Allostatic Load: Considering the Burden of Cumulative Trauma on Children in Foster Care

Abstract

In this article it is proposed that allostatic load may be a useful concept to describe the physiological dysregulation that occurs in maltreated children through repeated exposure to traumatic events, the chronic stress of inconsistent and inadequate caregiving, and the disruptions of attachments and instability caused by foster care placements. In order to counteract the deleterious effects of allostatic load, a trauma-informed approach to the assessment and treatment of children suffering from this condition is proposed. Using a case example to illustrate the application of concepts, this article offers five recommendations for clinical work with maltreated children, especially those in foster care. The principles are illustrated by a case study.

Keywords:

• allostasis
• traumatic stress
• homeostasis
• physiological dysregulation
• chronic stress