From the Research
Pervasive Arousal Withdrawal Syndrome (PAWS) is a severe condition that requires a multidisciplinary approach, including trauma-informed therapy, play therapy, and family-based interventions, with a focus on creating safe environments for children to rebuild trust and develop emotional regulation skills. This condition is characterized by extreme social withdrawal, anxiety, and emotional dysregulation in children, often developing after experiencing trauma or chronic stress, particularly in early childhood 1. Children with PAWS may exhibit complete social withdrawal, avoidance of eye contact, resistance to physical touch, and extreme anxiety when faced with social interactions.
Key Characteristics and Treatment
- PAWS differs from autism spectrum disorders or selective mutism, though symptoms may overlap 2.
- The condition stems from the brain's protective response to overwhelming stress, where withdrawal becomes a survival mechanism.
- Recovery is possible but typically requires consistent, long-term therapeutic support tailored to each child's specific needs and trauma history.
- Medications, such as low-dose anxiolytics or SSRIs, may be considered in severe cases but should always be prescribed by specialists 3, 4.
- Early intervention is crucial, and hospitalization in a child and adolescent psychiatric unit may be necessary in some cases 2.
Importance of Awareness and Support
- It is essential for healthcare professionals to be aware of PAWS and have insight into the most helpful approaches 5.
- Young people with PAWS need to feel that their experiences are validated, which can elicit feelings in staff from an urge to help to intense frustration.
- Staff should be able to talk and reflect to allow such feelings to be understood and provide the necessary support and care.