Trauma, Adversity, and Parent–Child Relationships AmongYoungChildren Experiencing Homelessness

Janette E. Herbers & J. J. Cutuli & Amy R. Monn &

Angela J. Narayan & Ann S. Masten

# Springer Science+Business Media New York 2014

Childhood adversity and potentially traumatic experienceshave been associated with increased risk for emotional andbehavioral problems (Davies et al. 2006). Psychological trau-ma occurs when an individual faces a situation that is life-threatening or causes terror to the extent that it disrupts func-tioning, requiring a righting response (Kiser and Black 2005;Van der Kolk 2003). When young children face overwhelm-ing threats to their safety or security without counteractinginfluences, the impacts can disrupt development across levelsof functioning with long-term consequences for behavior,physiology, emotion regulation, cognitive processes, socialrelationships, and health (Shonkoff et al. 2009; Van der Kolk2003). However, many children who experience significantadversity demonstrate resilience, functioning well in spite ofthe risks (Rutter 2013). Understanding how resilient childrennavigate potentially traumatic experiences can inform effortsto intervene and prevent negative outcomes for others insimilar circumstances. This study examined exposure to po-tentially traumatic events among children residing in emer-gency housing with their families. There were three maingoals of the study: to describe the experiences of these chil-dren; to examine the associations between cumulative adver-sity, trauma symptoms, emotional/behavior problems, andexecutive functioning; and to test parenting quality observedin parent–child interactions as a correlate and moderator ofthese outcomes.

Children who experience homelessness fall at the high endof a continuum of poverty-related risk (Masten et al. 1993;Samuels et al. 2010). In addition to the risks associated withextreme poverty, homeless children face residential instabilityand higher rates of recent stressful and potentially traumaticlife events than children who are poor but stably housed(Masten et al. 1993; Miller 2011). Homeless children alsotend to show difficulty with self-regulation skills and havehigher rates of behavioral and emotional problems comparedto non-homeless peers (Buckner et al. 2003; Samuels et al.2010). These risks likely are related, such that stressful lifeevents occurring within a context of unremitting poverty-related risk result in prolonged activation of the body’sstress-response systems, disrupting neurocognitive, behavior-al, and emotional development (Cutuli et al. 2010; Shonkoffet al. 2009). With high rates of family homelessness in recentyears (U.S. Department of Housing and Urban Development2013) many children are at risk for experiencing trauma in thecontext of homelessness and poverty. Resilience science ingeneral, and efforts to intervene with homeless children inparticular, can benefit from a better understanding of howtrauma negatively impacts young children experiencinghomelessness and how protective factors may mitigatethese risks.

Trauma reactions in children often are complex. Childrencan be traumatized by events that directly threaten their ownsafety or integrity, such as maltreatment, natural disaster, orinjury (Lieberman and Knorr 2007; Van der Kolk 2003).Exposure to trauma is associated with a range of difficultiesin children, including specific symptoms of post-traumaticstress disorder, general symptoms such as separation anxiety,hyperactivity, and irritability, and problems with cognitivecontrol or executive functions, including poor executive at-tention and inhibitory control (Blair and Raver 2012; Davieset al. 2006; DePrince et al. 2009; Evans and English 2002;Van der Kolk 2003). For young children, the impacts oftrauma exposure occur within the family context (David

J. E. Herbers (*)Department of Psychology, Villanova University, 800 E. LancasterAvenue, Villanova, PA 19085, USAe-mail: janette.herbers@villanova.edu

J. J. CutuliDepartment of Psychology, Rutgers University - Camden, ArmitageHall, Room 308, 311 North 5th Street, Camden, NJ 08102, USA

A. R. Monn :A. J. Narayan :A. S. MastenInstitute of Child Development, University of Minnesota,51 E. River Parkway, Minneapolis, MN 55455, USA

J Abnorm Child PsycholDOI 10.1007/s10802-014-9868-7

et al. 2012; Scheeringa and Zeanah 2001; Van der Kolk 2003).Young children depend on their caregivers to provide basiccare, structure, protection, and assistance in understandingtheir experiences (Sroufe et al. 2005). Thus children’s adjust-ment following trauma partly depends on responses of care-givers (Kiser and Black 2005; Lieberman and Knorr 2007;Scheeringa and Zeanah 2001). Often, the relationship betweentraumatic experiences and child symptoms or executive func-tioning is mediated entirely or partially through parent stressor caregiving behavior (Blair et al. 2011; Briggs‐Gowanet al. 2010; Lieberman and Knorr 2007; Scheeringa andZeanah 2001).

Children also may be traumatized by events that threatentheir caregivers, such as a parent injured by another person orcompromised by mental health problems (DePrince et al.2009; Kiser and Black 2005; Scheeringa and Zeanah 2001).Events that interfere with caregivers’ ability to provide sensi-tive parenting, or respond to heightened needs of a distressedchild, appear to place children at the highest level of risk for avariety of problems (Cook et al. 2005; Margolin andVickerman 2007; Scheeringa and Zeanah 2001). Conversely,a parent who copes effectively with distress and maintainsstructured parenting and appropriate responsiveness to herchild can provide a buffer, rendering the stress tolerable andprotecting critical developmental processes (Martinez‐Torteyaet al. 2009; Shonkoff et al. 2009).

Parenting characterized by warmth, structure, and respon-siveness is consistently associated with positive child out-comes, such as better self-regulation, executive functioning,and fewer behavioral and emotional problems in both highand low risk contexts (Bernier et al. 2010; Dennis 2006; Evansand Kim 2012; Gilliom and Shaw 2004). This associationlikely reflects processes of parent–child co-regulation, inwhich a parent and child alter their behaviors in response toand anticipation of each other’s behavior (Fogel 1993). Thecaregiver defines the quality of parent–child interactions byresponding to the child’s behavioral cues and physical andemotional needs; the child then internalizes these experiences,creating a foundation for a sense of safety, trust, and self-efficacy as well as the developing capacity for self-regulation(Calkins and Hill 2007; Sroufe et al. 2005). Children incaregiver relationships marked by more positive co-regulation are expected to navigate developmental tasks andmanage stress more effectively than children whose experi-ences are less nurturing and responsive.

Positive co-regulation with caregivers could serve as apowerful protective factor for children in contexts of chronicand acute stress related to homelessness, including experi-ences of trauma. Children experiencing homelessness andother potentially traumatic events without adequate supportfrom caregivers face increased risk for poor executive func-tioning and emotional/behavior problems. In the presentstudy, we expected a cumulative score of children’s adverse

experiences to predict child trauma symptoms,emotional/behavior problems, and executive functioning.We expected positive co-regulation within the parent–child relationship to relate directly to better functioning,consistent with a promotive effect, and to moderate theimpact of trauma on child outcomes, consistent with aprotective effect.

Method

Participants and Procedures

Participants were recruited from three emergency shelters forfamilies in a large urban area during the summers of 2008 and2009. Children ages 4 to 6 years (M=5 years, 9 months,SD=7 months) participated with their primary caregivers(N=138). Eligible children were entering kindergarten or firstgrade the subsequent fall, children and caregivers spoke En-glish, and children did not have identified developmentaldelays that would interfere with cognitive assessments. Over-all, 72 % of eligible families participated.

The mean child age was 5 years, 9 months (SD=7 months)and 78 (56 %) were female. The majority of children wereAfrican American (66.6 %) or Multiracial (15.9 %); the re-maining children were White (6.3 %), American Indian(6.3 %), or some other race (6.3 %). Most families wereheaded by single parents, and most primary caregivers werebiological mothers (92.7 %).

Research staff met with each family onsite in shelter. Eachchild completed a series of cognitive assessments with stan-dardized administration lasting about one hour while theparent completed an interview in a separate room. Next, theparent and child participated together in a series of eightstructured interaction tasks that were video-recorded for latercoding. The tasks presented a variety of situations for observ-ing parenting, including free play, clean-up, problem-solvingdiscussions, teaching tasks, and games. Detailed descriptionsof the parent–child interaction tasks are available elsewhere(Herbers 2011).

Measures

Adversity Primary caregivers responded to a list of 20 nega-tive lifetime events, indicating whether their children had everbeen victims of violence or accidents, witnessed violence intheir families or communities, experienced deaths in the fam-ily or mental or physical illness of parents, among others (SeeTable 1: Masten et al. 1993). The total number of differentevents endorsed for each child formed an index of potentiallytraumatic experiences.

J Abnorm Child Psychol

Trauma Symptoms

For children who experienced any negative lifetime event(n=126), caregivers responded to seven items designed tomeasure traumatic stress symptoms (e.g., becomes very fright-ened when reminded of something bad that happened, talksrepeatedly about something bad that happened; see Table 1).Cronbach’s alpha for the seven items was 0.67. The number oftrauma symptoms endorsed was summed for each child, rang-ing from 0 to 7.

Emotional/Behavior Problems

Primary caregivers also completed the Child Behavior Check-list (CBCL: Achenbach and Rescorla 2001), to indicatewhether each child never, sometimes, or often demonstratedany on a diverse list of psychiatric symptoms. Either of twodifferent forms of the CBCL was used as appropriate(1.5–5 year-old form versus 6–18 year-old form), and awithin-form total problems z-score was computed for each

child depending upon the form that was administered. Thesez-scores were then merged across study participants.Cronbach’s alpha for the total problems scale wasapproximately 0.93 within the sample.

Positive Co-regulation (PCR)

Parent and child behavior during interaction tasks were codedseparately by two teams of raters, then durations of eachcombination of parent and child behaviors were calculatedusing Gridware 1.1 and state space grid methodology(Hollenstein 2007; Lamey et al. 2004). All parent behaviorswere coded into four mutually exclusive categories: positivecontrol, negative control, non-directive responsiveness, anddisengaged. Positive control behaviors included parent effortsto guide, teach, or direct the child with positive or neutralaffect. Negative control behaviors were those with negativeaffect or other hostile, intrusive, or rejecting behavior towardsthe child. Non-directive responsiveness included behaviorsthat were responsive and warm or neutral in tone but not

Table 1 Endorsement rates ofstressful lifetime events and trau-ma symptoms

Life event n %

Lived in home with fights or severe relationship problems between adults 48 34.8

Had a parent in prison 45 32.6

Divorce or permanent separation of parents 41 29.7

Separated from parents for more than two weeks 39 28.3

Seen violence happening to people 35 25.4

Hospitalized 34 24.6

Seen parent injured by another person 28 20.3

Lived with parent who had a mental illness 27 19.6

Lived with parent who had a serious drug/alcohol problem 17 12.3

Been in a serious accident (car, bike, boat) or nearly drowned 14 10.1

Lived with parent who had a serious physical illness 13 9.4

Witnessed a serious accident involving a car, plane, or boat 10 7.2

Been attacked by an animal 10 7.2

Been in a house fire 9 6.5

Lived in a foster home 7 5.1

Victim of physical violence 7 5.1

Experienced a natural disaster 7 5.1

Death of parent 3 2.2

Death of sibling 3 2.2

Been kidnapped 2 1.4

Trauma symptom n %

Talk repeatedly about event 33 23.9

Worry about something terrible happening 32 23.2

Startle easily or seem jumpy 23 16.7

Nightmares 19 13.8

Extremely frightened by reminders of event 19 13.8

Avoid reminders of event 14 10.1

Playing games about event 5 3.6

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aimed at controlling or directing the child. Disengaged behav-iors included being distracted, ignoring, looking away, orotherwise withdrawing from interaction.

All child behaviors were coded as on-task, withdrawn,signaling/bidding, or disobedient/defiant. On-task was codedwhen the child was actively, appropriately engaged with theparent or task. Withdrawn involved distracted or disengagedbehaviors. Signaling/bidding included child behaviors indi-cating need for assistance, support, or external regulationwithout defiance. Disobedient/defiant behaviors were op-positional, aggressive, or hostile. Coding teams wereindependent of each other and blind to other measures.Each team consisted of a primary coder and a reliabilitycoder who completed 30 % of the cases. Observeraccuracy, calculated based on the kappa statistic andthe observed base rates of behavior in the sample(Bruckner et al. 2006), ranged from 0.85 to 0.96.

The PCR measure reflects the proportion of parent–childbehavior combinations presumed to represent appropriate par-ent engagement or response to the child: positive control withany child behaviors, non-directive responsiveness with childon-task and signaling/bidding, and parent disengaged withchild on-task (M=0.76, SD=0.105). Additional details on the

methodology regarding the PCR variable are available else-where (Herbers 2011).

Executive Functioning

Children completed a series of six behavioral tasks designedto measure executive functions, emphasizing inhibitory con-trol, working memory, set-shifting, and delay of gratification.These were the Simon Says task (Kochanska et al. 1997;Strommen 1973), theDimensional Change Card Sort (DCCS:Zelazo 2006), the Peg-Tapping task (Diamond and Taylor1996), the Computerized Pointing Stroop task (Berger et al.2000), the Dinky Toys task (Bruce et al. 2009), and the GiftDelay task (Kochanska et al. 1997). Details on these tasksincluding coding and reliability for use in this study can befound elsewhere (Masten et al. 2012). Overall EF scores werecomputed based on averaging z-scores from each task(Cronbach’s alpha=0.71). Assessments were valid, reliable,and distinguishable from IQ (Masten et al. 2012).

Child IQ

Estimates of child intellectual functioning were based onscores from two subscales (Block Design and Matrix Reason-ing) of the Wechsler Preschool and Primary Scales of Intelli-gence, Third Edition (WPPSI-III: Wechsler 2002) and thePeabody Picture Vocabulary Test, Fourth Edition (PPVT:Dunn and Dunn 2007). Block Design and Matrix Reasoningare two subscales from the WPPSI-III that measure fluidintelligence (Wechsler 2002). Scaled scores from the twosubscales (r=0.29) were averaged as an indicator of nonverbalintellectual functioning. The PPVT-IV is a standardized as-sessment of receptive vocabulary, or verbal intellectual func-tioning. Z-scores of the PPVT-IV score and the WPPSI-IIIcomposite (r=0.35) were averaged to create an estimate of thechild’s general intellectual functioning (IQ).

Results

Parents reported a range of potentially traumatic experiencesfor their children. The average number of stressful life eventswas 3.05 (SD=2.31, range 0–10), and each event on themeasure was endorsed for at least one child in the sample.Parents reported 1.05 child trauma symptoms on average(SD=1.42). Numbers and percentages of all stressful lifetimeevents and trauma symptoms are presented in Table 1. Ratesof total emotional/behavior problems endorsed on the CBCLwere above averages based on general norms, with averagetotal problem T-scores of 52.8 (SD=11.5) for children underage 6 and 58.3 (SD=10.0) for age 6 or older. In this sample,28 % had total problem T-scores above 60, which is the

Table 2 Results of hierarchical linear regressions

Traumasymptoms β

Totalproblems β

Executivefunctioning β

Age 0.10 0.01 0.33*

Sex −0.09 0.14 −0.10IQ 0.12 −0.14 0.42*

ΔR2 0.04 0.04 0.34*

Age 0.08 −0.02 0.32*

Sex −0.08 0.14 −0.10IQ 0.06 −0.19** 0.40*

Adversity 0.41* 0.37* 0.14†

ΔR2 0.16* 0.13* 0.02

Age 0.08 0.01 0.30*

Sex −0.07 0.16** −0.12IQ 0.09 −0.13 0.35*

Adversity 0.42* 0.40* 0.12

PCR −0.17** −0.40* 0.30*

ΔR2 0.03** 0.15* 0.09*

Age 0.10 0.02 0.31*

Sex −0.10 0.14 −0.14IQ 0.06 −0.15* 0.33*

Adversity 0.47* 0.45* 0.15**

PCR −0.17** −0.40* 0.30*

PCRxAdversity −0.17† −0.17** −0.14**ΔR2 0.03** 0.03** 0.02†

Total R2 0.26* 0.35* 0.47*

*p<0.01, **p<0.05, † p<0.10

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recommended clinical cut-off for the measure (compared tothe normative expected rate of 18 %).

Separate linear regressionmodels were run for outcomes oftrauma symptoms, emotional/behavior problems, and EF,with predictors added in ordered steps to test the significanceof incremental or explained variance afforded by each step(ΔR2). All models included control variables of child age, sex,and IQ in the first step. Next, adversity, parenting, and theinteraction term of adversity and parenting were entered con-secutively.When the interaction term contributed significantlyto variance explained, interactions were probed with post-hocanalyses to determine regions of significance for simple slopes(Preacher et al. 2006). Results are presented in Table 2.

When predicting trauma symptoms, adversity contributedto variance explained in the second step and emerged as asignificant predictor. PCR alsomade a significant contributionin step 3. Addition of the interaction term resulted in a signif-icant increment in explained variance, with the negative coef-ficient indicating that the association of adversity with traumasymptoms was attenuated for individuals with higher levels ofPCR. The simple slopes of trauma symptoms on adversitywere significant at the mean of PCR (slope=0.30, p<0.001) aswell as one standard deviation above (slope=0.17, p=0.015)and below the mean (slope=0.42, p<0.001). As shown inFig. 1, children who experienced three or more lifetime eventsand who also had less positive parenting had more traumasymptoms on average.

A similar pattern emerged in the model predicting overallemotional/behavior problems. Adversity explained an additional13 % of the variance in emotional/behavior problems. PCR alsocontributed to the variance explained. Finally, the interactionterm explained an additional 2.5 % of the variance. Again, thenegative coefficient associated with the interaction term indicat-ed that the association between adversity and emotional/behavior problems was weaker for individuals who experiencedmore PCR. Simple slopes of emotional/behavior problems onadversity were significant at one standard deviation above themean (slope=0.42, p=0.004), at the mean (slope=0.42,p<0.001), and at one standard deviation below the mean ofPCR (slope=0.27, p<0.001). Thus children at higher levels ofPCR had fewer emotional/behavior problems (see Fig. 1).

For the model predicting child EF, adding adversity in step2 did not result in a significant incremental variance ex-plained. In step 3, PCR did make a significant contribution.The interaction term did not produce a significant increment inexplained variance.

Discussion

Young homeless children in the sample experienced a range ofpotentially traumatic events, and these experiences were as-sociated with traumatic stress symptoms and other emotional/

behavior problems. Common experiences includedwitnessing violence within their families or communities andseparation from caregivers. Young children depend upon theircaregivers not only for physical care and protection, but alsofor comfort, support, structure, and guidance, especially intimes of stress. Threatening the child’s access to that caregiver,or threatening the caregiver’s ability to provide co-regulation,also threatens the safety and integrity of the child (Liebermanand Knorr 2007; Van der Kolk 2003).

While it is certainly important to consider whether traumat-ic experiences may be contributing to emotional/behaviorproblems in any young child (Margolin and Vickerman2007), this issue is particularly relevant to children experienc-ing homelessness, for whom histories of trauma are likely andrates of emotional/behavior problems tend to be elevated(Miller 2011). Understanding the emotional and behavioraldysregulation of children in the context of past and ongoingadversity will better inform efforts of parents, educators, phy-sicians, shelter providers, and mental health clinicians tosupport these children towards resilient outcomes.

Relationships with caregivers are important adaptive sys-tems for children coping with stress and trauma. Parents andother caregivers can provide some protection from the nega-tive impacts of adversity through supportive parenting behav-ior. In the current study, homeless children who experiencedparenting characterized by positive structure, direction, andresponsiveness had fewer trauma symptoms and feweremotional/behavior problems. Also, the association betweenpositive co-regulation and reduced symptomswas stronger forchildren who had experienced more adversity. For traumasymptoms and emotional/behavior problems, PCR likelyplayed both a promotive role, helping all children, and pro-tective role, buffering the impact of stress for children whoexperienced higher levels of trauma and adversity. PCR alsowas related to better EF in children, although the interactionterm of parenting and adversity did not contribute significant-ly to the explained variance in EF skills. Moreover, adversityhad a modest relation to EF skills, and the association waspositive rather than negative. This was contrary to expecta-tions. Additional research should examine how other factorsnot considered here might influence the development of EF incontexts of very high risk.

The present study contributes detailed information on trau-ma in a representative sample of young children residing inemergency shelters, a population at high risk for poor out-comes and a group more likely to experience trauma. As such,homeless children are deserving of continued attention tobetter understand their challenges and the complex develop-mental processes that underlie adaptive functioning. Thisstudy included multiple types of trauma, well-establishedmeasures of executive functioning and child emotional/behavior problems, and observational measures of parent–child co-regulation.

J Abnorm Child Psychol

As a limitation, all measures were gathered concurrently,thus relationships among variables are correlational with noevidence of causality or change over time. While the measureof PCR was dyadic, accounting for differences in child be-havior when making judgments of parent behavior, it is stillpossible that associations of PCR and outcomes reflect achild-driven effect wherein children with more behavior prob-lems are more difficult to parent. Another limitation involvesthe wording of the negative lifetime events questionnaire thatdid not specify whether the parent mentioned in certain items

(e.g. “lived with parent who had a serious drug/alcohol prob-lem”) was the observed parent or a different parent figure. Ifthe observed parent was implicated in these items, this couldimpact the association between adversity and the quality of theparent–child relationship.

Furthermore, a stay in shelter is a time of acute crisis formany families, and some disruptions in child behavior andfunctioning may be temporary responses to this crisis. Otherstudies with homeless families have indicated improvements inbehavior over time as families stabilize (Samuels et al. 2010),

Fig. 1 Interaction effects

J Abnorm Child Psychol

though links among trauma history, parenting, and child func-tioning likely maintain. Additionally, the current study com-bined discrete traumatic events with ongoing or repeated trau-matic events that are sometimes referred to as “complex trauma”and considered qualitatively different (Margolin and Vickerman2007). Future studies with larger samples could examine differ-ences in the impacts of discrete versus ongoing traumatic expe-riences and change over time in child and family functioning todescribe the impacts of homelessness on the interplay amongtrauma, parent–child relationships, and child functioning.

Young children who experience homelessness face consid-erable risks for healthy development, including chronicstressors associated with extreme poverty as well as potential-ly traumatic events that can disrupt functioning and challengedeveloping capabilities for emotional and behavioral regula-tion. Results of this study support not only the link betweenadversity and children’s symptoms of trauma and otheremotional/behavior problems, but also the importance of pos-itive parent–child relationships to buffer children from trauma.The complexity inherent in the developmental phenomena oftrauma, risk, and resilience warrants additional researchamong homeless and other high-risk populations with carefulconsideration of individual differences embedded within chil-dren, families, and socio-cultural contexts.

Acknowledgments This work was supported in part by a grant fromthe National Science Foundation awarded to the University of Minnesota(Ann S. Masten PI; NSF; #0745643) as well as a grant from the Univer-sity of Minnesota’s Center for Neurobehavioral Development (CNBD) toJanette Herbers, predoctoral fellowships awarded to J. J. Cutuli from theCNBD and to Cutuli and Angela Narayan from the National Institute ofMental Health (NIMH; 5T323MH015755), and an NSF fellowship toAmy Monn. Any opinions, conclusions, or recommendations expressedin this paper are those of the authors and do not necessarily reflect theviews of NSF, NIMH, the CNBD or the University of Minnesota.

This work was also made possible by the extraordinary efforts andsupport of a large collaborative team including the following: Jim Minor,Dan Goodermont, and Kelly Rogers from People Serving People; MaryJo Copeland, Charlotte Kinzley, and Chris Moore from Mary’s Place;Betsy LaMarre-Maddox from St. Anne’s Place; Elizabeth Hinz, MargoHurrle, Dave Heistad, and Alex Chan from the Minneapolis PublicSchools; Becky Hicks from the St. Paul Public Schools; and numerousfaculty, staff, and students from the University of Minnesota, as well asmany principals and teachers from both local and distant school districts.We are especially grateful to the children and families of People ServingPeople, Mary’s Place, and St. Anne’s Place who took time during a periodof family challenges to participate in this research.

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