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Supporting Students who have experienced trauma

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Adelina Tancioco

on 24 June 2014

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Transcript of Supporting Students who have experienced trauma

Elementary Middle & High School
-Increased distress (unusually whiny, irritable, moody)
-Distrust of others, affecting how children interact with both adults and peers
-A change in ability to interpret and respond appropriately to social cues
-Increased somatic complaints (e.g., headaches, stomachaches, overreaction to minor bumps and bruises)
-Recreating the event (e.g., repeatedly talking about, “playing” out, or drawing the event)
-Statements and questions about death and dying
-Difficulty with authority, redirection, or criticism
- Irritability with friends, teachers, events
-Increase in impulsivity, risk-taking behavior
-Discomfort with feelings (such as troubling thoughts of revenge)
-Increased risk for substance abuse
-Discussion of events and reviewing of details
-Negative impact on issues of trust and perceptions of others
-Repetitive thoughts and comments about death or dying (including suicidal thoughts, writing, art, or notebook covers about violent or morbid topics, internet searches)
- Heightened difficulty with authority, redirection, or criticism
-Irritability with friends, teachers, events
-Repeated discussion of event and focus on specific details of what happened
-Increased somatic complaints
-Discomfort with feelings (such as troubling thoughts of revenge)
Psychological and Behavioral Impact of Trauma
-Anxiety, fear, and worry about safety of self and others
-Worry about recurrence or consequences of violence
-Changes in behavior
-Increase in activity level
-Decreased attention and/or concentration-Withdrawal from others or activities
-Angry outbursts and/or aggression
-Absenteeism
-Change in academic performance
-Hyperarousal (e.g., sleep disturbance, tendency to be easily startled)
-Avoidance behaviors (e.g., resisting going to places that remind them of the event)
-Emotional numbing (e.g., seeming to have no feeling about the event)
-Re-experiencing the trauma (e.g., nightmares or disturbing memories during the day)
-Over- or under-reacting to bells, physical contact, doors slamming, sirens, lighting, sudden movements
Elementary
Middle
High
Supporting Students Who Have Experienced Trauma
Adelina Tancioco, Deandre Williams, and Matthew Schwartz
What is Trauma?
Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.
What Is Happening In Your Brain?




*With the right support the brain chemistry can change back to normal.*
True or False?
1. Less than 10% of American youth experience a serious traumatic event by their 16th birthday, and many children suffer multiple and repeated traumas.
T
More than 25% of American youth experience a serious traumatic event by their 16th birthday, and many children suffer multiple and repeated traumas.
F
2. Common sources of trauma include child abuse and neglect; serious accidental injury; disasters and terrorism; experiencing or witnessing violence in neighborhoods, schools and homes; and treatment for life-threatening illness (medical trauma).
T
F
3. After a crisis or traumatic event, a child is at risk of developing traumatic stress. About 15% of victims and witnesses of violence develop PTSD, depression or anxiety disorders.
T
F
After a crisis or traumatic event, a child is at risk of developing traumatic stress. About
25%
of victims and witnesses of violence develop PTSD, depression or anxiety disorders.
4. Children are more vulnerable to trauma because of their size, age, and dependence. Prior trauma, past mental health problems, or a family history of such problems may increase a child’s risk.
T
F
5. According to the National Child Traumatic Stress Network, about one in ten children will experience some traumatic event by age 16. T or F?
T
F
According to the National Child Traumatic Stress Network, about
one in four
children will experience some traumatic event by age 16.
What do you know about Trauma?
Traumatic experiences come in many forms, and can leave survivors with
overwhelming feelings of loss, danger, and helplessness, terror, and lack of control. A key component of trauma includes feeling that one’s physical or mental well-being is being threatened.


They include:
• Unexpected loss of a loved one
• Accidents
• School violence
• Community violence
• Domestic violence
• Neglect
• Physical abuse
• Sexual abuse
• Man-made and natural disasters
• Terrorism
 
Traumatic Expereinces
Trauma generally falls into two categories:
Acute traumatic stress typically
involves a one-time experience
(e.g., natural disaster or car accident).
 
Complex trauma involves prolonged or
multiple traumatic events that typically
occur within a caregiving relationship
(e.g., neglect, physical or sexual abuse).
Types of Trauma
Some children who experience complex trauma will develop and be diagnosed with post-traumatic stress disorder (PTSD). Not all children, however, will fit this label.
This type of exposure can have persistent neurological and emotional effects. According to Cooke et al., complex trauma can affect children across a variety of domains. These domains may include: attachment, behavioral control, cognition, self-concept, biology, affect regulation, and dissociation (NCTSN).
Exposure to Trauma
According to Zinsmeister (1990), inner-city youth experience the greatest exposure to violence and traumatic events. Numerous studies have documented that inner-city life
may be characterized by pervasive and
dramatic trauma.
Youth who have been exposed to community violence are more likely to exhibit aggressive behavior or depression.
Research on juvenile delinquents has identified a high prevalence of Posttraumatic Stress Disorder (PTSD) in this population
Many children use violence to protect themselves against the belief that “if you are not a predator, you are prey, and it is a whole lot better being a predator”
(Bell,1994)
Urban Violence
Trauma Exposed
As an educator you are mandated reporters of child abuse. Professional educators have a moral, ethical, and legal obligation to students who have experienced abuse. If you suspect abuse you are mandated to report.
Will I get sued if I do nothing?
The following situations are reportable conditions:
1) Physical abuse, 2) Sexual abuse, 3) Child exploitation, child pornography and child prostitution, 4) Severe or general neglect, 5) Extreme corporal punishment resulting in
injury, 6) Willful cruelty or unjustifiable punishment, 7) Abuse or neglect in out-of-home care.
Reportable Abuse
Immunity:
Any legally mandated reporter has immunity when making a report. In the event a civil suit is filed against the reporter, reimbursement for fees incurred in the suit will occur up to $50,000 (P.C. Section 11172). No individual can be dismissed, disciplined or harassed for making a report of suspected child abuse.
Immunity for Mandated Reporters
Liability: Legally mandated reporters can be criminally liable for failing to report suspected abuse. The penalty for this misdemeanor is up to six months in county jail, a fine of not more than $1,000 or both. Mandated reporters can also be civilly liable for failure to report. . (P.C. 11166(b)).
He or she may also be found civilly liable for damages, especially if the child-victim or another child is further victimized because of the failure to report.
(Landeros vs. Flood (1976) 17C.3d 399).
Liabilities for Failure to Make
A Required Report
The report should be discussed with the principal. A phone call to Children and Family Services. A written report must be sent within 36 hours. Each state law is different. Additional resource regarding mandated reporting in California.

There are four basic areas in which abuse may be
revealed:
1) Environmental Problems,
2) Parental or Caregiver Clues,
3) Physical Indicators in the Child, and
4) Behavioral Indicators in the Child
Best Practices
What Are My Legal Responsibilities?
Now time for a break of your choice
Breathing Exercise
Stretch as a Group
Students who have experienced traumatic events may have behavioral or academic problems or their suffering may not be apparent at all.
Psychological and Behavioral Impact of Trauma
Spacing out, not remembering, and having opposite behaviors – may indicate dissociation. 
Dissociation occurs when some part of the child’s mind and behavior becomes separated (dissociated) from the child’s awareness as a whole.
Some forms of dissociation are normal and are, at times, part of everyone’s experience (Ex: Thinking about other things while driving).
During times of crisis dissociation can serve as a survival mechanism (Ex: going into your mind while being abused). Although this is helpful during the crisis, persons who have experienced trauma sometimes go into a dissociative state too often. Being dissociated from emotions can prevent someone from fully living in the moment.

Knowing signs and symptoms can help in classroom management and support students.
What does it mean when children in your classroom “space out,”
• Signs of traumatic stress include fear, anger, withdrawal, trouble concentrating, digestive problems, and nightmares. Behavior disorders and “acting-out” can also be symptoms of trauma.
• Academic failure, lower drop-out rates, higher rates of absenteeism, expulsion and suspension are associated with students’ exposure to community violence.
• A child’s distress may not be obvious or visible. By talking with them you may find discover that they are experiencing traumatic stress: They may be re-experiencing the trauma through images, thoughts and feelings;
• They may try to avoid people and places that are traumatic reminders. They may seem numb because they are trying to avoid feeling their own feelings
Child Traumatic Stress can be Identified.
How to Support a Child At School
Follow school district and professional reporting procedures if you suspect abuse or neglect.
Work with the child’s caregivers to address trauma and school problems
Ecological perspective
Systems theory
When necessary inform school administration, staff and teachers. Work as a team support the child.
Make referrals to community resources when appropriate.
Advocate for PTSD assessments
PTSD symptoms mirror mental health symptoms
Helping a Child who has been Traumatized
Recognize behavioral problems can be related to trauma related anxiety.
Cognitive Behavior Therapy
Provide a safe place for the child to talk about what happened.
Give children simple and realistic answers to questions about trauma.
Be sensitive to environmental cues that may cause a reaction from the child.
Ecological Perspective: school, family, friends, community, etc.
create positive environment by giving space for them to calm down etc –
stand in back
, coach area or designated adult
School Interventions for Traumatized Students
Anticipate difficult times by providing additional support.
Keeps child’s hand busy:
Squeeze ball, play-do
, trust stone
Refocus zone, stretching, breathing exercises, mindfulness
Warn the child about things that are out of the ordinary
Fire drills & disaster preparation
Change in schedule, teacher, field trips, etc
Monitor the information traumatized children share with their peers. Protect the child and their classmates.
Groups (coping skills or grief )
Traumatic Grief
Talk and answer questions about death.
Review stages of grief
Validate feeling and emotions
Don’t force a child to talk about death and/or grief
School Interventions for Traumatized Students
Most traumatized children will not meet eligibility requirements for special education.
Accommodations and modifications should be considered for a short period including 504 plans.
Shorten assignments
Allow additional time to complete assignments
Give permission for a student to leave class to meet with a designated adult
Provide additional support for organizing and remembering school assignments
School mental health services
Accommodations and Modifications
When a child’s reaction is severe a referral should be made.
Monitor feelings of intense guilt, anger, shame or punishment
When reactions last longer than a month and interfere with the child’s functioning.
Be aware of the child that becomes avoidant or isolates themselves. These children appear to be fine b/c they don’t present academic or behavioral problems.
Referrals for Traumatized Children
Trauma-Focused Cognitive Behavior Therapy
Most effective intervention
Develop coping skills
Identifying triggers
Gradual exposure, narrative, psychoeducation
Child-Parent Therapy
Based on Attachment Theory
SW helps child and caregiver re-establishes safety.
Interpersonal Therapy
Uses behavioral and cognitive strategies to reduce fear
Relaxation training, guided self dialogue, music therapy
Evidence Based Clinical Interventions for Children with PTSD
Time for....

Role plays
Educators can develop “secondary traumatic stress” or “compassion
fatigue” from exposure to trauma through the traumatic experiences of children.
Tips:
Recognize the symptoms:
Irritability and impatience with students
Deceased concentration
Feeling numb or detached
Intrusive thoughts or feelings about the child’s trauma that do not go away over time.
Dreams about the students trauma

Don’t do it by yourself. Get support from school staff and colleagues, friends, and family.

Work through personal trauma and grief before working with children.

If you experience symptoms of secondary traumatic stress for more than two or three weeks, get support from a professional who is familiar with secondary traumatic stress.

Be sure to include self care as a necessary component to your line of work. Do things you love and enjoy that are separate from your work.

*Packet
Self Care
Burke, T. (n.d). How Trauma Impacts the Brain. Retrieved from www.rachelvineyard.org
Child Welfare Trauma Training Toolkit (2008). In The National Child Traumatic Stress Network.
Retrieved from http://www.nctsnet.org/products/child-welfare-trauma-training-toolkit-2008#top
Griffin. G., McClelland. G., Holzberg. M., Stolbach. B., Maj. N., & Kisiel. C. (n.d). Adressing the impact of
trauma before diagnosing mental illness in child welfare. Child Welfare, 90(6).
Grogan. S. & Murphy K.P. (2011).. Anticipatory stress response in ptsd: Extreme stress in children. Journal
of Child and Adolescent Psychiatric Nursing. 24, (58-71).
Matt’s Story (Digital Storytelling Workshop at Youth UpRising). (2008). Retrieved from

National Child Traumatic Stress Network Schools Committee. (October 2008). Child Trauma Toolkit for
Educators. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.
Post-traumatic stress disorder (PTSD): How PTSD is initiated by what happens in our brain? (2011).
Retrieved from
Smith, T. W., & Lambie, G. W. (2005, January). Teachers’ Responsibilities when Adolescent Abuse and
Neglect are Suspected. In Education Resource Information Center. Retrieved from
http://www.eric.ed.gov/PDFS/EJ752830.pdf
The California Child Abuse and Neglect Reporting Law Issues and Answers for Mandated Reporters (n.d.).
In California Department of Social Services Office of Child Abuse Prevention. Retrieved from
http://www.dominican.edu/about/forfaculty/file/childabuselaw.pdf
The National Association for the Education of Young Children. (2009). Retreived from
http://www.naeyc.org/tyc/next/v3n1/english
Trauma (n.d.). In American Psychological Association . Retrieved from
http://www.apa.org/topics/trauma/index.aspx
Volk, K. T., Konnath, LICSW, K., & Bassuk, M.D., E. L. (2006, February). Understanding Traumatic Stress in
Children . In The National Center on Family Homelessness. Retrieved from
www.familyhomelessness.org/media/91.pdf
Zinsmeister, K. (1990, June). Growing up Scared . In Violence How it Affects Children. Retrieved from
http://www.centrahealth.com/health-library/v/1296-violence-how-it-affects-children
References
Consistent schedule/routines help children feel safe.
agenda on board
Provide children with choices or control when appropriate.
breathing exercise or stretching
Increase support and encouragement to the traumatized child.
Work from a strengths based perspectiveSet clear firm limits for appropriate behavior with logical consequences.
School Interventions for Traumatized Students
Trauma changes your brain chemistry keeping your brain in stress mode more frequently.
Your Frontal Cortex which integrates your emotional and cognitive functions does not function to its full capacity in a person who has PTSD. This is because their traumatic memories stay stuck in the nonverbal,nonconscious regions (including amygdala and hippocampus).
Amygdala is the primitive part of the brain and interprets messages of whether it is safe or dangerous. Trauma makes amygdala hypersensitive (triggered into survival mode). Initiates and fires adreniline to be fired in body.
The Hippocampus involves memories and encoding new information. The Hippocampus prevents too much adreniline from being fired (balancing amygdala) Trauma shrinks Hoppocampus which results in too much adrenaline being fired into the body keeping the person in a high stress and anxious state.
This activates your survival mechanisms and makes it difficult to regulate emotions and think clearly.
Presenter: Adelina Tancioco
Presenter: Deandre Williams
Presenter: Adelina Tancioco
Presenter: Matthew Schwartz
Presenter: Adelina Tancioco
Hi School in SW Class,

Thank you all for your great feedback on the presentation. We would really appreciate being a part of any presentations that uses this prezi as it will give us more practice on presentations as well as build our network.

Please contact us at
Adelina Tancioco
atancioc@gmail.com
Deandre Williams
d.williams6500@gmail.com
Matthew Schwartz
schwartz5681@gmail.com
Full transcript