UNDERSTANDING THE IMPACT OF TRAUMA IDENTIFYING STRATEGIES TO

UNDERSTANDING THE IMPACT OF TRAUMA & IDENTIFYING STRATEGIES TO PROMOTE HEALING The California Child Care Resource & Referral Network & The California Department Of Social Services Bridge Program

WELCOME & INTRODUCTIONS

BY THE END OF THIS MODULE, PARTICIPANTS WILL BE ABLE TO • SHARE A SIMPLE DEFINITION OF TRAUMA. LEARNING OBJECTIVES • DESCRIBE TRAUMA’S EFFECTS ON CHILDREN’S DEVELOPMENT, EMOTIONS AND BEHAVIOR. • RECOGNIZE THE ROLES, RESPONSIBILITIES, AND OPPORTUNITIES THAT EACH MEMBER OF THE CHILD SERVING TEAM HAVE IN ENHANCING CHILD AND FAMILY RESILIENCY.

• BE HERE NOW • PARTICIPATE LEARNING AGREEMENTS • SPEAK FOR YOURSELF • BE OPEN • MAINTAIN CONFIDENTIALITY • GIVE CONSTRUCTIVE FEEDBACK • TAKE YOUR PULSE

DEFINING TRAUMA

TRAUMA DEFINED TRAUMA IS A LIFE-THREATENING OR FRIGHTENING EXPERIENCE FOR A CHILD OR SOMEONE FOR WHOM THE CHILD CARES THAT OVERWHELMS THE CHILD’S CAPACITY TO COPE

• ACUTE TYPES OF TRAUMA • CHRONIC • COMPLEX/INTERPERSONAL • HISTORICAL & INTERGENERATIONAL

• EACH YEAR, OVER 1, 500 CHILDREN DIE OF ABUSE OR NEGLECT TRAUMA IS WIDESPREAD • 70% OF CHILDREN ENDURE HIGHLY STRESSFUL OR TRAUMATIC EVENTS BY AGE 6 YEARS • 3. 6 MILLION REFERRALS MADE TO CHILD PROTECTIVE SERVICES IN 2014 INVOLVING 6. 6 MILLION CHILDREN • 9 OUT OF 10 CHILDREN INVOLVED WITH THE CHILD WELFARE SYSTEM HAVE BEEN EXPOSED TO VIOLENCE.

TRAUMATIC STRESS RESPONSE THE PHYSICAL & EMOTIONAL RESPONSES TO THE EVENT THE CHILD’S STRESS RESPONSE SYSTEM PERCEIVES AS A THREAT SIGNALS OF PERCEIVED THREAT (TRIGGERS) CAUSE A PHYSIOLOGICAL REACTION IN THE CHILD’S STRESS RESPONSE SYSTEM THAT OVERWHELMS THEIR CAPACITY TO COPE EVEN WHEN THERE IS NO ACTUAL DANGER

TRAUMATIZED CHILD THE TRAUMA SYSTEM • EXPERIENCES SURVIVAL-IN-THEMOMENT STATES IN SPECIFIC, DEFINABLE MOMENTS SOCIAL ENVIRONMENT • SYSTEM OF CARE THAT IS UNABLE TO HELP THE CHILD REGULATE THESE SURVIVAL STATES

• CHILDREN IN CHILD WELFARE DISPROPORTIONATELY IMPACTED BY TRAUMA • TRAUMATIC STRESS RESPONSES CAN IMPAIR HEALTH DEVELOPMENT TRAUMA & CHILD WELFARE • MANY CAREGIVERS ARE MANAGING THEIR OWN UNRESOLVED TRAUMATIC RESPONSES, INCREASING RISK OF INTERGENERATIONAL TRANSMISSION OF TRAUMA • CHILDREN & FAMILIES INVOLVED WITH CHILD WELFARE FACE ADDITIONAL STRESSORS, RISK FACTORS, & VULNERABILITIES

• TRAUMA IS ESPECIALLY PREVALENT AMONG YOUNG CHILDREN EARLY CHILDHOOD TRAUMA IS UNIQUE • YOUNGER CHILDREN HAVE DIFFERENT RESPONSES TO TRAUMA THAN OLDER CHILDREN & ADULTS WHICH CAREGIVERS MAY NOT RECOGNIZE AS TRAUMARELATED • APPROACHES USED TO ADDRESS THE CHALLENGING BEHAVIORS MAY NOT WORK AND SOMETIMES EXACERBATE THE BEHAVIORS

SHIFT IN PERSPECTIVE WHAT’S WRONG WITH YOU WHAT HAPPENED TO YOU?

THE DEVELOPING CHILD

PRINCIPLES OF DEVELOPMENT • ONGOING • DIRECTIONAL • MAY INVOLVE STAGES • CUMULATIVE

NATURE VS NURTURE • NATURE • GENES • NURTURE • ENVIRONMENT

S. P. E. C. S. DOMAINS OF CHILD DEVELOPMENT • SOCIAL • PHYSICAL • EMOTIONAL • COGNITIVE • SEXUAL

• NEURON THE DEVELOPING BRAIN • BRAIN STEM • LIMBIC SYSTEM • CORTEX

• COMBINATION OF NATURE AND NURTURE HOW THE BRAIN GROWS • SEQUENTIAL & BOTTOM-UP • ACTIVITY/EXPERIENCEDEPENDENT • SENSITIVE PERIODS THAT INCLUDE: WINDOWS OF OPPORTUNITY AND WINDOWS OF VULNERABILITY

FEEL A NEED/DISPLEASU RE ATTACHMENT SERVE & RETURN FEEL RELAXED EXPRESS NEED IS MET/SATISFIED CONSISTENTLY

ROLE OF CULTURE IN DEVELOPMENT A TOTAL SYSTEM THAT REGULATES LIFE WITHIN A PARTICULAR GROUP OF PEOPLE • SETS EXPECTATIONS & LIMITATIONS ON BEHAVIORS • CREATES CONTEXT • RESULTS IN SOME BEHAVIORS BEING REWARDED & OTHERS OFTEN IGNORED

• ATTACHMENT SIX CORE STRENGTHS FOR HEALTHY CHILD DEVELOPMENT • SELF-REGULATION • AFFILIATION • ATTUNEMENT • TOLERANCE • RESPECT

STRESS & ADVERSITY

POSITIVE STRESS CONTINUUM TOLERAB LE TOXIC

VARIABILITY IN RESPONSE TO STRESSORS HOW DO YOU COPE? • INTERNAL • EXTERNAL

FLIGH FIGHT T SURVIVAL RESPONSES FREE ZE AFFECT A CHILD’S MENTAL, EMOTIONAL, & PHYSICAL WELLBEING AS THEIR COPING BECOMES OVERWHELMED CAUSING SHIFTS IN • AWARENESS OF SELF & ENVIRONMENT • INTENSITY OF EMOTIONS • PHYSICAL RESPONSES

FROM SURVIVAL RESPONSE TO SURVIVAL IN THE MOMENT STATES • A WALK IN THE WOODS • IMPAIRED OFF SWITCH

HIGH ROAD: 30 -40 MILLISECONDS CORTEX (PERCEPTION, CONTEXT, & AWARENESS) INFORMATION PROCESSING & THREAT RESPONSE STIMULU S HIPPOCAMPUS (MEMORY) THALAMU S (SENSOR Y) LOW ROAD: 8 -10 MILLISECONDS AMYGDALA RESPONS E

THREATS SHUTDOWN THINKING LOW ROAD • HANDLES IMMEDIATE THREAT • IS LIGHTNING FAST • ACTS REFLEXIVELY • FOCUSES ON INFORMATION FROM SENSES • LOSES DETAILS HIGH ROAD • PLANS, PROBLEM SOLVES • TAKES LONGER • ALLOWS CHILD TO BE “MINDFUL” • USES INFORMATION FROM WORDS, CONCEPTS, THOUGHTS • ANALYZES DETAILS

• DIFFICULTIES WITH REGULATION • IMPAIRED COGNITIVE CAPACITIES • DEVELOPMENTAL DELAYS BEHAVIORAL CHALLENGES IN CHILDREN WITH TRAUMA • DIFFICULTY WITH RELATIONSHIPS • PEERS • ADULTS • ANXIETY/FEAR • EATING, SLEEPING, TOILETING ISSUES • LIMITED SELF-SOOTHING STRATEGIES • IMPAIRED EXECUTIVE FUNCTIONS • PLANNING • GOAL-SETTING • ANTICIPATING CONSEQUENCES

IMPACT OF ADVERSITY ON DEVELOPMENT

EARLY DEATH ADVERSE CHILDHOOD EXPERIENCES DISEASE, DISABILIT Y, & SOCIAL PROBLEM S HEALTH-RISK BEHAVIORS SOCIAL, EMOTIONAL, & COGNITIVE IMPAIRMENT DISRUPTED BRAIN DEVELOPMENT ADVERSE CHILDHOOD EXPERIENCES

PREFRONTA L CORTEX DISRUPTED BRAIN DEVELOPMENT AMYGDALA PITUITARY GLAND BRAINSTE M HYPOTHALAM US CEREBELLU HIPPOCAMPU M S

FEEL A NEED/DISPLEASU RE DISRUPTED ATTACHMENT FEEL OVERWHELMED EXPRESS NEED IS NOT MET/SATISFIED CONSISTENTLY

• ATTENTION-DEFICIT HYPERACTIVITY DISORDER COMMON CHILDHOOD DIAGNOSES • POST-TRAUMATIC STRESS DISORDER • OPPOSITIONAL DEFIANT DISORDER • CONDUCT DISORDER • BIPOLAR DISORDER • REACTIVE ATTACHMENT DISORDER

ADOPTION OF HEALTH-RISK BEHAVIORS PREFRONTAL CORTEX OR OUR THINKING BRAIN ALLOWS FOR • CONSIDERATION OF CONSEQUENCES • APPRAISAL OF SAFETY & DANGER • LONG-TERM PLANNING

INDIRECT • TRANSMISSION VIA PROBLEMATIC CAREGIVING SKILLS & BEHAVIORS TRAUMA TRANSMISSION DIRECT • TRANSMISSION VIA LEARNED BEHAVIORS INCLUDING EXPOSURE TO TRAUMA RESPONSES & MODELING OF MALADAPTIVE COPING STRATEGIES

• TRAUMA ACTIVATES THE CHILD’S EMERGENCY/SURVIVAL RESPONSE SYSTEM RECAPPING THE IMPACT OF TRAUMA • WHEN EXPOSED TO ONGOING OR INTENSE LEVELS OF THREAT, A CHILD’S SURVIVAL RESPONSE OF FLIGHT, FIGHT, OR FREEZE CAN BECOME A SURVIVAL STATE • WITH OVERUSE, A CHILD’S PRESENT MOMENT SURVIVAL RESPONSES CAN BE TRIGGERED BY A REMINDER OF PAST TRAUMATIC EXPERIENCES

TRAUMA RESPONSIVE CARE

A TRAUMA RESPONSIVE PROGRAM OR SYSTEM • REALIZES THE WIDESPREAD IMPACT OF TRAUMA & UNDERSTANDS PATHS TO RECOVERY • RECOGNIZES THE SIGNS & SYMPTOMS IN FAMILIES INVOLVED WITH THE SYSTEM • RESPONDS BY FULLY INTEGRATING KNOWLEDGE ABOUT TRAUMA INTO POLICIES, PROCEDURES, & PRACTICES INORDER TO RESIST RETRAUMATIZATION

SOCIETY COMMUNITY CHILDREN DO NOT LIVE IN ISOLATION FAMILY CHILD

A HEALTHY RIPPLE EFFECT SELFAWARENESS INSIGHT BEHAVIOR CHANGE ENDLESS OPPORTUNITI ES

ROLE OF THE CAREGIVER • IDENTIFY & LEVERAGE THE CHILD’S STRENGTHS • HELP CHILD MANAGE SURVIVAL RESPONSES • INCREASE CHILD’S FEELING OF CONNECTION & SAFETY

• LOOK AT THE WHOLE CHILD STRENGTHS • WHAT ARE SOME OF THE STRENGTHS YOU SEE IN THE CHILDREN WITH WHOM YOU WORK? • WOULD THEIR CAREGIVER?

SOCIAL ENVIRONMENT STRENGTHS • HOME • SCHOOL • NEIGHBORHOOD • CULTURAL COMMUNITIES • OTHER SYSTEMS OF CARE

LEARNING TO TRUST • TRAUMA CAN TEACH CHILDREN THAT ENVIRONMENTS ARE NOT SAFE & THAT CAREGIVERS CANNOT BE COUNTED UPON • HEALTHY TRUST IS BUILT OVER TIME IN SLOW, CONTINUOUS, & MEANINGFUL WAYS

SAFE POWER OF RELATIONSHIPS REGULATIO N STABLE RECOVERY NURTURING RESILIENCE RESPONSIV E

• TRANSITIONS • ARRANGEMENT & DESIGN PROVIDING TRAUMA RESPONSIVE ENVIRONMENTS • SCHEDULES & ROUTINES • LEARNING SPACE • VISUAL • AUDITORY • VESTIBULAR • TACTILE • PROPRIOCEPTIVE • INDOOR & OUTDOOR ELEMENTS

CREATING A SAFE SPACE CHILDREN MAY NEED TO LOOK FOR SPACES FROM WHICH TO OBSERVE OR BE BY THEMSELVES.

• CATCH THE CHILD DISPLAYING ACCEPTABLE/POSITIVE BEHAVIOR • PROVIDE POSITIVE FEEDBACK SIGNALS OF SAFETY • BE GENUINE • KEEP IT UP • ENGAGE OTHER TRUSTED ADULTS • START WHERE THE CHILD IS

PRESENCE HOW CAN WE COMMUNICATE TO CHILDREN THAT WE ARE PRESENT WHEN THEY ARE REVVING?

IDENTIFYING EMOTIONAL HOTSPOTS • STRATEGIES FOR SAYING NO

• BREATHE • MAINTAIN POSITIVITY STAYING CALM & NEUTRAL • BE OPEN • USE A LOW, QUIET VOICE • VOICE YOUR CONCERN

PROMOTING SENSORY &EMOTIONAL LITERACY • “TUNING IN” TO THE CHILD’S THOUGHTS, FEELINGS AND BEHAVIORS CAN HELP BUILD THE STAIRCASE IN THE CHILD’S BRAIN. • PROVIDE SENSORY LABELS AS CHILDREN EXPERIENCE VARIOUS AFFECTIVE STATES. • RECOGNIZE SENSATIONS IN YOUR BODY • RECOGNIZE EMOTIONS IN YOURSELF AND OTHERS • UNDERSTAND APPROPRIATE WAYS TO EXPRESS STRONG SENSATIONS AND EMOTIONS • LEARN SELF-REGULATION AND CALMING SKILLS

UNDERSTANDING A CHILD’S BEHAVIOR REGULATING REVVING REEXPERIENCING AWARENESS AFFECT ACTION RECONSTITUTIN G

MATCHING YOUR APPROACH

• REVVING IS A CRITICAL TIME TO HELP CHILDREN AVOID ESCALATING INTO THE REEXPERIENCING STAGE RESPONDING TO SIGNALS OF REVVING • SUPPORTIVE ADULTS CAN HELP BY RECOGNIZING A CHILD’S SIGNALS OF REVVING AND KNOWING WHAT TO DO IN RESPONSE. • WHAT YOU DO DEPENDS ON THE SIGNALS OF REVVING YOU ARE SEEING.

RECOGNIZING & RESPONDING TO SIGNALS OF RE-EXPERIENCING • USE DEEP BREATHING & POSITIVE SELF-TALK TO REMAIN CALM & NEUTRAL • REMOVE OTHER CHILDREN & DANGEROUS OBJECTS FROM THE AREA • REDUCE NOISES, SOURCES OF STIMULATION & TRIGGERS • APPROACH FROM SIDE IN A NON -THREATENING MANNER • REMIND THE CHILD THAT YOU ARE THERE TO HELP & THAT THE CHILD IS SAFE • USE SHORT SENTENCES, CALM VOICE, & PRAISE STEPS TOWARD REGULATION

RECOGNIZING & RESPONDING TO SIGNALS OF RECONSTITUTING CHILD • GRADUALLY APPEARS CALM OR QUIET • REENGAGES IN THE ENVIRONMENT • HIGH RISK FOR ESCALATING BACK INTO RE-EXPERIENCING ADULTS CAN HELP BY • REINFORCING THE CHILD’S POSITIVE RESPONSES • REASSURING CONTINUED SAFETY • LIMITING EXPOSURE TO STRESSORS & STIMULATION • AVOID LECTURING & PROVIDING CONSEQUENCES UNTIL CHILD IS COMPLETELY CALM

RESTORATIVE DISCIPLE ALLOWS THE CHILD AN OPPORTUNITY TO MAKE THINGS RIGHT. RETURNING TO REGULATING KIDS NEED BOUNDARIES, LIMITS AND STRUCTURE — BUT HOW YOU PROVIDE THEM IS KEY HOW CAN YOU USE RESTORATIVE DISCIPLINE TO BENEFIT THE CHILDREN IN YOUR HOME?

REGULATING • BE SPECIFIC & POSITIVE REVVING • STAY CALM & REMIND CHILD OF PAST SUCCESSES SAFETY ACROSS ALL BEHAVIORS RE-EXPERIENCING • KEEP IT SIMPLE, REPEAT AS NEEDED RECONSTITUTING • ALLOW CHILD TO FULLY RETURN TO BASELINE REGULATING • BUILD SKILLS & PLAN

BUILDING A SUPPORTIVE NETWORK LOOK FOR TRUSTED PEOPLE IN THE CHILD’S • EXTENDED FAMILY • SCHOOL • COMMUNITY

POWER OF AFFILIATION THE CAPACITY TO JOIN OTHERS & CONTRIBUTE AS PART OF A GROUP

FOSTER PARENT IT TAKES A TEAM EXTENDE D FAMILY SOCIAL WORKER BIRTH FAMILY CLINICIAN PROVIDER S AFTER CARE STAFF

FINAL REFLECTIONS