Beyond Behaviors: Uncovering the Trauma-Informed Approach to Supporting Individuals with IDD

Wajdi Akef Fakhoury, LMFT 148333

Individuals navigating intellectual and developmental disabilities (IDD) often face a range of challenges, both visible and hidden, that affect their ability to thrive in daily life. For those with co-occurring mental health conditions, these challenges are compounded by vulnerabilities stemming from trauma, systemic obstacles, and barriers in communication. Just as these difficulties present unique needs, they also require a unique approach to care. Trauma-informed care offers a compassionate, evidence-based framework that not only addresses the immediate needs of individuals with IDD but also fosters healing, empowerment, and resilience.

What is Trauma-Informed Care?

Trauma-informed care begins with a key assumption: that an individual’s behavior, emotions, and difficulties may be influenced by a history of trauma. This approach acknowledges that trauma impacts how the brain and body function and emphasizes creating environments that promote psychological and physical safety. It shifts the lens from “What’s wrong with you?” to “What has happened to you?” (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014).

Rather than focusing solely on managing behavior, trauma-informed care prioritizes understanding an individual’s experiences and providing proactive support that addresses their emotional needs. For individuals with IDD, who are at a higher risk of experiencing trauma compared to the general population, this approach is not just beneficial—it is essential.

Understanding Trauma in Individuals with IDD

Research consistently highlights the prevalence of trauma among individuals with IDD. Studies estimate that up to 90% of individuals with IDD have experienced at least one traumatic event during their lifetime, ranging from abuse and neglect to medical trauma or repeated relocations (Fletcher, 2011). These rates are significantly higher compared to the general population.

One reason for this disparity lies in the intersecting vulnerabilities that individuals with IDD face. These include, but are not limited to, communication barriers, dependency on caregivers, and systemic inequities. For example, the inability to effectively communicate distress or report abuse may leave individuals with IDD in unsafe environments. Similarly, frequent changes in caregiving arrangements can erode their sense of stability and trust, leading to a heightened risk for trauma exposure.

Trauma can have profound effects on the brain and body, particularly on the areas responsible for emotional regulation, decision-making, and memory. For individuals with IDD, who may already experience differences in cognitive and executive functioning, the impact of trauma can exacerbate difficulties in managing transitions, regulating emotions, or responding to stress in adaptive ways. Without proper understanding, these manifestations of trauma are often misinterpreted as “challenging behaviors” rather than expressions of underlying distress (Mevissen & de Jongh, 2010).

Why Trauma-Informed Care is Vital for Individuals with IDD

The pervasive impact of trauma on individuals with IDD extends across every domain of their lives—from their emotional well-being to their physical health and relationships. Adopting a trauma-informed approach helps caregivers, educators, and clinicians meet individuals where they are emotionally, providing support that feels safe, predictable, and affirming.

1. Safety and Stability: Trauma-informed care recognizes the importance of creating environments that reduce anxiety and promote a sense of predictability. For instance, providing clear routines and minimizing sudden changes can help individuals with IDD feel more secure.

2. Empathy and Understanding: Rather than assuming that behaviors are intentional or manipulative, trauma-informed care encourages practitioners to consider the potential role of past trauma in present difficulties. This fosters more compassionate and effective interactions.

3. Healing and Resilience: Trauma-informed interventions aim to not only reduce symptoms of distress but also build resilience by enhancing emotional regulation skills and strengthening support systems.

The Path Ahead

Bringing trauma-informed care into practice requires both a shift in perspective and a commitment to systemic change. It involves training caregivers and professionals, tailoring strategies to meet individual needs, and ensuring that every interaction reinforces a sense of trust, safety, and empowerment. For individuals with IDD who often face misunderstanding or marginalization, this approach can be life-changing.

This post serves as an introduction to the key principles and importance of trauma-informed care. Over the course of this blog series, we’ll explore specific topics such as executive functioning, proactive strategies, and systems-level collaboration to deepen our understanding of how trauma-informed care can transform the lives of individuals with IDD.

References

• Fletcher, R. (2011). Psychotherapy for Individuals with Intellectual Disability. Kingston, NY: NADD Press.

• Mevissen, L., & de Jongh, A. (2010). PTSD and its treatment in people with intellectual disabilities: A review of the literature. Clinical Psychology Review, 30(3), 308-316.

• Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach. U.S. Department of Health and Human Services.

Stay tuned for the next post in this series, where we’ll explore the role of executive functioning and how it intersects with trauma in individuals with IDD.