The Effects of Trauma on Behavior in the Classroom. Presented By: Kacey Rodenbush, LMFT Behavioral Health Unit Supervisor

Transcription

1 The Effects of Trauma on Behavior in the Classroom Presented By: Kacey Rodenbush, LMFT Behavioral Health Unit Supervisor

2 My experience working with trauma Worked as Wraparound and TBS provider for 5 years serving youth in the foster care and probation systems- youth who have all experienced trauma in one form or another Worked as line staff for 3 years and then moved into a supervisory role in 2010 as Clinical Supervisor for TBS program Joined the MCBH Services to Education team in 2012 to start the HART program- a Wraparound like service for high acuity students at imminent risk of residential treatment Now as a supervisor overseeing counseling services for our TIP Classrooms and HART, I have a cross systems/cross district perspective of how trauma is affecting the mental health of students in Monterey County

3 Objectives Define and identify symptoms of complex trauma and how it affects student learning and behavior in the classroom Understand the effects of trauma on the human body and how it affects overall functioning Explore the relationship between attachment and trauma and how it affects student behavior Increase understanding of how Adverse Childhood Experiences impact child development and the implications of the ACE study for education Learn strategies that will assist schools to become more trauma-informed Identify what each of our roles is in helping students who have experienced trauma and how we can collaborate across systems in a way that will best meet student needs

4 Why the need for this training? There is a need to shift our thinking about trauma from the suffering individual into a framework that recognizes the structural, economic, racial, gender, and class-based forces that generate trauma We are all working with students who have experienced or are currently experiencing trauma Teachers, administration, and school staff receive minimal training on how to identify and approach students experiencing trauma and yet they work with them on a daily basis Acuity of youth we are serving is becoming more severe We are often the only safe and trusted adults in the lives of the students who have experienced or ar experiencing Trauma is transgenerational, so by training educators and mental health providers to understand and respond to trauma, together we can help to address the root issues that contribute to it

5 What types of trauma do students experience? Physical, emotional, or sexual abuse Neglect* Domestic violence* Death of a loved one* Community Violence* Serious accident Natural disaster Physical injury Severe bullying* Homelessness Immigration Disrupted attachment from parent or caregiver* Unstable caregiver* War or armed combat* Home fire Early intrusive medical interventions Sexual assault/exploitation* Prenatal drug exposure* Interpersonal Trauma

6 Exposure to trauma can interfere with a student s ability to: Focus or maintain attention Develop language properly Communicate wants and needs effectively Organize and remember new information Attend to classroom activities Transition from one task to another Follow step-by-step instructions Comply with adult directives Grasping of cause and effect relationships Engage in creative play Problem-solve Resolve conflict Initiate and cultivate healthy interpersonal relationships Objectively respond to cues in the environment

7 What is Developmental Childhood Trauma? New mental health diagnosis developed by psychiatrist Bessel van der Kolk for DSM that more appropriately captures developmental trauma PTSD cannot capture the multiplicity of exposure to trauma over critical times in childhood development

8 What are symptoms of Developmental Trauma Disorder? Disturbance causes clinically significant impairment in at least 2 of the following areas of functioning: Scholastic-under-performance, disciplinary problems, truancy, conflict with school personnel, learning disabilities Familial -avoidance, running away, detachment, attempts to physically or emotionally hurt family members Peer group-isolation, persistent physical or emotional conflict, inappropriate age affliction Legal-arrests/recidivism, increasingly severe offenses, disregard or contempt for the law Health-physical illness or problems that cannot be fully accounted for, physical injury or degeneration, sexual problems, chronic pain or fatigue

9 What are some emotional and psychological symptoms of student trauma? Intense anger, irritability, mood swings Guilt, shame or self-blame feeling sad, hopeless and depressed difficulty concentrating and focusing withdrawing /isolating from others appearing disconnected,numb or zoned out with a blank stare anxiety or fear

10 What are some physical symptoms of student trauma? insomnia or nightmares startling easily aches and pains/frequent somatic complaints racing heartbeat fatigue edginess muscle tension

11 What are some behavioral symptoms of student trauma? Needy and/or clingy, afraid to go home at the end of the school day Continuously scanning the environment- hypervigliant Eloping away from the classroom/from school campus Inability to copy with stress and engage in problem-solving Lack of self-control/impulsivity Inability to make and develop friendships Antisocial behaviors and attitudes Problems with expressive and receptive language

12 Hiding under tables, desks, in cabinets Assuming the fetal position Regressing to baby talk or babble Acting like an animal Highly sexualized behaviors and language, promiscuity Overly compliant Non-suicidal self injury Suicidal ideation, gestures, or attempts

13 Alienation from and opposition to authority figures Aggression, violence and impulsivity- quick to react Difficulty with genuine trust, intimacy and affection Negative, hopeless and pessimistic view of self, family and society Lack of empathy, compassion and remorse Hoarding of food- hoards, gorges, hiding of food, refuses to eat Poor physical boundaries

14 Trauma and Student Attachment

15 What does a healthy attachment provide a child? Special and primary emotional and social bonds Primary source of values and beliefs Primary role model for appropriate social interactions Initial template for all future relationships

16 Why is it important to understand attachment theory as it relates to student trauma? There is a direct correlation between a student s social emotional skills and success in school If a student has a secure attachment, his/her develops a sense of self-confidence, self-regulation and an ability to make other good relationships Recognizing behaviors that are consistent with a child with a disorganized attachment will assist the educator in holding a context for why the student is demonstrating them

17 Early patterns of attachment inform the quality of information processing throughout life Children learn to regulate their behavior by anticipating their caregiver responses to them The more disorganized the parent, the more disorganized the child If a parent or caregiver is emotionally absent, inconsistent, violent, intrusive or neglectful, the child learns that s/he cannot rely on the external environment to get needs met

18 How does trauma affect a baby s development in-utero? As sensory systems develop, the fetus becomes aware of the outside world If a mother is in a violent relationship, the unborn fetus will experience the stress from the acts of aggression If a mother is using alcohol or other drugs, the brain development of the fetus is severely impacted and is much smaller than a fully developed healthy brain

19 Trust vs. Mistrust Healthy Attachment Cycle Infant Trauma Cycle Baby has a need Baby has a need Trust develops Baby cries Mistrust develops Baby cries Needs met by caregiver Needs not met by caregiver

20 What are risk factors to a caregiver developing a healthy attachment with a child? Substance abuse Domestic violence Multiple children to care for Unemployment Lack of food, clothing, and shelter; poverty Caregiver did not have a secure attachment as a child Mental health issues Young parenting/single parenting Disabilities/Chronic Illness Low quality childcare

21 Why is it important to understand the cycle of domestic violence as it relates to student trauma?

22 What is Maslow s Hierarchy of Needs and how does it relate to students with trauma?

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24 How is the Autonomic Nervous System affected by trauma? The Autonomic Nervous System is responsible for regulating the body Composed of the sympathetic nervous system (gas) and the parasympathetic nervous system(brakes) The two systems are meant to mirror each other s responses to control one another s opposite reactions With traumatic experiences and complex trauma, the body can get stuck in either system

25 Healthy nervous system vs. traumatized nervous system Arousal~Settle Fight~Flight~ Freeze

26 What are evocative cues and why are they important to be aware of? Implicit memories and physical sensations from early infancy or childhood of angry faces remain encoded in a student s amygdala When a traumatized student sees the same facial expression on a staff member, the same sense of rejection and shame can be generated, only the student has no awareness of why the reaction has arisen and is often unable to articulate their experience Traumatic experiences can also be triggered by particular smells or odors, sounds or music that reminds the student of his/her traumatic experiences, or memories that are triggered by other senses Interpersonal dynamics between the traumatized student and his/her peers or teacher can also evoke traumatic memories or traumatic stress

27 What is the ACE study and how is it relevant to education?

28 ACE= Adverse Childhood Experiences Kaiser Adverse Childhood Experiences studied 17, 000 people from and discovered a direct correlation of childhood trauma with adult onset of: chronic diseases mental illness violence being a victim of violence

29 What were the key findings from the ACE study?

30 What are the implications of a high ACE score for students? Research from Washington State indicates that children with an ACE score of 3 or higher are: More than twice as likely to be suspended from school 6 times more likely to experience behavioral problems in school 5 times more likely to have severe attendance issues At higher risk for having learning difficulties and low grade point averages

31 in California to make trauma-informed practices mandatory Kimberly Cervantes, student-plaintiff in law suit against Compton Unified School District in California.

32 ACE Questionnaire Please discuss the ACE questionnaire and any reactions you have to reading it if this is your first exposure to it Maintaining student confidentiality, please also think about students you know who have experienced complex trauma and dialogue about the following: 1. Do any of these students have an ACE score of 3 or higher? 2. What do you know about the their life circumstances and how they contribute to his/her current mental health issues? 3. What types of behaviors have you seen or heard about students demonstrating in the classroom and/or at school that are related to their traumatic experiences?

33 What are some protective factors to student trauma? Positive and supportive relationships with teachers, school staff, administrators Connection to family and involved parents No use of drugs or alcohol Participation in school sports or other extra-curricular activities Participation in counseling services Positive peer group Support from church / connection with spirituality Participating and engaging in mental health counseling and other supportive services Takes medication as prescribed Physically active Regular school attendance

34 How does trauma impact language and communication skills? When in a hyperarousal state, a traumatized student cannot attend to or process information In survival mode, language becomes a tool to get things accomplished/needs met vs.a tool for articulating thoughts and expressing feelings Traumatized students have had little exposure to adults who encourage expressing ideas or feelings and limited experience tending to complex communications

35 How does trauma impact a student s ability to organize narrative material? If a traumatized student is living in chaos, the ability to bring linear order to narrative material is significantly affected If the development of sequential memory is delayed and the ability learn information sequentially is impaired, traumatized children will have difficulty with organizing information in sequence Bringing coherence to a collection of random events is most easily accomplished in an environment marked by consistent, predicable routines and reliable caregivers

36 How does trauma impact a student s ability to understand cause and effect relationships? Children develop understanding of cause and effect relationships during the sensorimotor period through an active exploration of the world around them Children living with trauma may suffer from physical restriction and unrealistic parental expectations that inhibit their exploration of the world A child s sense of object constancy is damaged by trauma and the child lacks a sense of predictability in his/her environment

37 How does trauma impact a student s ability to take another s perspective? When a child learns not to express a preference before assessing the mood of the parent, s/he cannot fully develop a sense of self student unable to define the boundaries of the self which can lead to difficulty making independent choices, articulating preferences and gaining perspective If stress from trauma interferes with normal playtime, the ability to take the role of the other or to appreciate another person s point of view is seriously impaired

38 How does trauma impact a student s attentiveness to classroom tasks? Student has fear and anxiety about his/her own and other s safety, which chronically occupies thoughts Student may actually be focused on interpreting the teacher s mood Student might dissociate from the immediate environment and not process information presented by the teacher at all Many students diagnosed with ADHD due to symptoms of anxiety and hypervigilance to danger

39 How does trauma impact a student s ability to regulate emotions? Feelings of fear, anxiety, irritability, helplessness, anger, shame, depression and guilt are often difficult for children to identify and express verbally Often the traumatized student does not have a choice in how they react to people or situations May overreact to perceived or real provocation in the classroom or on the playground

40 How does trauma affect a student s executive functioning? Working memory, problem solving, planning, setmaintenance, reasoning, and flexibility make significant contributions to school performance T Trauma damages the prefrontal cortex portion of the brain responsible for executive functioning so a student has deficits in these skills required for academic success

41 Taking things away Threats Use of physical force Observing threats or assaults peers Isolation Lockdowns Bomb threats Physical restraints Changes in staff Contact with authority figures Removal of clothing Being touched Being observed or followed Loud noises alarms, fire drills, ambulance/sirens Smells or scents that trigger memories Teacher absence or illness Escalation of another student

42 What can help a student manage trauma? Encourage drawing and journaling- we digest and and express experience in a very different way through drawing and journaling; takes pressure off the student to communicate thoughts and feelings verbally Jump around! exercise helps to release tension that the body is holding related to the trauma and is a natural mood regulator Creativity and play- allows students how to access their own internal experiences and express them in a way that is congruent with who they are Mindfulness- short moments of awareness practiced many times. teaches students to become aware of thoughts, feelings, and internal sensations that affect behavior and the ability to connect with others; connects them with their environment through engaging the senses- internally or externally

43 Ground the student in his/her environment through engaging the senses Identify and tend to sensory needs if appropriate Enlist support and/or input from therapist if unsure of how to respond Remain calm and speak in a neutral tone of voice Speak in the positive, avoiding negative language Utilize staff that the student responds well to Provide space during escalation but remain in line of sight Ask the student if s/he knows what they need in the moment Get down to their level Communicate that you care about them and are there provide support Enlist support from school administrators, law enforcement or campus resource officers when necessary Avoid using timing or countdowns as a behavioral strategy

44 Understand that the students are bringing their entire lives through the classroom door everyday- some are in active trauma Do daily check-ins and check-outs- Greet them when you see them- it relays that you care about them and are paying attention Be consistent- maintain daily routine and structure as much as possible and model flexibility when the unexpected happens Avoid side talk, whispering, or gossip Keep your cell phones put away Monitor student cell phone and computer usage Follow all verbal de-escalation strategies prior to physical restraint Avoid discussing student issues publicly in the classroom Provide ongoing, positive feedback to students on what progress you have seen and highlight strengths

45 Avoid engaging in power struggles, and know when you re hooked, negotiate when appropriate Avoid the my way or the highway approach- offer choices Put behavior in context of the students life circumstances Begin again with each school day/hit the reset button and try not to take things personally Maintain good and professional communication with classroom staff, school psychologists, administrators and therapist Develop and follow a consistent home/school communication plan with parents so you are aware of stressors or crises that occur outside of school Be aware of how medications affect the student and be on the lookout for changes in mood and/or behaviors Keep good professional boundaries and be selective when disclosing personal information

46 Why is it important to set and hold consistent boundaries with students who have experienced trauma?

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48 Understands the impact of trauma on a child s behavior, development, relationships and survival strategies Can integrate that understanding into planning for the child and learning Understands his or her role in responding to child traumatic stress Is flexible to the needs of the student and understands that establishing a safe learning environment is primary and essential before engagement with academic work can occur

49 Offers interventions that increase a student s sense of self-worth Forms strong relationships to enhance sense of trust Emphasizes the natural consequences of behaviors Builds up avenues for achievement and hope Helps students to learn both emotion management skills and relationship skills through consistency and modeling Teaches students how to calm biology to increase ability to think

50 What are the essential elements to Trauma-informed education? Maximizes the child s sense of safety. Assists children in reducing hyperarousal and/or dissociation Addresses the impact of trauma and subsequent changes in the child s behavior, learning, development, and relationship Utilizes comprehensive assessments of the child s trauma experiences and their impact on the child s development and behavior to guide services Collaboration with other agencies and service providers involved with the student

51 How do we develop a traumainformed school climate? Deepen our shared understanding of trauma s impacts on learning and the need for a school-wide approach Help the school effectively support all students to feel safe physically, socially, emotionally, and academically- Address students needs in holistic ways, taking into account their relationships, self-regulation, academic competence, and physical and emotional well-being Explicitly connect students to the school community and provide them with multiple opportunities to practice newly developing skills throughout the school

52 Developing a trauma informed school climate cont. support staff to work together as a team with a sense of shared responsibility for every student- this includes cafeteria staff, bus drivers, front office staff, school nurses, yardduty staff, janitorial staff, etc. help the school anticipate and adapt to the ever-changing needs of students and the surrounding community collaborate with all student support service providers to ensure that student needs are being identified and appropriately addressed Involve parents in student education and behavioral incidences with every opportunity Be aware of when you are in need of support and are experiencing burnout and work with your supervisor to foster consistent self-care Make mandated suspected child abuse reports when indicated

53 Collaboration is key

54 Table Discussion As teachers, school psychologists, mental health clinicians, community-based mental health providers, special education directors, school administrators, support staff, behavioral specialists: What is your role in addressing and responding to student trauma? Why is collaboration among teachers, school staff, administrators and mental health providers so important when it comes to student trauma?

55 Every kid needs a champion Rita Pierson, Ed.D, LPC Elementary Special Education Teacher, School Counselor, Assistant Principal, Director, Testing Coordinator and Consultant

56 Thank you kindly!

57 References Helping Traumatized Children Learn