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


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


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)


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)


Physical complaintsBedwettingSchool failure/absenteeismBehavioral problemsAttention problemsFighting or threatening behaviorsGuilt feelingsActing like a parent to siblingsDepression

Response to Trauma Adolescents (12 to 18 years)


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


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


Social/Environmental Protective Factors

Mid to high socioeconomic statusAccess to health care and social servicesParental employmentParticipation in faith based activitiesGood schoolsSupportive adults


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


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)


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



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

The Trauma Informed Classroom

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Transcript of The Trauma Informed Classroom