Changing Spaces with Dr. Allie Broaddus

Dr. Allie Broaddus is an occupational therapist who specializes in developmental trauma in children. She discusses the impact of early trauma on children's development, including behavioral responses like fight, flight, and freeze, and sensory issues similar to those seen in autism. She highlights the importance of co-regulation and play in therapy, and the need for prevention through community support and education.

The episode concludes with a call for compassion and understanding towards children with challenging behaviors, and a reminder of the significant influence adults have on children's spiritual, physical, emotional, and behavioral development.

Transcript

TOPIC: Changing Spaces: Developmental Trauma – Abuse, Neglect, and Violence

GUEST: Dr. Allie Broaddus

Season 4, Episode 6

Ric Shields (00:00):

You're the second therapist I've spoken with in a couple weeks that talked about play therapy, and I'm going, what a great job this is. You get paid to play.

Allie Broaddus (00:09):

Yeah.

Ric Shields (00:10):

And how did I not figure this out early on in life? Because this really would've been good for me,

Allie Broaddus (00:16):

<Laugh>. Yeah, it is. And an amazing way to reach children. And I'm not a licensed play therapist, but I use play to reach children every day.

Ric Shields (00:36):

Thank you for joining us on the Doorways Ministry Network podcast. I'm Ric Shields, your host. We're currently in a series with a focus on mental health. As a reminder, maybe it's a disclaimer. I am not a mental health professional. I've recently interviewed professional counselors who work with children and adolescents, and we will address a variety of issues in the episodes ahead. But also, we're going to include some mental health topics for adults. If you'd like us to consider a topic, drop me a note, an info at doorways, do cc and we'll work to develop an episode related to your suggestion.

(01:16):

My guest today is my friend Allie Broaddus, who is a clinical doctorate in occupational therapy from Washington University in St. Louis, Missouri. Thank you. And I'm going to go ahead and call you Dr. Broaddus. Thank you for joining me today.

Allie Broaddus (01:32):

Thank you so much for having me.

Ric Shields (01:34):

Yeah. You told me I don't have to call you that, but you work so hard to get this program and to earn this doctorate, so it's okay if I do that. We, we know that.

Allie Broaddus (01:44):

Thank you.

Ric Shields (01:45):

So, a couple of questions come to mind, Dr. Allie. First, how did you decide to get started down this path? And second, do you consider this as a job, a career, or is it more like a calling?

Allie Broaddus (01:59):

Yeah, so when first talking about how I got into the field of occupational therapy, there were a lot of things that I kind of experienced in high school and college that led me down this path. My youngest sister is autistic and she was also adopted later in life and had some, some early trauma that affected a lot of, you know, what she could do and different struggles that she had. And so, I was able to go with her to a lot of her therapy appointments and really loved what they did and what they were working on.

(02:29):

And then I also spent a couple summers working in China in a care center for children with disabilities who had experienced trauma and were kind of, were living in institutionalized care. And so that's kind of where my interests kind of developed. I loved working with these children with disabilities, but also kind of working in this field of trauma as well.

(02:51):

And then when looking at what I'm doing do I consider it a career or a calling? And I would say both. I only been graduated a few years and I love what I've been able to do and learn, but I do feel in a way that I am kind of created for this. I think a lot of my experiences leading up to this really prepared me for what I'm doing. And I think that's, that's a really special thing. Like to just feel like this is where I'm supposed to be and to feel just really...

Ric Shields (03:19):

And you're doing it.

Allie Broaddus (03:20):

I am.

Ric Shields (03:20):

Like where it's supposed to be. And you're doing it too.

Allie Broaddus (03:22):

Yes. Yes. And it was a long time coming. It was, I decided in later, like when I was 18 that this is what I wanted to do. So, it's really exciting to be here.

Ric Shields (03:32):

You heard my introduction. Please take a minute and expand a bit about your current focus as an occupational therapist. It might be really a good idea to start by helping us to understand what is occupational therapy. I've heard of physical therapy, maybe others, you know, know more about occupational therapy than I do, but what is it, what role can it play in mental health?

Allie Broaddus (03:53):

Occupational therapists and physical therapists often work really closely with each other. Occupational therapists focus tends to be kind of helping people be able to do all the things they want and need to do in their life. So, we can work on things with fine motor skills and cognitive skills and just a lot of these things that we take for granted every day that help us to kind of just live and have meaningful lives.

(04:18):

So, we work a lot in hospitals and outpatient clinics and schools and, and things like that. Our roots as occupational therapists are actually in mental health, but now most people kind of work in more of the physical health world and that's where a lot of people kind of understand occupational therapy to be.

(04:36):

But we really are, a lot of us are returning kind of to our roots and really delving into this mental health field because we know if people have struggles with their mental health, this is going to affect how they live their lives, their engagement in those occupations that they want to do in their everyday life. And so, it's a really exciting place to be. It's in a way kind of an emerging area. Kind of like returning to our roots, but a lot of people have been working in mental health for many, many years and been putting in the work. And so it's been really fun to kind of like learn from them as we're expanding in this area.

Ric Shields (05:13):

If I understand it correctly, you help people, especially children who are experienced or maybe have experienced trauma or they, they could experience it if the environment they currently occupy doesn't see meaningful change. So, when preparing for this episode, you told me that most people may not be aware of the effects of developmental trauma. So, what is developmental trauma? What does it look like? What are some of its effects on development?

Allie Broaddus (05:44):

Yeah, so developmental trauma is really going to refer to this trauma that happens in those early years. This is where, you know, a child is developing rapidly. So, this is, and this includes while they're developing in utero.

(05:56):

So early childhood trauma, this developmental trauma can affect all areas of development from their physical development to their cognitive development, how their nervous system develops and in turn this can affect, you know, are they meeting their milestones? Are they, are they able to connect socially? Are they able to participate in school? All of those things that kids do every day. And there's just a lot of misunderstanding about this kind of traumas impact on, especially things like behavior.

(06:28):

I think, you know, a lot of people kind of just think they're, you know, these children are being naughty when they maybe have these behavioral challenges. But when we look at it, a lot of us know kind of about this fight or flight response that many people have when they're experiencing danger, adverse events, stressors, fight or flight.

(06:48):

You know, fight would be you're preparing to fight off the aggressor or the stressor fight would be you're trying to flee from it and then freeze would be if you're kind of shutting down. And I see kids that respond to stressors in this way every day. And I just think it's really important for me and everyone to remember that many people, especially these children that I work with, they, these are survival mechanisms. These are things that have gotten them through really, really stressful times. They have kept them alive.

(07:19):

And so really kind of honoring all of those pieces of them while helping them to just be able to live life fully and really kind of resolve maybe some of these things that are causing these stress responses when maybe it's not needed anymore. And if it's, if it's causing them stress, then being able to address that. But just coming with from a place of understanding.

Ric Shields (07:39):

So how do you help them?

Allie Broaddus (07:41):

There's a lot of different things and it's going to depend greatly on the child and a lot of kind of the symptoms that they're presenting with. But the first thing is co-regulation. Children don't learn to regulate unless they see it modeled. And a lot of the kids I work with don't see it modeled healthily or regularly. And so, it's meeting them where they're at and helping them regulate whether, you know, that's through hugs and that's through playing with them. That's through all of these things, modeling these coping skills, but then of course addressing anything that is causing them stressors. So, if it's environmental things that we can fix, we're going to help fix those. We're going to help we're going to communicate with them, we're going to listen to them. But all the while helping them kind of develop more of those coping skills, more of those regulation skills, being able to kind of return into their own bodies so that they can tell us what is wrong and what would make them feel better. Those are all really empowering things that those are, that's where I start.

Ric Shields (08:40):

You're the second therapist I've spoken with in a couple weeks that talked about play therapy

Allie Broaddus (08:46):

<Laugh>,

Ric Shields (08:46):

And I'm going, what a great job this is. You get paid to play.

Allie Broaddus (08:49):

Yeah.

Ric Shields (08:51):

And how did I not figure this out early on in life because this really would've been good for me.

Allie Broaddus (08:57):

Yeah. It is an amazing way to reach children. And I'm not a licensed play therapist, but I use play to reach children every day. That is how children communicate. That's how children develop skills. That's how that's, it's so important. It is one of their primary languages. And so it is so fun that I get to just play every day with these kids.

Ric Shields (09:20):

You're listening to the Doorways Ministry Network podcast. My name is Ric Shields and I'm joined on this episode with Dr. Allie Broaddus, an occupational therapist who works especially with children who are experiencing developmental trauma.

(09:34):

Dr. Riley, what are some of the behaviors children display who are experiencing this? You've already talked about fight or flight and freeze, but what are some of these other behaviors?

Allie Broaddus (09:45):

I can break down some of these behaviors within those categories. So, these children that maybe they go to fight, they're going to maybe be yelling a lot more. There might be aggressive. We especially see the aggression for kids that maybe have witnessed domestic violence. It is very, very common for them to kind of, that's how then they start showing that they're stressed or that there's a problem. They're copying those kind of skills that they've

Ric Shields (10:10):

Yeah, just kind of a reflection of what they're seeing at home, isn't it?

Allie Broaddus (10:13):

Exactly, exactly. It is, it is very common. So those are like the big things that I see with fight. And then kind of flight is I have a lot of eloping behaviors, children that are just trying, they're not in, maybe they're not thinking rationally and so they're trying to run out of the building, trying to escape situations even if there's no danger present. But something's reminding them of that danger even if they can't communicate what it is and they don't even understand what it is.

(10:41):

As well as, you know, those children that are, maybe they go to the freeze, they're often a lot more, they might isolate a lot more, they're a lot more quiet and reserved. So those are a lot of behaviors I see every day. And all of them can be challenging because it's, it's hard to know how to meet these kids in the moment but being able to kind of understand where these responses are coming from is super important. And once I kind of can understand kind of where they're, where they go to when they're really stressed, that's when we can start working on these coping skills and these regulation skills so that they will learn to monitor kind of their own body state and be able to respond appropriately.

Ric Shields (11:19):

You told me the kids who've experienced developmental traumas can sometimes have sensory issues similar to those with autism. When you told me that I have some ideas what that may mean but tell me what you're talking about.

Allie Broaddus (11:32):

There's a lot of kind of emerging research in this area. I do want to clarify, a lot of my kids are diagnosed autistic or suspected autistic. And so a lot of these things I see in my autistic kids and then my, my typically developing kids or the kids that maybe they don't have a diagnosis, there is some differences when I see maybe a, a child who is diagnosed autistic as opposed to maybe a child who isn't sensory sensitivities. These are, we typically kind of categorize them into hypersensitivity and hyposensitivity. Not that one kid will be hyper and not hypo. They often exist together. But if you're hypersensitive, you might get really anxious when there's loud noises or bright lights or multiple people or maybe different textures. You might have those aversions to different foods like the textures of foods you don't, like the tags maybe in your clothes.

(12:28):

Whereas hypo is, are a lot of kids that are responsive to sensory input. So, they crave it, right? They want their music loud, they want brighter lights. They are often also ones that maybe will do some self-injurious behavior. They might be doing the head banging or things like that. I see this, all of these things and so many of the kids I work with.

(12:51):

But one thing that I do always keep in mind is that sometimes what we see as a sensory, like sensitivity the root is in maybe a traumatic trigger. A good example is one area where kids or people may struggle with sensory experiences is what we call interoception. This is what's happening within our body and how we're able to understand body signals. I have a lot of kids that seem to be really under responsive. They don't know what's going on in their body.

(13:21):

They may have a really high pain threshold or they're maybe not getting dizzy even though they're running in circles a lot. But one area that I see a lot is kids that don't understand when they're full. And so, they might eat a lot, but this starts to maybe make sense when I recognize a lot of my kids have had food insecurity and they've had to one kind of, their responses to hunger have been dull because they've been hungry a lot.

(13:47):

And that's how you learn to survive cognitively, right? You're, you start to disconnect from your body and you're taught that when you have food, you eat it all as fast as you can because you don't know when you're going to get food again. So, all of this can affect how we exist in our bodies. That is one reason why a lot of these kids might have some of these sensory sensitivities that maybe it's not the same reason an autistic child may. And it may also be because we do know trauma affects the development and sensory experience is interpreted by the nervous system, which is largely affected.

(14:20):

So, there's a lot of research in this area. But yes, most of my kids do have sensitivities and really, really benefit from sensory activities. So, I always have so many sensory activities with me because those can be really calming and regulating for most of my kids.

Ric Shields (14:36):

I understood you to say it's quite common to find children with developmental traumas who are in crisis care.

Allie Broaddus (14:43):

Yes.

Ric Shields (14:43):

So please give me some examples. What do you mean when you talk about crisis care? What is that?

Allie Broaddus (14:48):

Crisis care. I work in crisis care. I work in a community practice that is really serving families that are going through acute crises. Many of these families have turned to, you know, their, their resources have run out. They're maybe their family resources, different things. And so, they're really relying on the community to help them through really, really hard times.

(15:12):

A lot of these families and a lot of these kids have already experienced a lot of trauma by the time they get to our doors. So, a lot of my kids, you know, they're fleeing domestic violence situations right then. So, they're undergoing trauma while they're walking in to my doors. That is, I think one of the biggest places that you will see kids who've experienced trauma is in kind of these crisis care situations. Because so many of these kids that maybe they're experiencing community violence and poverty, there's so many barriers to accessing regular therapeutic support. And so, it ends up being when they're in a crisis and they're in these crisis care situations that they're able to kind of get the support that they need.

Ric Shields (15:53):

One of the goals that you've talked about with me is looking at this issue through a lens of prevention. Specifically, the prevention of developmental trauma through childhood neglect and abuse. So how can you do that?

Allie Broaddus (16:08):

I'm really thankful to work in an organization where this is the forefront of our mission. We have our services there to kind of reach these families and these children before abuse happens as much as possible. because We know that, you know, a lot of these things, these families are going through things like poverty and violence and, and just all of these things can oftentimes lead to abuse or neglect even, you know, if it's, it's unintentional, but those things can happen. And so...

Ric Shields (16:39):

Just the big stressors in people's lives that make it so they do things they didn't, don't really want to do, but they did them. It's hard.

Allie Broaddus (16:47):

Exactly. And we know...

Ric Shields (16:49):

The base nature of us just comes out, doesn't it?

Allie Broaddus (16:51):

Exactly. And so, we really want to reach these families before these children are abused. Before, you know, maybe if they don't get support, maybe these children would have to be removed from their home. And we just really don't want that to happen. And so kind of coming along these side families before it gets to that point.

(17:11):

And I love what I do because I can kind of support these children through their trauma. And also help kind of with them to just develop new skills which can also, you know, help their families to be able to kind of respond to their needs. I also provide educational resources and support to the families as I'm able to, which all just kind of helps with that prevention piece.

Ric Shields (17:34):

Can you share some success stories with us?

Allie Broaddus (17:37):

There's so many. I just, every day I feel like there's something that I learn. But one story always stands out to me. A lot of my kids, right, don't have a disability, but some of them do. And I was working with a little girl that did have a disability that affected how she was able to move her body. She was just a little kid and her family was obviously going through some really, really hard times. And I was able to work with her and help her just be able to engage in play using her feet as opposed to her arms. because She had very limited use in her arms and talk to her mom afterwards and supply her with toys, cause and effect toys she could use. Her mom was very emotional because her mom said she didn't know that she knew how to play.

(18:24):

So, being able to work with this girl and her mom to just kind of open up this world through play, right? This, this is the language of children was really, really special. And then when I was able to see them again, she was able to tell her progress and the new toys that she was able to activate with her feet, which was super, super fun.

(18:43):

So, it was really partnering with these families as they were going through these hard, really hard times, but really showing them right that their child is perfect how they are and has so much meaning and so much life. It was just like a really, really sweet thing, a sweet experience that I got to have.

Ric Shields (19:01):

We need to draw our time to a close. I wonder, do you have any special words of encouragement you'd like to share with those who are listening today?

Allie Broaddus (19:08):

Just a reminder that there's so much behind so many things that you don't see. And really when you see a child that maybe does have these challenging behaviors to kind of come with curiosity and compassion. And that doesn't mean, you know, we allow behaviors that are destructive, but it's really just looking at a child and respecting who they are and remembering that behaviors is often communication in a message and that every child deserves to be heard and seen instead of being labeled.

Ric Shields (19:42):

Children are amazing. They come with no preconceived notions of prejudice or privilege. Those are learned behaviors.

(19:51):

There are other learned behaviors too. Dr. Allie Broaddus highlighted some of them for us: fight, flight, and freeze. Kids weren't born that way. For some, their behaviors are reflections of what they've seen at home. Others have developed, learned responses that they use as survival skills.

(20:13):

Moms and dads, grandmothers and grandfathers, extended family and friends; our behaviors and the ways we respond to each other can be deposited into the lives and minds and hearts of the children God has entrusted to us, whether positive or negative, healthy or unhealthy, godly or ungodly kind or cruel, generous or greedy, encouraging or cynical. You have the ability to imprint behaviors and attitudes on the children in your charge.

(20:54):

Abuse, trauma and violence are like ravenous wolves waiting to attack your home and your child's emotional health. But if you don't feed those wolves, they will eventually turn on each other.

(21:10):

In the New Testament book of Mark chapter 10, we read that Jesus loved the children, held them close to himself and blessed them. May his example be our guide as we make every effort to raise spiritually, physically, and emotionally healthy children within our spheres of relationship and influence.

(21:34):

Until next week, grace and peace to you and to those you love.