Should we hold back on diagnosing children?

Should we hold back on diagnosing children? 150 150 Jane Evans

“Of course Jane I know you don’t like diagnoses for children.”

Where do you sit when it comes to diagnosing children based on their behaviour? During a recent discussion, not for the first time, the above comment was levelled at me. I can’t deny it’s true BUT I can qualify it, and I did. So I wondered if it would be useful to share it with you too?

How often do you hear there’s something ‘wrong’ with a child because their behaviour is difficult, confusing, highly erratic and doesn’t respond to reason, rewards or incentives? Have you ever googled, Signs of…. Or why does my child…Or does my child have ADHD, ADD, ODD etc? Understandable, especially when far too many professionals go this route quite quickly these days. But this is often without considering a child’s pre-birth, birth and early years experiences.

As a former foster carer, who began learning about developmental trauma to better understand the children’s needs. And someone who has worked with children, young people, birth and adoptive parents, foster and kinship carers for 25 years, I know a thing or two about the very real existence of, and impact of developmental trauma.

Let me be crystal clear…

I am NOT medically or therapeutically trained or qualified so I am not telling anyone what to do. I am merely urging everyone to ALWAYS be curious about any trauma in a child’s early life.

If you are concerned about a child’s mental or physical health and/or safety because they are harming themselves, talking about it, or perhaps about killing themselves…


Contact a helpline ASAP. In the UK, Young Minds has a helpline .  Most countries will have something similar. Search online, Helpline forParental support for my child’s self-harm/mental health/suicidal thinking, or something similar.

Get an emergency doctor’s appointment or even go to the emergency department if it is happening.


Get informed and educated as well as you will always be their most precious resource.

Why EVERYONE MUST consider developmental trauma

Ready for a shock? Many professionals who work with children on a daily basis and/or who explore their specific needs, or diagnose and suggest treatments. ARE NOT routinely trained to recognise and understand the impact of early developmental trauma. In fact many don’t even know what causes developmental trauma, or that it exists. And, that in its broadest sense, trauma can come from what a baby experiences whilst developing in the womb during a very stressful pregnancy, or living through a difficult birthing experience.

Then there is emotional trauma which is very common, but again poorly understood. For example, growing up with adults who are constantly distracted so they are emotionally and physically distant. This creates a level of ongoing stress and distress a baby or child can’t escape from but will feel deeply. All this at a time when their brains and bodies are at their most vulnerable stages of development.

What goes wrong for far too many children

Because doctors, paediatricians and mental health professionals have not extensively studied the neuroscience, neurobiology and neurophysiology of developmental trauma. They are less likely to gather the much needed micro details of a child’s life. If they did, surely fewer children in foster or kinship care, or in their adoptive families, or post domestic and other abuse, would be diagnosed with the endless list of things they are.

Likewise we wouldn’t have children, with trauma, taking medication that’s not recommended for someone at their developmental age or stage. Now, let’s be clear, there is sometimes room (although the more I study the less I’m convinced) for short term medication in some situations. Otherwise, we should be robustly implementing what is globally known, about what trauma DOES respond to and need. All from a place of real curiosity and compassion as trauma is complex and one-size does NOT fit fall.

Where to begin?

Doctors or pediatricians need to be taking a full and extensive history of all that is known about the child from conception (although even before this is also helpful e.g. how stressed the parents were, what jobs they were doing and their childhood trauma), through to now. Of course, with a child who has been removed from their birth family, this is not possible in a detailed way. But common sense should dictate that these experiences alone, will have been traumatic! Or, if their removal was because of a catastrophic event, such as a parental bereavement or accident. 

If a detailed history, along with all the people and factors that will have been a protective force, was routinely undertaken. I wonder how many children would be seen as having trauma rather than a condition

Let’s be optimistic

There are amazing body-based and sensory therapies and tools that DO help children with developmental trauma. And I would always prescribe the powerful therapeutic grade essential oils I use, because they are natural and very effective. Furthermore, there are people like myself, and many others, who work with parents and carers to explain and support them in caring for the children in a way that works with the child’s trauma based behaviours, responses and needs.

Sadly, simply knowing a child’s lack of concentration, huge outbursts, issues with eating, tolietting, refusing to budge, lashing out, jumping from one thing to another, becoming totally immobile, getting stressed by any and everything, are trauma based reactions, won’t take it all away. Likewise, being told that a child’s early experiences mean they have been traumatised, will rarely bring extra funding and support, EVEN THOUGH it SHOULD do! Developmental trauma being misunderstood, dismissed or totally overlooked by so many professionals, continues to fail the children and everyone who is there to care, love and support them…and that is NOT OK!

Thank you

A word of gratitude to the teachers, teaching support professionals, early years practitioners, foster and kinship carers and adoptive parents, who often approach me at the end of my keynote presentations and training days. Telling me how they are strongly advocating for children they care for who are being catapulted towards a diagnosis. These adults are often distressed, because, given what they know about the children and their histories, and having some additional trauma information, they want the child’s experiences of trauma to be considered first, before a label or diagnosis.

Meanwhile, the trauma greats such as Judith Herman, Bruce Perry, Peter Levine, Pat Ogden, Bessel van der Kolk, Gabor Mate, Stephen Porges and many others, continue their 30 years, or more efforts to bring all their research findings on developmental trauma to the forefront of everything that is done to and with children. And, along with the incredible Beacon House, Dr Karen Treisman, Mike Armiger, Lisa Cherry, Betsy de Thierry, and so many more of my esteemed UK colleagues who do so much to raise understanding of what early trauma is, how it shows up and what children need. I will keep on keeping on, as that’s what the children need us all to do.

Learn more…

Watch these short videos How trauma affects the brain childhood trauma and abuse Trauma, brain development and relationship

Check out…

The Child Trauma Academy

Beacon House


The boy who was raised as a dog by Bruce Perry and Maia Szalavitz   

Jane Evans

Jane is a ‘learn the hard way’ person. She has learnt from her personal experiences and her direct work with people who have often been in really bad places emotionally, relationally, practically and sometimes professionally.

All stories by: Jane Evans

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