5/12/2014. Trauma definitions & stats Trauma and impact on development Interventions Trauma-Informed Care Consortium of Central Texas Questions

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1 Austin Child Guidance Center Trauma definitions & stats Trauma and impact on development Interventions Trauma-Informed Care Consortium of Central Texas Questions 1

2 Community Impact of Trauma Child Abuse Domestic Violence Serious Car Accident Natural Disasters Witnessing a Death Cancer or Serious Illness Crime Victim or Witness of a Crime War Chronic Bullying Sex trafficking Medical Procedures Secondary Trauma Chronic Neglect Copied from cdc.gov/ace 2

3 Pervasive Life domains Life-shaping Self-perpetuating Preys vulnerable populations Relationships Perpetuated by non-informed trauma systems Trauma affects staff members (Fallot, R. & Harris, M., 2009; Community Connections) What does trauma look like in In Children? Return to bedwetting Return to baby talk Cries a more than usual Separation anxiety Sleep difficulties Process trauma through play Feel guilt or shame Easily startled Feel numb Talk a lot about event Eating difficulties Attachment problems Taken from s/parents-caregivers 3

4 Sleep disturbance Suicidal ideation/attempts Self-injurious behavior Becoming engaged sexual or hyper-sexual behavior Changes in academic performance Using drugs/alcohol Exaggerated startle response Withdrawn/Depressed Weight gain/loss Preoccupation with traumatic event Avoidance Taken from Exposure to actual or threatened death, serious injury or sexual violation. DSM-5 now lists four clusters: Re-experiencing the event Heightened arousal Avoidance Negative thoughts and mood or feelings 4

5 Increase cortisol. Alarm centers of the body. Increase heart rate and blood pressure. Long-term, it can change brain chemistry or brain development, leading to difficulty with regulating emotions. Neglect the worst! Amygdala Hippocampus Pre-frontal cortex. Taken from Traumatic Experience and the Brain by D. Ziegler, Ph.D. 5

6 PRE-FRONTAL CORTEX Controlling impulses Inhibiting inappropriate behavior Initiating appropriate behavior Working memory Plan center of the brain Organizes information Insight Sets priorities Makes decisions Copied from Assisting those recovering from trauma 6

7 Safety Culturally Inclusive Trustworthiness Empowerment Choice Collaboration Enhance safety Create normalcy Develop routines Sleep Food and hydration Be mindful of sensory overload Manage/identify triggers Be aware of relationship dynamics Model appropriate boundaries Always remain calm replaying trauma 7

8 Transitions or changes-gentle and slow Set clear, firm limits for inappropriate behavior Increase the level of support & encouragement Use reflective listening & feelings identification Encourage exercise and calming techniques Consider impact of multi-generational trauma ALWAYS keep in mind, that trauma is a brain disorder!!! Develop short, step-by-step processes Consider making accommodations and modifications to academic work, even including these in a 504 plan. You might: Shorten assignments Allow additional time to complete assignments Give permission to leave class to go to a designated adult (such as a counselor or school nurse) if feelings become overwhelming Provide additional support for organizing and remembering assignments 8

9 1. Assess for trauma 2. Provide a safe place 3. Model self-regulation 4. Encourage routines 5. Focus on positive reinforcement & special time together 6. Refer to trauma-informed services 7. Consider evaluation for school assessment Trauma-Informed Care Consortium (TICC) of Central Texas When the Japanese mend broken objects, they aggrandize the damage by filling the cracks with gold. They believe that when something's suffered damage and has a history it becomes more beautiful. ~Barbara Bloom 9

10 National Institute for Mental Health National Child Traumatic Stress Network Texas Education Agency (Info on Special Education and 504) SAMHSA Trauma-Informed Care Consortium of Central Texas

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