08/18/2025
By: Julie Bolduc DeFilippo, PhD, MSW, LICSW
Dedication: For my dearest friend and her son as they endure more medical procedures:
Bravery written in whispers, strength stitched into the ordinary moments of each day. This work is for you, and for all who rise again and again, weaving light from the hardest shadows.
I wish this statement didn’t need to be made in 2025, but it does: holding down a child against their will is not care, it is harm. Whether in a classroom or a clinic, this practice must end.
The Importance of Basic Autonomy
Respect for autonomy begins with the most fundamental human right: bodily autonomy. For children, that should mean one clear rule — never hold a child down.
And yet, across medical offices and school buildings, children are still being physically restrained in the name of compliance. What may appear to adults as a brief or “necessary” intervention often leaves a lasting imprint. These moments of force profoundly alter a child’s relationship with safety, trust, and care, resulting in disengagement from the very systems designed to support them.
Medical trauma doesn’t only occur in emergencies. It is just as likely to happen during everyday encounters when autonomy is ignored — during a shot, a blood draw, or a strep test.
Clinically, we know trauma is not defined by the event itself, but by the individual’s experience of it. Again and again, I’ve heard autistic children recount being pinned down for a vaccine or throat swab. Their words are chillingly similar to those I’ve heard from adult survivors of sexual assault: the terror of being powerless, unsafe, and unheard.
This problem doesn’t stop in medical settings. Families describe staff physically forcing children into school buildings when they resist. Add to that the widespread use of seclusion and restraint, and the message becomes clear: autonomy is optional when children resist systems.
Our trusty weighted Slothie—always with my boys during the hardest appointments.
This is never the fault of the parent or the child. I’ve been in that position myself — pressured by providers who insisted that a shot or test “must” happen now. Against my instincts, I agreed to help restrain my son.
The outcome? He stopped telling anyone when he didn’t feel well. The cost of that moment was not better care, but broken trust and long-term fear. Repair was possible only because I owned my mistake, told him I was wrong, and committed to never letting it happen again.
Another story stays with me from a client with medical trauma. Despite the family disclosing their child’s history in advance, hospital staff responded to dysregulation with impatience and pressure. When the parent refused to compromise their child’s psychological safety, the hospital called security — on a frightened autistic child.
In 2025, being autistic is still treated as a security threat.
Good people — doctors, nurses, teachers — end up in these situations because of systemic pressures: productivity quotas, insurance demands, and time shortages. But forcing compliance is self-defeating. Children disengage. Parents lose trust. Outcomes suffer.
When you walk into a doctor’s office or a school meeting, you have the right to ask:
Has this team been trained in trauma-informed care?
What safety protocols are in place?
How will my child’s autonomy be respected?
And remember: you never have to consent to something that doesn’t feel safe. Saying no is your right.
Autonomy and consent are not optional extras. Children must learn — and experience — that they have the right to say no, the right to set boundaries, and the right to control what happens to their body. It’s especially troubling when the very adults who should be teaching consent — doctors and teachers — are the ones violating it.
Trauma-informed care requires intentional training and reflection. Providers need space to debrief, repair, and normalize that it is not a professional failure to admit harm and do better next time. Every provider, school, and hospital should embed this into their culture — not treat it as optional.
True systemic change requires structural reform. Reducing caseloads and moving away from fee-for-service models would give providers the time to build relationships and practice trauma-informed care. And in schools, one step is non-negotiable: end seclusion and restraint. When bodily autonomy is violated in school, it mirrors medical trauma.
Even as we push for systemic change, children and families already carry the scars of trauma. Thankfully, integrative therapies can support recovery.
Eye Movement Desensitization and Reprocessing (EMDR): backed by strong evidence, EMDR reduces intrusive symptoms, supports regulation, and builds resilience.
Sound-based therapies: grounded in Polyvagal Theory, these help calm the nervous system and are especially effective for autistic individuals with sensory sensitivities
In my own work, the need has been overwhelming. Many of my clients live with trauma rooted in medical and school experiences. This has led me to pursue training in the Safe and Sound Protocol (SSP), a sound-based intervention designed to reduce autonomic stress and support regulation. I will soon be offering SSP to clients because I see, every day, how urgently needed these tools are.
Respecting autonomy isn’t an “extra.” It’s the baseline for safe, ethical, and effective care.
When we honor autonomy, children return. They trust. They heal. When we don’t, the damage can last a lifetime.
The measure of good care is not whether a child complies in the moment. It’s whether they feel safe enough to come back tomorrow.
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No spam. Just stories, reflections, and practical tools from life, parenting, and practice, all through a neurodivergent lens.
NeuroWild – “NeuroWild Shift” Workshop (Em Mainey)
Created by an autistic speech pathologist and illustrator, this workshop offers practical, strengths-based strategies for supporting autistic children in moments of crisis by respecting capacity and autonomy.
Kristy Forbes – inTune Pathways Programs
Led by an autistic, PDA-identified educator and parent, these programs provide deep, identity-affirming, trauma-informed guidance for families and professionals. Focus is on connection, consent, and relational safety over compliance.
Trauma-Informed, Neurodiversity-Affirming Trainings
Learn Play Thrive: Trauma-Informed Therapy for Autistic People
A self-paced, evidence-informed course specifically designed to equip therapists with strategies that honor autonomy and support regulation in autistic individuals.
AutPlay Therapy Clinic: Neurodiversity-Affirming Play Therapy Webinar
Training for clinicians and play therapists to use affirming, strengths-based approaches when working with neurodivergent children.
Empower Who You Are: Neurodiversity-Affirming Autism Evaluations
A Zoom-based cohort training that helps professionals move away from deficit-based evaluation models and toward affirming, identity-respecting practice.
Trauma Therapist Institute: Neurodivergent-Informed EMDR for Autism/ADHD
Specialized training for EMDR therapists on adapting protocols for autistic and ADHD clients, integrating trauma-informed and neuro-affirming approaches.
Neurodiverse Counseling Services
Workshops and trainings rooted in strengths-based, trauma-informed principles for professionals supporting neurodivergent individuals.
Eye Movement Desensitization and Reprocessing (EMDR)
A trauma treatment with strong clinical support—24+ RCTs show EMDR effectively reduces PTSD symptoms, reprocessing distressing memories rapidly and deeply. Recommended by professional bodies such as AHRQ, VA/DoD, ISTSS, and WHO.
Safe and Sound Protocol (SSP)
A non-invasive, sound-based therapy rooted in Polyvagal Theory. Research shows SSP increases vagal regulation, improves social awareness, and reduces sensory hypersensitivity in autistic individuals. Preliminary studies also suggest lasting benefits when administered in safe home or school environments.
Somatic Experiencing (SE)
A body-oriented trauma approach focusing on subtle internal sensations to help regulate chronic physiological stress—particularly helpful in situations where cognitive/talk-based therapies fall short.
Imagery Rescripting
A trauma-focused technique that reshapes the core emotional meaning of traumatic memories by working with mental imagery rather than direct exposure, allowing healing without re-traumatization.
Other Trauma-Informed Resources
Massachusetts Center for Trauma Informed Care Trainings
Targeted instruction for teachers, healthcare staff, and caregivers on implementing trauma-informed approaches in practice.
UMass Chan Medical School – Trauma Informed Care Programs
Training programs equipping medical professionals with practical strategies focused on safety, emotional containment, and resilience.
Aquifer – Trauma Informed Care Module
A brief, case-based online module introducing healthcare learners to the principles of trauma-informed care.
Safe Spaces: Foundations of Trauma Informed Practice
A free, self-paced training helping educators and school staff recognize and respond to stress and trauma.
Trauma-Informed Schools and Workplaces (TISE)
A strengths-based, online or in-person curriculum for K–12 educators, offering strategies on trauma-responsive classrooms, de-escalation, and fostering resilience and connection in schools.
UMass Chan Medical School – Trauma-Informed Care Training for Schools
Professional development offerings—online or onsite—for school staff and educators covering trauma impacts, regulation, connection, and strategies to support learning and resilience.
NCTSN: Child Trauma Toolkit for Educators
Free toolkit providing trauma information, behavioral strategies, self-care tips, and organizational guidance tailored for educators supporting children affected by trauma.
Advocacy Organizations
Alliance Against Seclusion and Restraint (AASR)
A U.S.-based nonprofit committed to ending the use of punitive disciplinary practices in schools—including restraint, seclusion, and corporal punishment. AASR offers policy resources, caregiver training, survivor groups, and legislative advocacy.
Lives in the Balance (Collaborative & Proactive Solutions)
Founded by Dr. Ross Greene, this organization promotes CPS, an evidence-based, trauma-informed, and non-punitive approach to behavioral challenges in children. They provide free resources and trainings for families, educators, clinicians, and child welfare professionals.
Autistic Self Advocacy Network (ASAN)
A nonprofit run by and for autistic individuals, dedicated to disability rights advocacy. ASAN leads policy reform, campaigns against abusive practices (like seclusion and restraint), and amplifies autistic voices at the national level.
