When care providers acknowledge a patient’s trauma history, the patient is more likely to trust their provider, engage in therapy, and participate actively in interventions.

• Individually tailored: Recognizing trauma allows clinicians to tailor interventions, adjust communication strategies, and set realistic goals based on a patient’s readiness and emotional state.

Practical outcomes to this approach include:

• Reducing Communication Barriers: A trauma-informed approach minimizes triggers and anxieties that often impede meaningful communication.

• Supporting Long-Term Progress: Patients are more likely to achieve positive and sustainable communication outcomes when therapy addresses both linguistic needs and underlying emotional challenges.

• Fostering Resilience and Confidence: By validating experiences and offering choice, trauma-sensitive interventions build patients’ confidence and resilience in communication situations.

What should families or caregivers know about trauma-informed speech therapy?

Trauma-informed therapy is highly collaborative. Caregivers are active partners in creating a safe, supportive environment and are encouraged to openly communicate with the SLP about any concerns or questions.

Trauma-informed SLPs value relationship over rapport. Therapeutic progress may seem slow at first as the foundations of safety and trust are being established. Additionally, caregivers of children may notice the SLP giving their child more autonomy and choice, without an emphasis on having the child “behave” immediately. This is all a part of making safety and developing a trusting therapeutic relationship the main priority, which often results in greater progress once the relationship is more established.

Trauma-informed SLPs focus on speech and language in the context of the whole person — including their family, culture, and emotional well-being for clients of all ages.