trauma informed early learning...the executive brain: frontal lobes an the civilized mind. new york:...

Trauma Informed Early Learning

Presented by: Misty Cole, MSW, LSW

Nicole Kennedy, LISW-S & Erin Lucas, LISW-S

Becoming a Trauma Informed Early Learning Professional

• Created by:

Nicolle Moore, MA, IMFT

Child-Focus, Inc.

Erin Lucas, LISW-S

Hopewell Health Centers, Inc.

• Brought to you by:

Early Childhood Mental Health Initiatives

Whole Child Matters Grant

Valerie Alloy, Ph.D. , Lead

Trauma Informed Early Learning

Housekeeping: Setting the Stage for Success

• Restroom Location

• Cell Phone Reminder

• Feel free to pass notes

• Respect each other

Opinions

Feedback on videosDuring Activities

The Value of Empathy

Agenda: Setting Expectations for the Day

Objectives1. Understand how our own resiliency impacts our ability to support

children2. Use strategies (the DARS and Building Your Bounce) to promote

resiliency in Early Learning Professionals3. Learn how to create a trauma informed early learning setting using

trauma-informed perspective and strategiesActivity

Fold a piece of paper into thirds1. What do I know?2. What do I want to know?3. What did I learn?

Objective One: Understand how our own resiliency impacts our ability to support children

Page title line here

ACE Score and Health Risk

• Alcoholism and alcohol abuse

• Chronic obstructive pulmonary disease (COPD)

• Depression

• Hallucinations

• Fetal death

• Decline in Health-related quality

of life

• Illicit drug use

• Ischemic heart disease (IHD)

• Risk for intimate partner violence• Multiple sexual partners• Sexually transmitted diseases

(STDs)• Smoking• Suicide attempts• Unintended pregnancies• Early initiation of smoking• Early initiation of sexual activity• Adolescent pregnancy• HIV

Page title line here

ACE Study Stats:

2/3rd (67%) of all suicide attempts

64% of adult suicide attempts

80% of child/adolescent suicide attempts

Are Attributable to Adverse Childhood Experiences

http://i11.photobucket.com/albums/a194/XxVonDucheSsexX/black_woman_in_profile.jpg

Trauma in Adults: Mental Health

• More than 84% of adult mental health clients will have trauma histories (Meuser et al, 2004)

• 50% of female and 25% of male clients experienced sexual assault in adulthood (Read et al, 2008)

• Clients with histories of childhood abuse will have earlier first admissions, more frequent and longer hospital stays, more time in seclusion and restraints, greater likelihood of self-injury or suicide attempts, more medication use and more severe symptoms

(Read et al, 2008)

Trauma in Adults Continued

Adults with histories of child abuse:

Earlier first psychiatric admissions

More frequent and longer hospital stays

More time in seclusion or restraint

Greater likelihood of self-injury or suicide attempt

More medication use

More severe symptoms (Read et al, 2005

Trauma in Children:

71% of children are exposed to violence each year (Finkelhor et al, 2013)

3 million children are maltreated or neglected each year (Child Welfare info, 2013)

3.5-10 million witness violence against their mother each year (Child Witness to Violence Project, 2013)

1 in 4 girls and 1 in 6 boys were sexually abused before adulthood (NCTSN Fact Sheet, 2009)

94% of children in juvenile justice settings have experience trauma (Rosenberg et al, 2014)

Interactive Input

Abuse and neglect have profound influences on brain development. The more prolonged the abuse or neglect, the more likely it is that permanent brain damage will occur.

Not only are people with developmental disabilities more likely to be exposed to trauma, but exposure to trauma makes developmental delays more likely.

Joan Gillece, Ph.D. ,NASMHPD

Brain Development

Brainstem

• Blood pressure

• Body temperature

• Heart rate

• Arousal states

Thalamus/ Hypothalamus

• Motor regulation

• Affect regulation

• Hunger/satiety

• Sleep

Limbic

• Affiliation

• Attachment

• Sexual Behavior

• Emotional Reactivity

Neocortex• Abstract Thought

• Concrete Thought

Mother

Caregiver

Family and Friends

Peers, TeachersCommunity

16

Bottoms Up Reaction to Fear

Lens Shift

“What happened to you?” instead of

“What’s wrong with you?

From “What’s WRONG?” to “What’s HAPPENED?”

• What is your diagnosis?

• What are your symptoms?

• How can I best help or treat you?

• What is your story? How did you end up here?

• How have you coped and adapted?

• How can we work together to figure out what helps?

What do I bring to the table?

Risk Factors versus Protective Factors

Risk FactorsProtective Factors

• Attachment

• Initiative

• Curiosity

• Trauma history/ACES

• Poverty

• Stressful events

Resilience Questionnaire

• RESILIENCE: an individual’s capacity to adapt positively to pressure, setbacks, challenges and change, in order to achieve and sustain peak personal effectiveness and recovery

• ELP’s resilience impacts the early learning environment…

Resilience Score

What’s Your Resilience Score???

Reflect on your Resiliency Score

Resiliency

Score

Complete DARS & Activity

Excerpts from ACES Too High

Building on Strengths

Building Resilience in Early Learning Professionals

Areas to Build Staff Resilience

1.• Relationships

2.• Internal Beliefs

3.• Initiative

4. • Self-Control

Mackrain, M. & Bruce, N. (2009). Building Your Bounce: Simple Strategies for a Resilient You. Lewisville, NC: Kaplan.

Relationships

• Positive, interpersonal supports are important for our overall mental health.

• Healthy relationships have an equal amount of giving and receiving. It is important that our relationships have a balanced

mix of closeness, mentorship, and friendly acquaintances.

1.•Relationships


Who Supports You??

• Our internal language guides facial expressions and our ability to focus on solutions.

• Personal thoughts/feelings and our perception of how effectively we are taking action in life.

2.•Internal Beliefs


Cognitive Behavioral Approach

Internal

Beliefs

Feelings

Behaviors

Kid President

• Do we have the ability to make positive changes/choices and act on them through good decision making skills?

• If we have the ability, how often are we using it?

• Can I say “no” and not feel guilty?

• Am I open to and seek out new knowledge?

• Am I open to considering other’s views?

• How often do I ask for help?

• Do I know what I need to relieve stress? Do I need physical exertion or physical rest?

3. •Initiative


Building your Bounce: Initiative

• There are only 24 hours in a day

• There’s always tomorrow

• Am I delegating what I can?

• Are my control issues getting in the way of delegation?

4.•Self-Control


Objective Three: Creating a Trauma Informed Setting Using Trauma Informed Perspective and Strategies

Trauma-Informed Early

Learning Settings

In small groups, discuss the questions on the handout

Components of a Trauma Informed Early Learning Setting

Trauma Informed Early Learning Settings

• This is achieved by receiving training about trauma and its impact on children on a regular basis.

• There is always more to learn…

1.


• Environments that are set up for success

appropriate spaces for play and learning

so children are engaged

• Areas in the setting for alone time/quiet time

• Warm, inviting, and a homelike atmosphere

2.


In TIC settings, professionals will continue to be monitored as well as monitor themselves. This can be done using tools such as the DECA Reflective checklist or the CLASS.

3.


• Areas will be identified on a regular basis in which professionals can make improvements to the current environment or with the interactions they are having with children and their families.

• There is a continuum of support available at all times.

.

3. Continued


Professionals need to build a positive relationship with each child as well as effectively becoming part of a wider support system. The crucial issues are:

A. Creating connection and defusing conflict

B. Planning for challenging incidents

C. Participating in systems – a team approach

Downey, Laura. (2007) Calmer classrooms: a guide to working with traumatized children, Child Safety Commissioner, Melbourne, Victoria, Australia.

4.

Creating Connection and Diffusing Conflict

• ELP must be in control of relationships without being controlling.

• Children will learn to trust an ELP when the ELP controls the tone, rhythm, and emotional quality of the relationship – the child will feel safe.

• ELP must understand children’s individual needs. • ELP should manage their own reactions.• ELP should provide structure and consistency.• Connecting is key• Positive reinforcement not always praise.Downey, Laura. (2007) Calmer classrooms: a guide to working with traumatized children, Child Safety Commissioner, Melbourne, Victoria, Australia.

4 A. Creating

Connection and diffusing Conflict

Planning for Challenging Incidents

• Children who have trauma histories will have outburst of extreme emotion. It is always better to diffuse these before they become extreme; however, this cannot happen all of the time. So…

• Establish safety

• Maintain self regulation

• Calm the child

• Assist the child to understand what happened

• Help the child take responsibility

• Speak with other children about it


4 B. Planning for

Challenging incidents

A Team Approach

• Settings should have a forum to meet and debrief about situations that may arise with children who have trauma history. Reflection and processing emotions is an important step to take after an incident has occurred. It will better help the ELP in the next situation and it will allow for other input about how things could be handled differently.

• Settings that have administration and directors that provide support and allow for parent involvement and input, are the most effective in being supportive and proactive.


4 C. A team Approach

Why is It Important to Have a Resilience Oriented Early Learning Environment?

1. Unconditional acceptance- staff are affirming of youth and families

2. Supports and services focus on promoting resiliency, while reducing risks and stabilizing symptoms.

3. These environments provide access to a complete continuum of care that addresses not only education but positive mental health and supportive intervention across developmental ages and stages.

4. These environments invest in our youth as our most valuable resources.

Benefits for Children

Safety

Safe environment for learning

Social-Emotional Environment

Feelings are understood and validated

Relationships

Adults respond confidently to child behavior

Benefits for Professionals

• Deeper understanding

• Renewed hope

• Confidence in responding to children

• Professional support system

• Community value

• Expert in the field

Benefits Far Outweigh Costs!!!

Let’s Read Together

Responding to trauma means creating early learning environments AND professionals that are supportive!!!

Reflection: Taking Key Points Home With Me!

What did I learn today?

What can I do tomorrow?

What can I add next week?

What do I need?

What can I add next month?

What do I need?

How can I ensure I am creating a trauma-informed early learning setting?!

Every Child Needs a Champion

Other Trainings

• Level 1: Toxic Stress to Safe Zone

• Level 3: Becoming a Trauma-Informed Early Learning Setting

• Challenging Behavior

Thank YOU For Your Time and Attention!!!

Please share any questions, “takeaways”, or reflections…

Trauma Informed Care Resources

• SAMHSA

• Devereux Center for Resilient Children

• National Council for Behavioral Health

• National Center for Trauma Informed Care

www.ChildTrauma.org

Read, J., van Os, J., Morrison, A.P., and Ross, C.A. (2005) Childhood trauma, psychosis and schizophrenia: A literature review with theoretical and clinical implications. Acta Pschiatr Scan, 112, 330-350.

Child Welfare Information Gateway (2013) Child Maltreatment 2011: Summary of Key Findings. Children Bureau, DHHS Administration fro Children Youth and Families, February, 2013.

https://www.childwelfare.gove/pubs/factsheets/canstats.cfm

Child Witness to Violence Project. Facts and Myths. https://childwitnesstoviolence.org/facts-myths.html Accessed 9/14/13

Finkelhor, D., turner, H.A., Shattuck, A., & Hamby, S.L. (2013) Violence, crime, and abuse exposure in a national sample of children and youth: an update. JAMA pediatrics, 167(7), 614-621

https://www.childwelfare.gove/pubs/factsheets/canstats.cfm

https://childwitnesstoviolence.org/facts-myths.html

Trauma Informed Care Resources

Goldberg, E. (2001). The executive brain: frontal lobes an the civilized mind. New York: Oxford Press.

LeDoux, J. (1996) The emotional brain: the mysterious underpinnings of emotional life. New York: Touchstone.

LeDoux, J. (2002) Synaptic self: how the brain becomes who we are. New York: Viking.


Perry, B. D. (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatized children: The neurosequential model of therapeutics. In Boyd-Webb, N, ed. Working with traumatized youth in child welfare. New York: Guilford Press.

trauma informed early learning...the executive brain: frontal lobes an the civilized mind. new york:...

Documents