Over the Hills and Far Away: Inviting and Holding Traumatic Stories in School (original) (raw)
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Policy Insights from the Behavioral and Brain Sciences, 2021
Every year in the United States, millions of young children under the age of 5 are exposed to potentially traumatic events that threaten their safety, security, and well-being. Decades of scientific research clearly demonstrate the pervasive negative consequences of trauma exposure on young children’s neurocognitive, psychosocial, and physical development, with adverse effects extending into adulthood. In addition, early childhood trauma is now widely recognized as a significant public health concern warranting comprehensive intervention. Federal, state, and private early care and education (ECE) programs serve a large number of the 0 to 5 population and can mitigate the harmful consequences of trauma exposure for children’s health and well-being. The literature on early childhood trauma should guide the creation of policies that strengthen ECE, enabling the delivery of high-quality, equitable, trauma-informed care to young children prior to formal school entry.
Unlocking the Door to Learning: Trauma-Informed Classrooms & Transformational Schools
Childhood trauma can have a direct, immediate, and potentially overwhelming impact on the ability of a child to learn. Yet, this issue has largely been ignored by our education system. This issue brief discusses how educators can begin to understand the role of trauma, its effect on children and learning, and how educators can change methods of interacting and responding to children impacted by trauma. By adopting a trauma-informed approach, schools undertake a paradigm shift at the staff and organizational level to recognize, understand and address the learning needs of children impacted by trauma. This requires a commitment to shaping school culture, practices, and policies to be sensitive to the needs of traumatized learners. This effort positively impacts schools and changes the lifetrajectory of vulnerable students. The first step is to understand who experiences trauma and why, and how it impacts learning. "Trauma-informed" approaches are not new-they have been implemented in many fields including the medical profession and our judicial system. The lessons learned from these evidence-based approaches can be directly applied to classrooms and schools. At the heart of these approaches is the belief that students' actions are a direct result of their experiences, and when students act out or disengage, the question we should ask is not "what's wrong with you," but rather "what happened to you?" 1 By being sensitive to students' past and current experiences with trauma, educators can break the cycle of trauma, prevent re-traumatization, and engage a child in learning and finding success in school. Defining Trauma-What happened to this child? Childhood trauma has been conceptualized as a response to a negative external event or series of events which render a child "temporarily helpless" and surpass the child's "ordinary coping and defensive operations." 2 A wide range of experiences can result in childhood trauma, and a child's response to these potentially traumatizing events will vary depending on the characteristics of the child (e.g., age, stage of development, personality, intelligence and prior history of trauma) environment (e.g., school and family supports), and experience (e.g., relationship to perpetrator). 3 The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) defines traumatic events as those in which an individual experiences, witnesses, or is confronted with actual or threatened death or serious injury, or threatened physical integrity of self or others. 4 Importantly, the event need not be violent and need not be directed at the child who experiences trauma. One well-known study describes traumatic experiences in childhood as Adverse Childhood Experiences (ACEs), which may include physical, psychological, or sexual abuse; violence against one's mother; or living with household members who are mentally ill, suicidal, substance abusers, or were ever incarcerated. This study linked ACEs to many common adult medical and psychological problems. 5 In response to a traumatic event, a person may feel intense fear, horror, or helplessness, and in response, a child may display disorganized or agitated behavior. 6 Who Experiences Trauma? Children from all races and socioeconomic backgrounds experience and are impacted by trauma. Research suggests that between half and two-thirds of all school-aged children experience trauma 7 as they are exposed to one or more adverse childhood experience that can be trauma-inducing. 8 Trauma can come in many forms. There are obvious examples of trauma. For example, in 2011, there were 4,566 reports of abuse or neglect in Philadelphia, with 2.1 substantiated cases of abuse or neglect per 1,000 children. 9 However, there are also other hidden examples of exposure to trauma. Here are some statistical examples: Among 769 students sampled in the LA Unified School District, the average number of violent events experienced in the previous year was 2.8, and the average number of witnessed events was 5.9. In this context, 76% of surveyed students experienced or witnessed violence involving a gun or knife. 10 In another study of this cohort by Flannery et al., between 56% and 87% of adolescents had witnessed someone being physically assaulted at school during the past year. 11 In one representative sample of children in western North Carolina, 68% of 16-year-olds had experienced trauma and 37% had experienced two or more traumatic events. More specifically: o 25% had been exposed to violence. 15% had experienced the violent death of a sibling or peer. 7% had experienced physical abuse by a relative. o 11% had experienced sexual trauma in the form of sexual abuse, rape, or coercion.
Trauma, Learning, Memory & Development
Trauma is a complex, common, challenging, confounding and dynamic issue that has only recently begun to be understood from holistic perspectives (Suzuki et al 2014). People of all ages, backgrounds, cultures and genders can experience trauma. However, when trauma strikes in early childhood (early childhood trauma or ECT), and particularly when trauma is chronic as opposed to acute, it can result in complex symptoms that can confuse mental health care providers as well as the individual suffering with the issue, making it particularly hard to live with and treat (Suzuki et al, 2014). ECT can also cause lasting physiological as well as psychological developmental issues, especially when the trauma continues through adulthood, and sometimes results in PTSD (Suzuki et al, 2014). Recently, one study developed a self-report test called the Aversive Childhood Experiences (ACE) questionnaire to examine the type and degree of trauma experienced in order to further understand treatment with trauma-informed therapy (Starecheski, 2014). This self-administered questionnaire presents nominal-dichotomous items to evaluate and scale the possible abuse or neglect experienced as a child on a scale with high sensitivity (level one through ten based on ten questions) (Mitchell & Jolley, 2014). This paper will describe an overview of the interaction of biopsychology and behavior and the conspiracy of factors that cause developmental issues with learning and memory, especially in children. Cutting-edge research on trauma and recovery will be summarized, as well as ideas for future studies. Finally, successful, empirically-supported treatment modalities of healing will be discussed with the hope of demystifying trauma.
Australian and New Zealand Journal of Psychiatry, 2000
Given the enormous scope of the problem, scant attention has been paid to the consequences of chronic child maltreatment, such as neglect and physical or sexual abuse. Isolated traumatic incidents tend to produce discrete conditioned behavioural and biological responses to reminders of the trauma. In contrast, chronic maltreatment or medical traumatisation, such as occurs in children who are exposed to repeated surgical procedures, have pervasive effects on development. Chronic childhood trauma interferes with the capacity to integrate sensory, emotional and cognitive information into a cohesive whole and sets the stage for unfocused and irrelevant responses to subsequent stress. When trauma occurs in the presence of a supportive, if helpless, caregiver, the child's response will largely mimic that of the parent: the more disorganised the parent, the more disorganised the child [1,2]; the security of the attachment bond mitigates against trauma-induced terror. In the long term abuse, neglect and exposure to multiple surgical procedures have much more pervasive effects than single incident traumas. The resulting spectrum of biological, emotional and cognitive abnormalities is expressed in a multitude of psychological, somatic
Addressing childhood trauma in a developmental context
Journal of Child & Adolescent Mental Health, 2013
With the anticipated publication of the DSM-5 in May 2013, much reflection and work has been done on reviewing existing psychiatric nomenclature including, but not limited to the field of traumatic exposure. Traditionally, understanding of the psychiatric and psychological effects of trauma have been developed from studies with adults and then applied to trauma-exposed children with some modifications. While this is an important step to understanding the sequelae of trauma in children and adolescents, the adverse developmental effects of traumatic exposures on the rapidly evolving neurological, physical, social and psychological capacities of children calls for a developmentally sensitive framework for understanding, assessing and treating trauma-exposed children. The importance of early attachment relationships in infancy and childhood means that severely disrupted early caregiving relationships may have far-reaching and lifelong developmental consequences and can therefore be considered traumatic. Given the high rates of violence and trauma exposure of South African children and adolescents, the need for a developmentally based understanding of the effects of trauma on child and adolescent mental health becomes even more pronounced. In this paper, we draw on theoretical perspectives to provide a practical, clinically driven approach to the management of developmental trauma.
Impact of Traumatic Life Events in a Community Sample of Toddlers
Journal of Abnormal Child Psychology, 2009
Toddlers may be at particularly high risk for a number of psychiatric, developmental and neurobiological consequences in the aftermath of trauma. The social and emotional impact of potentially traumatic life events experienced between 6 and 36-months of age was assessed in an epidemiological birth cohort of 18-to 36-month-olds from the Greater New Haven Area. Event-exposed toddlers evidenced greater symptom severity on the ITSEA Internalizing, Externalizing, Dysregulation, Atypical and Maladaptive scales, as well on the CBCL Internalizing and Externalizing scales than those not exposed. Approximately one-fifth of event-exposed toddlers were reported by their parents to have experienced a dramatic change in functioning following the event, and were described as experiencing higher levels of symptoms consistent with Post-Traumatic Stress Disorder (PTSD), namely re-experiencing and arousal, than exposed toddlers whose parents did not report a change in their functioning. Implications for clinicians and child care providers working with toddlers and their parents are discussed.
Journal of Traumatic Stress, 2012
Children may be exposed to numerous types of traumatic events that can negatively affect their development. The scope to which studies have examined an array of events among young children has been limited, thereby restricting our understanding of exposure and its relationship to behavioral functioning. The current cross-sectional study describes traumatic event exposure in detail and its relationship to behavioral health among an at-risk sample of young children (N = 184), under 6 years of age, upon enrollment into an early childhood, family-based, mental health system of care. Caregivers completed home-based semistructured interviews that covered children's exposure to 24 different types of traumatic events and behavioral and emotional functioning. Findings indicated that nearly 72% of young children experienced 1 or more types of traumatic events. Multiple regression model results showed that exposure was significantly associated with greater behavioral and emotional challenges with children's age, gender, race/ ethnicity, household income, and caregiver's education in the model. These findings highlight the prevalence of traumatic exposures among an at-risk sample of young children in a system of care and suggest that this exposure is associated with behavioral and emotional challenges at a young age. Exposure to traumatic events (e.g., violence, abuse, natural disasters) among children is a major public health concern in the United States that carries an enormous cost to society, both in lives affected and dollars spent (Leventhal, Martin, & Gaither, 2012). The annual financial burden to society of childhood abuse and trauma-encompassing medical costs, mental health utilization, law enforcement, child welfare, and judicial system costs-is approximately $103 billion (Wang & Holton, 2007). It is estimated that among a healthy cohort of children, 26% will witness or experience a traumatic event before the age of 4 years (Briggs-Gowan, Ford, Fraleigh, McCarthy, & Carter, 2010) and that the majority of maltreatment and family violence occurs during the first 5 years of life (Fantuzzo & Fusco, 2007). Research has shown that exposure to traumatic events early in life can have negative effects throughout the lifespan (Goodwin & Stein, 2004; Heim, 2001). Little, however, is known about the specific types of trauma young children (under 6 years of age) experience.
PROTOCOL: Effects of trauma-informed approaches in schools
Campbell Systematic Reviews
BACKGROUND The problem, condition or issue Childhood trauma has been receiving increased attention and it is increasingly being recognized as a significant public health concern (Lang, Campbell, & Vanerploeg, 2015). Trauma exposure involves "actual or threatened death, serious injury, or sexual violence" that is either directly experienced or witnessed, or learning that any traumatic experiences have happened to a loved one, or having repeated exposure to details of traumatic events (APA, 2013, p. 271). Prevalence estimates of trauma experienced in childhood or adolescence vary by type of traumatic event (e.g., physical abuse, neglect, sexual abuse, witnessing violence, natural disasters) and how and when the traumatic experience is measured, but can range between 4% and 71% (Finkelhor et al., 2015; McLaughlin et al., 2013; Saunders & Adams, 2014). Exposure to traumatic events can disrupt brain development and can have immediate and lifelong adverse effects on social, emotional and physical wellbeing, including deficits executive functioning, developmental delays, behavioural health problems, difficulty regulating emotions and behaviour, academic performance and IQ, school behaviour problems, delinquency, substance abuse, and mental health and psychiatric disorders (Anda et al.