Raising Awareness: Trauma Informed Practices Presented by Michele A. Carmichael Director IL AWARE Principal Consultant for Behavioral Health Supports in Schools Illinois State Board of Education Define Trauma Intentions: Create a shared understanding of a traumasensitive lens Explore statewide resources available Trauma Defined The experience of an event by a child that is emotionally painful or distressful which often results in lasting mental and physical effects. National Institute of Mental Health CKnight/ICAAP 2016 1
3 Es of Trauma Event Experience Effects 3 Es Examples Event Experience Effects Abuse physical, emotional, sexual Neglect Victimization Domestic violence Community violence Accident/illness Natural Disaster War/terrorism Life threatening overwhelming Chronic A subjective, internal state Varies between people Varies over time with the same person Developmental level Emotional experience at the time VS later Symptoms can include: Nightmares Flashbacks Fight or Flight Dissociation Cutting Hyperarousal Misinterpretation of cues Overreaction WHAT ARE ACEs? Adverse Childhood Experiences (ACEs) is the term given to describe all types of abuse, neglect, and other traumatic experiences that occur to individuals under the age of 18. WHO PARTICIPATED CKnight/ICAAP 2016 2
TYPES OF ACEs http://www.acestudy.org or http://www.cdc.gov/nccdphp/ace Prevalence HOW COMMON ARE ACEs? CKnight/ICAAP 2016 3
40% physically assaulted 2% experienced sexual assault or abuse 14% experienced repeated maltreatment by a caregiver 25% victims of robbery, vandalism or theft 13% reported being physically bullied 20% witnessed violence in their family or the neighborhood CM1 Impact on Urban, Minority, and Poor 98.5% of urban adolescents report exposure to violent crime (65.9% rural) African American adolescents report more victimization Poor adolescents report more child maltreatment Overstreet & Mathews (2011) Youth from families earning less than $15,000 annually were 26.5 times more likely to experience maltreatment compared with a youth from families earning over $30,000 National Center on Child Abuse and Neglect, Sedlak and Broadhurst 1996 CKnight/ICAAP 2016 4
Slide 10 CM1 spelling I like this AND wonder if we should have more generic data not just a detention center? CARMICHAEL MICHELE, 4/26/2016
Impact of ACEs on Education 51% of children with 4+ ACE scores had learning and behavior problems in school compared with only 3% of children with no ACE score Illinois ACEs Response Collaborative Summit 2015 Education Policy Brief Impact of ACEs on Education Students with 3 or more ACEs Are 2 ½ times more likely to fail a grade, Score lower on standardized tests, Have language difficulties, More likely to be suspended or expelled, and Are designated as special education more frequently Illinois ACEs Response Collaborative Summit 2015 Education Policy Brief CKnight/ICAAP 2016 5
Impact of Trauma on Learning at School Academic performance: Organization Comprehension Memory The ability to produce work Engagement in learning Ability to self regulate attention, emotions, and behavior The Problem: Impact Trauma Sensitive Schools. Retrieved from http://www.traumasensitiveschools.org/trauma and learning/the problem impact/ Impact of Trauma on Behavior at School Classroom behavior: Ability to remain calm and regulate their behavior in the classroom Ability to process social cues Ability to convey feelings in appropriate manner The Problem: Impact Trauma Sensitive Schools. Retrieved from http://www.traumasensitiveschools.org/trauma and learning/the problem impact/ Impact of Trauma on Relationships at School Relationships: Preoccupied with physical and psychological safety Distrustful of adults and/or fellow students The Problem: Impact Trauma Sensitive Schools. Retrieved from http://www.traumasensitiveschools.org/trauma and learning/the problem impact/ CKnight/ICAAP 2016 6
Trauma s Impact on the Brain Disruption in neural development can include: Failure to expose youth to appropriate experiences at the critical times (Neglect) Overwhelming the brain s alarm system (Abuse) The ChildTrauma Academy www.childtrauma.org All rights reserved 2007-2015 Bruce D. Perry Trauma: Brain Stem and Limbic System CKnight/ICAAP 2016 7
Slide 19 1 _Re-opened_ -Katie Pohlman, 4/18/2016 2 I am guessing the notes for this slide are what CTA provided. Do we have more if we looked back at Module work or personal notes? Thinking Dr. Perry may have said more specifics about how the brain changes. Don't think we need a ton, but would like a bit more to provide the trainer with the information if nothing else. -Katie Pohlman, 4/18/2016
Can You Relate? Trauma: Cortex Impact of Trauma During Childhood Early childhood is both the most critical and the most vulnerable time in any child s development. In the first few years, the ingredients for intellectual, emotional and moral growth are laid down. We cannot fail children in these early years. Brazelton & Greenspan CKnight/ICAAP 2016 8
A Child s Reaction Will vary depending on: Age and developmental stage Temperament Perception of the danger faced Trauma history Adversities faced following the trauma Availability of adults who can offer help, reassurance and protection Trauma informed in a nutshell Instead of asking What s wrong with you? a trauma informed approach asks What has happened to you? Roger Fallot and Maxine Harris Using Trauma Theory to Design Service Systems Teachers are Not to Blame for Dysregulation Neither teacher nor child caused the dysregulation, but both will pay for the results unless the classroom is crafted with developmentally targeted strategies. CKnight/ICAAP 2016 9
Resilience Resiliency is essentially the capacity to face a stressor or a life experience that s challenging without having any significant damaging impact on the individual. If a student suffers grief, they would feel loss and a normal range of emotions. But over time, it wouldn t interrupt their ability to go to school and to lead a healthy life. That s resilience. Dr. Bruce Perry A student s resilience is fostered when his or her internal and environmental protective factors are strengthened. These protective factors can buffer, ameliorate, and mitigate the effects of risk and stress, propelling the student to academic and life success. O Dougherty Wright, Masten, & Narayan, 2013 CKnight/ICAAP 2016 10
Pause & Reflect Consider the significance of resiliency in students impacted by trauma. What might be some protective factors schools might already be providing to strengthen resiliency in students? Trauma Informed Developmental Educational Experiences Relational (safe) Relevant (developmentally matched) Repetitive (patterned) Rewarding (pleasurable) Rhythmic (resonant with neural patterns) Respectful (child, family, culture) CKnight/ICAAP 2016 11
The more healthy relationships a child has, the more likely he will be able to recover from trauma and thrive. Relationships are the agents of change and the most powerful therapy is human love. Bruce D. Perry The Neuro sequential Lens Using the Neuro sequential Model in Education as a foundation for service delivery, all people who work with children potentially impacted by trauma can begin to see these children as what they are: Children. Know the Stage and Watch the State Effective adult interactions to teach, enrich or heal young children comes when the developmental stage and present state of the child are respected Attunement becomes the key Core principles of development should be central educational objective for caregivers and educators of young children All rights reserved 2007-2015 Bruce D. Perry CKnight/ICAAP 2016 12
Symptoms Restless, hyperactive, disorganized, and/or agitated activity, difficulty sleeping, poor concentration, and hypervigilant motor activity Hyperarousal and other anxiety symptoms, mimicking hypomania, traumatic reenactment mimicking aggressive or hyperarousal behavior, and maladaptive attempts at cognitive coping mimicking pseudo manic statements Self injurious behaviors as avoidant coping with trauma reminders, social withdrawal, affective numbing, and/or sleep difficulties Severely agitated, hypervigilance, flashbacks, sleep disturbance, numbing and/or social withdrawal,, unusual perceptions, impairment of sensorium and fluctuating levels of consciousness Slide courtesy of: Gene Griffin, J.D., Ph.D. How Do You Interpret What You See? DSM Diagnosis Overlapping Symptoms Trauma Attention Deficit/ Hyperactivity Disorder Intervention? Bipolar Disorder Intervention? Major Depressive Disorder Intervention? Restless, hyperactive, disorganized, and/or agitated activity, difficulty sleeping, poor concentration, and hypervigilant motor activity Hyperarousal and other anxiety symptoms, mimicking hypomania, traumatic reenactment mimicking aggressive or hyperarousal behavior, and maladaptive attempts at cognitive coping mimicking pseudo manic statements Self injurious behaviors as avoidant coping with trauma reminders, social withdrawal, affective numbing, and/or sleep difficulties Child Trauma Child Trauma Child Trauma Psychotic Disorder Intervention? Severely agitated, hypervigilance, flashbacks, sleep disturbance, numbing and/or social withdrawal,, unusual perceptions, impairment of sensorium and fluctuating levels of consciousness Child Trauma Slide courtesy of: Gene Griffin, J.D., Ph.D. CKnight/ICAAP 2016 13
All rights reserved 2007-2015 Bruce D. Perry For more information: IL MTSS Network Regional Awareness Trainings Suggested Training Plans District Leadership Teams (Webinar, Face to Face Action Planning) Building Leadership Teams (Book Study, Webinars, Face to Face Action Planning) Pupil Personnel Staff (Targeted Supports) Contact/Website Resources Michele Carmichael Mcarmich@isbe.net 217/782 5589 Illinois State Board of Education: Learning Supports http://www.isbe.net/learningsupports/default.htm IL MTSS Network http://www.ilmtss.net/ CKnight/ICAAP 2016 14