The Trauma Informed Classroom
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Transcript of The Trauma Informed Classroom
Dr. Toni Tollerud, NIU
Linda Delimata, ICMHP
The Trauma Informed Classroom
ACES StudyBuilt upon a conceptual framework that risk
factors for disease and other physical ailments are strongly affected by adverse childhood experiences.
The study assesses what might be considered “scientific gaps” about the origins of risk factors.
This study takes a whole life perspective. If childhood stressors can be identified, we might be able to provide early intervention or utilize protective factors that would reduce the risk.
Adverse Childhood Experiences (ACEs) Growing up in a household with:
Verbal Abuse Recurrent physical, sexual or emotional abuse Emotional or physical neglect Domestic violence between parents An alcoholic Substance abuser An incarcerated household member Someone who is chronically depressed, suicidal,
institutionalized or mentally ill Live with One or no biological parents
(2006, http://www.acestudy.org/)
Consequences Of Unresolved Trauma
(2004, http://www.acestudy.org/)
Findings of the StudyOver 17,000 people participated in the studyAlmost 2/3 experienced at least one ACEOver ¼ reported one ACEOver 25% reported 2 or moreOver 12% reported 4 or more. One out of 8Higher ACES scores =
Higher scores = increased risk for health problems
Strong relationship to health-related behaviors during childhood & adolescence including smoking, early sexual activity, illicit drug use, teen pregnancies, and suicide attempts.
What is Stress?
Stress is defined as a process that exists over time. When is continues, it can often lead to a debilitating outcomes as it accumulates.
Stress affects all aspects of ones functioning Collins & Collins (2005)
When a child encounters a perceived threat to their safety, their brains trigger a complex set of chemical and neurological events known as the “stress response”.
Massachusetts Advocates for Children (2005)
Stress and the Body & Brain
Stress is the set of changes in the body and the brain that are set into motion when there are overwhelming threats to physical or psychological well-being.
Under threat, the limbic system engages and the frontal lobes disengage. When safety returns, the limbic chemical reaction stops and the frontal lobes re-engage.
(van der Kolk, B., 2005)
Reactions to Stress and Trauma Fight Freeze Flee
Under normal circumstances these responses to stress are constructive and help keep a child or adolescent safe.
However, when a child is traumatized, and is overwhelmed with stress and fear, these responses can become a regular mode of functioning.
Consequently, a youth may react to their world even when the dangers are NOT present because they cannot turn off the survival strategies in their brains.
Traumatic Stress and Critical Windows of Brain Development
Brain Stem
Cortex
Limbic Brain
Mid Brain
cognitive functioning: 12 months - 48 months
emotional functioning: 6 months - 30 months
motor functioning: first year
state regulation: pre-birth - 8 months
Nor
mal
Gro
wth
(Adapted from: Perry, 2002)
The Impact of Extreme Trauma on Brain Development
1997, Bruce D. Perry, M.D., Ph.D.
Explicit and Implicit Memory HIPPOCAMPUS:
Explicit memory - governs recollection of facts, events or associationsAMYGDALA:
Implicit memory – No conscious awareness (procedural memory – e.g., riding a bike and emotional memory- e.g., fear)
CORTEX:
higher level thought processes, planning, problem solving
Chronic stress = overstimulation of the Amygdala, resulting in the release of cortisol, possible shrinkage or atrophy of the Hippocampus and Cortex, affecting memory and cognition, and leading to anxiety or depression.
(Adapted from: Brunson, Lorang, & Baram, 2002)
Cor
tiso
l
Adrenal gland
Cortisol
What is Trauma?
Trauma is a serious physical or psychological injury that has resulted from a highly threatening, terrifying, or horrifying experience.
(Echterling, Presbury & McKee, 2005)
Trauma arises from an inescapable stressful event that overwhelms an individuals’ coping mechanisms.
(van der Kolk & Fisler, 1995).
Trauma Can Be…..Characterized as more than simple lossDependent upon an actual eventDependent upon a child’s proximity to the
traumatic eventDependent upon the number of risk factors
that confront a childDependent upon a child’s age
“In a study that assess adolescent females who witness or experienced violence, 67 % met the diagnosis for PTSD”
CIVITAS (2002)
Physiological Effects
Perpetual extreme levels of stress arousal may lead to: hypervigilance and loss of ability to concentrate altered vision and hearing hyperactivity or dissociation avoidance of potential triggers to trauma altered sleep patterns altered eating patterns compulsive self harm attempts to self medicate with substances
(Cairns, K. & Stanway, S., 2004.)
Physical Effects
Continued stress arousal may lead to: headaches digestive disorders respiratory disorders other psychosomatic illnesses muscle tension aching joints clumsiness altered spatial awareness
(Cairns, K. & Stanway, S., 2004.)
Emotional Effects
Inability to process emotions through language
Diminished capacity for empathy
Hypersensitivity to trauma in others
Diminished range of emotions: terror or rage
Depression or sadness
Feelings of worthlessness and shame
Bad memories
Recurring outbreaks
Dissociation (Cairns, K. & Stanway, S., 2004; CIVITAS,
2002)
Social Effects
May become socially isolated or member of deviant peer group due to: Extreme reactions of terror or rage
Diminished empathy limits social connectedness
Survival mode restricts motivation to be sociable
Avoidance restricts capacity to connect to others
Diminished language restricts social accountability
Traumatic identity leads to persistent victim or aggressor behaviour
(Cairns, K. & Stanway, S., 2004.)
Cognitive EffectsNegative cognitive reactions affect how a
youth processes information and performs advanced thinking.Inability to remember detailsMemory impairmentPoor attentionUnable to concentrateLack of goalsPoor problem solvingSense of shortened future CIVITAS ( 2002)
Response to Trauma Infants (Birth -2 ½ year)
DCFS Trauma Training, 2006
Eating disturbancesIrritable, difficult to sootheDevelopmental regressionLanguage delayAttachment disorderFailure to thriveSleep disturbance
Response to Trauma Young Children (2 ½ -6 years)
DCFS Trauma Training, 2006
Helplessness and PassivityGeneralized FearConfusion, difficulty planningDifficulty identifying what is bothering themAttributing magical qualities to traumatic
remindersFighting or threatening behaviorAttention ProblemsSadness/DepressionSeparation AnxietySpecific Fears
Response to Trauma School-age Children (6-11year)
DCFS Trauma Training, 2006
Physical complaintsBedwettingSchool failure/absenteeismBehavioral problemsAttention problemsFighting or threatening behaviorsGuilt feelingsActing like a parent to siblingsDepression
Response to Trauma Adolescents (12 to 18 years)
DCFS Trauma Training, 2006
Antisocial behaviorRunawayDepression/Suicidal thoughtSleep DisordersAbsenteeismActing like a parent to siblingsEating DisordersDating violenceSubstance abuseSchool failureRelationship problems
Most Frequent Difficulties Following Chronic Trauma
61.5% 59.2% 57.9%53.1%
45.8%
0%
15%
30%
45%
60%
75%
Affect
Dysre
gulat
ion
Attent
ion/C
once
ntra
tion
Negat
ive S
elf-Im
age
Impu
lse C
ontro
l
Aggre
ssion
/Risk
-takin
g
(Spinazzola.J, et.al., 2005)
Relationship Between Diagnoses & Eligibilities
Special Education Eligibility:
Emotional Disturbance
Inability to learn not explained by health, intellectual, or sensory disability;
Inability to build/maintain relationships;
Inappropriate behavior or feelings under normal circumstances;
Pervasive anxiety or depression;
Physical symptoms or fears.
Special Education Eligibility:
Specific Learning Disability
Disorder in basic psychological processes involved in understanding/using language, spoken or written, may manifest in an imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations.
Psychological/Neurobiological Diagnosis:
Traumatic Stress
Rarely in attentive state
Defiant, aggressive, oppositional
Hyperarousal
Internalizing disorders
Fear, somatic disorders
Rarely in attentive state;Lack of concentration;Misperceptions;Avoidance;Dissociation;
Repeated intrusive memories
(Shumow & Perry, 2006)
Trauma’s Impact on LearningInability to process social cues and to convey feelings in an appropriate manner.
ACADEMIC PERFORMANCE DIFFICULTIES
Language & communication skills
Learning and retrieving new verbal information
Problem-solving Goal setting Lack capacity for self-
regulation Distorted world view
CLASSROOM BEHAVIORS
Reactivity and impulsivity
Aggression Defiance Withdrawal Perfectionism
Protective Factors
Some children who are exposed to traumatic events appear to be more resilient than others. What are those factors that protect the children from the risks of the trauma?
Protective Factors fall into three basic categories:
Child Protective FactorsParental/Family Protective FactorsSocial/Environmental Protective Factors
Common Protective Factors for Child Abuse and Neglect
Child Welfare Information Gateway, www.childwelfare.gov/preventing/programs/whatworks/riskprotectivefactors.cfm.
Child Protective FactorsGood healthAbove average intelligenceHobbies and interestsGood peer relationshipsPersonality factors
temperament, disposition, coping style, positive self-esteem, social skills, internal locus of control
Child Welfare Information Gateway, www.childwelfare.gov/preventing/programs/whatworks/riskprotectivefactors.cfm.
Parental/Family Protective Factors
Positive and warm relationshipsSupportive family environmentsClear boundaries and consistent follow-
throughHelp from extended familyStable relationship with parentsRole modelsFamily expectations of pro-social skillsParental education
Child Welfare Information Gateway, www.childwelfare.gov/preventing/programs/whatworks/riskprotectivefactors.cfm.
Social/Environmental Protective Factors
Mid to high socioeconomic statusAccess to health care and social servicesParental employmentParticipation in faith based activitiesGood schoolsSupportive adults
Child Welfare Information Gateway, www.childwelfare.gov/preventing/programs/whatworks/riskprotectivefactors.cfm.
Mental HealthMental health is the “successful
performance of mental function resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity.”
Department of Health and Human Services (1999)Mental Health: A Report of the Surgeon General
Social Emotional Learning
SEL is the process of acquiring the skills to recognize and manage emotions, develop caring and concern for others, establish positive relationships, make responsible decisions, and handle challenging tasks effectively.
Collaborative for Academic, Social, and Emotional Learning (2005). Safe and Sound, IL Edition
What are the CoreSEL Competencies?
SEL
Self-awareness
Social awareness
Relationship Skills
Responsible decision-making
Self-management
Forming positiverelationships, working in
teams, and dealing effectivelywith conflict
Making ethical, constructive
choices aboutpersonal and
social behavior
Managing emotions andbehaviors to
achieve one’s goals
Showing understanding and empathy for others
Recognizing one’s emotions and values as well as one’s strengths
and limitations
Graphic: CASEL
Approaches to Helping Traumatized Students Learn
Understand the needs of the students Create a trauma-sensitive school
environment where needs are addressed Connect with families and communities,
mental health and child welfare staff, and others as part of the social and professional network to support the recovering child
Curriculum for Helping Your School Create a Trauma Sensitive
Environment
The Massachusetts Advocates for Children provides a free resource to download at
http://www.massadvocates.org/helping_traumatized_children_learn
.
Steps to Building a Trauma-Sensitive Perspective in Your School
Change the School-Wide Infrastructure and Culture of the schoolSchool leadership and administrators need to build
into the SIP or school-wide plan a way to integrate trauma-sensitive routines into the school
The school must weave trauma-sensitive approaches across the fabric of the school
All stakeholders need to identify and address barriers to incorporating trauma sensitive approaches into the school
Massachusetts Advocates for Children (2005)
Steps to Building a Trauma-Sensitive Perspective in Your SchoolTrain Staff to do three important tasks:
Strengthen relationships between children and adults and convey the fact that staff are caring adults in the lives of traumatized youth and their caregivers
Identify and use outside supports and resourcesHelp youth modulate their emotions and gain
social and academic acceptanceSELRole of the Counselor is paramount here
Massachusetts Advocates for Children
(2005)
Steps to Building a Trauma-Sensitive Perspective in Your School
Begin the process of a school-wide Implementation of Social and Emotional Learning
SEL enhances factors that help traumatized children do better in school: - creates a safer environment
- helps make closer connections with others - teachers the skills needed to move through our world - helps students perform to their fullest potential
How Safe is Your School?What things are you seeing in your school
that might be problematic for youth who have experienced trauma/
What kinds of things does your school do to promote the safety of all students?
What might your school do to enhance the safety of your school?
What supports or resources do you need?
Steps to Building a Trauma-Sensitive Perspective in Your SchoolWhat teachers and counselors can do:
Maintain high academic standardsHelp students feel safeTeach students how to manage behaviors and set
limitsReduce bullying and harassmentProvide youth with a sense of agency—youth need to
be able to make choices which strengthens their sense of empowerment
Build on strengthsUnderstand the connection between behavior and
emotionAvoid labels Massachusetts Advocates for Children
(2005)
Steps to Building a Trauma-Sensitive Perspective in Your SchoolLink with Mental Health Professionals in the
School and CommunityBe sure they are trauma sensitive providers
Create classrooms that address the needs of traumatized children in academic instructionHelp teachers to learn teaching techniques that
support these students. Work from a students area of competence Reinforce student success Establish routines for students-make things predictable Focus on the timing of lessons and activities Describe plans in detail Use language-based teaching approaches Identify and process feelings
Massachusetts Advocates for Children (2005)
Steps to Building a Trauma-Sensitive Perspective in Your School
Build Non-academic relationships with youth
Develop policies and protocol for students regarding discipline, safety, confidentiality
Balance accountability with understanding traumatic behavior Massachusetts Advocates for Children
(2005)
• Keep in mind the role that trauma plays in so many aspects of a child’s world.
• Ask yourself if the behaviors being exhibited are affected by trauma as well as other concerns, and if co-morbidity exists how to approach the intervention for that child.
• By seeing the relationship of learning and social problems in the child’s environment we can better impact their success by unifying our approach.
Resources:
www.cdc.gov/nccdphp/ACE
www.massadvocates.org
www.acestudy.org
www.icmhp.org
www.childwelfare.gov/preventing/programs/whatworks/riskprotectivefactors.cfm
www.casel.org