Foster Children – Is It PTSD, or Complex Trauma Instead?

I thought I spent most of my life suffering from PTSD (Post-Traumatic Stress Disorder), RAD (Reactive Attachment Disorder), sleep disorder, a communication disorder, and other disorders commonly placed on the heads of foster children.

But then I learn about PTSD’s larger and meaner cousin called ‘Complex Trauma’. Now I had one label for a multitude of sins, so to speak.

From the article, “Complex Trauma in Children and Adolescents,” published in the Winter 2007 issue of the journal Focal Point, a publication of the Research and Training Center on Family Support and Children’s Mental Health:

“The current psychiatric diagnostic classification system does not have an adequate category to capture the full range of difficulties that traumatized children experience.”

I completely agree with that.

What is complex trauma you ask? This same publication says:

“The term complex trauma describes the dual problem of children’s exposure to multiple traumatic events and the impact of this exposure on immediate and long-term outcomes. Typically, complex trauma exposure results when a child is abused or neglected, but it can also be caused by other kinds of events such as witnessing domestic violence, ethnic cleansing, or war. Many children involved in the child welfare system have experienced complex trauma.

This same publication also states:

“The diagnosis of post-traumatic stress disorder (PTSD) does not capture the full range of developmental difficulties that traumatized children experience. Children exposed to maltreatment, family violence, or loss of their caregivers often meet diagnostic criteria for depression, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder, anxiety disorders, eating disorders, sleep disorders, communication disorders, separation anxiety disorder, and/or reactive attachment disorder. Yet each of these diagnoses captures only a limited aspect of the traumatized child’s complex self-regulatory and relational difficulties. A more comprehensive view of the impact of complex trauma can be gained by examining trauma’s impact on a child’s growth and development.”

When I read this article, I knew I finally had my answer. I had been, and always will live with, the effects of complex trauma. The monster I dubbed ‘the unknown’ in my book “From Foster to Fabulous,” now had a name. I also learned that this monster had many arms. One of these arms I was familiar with was named RAD (reactive attachment disorder); I was also familiar with the arm that rendered me unable to express my feelings or thoughts, or the one called Fear that rendered me incapacitated at times.

I felt trapped in a silent prison for most of my life and I couldn’t put my finger on it, but I knew that the label PTSD didn’t begin to cover all that I had been silently suffering with throughout my entire life.

PTSD also didn’t cover the magnitude of issues present in my own foster children. They ranged in age from 2 – 5 when they came to us, and all three suffered from severe complex trauma. We were their seventh placement and the monster had already taken over their poor little bodies.

They went into foster care directly from the hospital as newborns, yet they had suffered greatly during the two short years they were in foster care. The older child went into custody when she was two, she also suffered and continues to suffer severely from these types of issues. She is currently labeled with many diagnoses, but when you really get down to it, it’s probably really complex trauma.

When I lead training sessions for foster parents, all of my classes are based around one of the many arms of trauma, through the eyes of the foster child of course. I tell them: “I am a stage 5 terminal trauma victim with a focus on communication. As a foster child, if you didn’t learn to speak trauma language you would not have been able to help me. I spoke ‘trauma’ and my dialect was ‘Helen’.” No one learned to speak my trauma language and I was left to find my way through life as a shell of a child, who became a shell of a woman.

You see, until we truly get to know our foster children and learn their ‘reality’ and their ‘trauma language,’ we are going to continue to see disrupted living environments, disrupted adoptions and a continued lack of available foster homes. From my experience, from my foster children’s experience and the voices of foster children I work with every day, if we don’t teach our foster families how to parent a child of trauma we will continue to see an 80 percent foster child failure rate.

Every time I lead a training class I see light bulbs go off constantly. Every session so far I have heard, “I was about to give up, or, this conference was my last hope. Thank you for sharing your life story and for allowing me to take your journey with you. You opened my eye to so much. I have had a change of heart. I will continue to fight this fight with and for my foster child. I will not give up again.”

Words I can never hear enough.

Helen Ramaglia is a foster alumni who became a foster/adoptive parent. She is the founder and Director of Fostering Superstars, a Congressional Award Winner for her work with foster children and is the author of “From Foster to Fabulous”. She is a popular speaker, trainer and advocate for foster children.

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About Helen Ramaglia 18 Articles
Helen Ramaglia is a foster alumni who became a foster/adoptive parent. She is the founder and Director of Fostering Superstars, a Congressional Award Winner for her work with foster children and is the author of “From Foster to Fabulous”. She is a popular speaker, trainer and advocate for foster children.


  1. Hello, my name is William. I was sold at birth, illegally, by the age of 1 I was again involved in a illegal adoption. The family I knew, were violent, sexual predators, and of course alcoholics. By 8 the state I lived in, found out about the illegal adoptions, and I was put into the, so called, protection of the state of Iowa, into foster care, where abuse continued, then I was adopted that iowa department of human services at age 11, where I suffered abuse and was treated like a servant. I have never been to prison, or court order for psych evaluation. I am seriously affected by it all, I cant work, I can’t even perform simple tasks when being watched, I dint receive disability, in so grateful that I have a wife that is understanding, and still loves and supports me, even though the first two didn’t. I have adult children, I don’t know if they understand. I am almost fifty, I have never been able to own a house, or a vehicle, they took everything, and left me nothing.

  2. I will be 36 years old Saturday, September 27, and my mother past away when I was 4 years old. I was taken away form my father when my 9 year old brother rode his bicycle downtown in the small, 4 red lights, town in Alabama and was hit by a semi-truck. We were put in foster care for a year and a half until my father got re-married. I have always struggled with chemical dependency and depression. I am going to the University of Alabama in Birmingham for my Bachelor’s in Social Work. However, I am still struggling with depression and my mood goes up and down very easily. Any help on what I can do to help myself would be greatly appreciated.

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