Trauma Smart Crittenton Children’s Center

Statistics Nationwide, 25% of children experience one traumatic event by age 4. Pre-K Expulsion Rates are 3X the national rate for K-12. Gilliam W.S. Pre-kindergarteners left behind: Expulsion rates in state prekindergarten programs. (Foundation for Child Development Policy Brief Series No. 3, May 2005) available at http://www.fcdus.org/usr_doc/ExpulsionComplete Report.pdf.

Trauma Smart Model

Childhood Trust Events Survey 2013-2014 8 Head Start programs in 26 counties (3,265 children)

89%

• Of children referred for tx with 1 traumatic event

75%

• Of children referred for tx with 2 traumatic events

69%

• Of children referred for tx with 3 or more traumatic events

Attachment, Self-Regulation, & Competency Trauma Integration Self Dev’t & Identity

Executive Functions

Affect Identification Caregiver Affect Mgmt.

Affect Modulation Attunement

Affect Expression Consistent Response

Kinniburgh and Blaustein, 2005

Routines and Rituals

Trauma Smart: Intervening When Young Children Experience Trauma • Understand how trauma affects early childhood growth and development. • Understand how trauma impacts a child’s ability to form attachment, regulate emotion and build age appropriate competencies. • Demonstrate ways to intervene that are least likely to harm or re-traumatize children.

A Perception An Experience

An Emotion “Any event that places overwhelming demands on the body’s physiological systems resulting in a profound sense of helplessness and loss of control.”—RD Macy

Types of Trauma

Acute

• A single traumatic event

Complex

• Multiple traumatic events often related to the care-giving system

Acute

Complex

Complex

Complex

How do these events IMPACT the child’s current and future development?

Current Impact: How does Trauma Affect Children? Tantrums

Withdrawn/Fearful Inability to get along with others Separation Anxiety

School Phobia Eating Problems Stomachaches/Headaches

Spacing Out

Future Impact Teen Pregnancy and Paternity

Suicidality

AOD Use and Addiction

Early Onset Sexuality and Sexual Promiscuity

Adult Sexual Assault

General Health Problems

Depression

Cigarette Use

Complex Trauma Adult domestic violence

Increases the Risk of …

Obesity

Felitti et al., 1998

The Human Brain

How Does Trauma Affect the Brain? Video: First Impressions: Exposure to Violence and a Child’s Developing Brain.mov

The Brain as a Car

Trunk: Physical State Fight : hitting, kicking, yelling, lying Flight: running away; giving up Freeze: becoming numb, checking out, dissociation

Need: Safety

Back Seat: Emotional State

• • • •

Emotional Center Amygdala Hippocampus Memories related to fear and anxiety

Need: Connection

Front Seat: Thinking State • • • • •

Problem Solve Impulse Control Decision-Making Regulates Emotion Skills begin to develop at 3 to 5yrs • Not fully developed until mid 20s Need: To find meaning

Question: What happens to the thinking state of the brain when repeated trauma is part of a child’s everyday experience?

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Triggers When someone experiences a trauma, the brain creates short cuts called triggers. A trigger is a anything that reminds a person of a prior negative event. Once the trigger is established, it becomes automatic and works when there is real OR perceived danger.

A trigger’s job is to keep us safe from danger.

Triggers are often outside of conscious awareness.

Lack of power or control

Feeling Shame

Key Triggers

Change or Transition

For children

Feeling vulnerable or afraid

Feeling threatened or attacked

Traumatic Beliefs

I am not safe. People want to hurt me. The world is dangerous. If I am in danger, no one will help. • I am not good enough/ smart enough/ worthy enough for people to care about me. • It will never get better, etc. • • • •

Ask the Questions… What did the child learn about relationships?

What did the child learn about him/herself?

What did the child have to do to survive?

Consider these questions for yourself and for your team.

Trauma Smart in Action Head Start Trauma Smart.mov

Caregiver Affect Management

Caregiver Affect Management (Self-Control)

Ability + willingness to guide ourselves from the trunk (brain stem) or back seat (limbic system)

to the front seat (pre-frontal lobe) so that we can Respond instead of React to life events.

Why is it important to manage our affect? Before we can help children manage their feelings, we have to manage ours. Children take their cues from us. If we are irritable, the children become irritable. When we are calm, children feel safe.

Managing Yourself: It’s Not easy!

We feel demoralized and burned out.

We get angry and blame the child, family, system.

Common Caregiver Reactions

We get triggered by our own difficult experiences.

We personalize the child/family rejection.

We don’t feel effective in our job.

Trauma Cycle

I am not effective

The Cycle: Child: “I’m being controlled” Caregiver: “They keep fighting me, I’m in charge.”

The child is rejecting me

Over React,

Frustration,

Controlling,

Sadness,

Shutdown

Worry

Avoidance, Aggression, Actively Pushing Away

I am bad. I can’t trust anyone

Shame, Fear, Anger.

Question What causes us to REACT instead of RESPOND?

Secondary Trauma Inadequate Self Care

Your “Buttons”

Reaction

Know your Buttons

• • • • • • • • • • • • • • • •

Whining Bickering Blaming Pouting Sassing Lying Interrupting Not Listening Showing Anger Silliness Tattling Sulking Showing Disrespect Laziness Physical aggression Other… ?

Secondary Trauma Stress that comes from helping others who have experienced trauma or stress

Risk Factors

Symptoms

Not Enough Recovery Time Empathy Unresolved Personal Trauma Vulnerability of Children Isolation Lack of System Resources

Intrusive Thoughts Dreams Flashbacks Intense Emotions Avoiding Freezing or Numbing Sleep Problems Hypervigilance

Inadequate Self Care Barriers to Self Care

Symptoms of Inadequate Self Care

Lack of Time

Irritability

Lack of Support

Exhausted

Willingness

Feeling Ineffective at work

Accessibility

Blaming Others

Prioritizing

Frequent Illness

Too Many Demands

Bodily Complaints Feeling Tense

Self Monitoring Skills Body

• What are my warning signs for “losing control”?

Emotions

• What do I feel in difficult situations? • Are there particular “trigger” emotions?

Thoughts

• What do I say to myself in difficult situations?

Behavior

• What do I do in the face of strong emotions? • Withdraw • Freeze

This child doesn’t trust me yet.

Takes time for self. Keeps on trying.

Trauma Cycle Learning to control ourselves is the first step in breaking the cycle.

Hopeful. Encouraged.

Cooperative Shame. Fear. andAnger Playful

I am bad. I I can trust trust can’t adults. anyone.

Avoidance, Happy and Aggression, cheerful Actively Pushing Away

Attunement

Attunement

Ability to accurately read another person’s cues

and respond to the emotion driving the behavior

instead of reacting to the symptom.

Attunement is about… Building relationships

Acknowledging and recognizing needs

Meeting needs

Attunement is a tool that helps build relationships

Make an Attunement Plan Think of a child in your classroom or person in your life with whom you want a stronger relationship.

Identify a situation that you commonly encounter with this person.

Attunement Steps

Notice

Name

Validate

Respond

Notice

Check in with yourself.

Notice the feeling/need of the individual before it escalates.

Name Name need or feeling • It seems like….. • I wonder if …..

Consider STAGE not AGE!

Validate The feeling or need behind the behaviors to help child/person feel understood and heard.

“That would make me ________ too!” “It is hard when _________.” “It makes sense that _______.”

Respond Give a structured choice: calm down or connection choice -- OR --

Ask an open ended question about how you can help. “What do you need?” “How can I help?” “Thanks for sharing!”

Respond Choices: Connection Hold Hands with the Teacher Hug Sit on the Teachers Lap Help the Teachers do a Task

Hand Massage Talk to a Friend

Respond Choices: Calm Down Breathe Hug a Bear Sunglasses Butterfly Hug

Squeeze Stress Ball Glitter Wand Draw

Attunement Steps Notice: Check in with yourself. Notice before the behavior escalates.

Name: The need or feeling

• What feeling is the child having? • What need is the child trying to meet?

• “It seems like…” • “I wonder if ….”

Validate: The feeling so a child feels understood

Respond: Give structured choices.

• “It makes sense that….” • “It is hard when…”

• Calm down or Connection • “What do you need?” • “How can I help?”

Putting it All Together

Feelings Charades Follow-the-Leader Games Music Movement Mirroring Zip, Zap, Zop Cat and Mouse Balloon Toss

Notice when you are in the back seat or trunk. What skill can you use to move forward?

Choose an “in the moment” and preventative self care skill. Share it with a co-worker for support.

Practice the attunement steps to help others feel seen and heard and valued.

Gratitude by Louie Schwartzburg

Avis Smith, LSCSW, LCSW Director of Trauma Smart Crittenton Children’s Center

www.traumasmart.org