YOUTH BEHAVIOR AND SAFETY CHILD ABUSE NEGLECT Adverse

YOUTH BEHAVIOR AND SAFETY CHILD ABUSE & NEGLECT Adverse Childhood Experiences(ACEs) Tuesday, October 17 th 1 PM ET The webinar will begin shortly.

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AGENDA RESILIENCE & LEARNING PROJECT Keith Poston, Public School Forum of North Carolina CHILD ABUSE AND NEGLECT Melea Rose-Waters, Prevent Child Abuse North Carolina ADVERSE CHILDHOOD EXPERIENCES (ACEs) OVERVIEW Elizabeth De. Konty, Public School Forum of North Carolina TRAUMA-SENSITIVE STRATEGIES Katie Rosanbalm, Ph. D. , Duke Center for Child and Family Policy QUESTIONS

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GUEST PRESENTER Keith Poston Public School Forum of North Carolina

Resilience & Learning An Initiative of the Public School Forum of NC Resilience & Learning Project To ensure academic success and improve the social and emotional well-being of children impacted by trauma

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GUEST PRESENTER Melea Rose-Waters Prevent Child Abuse North Carolina

Recognizing and Responding to Suspicions of Child Maltreatment Preventing Child Abuse: It’s Essential Melea Rose-Waters, MSW Prevent Child Abuse North Carolina

All children deserve great childhoods. It’s essential! Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

Social-Ecological Model of Child Abuse & Neglect Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

Types of Abuse �Physical Abuse �Sexual Abuse �Emotional Abuse �Neglect Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

§ Indicators can be signs of abuse or neglect (but are NOT definitive and should be considered flags) § Indicators can be physical, emotional or behavioral § Indicators should always be documented § Indicators can occur individually but will usually occur together or repeatedly Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

What Is Emotional Abuse? Emotional abuse is constant and recurring. Examples of emotional abuse: Criticizing a child for developmentally appropriate behavior, unrealistic expectations, favoritism, little or no interest in child, withholding love and affection, social isolation Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

What is Physical Abuse? Examples of physical abuse include: Physical abuse is defined as nonaccidental serious injury or injuries to a child. It can include any serious injury or risk of serious injury to a child by other than accidental means. Harmful restraint, beating, use of a weapon, punching, biting, burning, shaking and kicking. Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

Behavioral/Emotional Indicators of Physical Abuse • Excessive absences from school or child care • Fear of parents or other adults • Extreme aggressiveness • Cognitive and intellectual impairment • Deficits in speech and language • Hyperactivity, impulsivity, and low frustration tolerance • Depression, low self-esteem, and suicidal tendencies • Constant tiredness and inability to stay awake • Being easily agitated or defensive Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

Does the injury match the story? Is the child developmentally capable of injuring herself in the manner described? Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

What is Sexual Abuse? Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

What is Child Neglect? Neglect means that, despite available resources, a child’s needs are not met. Neglect is the most basic and frequently charged form of child mistreatment Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

Indicators of Neglect Physical indicators of neglect can include a child who is: • Undernourished • Lethargic • Physical health issues that go untreated • Lack of supervision Emotional/Behavioral indicators may include: • Begging for or stealing food • Poor hygiene • Frequent accidents and injuries • Risky adolescent behavior • Developmental delays that are not caused by a disability • Clinging behavior or being indiscriminate with affection • Poor ability to relate to others and poor social skills Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

All North Carolinians are Mandated Reporters NCGS 7 B-301 defines who should REPORT suspected abuse or neglect as: Any person or institution that has cause to suspect that a child is being abused or neglected is required by law to report it. Keep in Mind: § If you make the report in good faith, you will receive immunity from possible civil or criminal liability that may result from your report. § This means there is a legal obligation to report. This legal obligation supersedes organizational policies. Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

Making the Referral to DSS • Notify DSS – Child Protective Services (CPS) unit in the county where the child lives or is found • In person, by telephone, or in writing • May report anonymously (but check with your organization protocol) • DSS is required to keep reporters identification confidential • If the case goes to court, you make be called to testify • The CPS worker will use a standard intake form and may ask you questions that might not seem relevant – answer to the best of your ability • If your organization has a policy that an administrator make the referral, it is still your responsibility to make sure the referral gets made; and if possible, you should be there when they make the referral in case questions arise • If you think a child is in immediate danger, call 911 Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

www. Prevent. Child. Abuse. NC. org Recognizing and Responding to Suspicions of Child Maltreatment FREE Online Training Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

T k n ha ! u yo Contact Information Melea Rose-Waters, MSW Parent and Community Engagement Manager (919) 256 -6614 mrosewaters@preventchildabusenc. org www. Prevent. Child. Abuse. NC. org 1 -800 -CHILDREN Stay Connected: Facebook. com/Prevent. Child. Abuse. NC Twitter. com/PCANC

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GUEST PRESENTER Elizabeth De. Konty Public School Forum of North Carolina

GUEST PRESENTER Katie Rosanbalm, Ph. D. Duke Center for Child and Family Policy

Resilience & Learning Creating trauma-sensitive schools to ensure academic success and improve the social and emotional well-being of children impacted by trauma. NC Resilience & Learning Project To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Introductions • Public School Forum of North Carolina • Katie and Elizabeth NC Resilience & Learning Project 31 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

NC Resilience & Learning Project Overview • Two key components: – Professional Development: Ø Training for the entire staff school-wide Ø More in-depth training for the Resilience Team – Resilience Team: Ø A team within each school that will meet bi-weekly throughout the year to identify areas of urgency and work through a focused action planning process to create strategies that will make your school trauma-sensitive NC Resilience & Learning Project 32 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

TRAUMA AND TOXIC STRESS NC Resilience & Learning Project 33 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

What is Trauma? “Trauma is not an event itself, but rather a response to a stressful experience in which a person’s ability to cope is dramatically undermined” Cole, S. F. , O’Brien, J. G. , Gadd, M. G. , Ristuccia, J. , Wallace, D. L. , Gregory, M. (2005). Helping Traumatized Children Learn. Boston, MA: Massachusetts Advocates for Children, pp. 18. NC Resilience & Learning Project 34 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

What is Trauma? • Trauma may be a response resulting from: – a one-time event OR – a chronic situation • Trauma can be the result of a number of categories of events such as: – – – Poverty/homelessness/lack of basic needs Exposure to violence Physical, sexual, or emotional maltreatment Chronic neglect Caregiver substance abuse or mental illness Loss of caregiver (e. g. , incarceration, custody change, death, parents serving overseas) NC Resilience & Learning Project 35 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

What are ACEs? • ACEs: Adverse Childhood Experiences • In 1995 -1997, the largest study ever conducted on ACEs was done by the CDC and Kaiser-Permanente in California and included over 17, 000 participants • The ACE Questionnaire includes 10 questions about 10 different adverse childhood experiences https: //www. cdc. gov/violenceprevention/acestudy/about. html NC Resilience & Learning Project 36 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

What did the ACE study find? Out of the over 17, 000 participants: – 64% reported at least ONE ACE § § 26% reported ONE ACE 16% reported TWO ACEs 9. 5% reported THREE ACEs 12. 4% reported FOUR OR MORE ACEs https: //www. cdc. gov/violenceprevention/acestudy/about. html NC Resilience & Learning Project 37 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

https: //www. cdc. gov/violenceprevention/acestudy/about. html NC Resilience & Learning Project To ensure academic success and improve the social and emotional well-being of children impacted by trauma

IMPACTS OF ACES / TRAUMA EXPOSURE NC Resilience & Learning Project 39 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

What did the ACE study find? ACEs can lead to: – Delays and disruption in brain development – Social and emotional problems – Short- and long-term mental and physical health problems – Early death https: //www. cdc. gov/violenceprevention/ acestudy/about. html rwjf. org/aces NC Resilience & Learning Project 40 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

What is the impact of trauma and toxic stress? • Toxic stress is caused by prolonged or pronounced stress that overwhelms children’s skills or support • This causes children to go into “survival mode” or remain in a state of “stress response” • Being in this state on a regular basis actually alters the chemical and neurological events in a child’s brain NC Resilience & Learning Project 41 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Neurobiology & Brain Development MRI scan of a brain with no trauma: MRI scan of a brain with trauma: NC Resilience & Learning Project 42 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Think about a time… • Have you ever been driving and focused on one thought – maybe your grocery list, what to cook for dinner, your first to-do item at work that day – and all of a sudden someone cuts you off or you have to suddenly slam on your brakes? – What does your mind do in that moment? – What does your body do in that moment? – Are you able to easily go back to the task you were originally thinking about? This is how children with trauma may feel ALL the time. NC Resilience & Learning Project 43 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Fight, Flight, Freeze Response • When the a child feels danger, the brain tells the body to respond in one of three ways: – Fight: verbal and physical aggression or defiance – Flight: instinct to run and escape the danger – Freeze: wanting to shut down, withdraw, or become invisible • In normal situations, this keeps us safe • When this becomes a constant state of being, it interferes with functioning in non-dangerous situations • These three responses are seen in a wide range of behaviors in kids How have you seen the fight, flight, or freeze response in children in your classes? NC Resilience & Learning Project 44 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

WHAT DOES THIS LOOK LIKE IN CHILDREN? NC Resilience & Learning Project 45 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Why does trauma have such a big impact on children? Streeck-Fischer and van der Kolk share: …children who have experienced trauma “are easily overstimulated and cannot achieve the state of secure readiness that is necessary in order to be open to new information. ” Cole, S. F. , O’Brien, J. G. , Gadd, M. G. , Ristuccia, J. , Wallace, D. L. , Gregory, M. (2005). Helping Traumatized Children Learn. Boston, MA: Massachusetts Advocates for Children. NC Resilience & Learning Project 46 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

How does all of this impact children? NC Resilience & Learning Project 47 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

How does all of this impact children? • The impact of trauma can be seen the most in children in school in the following three areas: – Learning and academic performance – Classroom behavior – Relationships NC Resilience & Learning Project 48 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Blodgett et al, 2010 NC Resilience & Learning Project To ensure academic success and improve the social and emotional well-being of children impacted by trauma

WHAT CAN WE DO FOR CHILDREN IMPACTED BY TRAUMA? NC Resilience & Learning Project 50 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

How can we start? • A total culture and mindset shift – looking at a child and thinking “What happened to you? ” instead of “What is wrong with you? ” – Thinking about a child’s behaviors more as symptoms of his or trauma rather than bad behavior – Responding to what the child is FEELING rather than to the disruptive behavior “She controlled herself yesterday, she can control herself today. . . ” If we only knew what happened last night, or this morning before she got to school, we would be shielding the same child we’re now reprimanding. Cole, S. F. , O’Brien, J. G. , Gadd, M. G. , Ristuccia, J. , Wallace, D. L. , Gregory, M. (2005). Helping Traumatized Children Learn. Boston, MA: Massachusetts Advocates for Children. NC Resilience & Learning Project 51 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

“Cause I Ain’t Got a Pencil, ” Joshua T. Dickerson I woke myself up Because we ain’t got an alarm clock Dug in the dirty clothes basket, Cause ain’t nobody washed my uniform Brushed my hair and teeth in the dark, Cause the lights ain’t on Even got my baby sister ready, Cause my mama wasn’t home. Got us both to school on time, To eat us a good breakfast. Then when I got to class the teacher fussed Cause I ain’t got no pencil NC Resilience & Learning Project 52 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Shifting Our View Traditional View Trauma-informed View Impulsive Difficulty regulating emotions Aggressive/Defiant Trauma response triggered, trying to gain control and find safety Withdrawn/”unmotivated” Afraid, overwhelmed, world is a dangerous place Over-reacting Seeking to get needs met ADHD Lacking necessary skills Reaction: STUDENT NEEDS TO BE PUNISHED Reaction: STUDENT NEEDS SKILLS AND SUPPORT NC Resilience & Learning Project 53 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

CONCRETE TRAUMA-SENSITIVE STRATEGIES NC Resilience & Learning Project 54 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

BUILDING STUDENT SELF-REGULATION NC Resilience & Learning Project 55 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Self-Regulation To be successful in school and life, we all need to learn to manage our: • feelings –thoughts • behaviors NC Resilience & Learning Project 56 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Self-Regulation Skills • Managing Feelings – Identifying feelings in self and others – Managing frustration and distress effectively – Empathy, compassion • Managing Behavior • Managing Thoughts – – – Controlling attention Setting goals, planning Problem-solving Self-talk Perspective-taking NC Resilience & Learning Project • Following rules and directions • Controlling impulses • Persisting on hard tasks • Enacting coping skills • Delaying gratification 57 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Self-Regulation is a Skill like Literacy • Characteristics of both: – Many sub-skills – Require developmentally appropriate instruction over time – Develop earlier in supportive environments – Can be acquired later with intervention – Multiple intervention opportunities exist – Some youth need more specialized instruction and support than others 58 NC Resilience & Learning Project To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Strategies to Support Skill Development • Incorporate a curriculum or practice that teaches selfregulation and coping skills – – – Second Step Heart Smarts Zones of Regulation Mindfulness exercises Yoga for kids NC Resilience & Learning Project What are you doing now? What could you add? 59 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

STRATEGIES TO SUPPORT CO-REGULATION AND CLIMATE: BUILDING A TRAUMA-INFORMED SCHOOL NC Resilience & Learning Project 60 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

To build self-regulation, students need A LOT of support! Caregivers, educators, and professionals support youth by providing: Warm, responsive relationship Structured environment NC Resilience & Learning Project Skills instruction and coaching 61 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Your capacity to support students is based on your OWN abilities to self-regulate! • Learn and practice self-regulation skills: - Stress management/coping skills - Problem-solving for life stressors - Mindfulness to decrease emotional reactivity • When you are in a stressful interaction: - Pay attention to your own feelings - View problem-behaviors with a trauma-focused lens - Use strategies to stay calm and respond effectively NC Resilience & Learning Project 62 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Strategies to Support Staff • Training on ACEs, Learning, and Behavior What a you d re oing now? • Staff Self-Care – Staff coping skills/stress management – Mindfulness, yoga, or exercise classes – Buddy/mentor system • Staff Climate – Spa goody bags or snack attacks to “treat” staff – Communication tone, relationships NC Resilience & Learning Project What could you add? 63 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Strategies for Building Relationships • Daily greetings by name • 30 -second check-ins – Ask about interests, how things are going • Positive comments – At least 5: 1 ratio of positive to negative interactions • Smiles, positive connections throughout the afternoon • Emphasize culture of care, respect, and kindness NC Resilience & Learning Project 64 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Structure: Expectations and Routines • Clear, concrete rules and expectations – Post visual cues, reminders • Predictable routines – Emphasize rules for transition times • Catch students being good • Limit opportunities for risky/undesirable behavior NC Resilience & Learning Project 65 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Structure: Physical Space • Structure the space – Clear areas for different activities • Calm-down areas or routines • Awareness of “trouble zones”, times, or activities that trigger problems • Physical ambiance – – – Paint colors? Posters? Music? Gardens, plants, flowers? Enlist students to help! NC Resilience & Learning Project 66 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Discipline & Behavior Management • When you are in a stressful interaction: – Pay attention to your own feelings – View problem-behaviors with a trauma-focused lens • Consider what might be triggering a student • Use strategies to stay calm and steady in the face of strong student emotion – Reassure and calm/comfort, if appropriate – Give time and space to calm down; reduce emotional intensity in conflict situations • Redirect with calm, firm reminders – Provide consequences calmly and with respect – Communicate that you believe the student will make a better choice next time NC Resilience & Learning Project 67 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

When are good times to help youth calm down? e e. M v a Le e n Alo Ea W rly ar ni ng Intervene Here Irritability and Explosiveness NC Resilience & Learning Project Intervene Here Calm 68 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

Contact Information Katie Rosanbalm katie. rosanbalm@duke. edu Elizabeth De. Konty edekonty@ncforum. org NC Resilience & Learning Project 69 To ensure academic success and improve the social and emotional well-being of children impacted by trauma

QUESTIONS

YOUTH BEHAVIOR AND SAFETY CHILD ABUSE & NEGLECT Adverse Childhood Experiences(ACEs) Thanks for attending this Webinar! For Webinar Presentation Slides, visit our website: http: //www. nccap. net/