Cumulative Cumulative harm is experienced by a child as a result of a series or pattern of harmful events and experiences that may be historical, or ongoing, with the strong possibility of the risk factors being multiple, inter-related and co-existing over critical developmental periods. Isolated maltreatment might be defined as a single maltreatment or interrelated events or a series of interrelated episodes within a time specified period. Chronic maltreatment might be defined as recurrent incidents of maltreatment over a prolonged period of time (Bromfield & Higgins 2005). The unremitting daily impact of these experiences on the child can be profound and exponential, and diminish a child’s sense of safety, stability and wellbeing. The Main theories used to help understand Cumulative Harm are: Child Development (including early brain development) Researchers investigating brain development have used the term ‘toxic stress’ to describe prolonged activation of stress management systems in the absence of support. If prolonged (e.g., if a child experienced multiple adverse circumstances or events) stress can disrupt the brain’s architecture and stress management systems. In children, ‘toxic stress’ can damage the developing brain (Shonkoff and Phillips, 2001).’ Trauma (including complex trauma) Babies and young infants exposed to cumulative harm are more likely to experience insecure or disorganised attachment problems with their primary caregiver. For children with a disorganised attachment, the parent/caregiver who should be the primary source of safety and protection, can become a source of danger or harm or be overwhelmed themselves, leaving the child in irresolvable conflict. Attachment difficulties are likely to increase when maltreatment is prolonged. Children’s responses will largely mimic those of their parents and therefore the more disorganised and inconsistent the parent, the more disorganised the child (StreeckFischer & van der Kolk 2000) Attachment.