Treating Traumatized Children Who Have Intellectual and Developmental Disabilities: Adapting Trauma-Focused Cognitive Behavior Therapy





For over two decades, many children with trauma related symptoms have been effectively treated with Trauma-Focused Cognitive Behavior Therapy (TF-CBT). The model’s flexibility and applicability to children and families of varying cultures and types of trauma are major strengths. The efficacy of TF-CBT has been demonstrated in over a dozen randomized controlled trials and across the developmental spectrum for multiple index traumas and settings. Children with intellectual and developmental disabilities (IDD) are an underserved and poorly understood group among mental health clinicians and those who treat traumatic stress. They are exposed to maltreatment, bullying, potentially traumatizing medical and restraint procedures, and other adverse childhood experiences at a rate conservatively estimated to be 2-3 times that of their non-disabled peers. Efforts are underway for adapting TF-CBT to meet the needs of children and caregivers with significant limitations in cognitive, language, and other executive functions. As there is a growing evidence base for the effectiveness of cognitive-behavior therapy for anxiety in autism spectrum disorders, this literature is being tapped as a guide for approaching the broader IDD population.


The two presenters, one a certified TF-CBT trainer, and the other a director of a trauma clinic serving children with IDD, will start with the issue of bias and "diagnostic overshadowing" in the assessment of IDD/Trauma cases, including the importance of child self-report and the current state of the literature in this area. They will then present a formal model based on a "matrix" of TF-CBT steps which allows for flexibilty within fidelity of the treatment relying on assessments of the child and caregivers’: a) verbal comprehension; b) visual-spatial skills; c) sensory differences; d) motivation for treatment; and e) ability to generalize skills learned in therapy. Recommendations for treatment structure, process, and supplemental resources from the IDD/autism literature will be provided. The steps and approach will be illustrated by clinical case examples.

This is an Intermediate Level day-long presentation for clinicians who have already been trained in TF-CBT and are practicing the model.

Learning Objectives: 

  1. Understand current definitions of developmental disorders and their impacts on treatment planning and implementation of TF-CBT

  2. Utilizing recent research findings, demonstrate the prevalence of maltreatment and other types of childhood adversity in children with IDD.

  3. Describe the concepts of dual diagnosis and diagnostic overshadowing and their implications forequitable and accurate assessment of children with IDD. 

  4. Understand the range of assessment tools for differentiating trauma symptoms from IDD in this population.

  5. Select and apply adaptations of TF-CBT based on specific functional differences in children and families with IDD.




Daniel Hoover, Ph.D., ABPP is a board certified clinical child and adolescent psychologist at Kennedy Krieger Institute and Instructor, Department of Psychiatry, Johns Hopkins School of Medicine. He has 25 years of experience as a service provider, trainer, andclinical supervisor. He directs psychology internship and postdoctoral training at the Center for Child and Family Traumatic Stress. Dr. Hoover founded and directs the Horizons Clinic, treating children with developmental disabilities who are exposed to trauma; one of the few such treatment clinics nationwide. Dr. Hoover consults on a SAMSHA National Child Traumatic Stress Network grant entitled: Supporting Trauma Recovery for Youth with Developmental Disabilities. He has published several papers and chapters, a treatment manual, and developedtheInteractive Trauma Scale, touchscreen app/assessment measure on the treatment of trauma responses in children with autism.

PeterD’Amico, PhD, ABPP is Director of Child and Adolescent Psychology at Long Island Jewish Medical Center of Northwell Health. He also directs a National Child Traumatic Stress Network (NCTSN) sponsored grant project on Supporting Trauma Recovery for Youth with Developmental Disabilities (STRYDD Center). He previously directed the Alliance for School Mental Health where he conducted school-based consultation, program development and professional development for more than 15 years. He is an Associate Professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. Dr. D’Amico has specialty board certification in Cognitive and Behavioral Psychology and a long history of service provision, program development and consultation with agencies serving youth with serious emotional/behavioral difficulties including individuals with developmental disabilities. His interests include positive behavioral supports, child and adolescent trauma, dissemination and training of evidence-based child and adolescent interventions. He is a certified trainer of Trauma-Focused Cognitive-Behavior Therapy (TF-CBT) and the Core Curriculum on Childhood Trauma (NCTSN sponsored).




  • When

  • 02/13/20
    8:00 AM - 5:00 PM
    Eastern Time

  • Where

  • Kennedy Krieger Institute Broadway Campus - Harry & Jeanette Weinberg Outpatient Center
    1741 Ashland Ave
    8th Floor Conference Center
    Baltimore, Maryland 21205

  • Capacity

  • 30 (30 remaining)

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