Integrated Physical and Behavioral Health

Last update: July 1, 2022

Nearly 50 percent of children experience at least one adverse childhood event prior to turning 18.

Nearly 22 percent of children experience two or more adverse childhood events prior to turning 18.

Based on the research, we know that, as children’s exposure to adverse childhood events increases, children experience more difficulty with social determinants of health, physical health issues and behavioral health issues. These conditions and illnesses become increasingly chronic, especially with increasing exposure to adverse childhood events and can lead to early death. The exposure to adverse childhood events may range from experiencing the death of a parent, to experiencing poverty, to experiencing long-term and chronic abuse and/or neglect. It is important for physical and behavioral health providers to be aware of and understand the impact that adverse childhood events and trauma have on children’s developing brains and subsequent physical health and behavior.

Trauma can affect every aspect of children’s brain development. When the brainstem is affected, children will display difficulties in somatic and sensory areas. When the limbic system is affected, children display difficulties with attachment, emotion regulation, and behavioral regulation.  When a child’s cortical brain is affected, they display difficulties with self-esteem, dissociation, and cognitive functioning. Many children may shift between one or more of these areas of dysfunction or difficulty. (Please see the lists below for specific symptoms/behaviors for each of the parts of the brain).

Providers and caregivers need to understand the connection between brain development and children’s social, emotional and behavioral symptoms to assist with better connecting them to the additional treatment providers and resources they need. Adults in these children’s lives also need to remember that the children are responding to trauma and exhibiting fight, flight and/or freeze responses. They are attempting to create a sense of safety for themselves, not trying to engage in problematic behavior.

If a child for whom you are providing services needs additional assistance or assessment, please contact the following numbers to contact him/her with a care manager.

  • For all other members, please call 866-292-0359.


Sensory Processing


Pervasive Anxiety

High/Low Arousal

Sleep Disturbance

Heart Rate Irregularity

Breathing Difficulty

Unexplained Medical Problems

Somatic Re-enactment

Limbic System

Clingy Behavior

Oppositional Behavior

Rejecting Others

Distrustful/Suspicious Behavior

Overly Compliant Behavior

Heightened Emotions

Aggressive Behavior

Feelings of numbing, emptiness or low mood

Traumatic re-enactment

Running or hiding

Cortical Brain

Trouble processing information

Difficulty with planning

Trouble with organizing

Difficulty with making decisions

Memory impairment or difficulty

Identity confusion

Disorientation or dissociation

Self-hate, self-blame and/or self-doubt

Feelings of worthlessness

Feelings of helplessness