Transcript Childhood Trauma - Prevention First

Natasha Harmon, MS
Children’s Home + Aid
Today Goals
 Realize that you may be seeing the impact of trauma in
children you serve
 Recognize how trauma affects all individuals involved
 Respond by asking the important questions and by
trying to do what you can
Brain Development (Perry)
Limbic
Midbrain
Brainstem
Complexity and Plasticity
Cortex
Abstract Thought
Concrete Thought
Affiliation
"Attachment"
Sexual Behavior
Emotional Reactivity
Motor Regulation
"Arousal"
Appetite/Satiety
Sleep
Blood Pressure
Heart Rate
Body Temperature
4
Brain Development
Neurons are chemical messages
-Message comes in and the neurons fire
-More times the same message is repeated the thicker
the neuron connection
-The experience children have with their environment
determines which neurons and synapses survive and
which do not
Brain Development
 Critical Periods- for some aspects of brain
development, timing is critical. Important abilities will
be lost or diminished if they don’t develop at the right
time (e.g. vision, attachment, language)
 Childhood experiences impact how the brain develops
 Traumatic experiences interfere with normal brain
development when they occur during a period when
the brain is developing
Brain Development
• Events can cause changes in the brain. A single, powerful
experience can affect our brain for life.
• Repeated smaller experiences can also change our brain.
• Practice (sports, art, studies, etc.)- the more we repeat
things the stronger the brain connections become
• This is why there is always hope that youth can get better
with new, positive experiences
Brain Development
Teenage Development
 Physical Appearance
 Emotional rollercoaster
 Cognitive-Always the last to develop
Cognitive Development
Science has taught us that the part of the brain that
develops last during adolescence is the prefrontal lobe,
which controls:
 Complicated Decision-Making
 Thinking Ahead
 Planning
 Comparing Risks and Rewards
Teen’s Cognition
Teens make decisions differently than adults.
 They rely more on their “emotional” centers than their
“thinking” centers
 They often think before they act but they are using a
different set of “values” to make these decisions
 They often choose actions that are much riskier than
adults would choose
Childhood Trauma
The experience of an event by a child that is emotionally
painful or distressful which often results in lasting
mental and physical effects.
National Institute of Mental Health
Overwhelming, uncontrollable experiences that
psychologically impact victims by creating in them
feelings of helplessness, vulnerability, loss of safety
and loss of control—Beverly James
Childhood Trauma
 Event – One time or chronic
 Experience – whether the event is experienced as scary
or threatening
 Effect - long-lasting and life altering
Adverse Childhood Experiences(ACEs)
Growing up (prior to age 18) in a household with:
 Recurrent physical abuse
 Recurrent emotional abuse
 Sexual abuse
 Emotional or physical neglect
Felitti, 2009
Adverse Childhood Experiences
Growing up (prior to age 18) in a household with:
 An alcohol or drug abuser
 An incarcerated household member
 Someone who is chronically depressed, suicidal,
institutionalized or mentally ill
 Mother being treated violently
 One or no biological parents
Felitti, 2009
Beyond ACEs
 Being a victim of crime
 Community violence
 Traumatic loss
Experience
 Definition says “emotionally painful or distressful
 Scary or threatening
 Age matters – What is threatening for a 3 year old may
not be threatening to a 15 year old
Prenatal Experience
(Henry, Sloane & Black-Pond)
 Children exposed to prenatal alcohol combined with
childhood trauma have significantly greater severe
neurodevelopmental deficits in :
 Attention
 Language
 Memory
 These children have also been shown to have greater
 Oppositional/Defiant Behavior
 Inattention
 Hyperactivity
 Impulsivity
 Social problems
Effects
 A child’s brain development responds to the child’s
experiences
 Stress
 Alarm System as a Survival Mechanism
 After Trauma
 Child overreacts to normal situations
 Child is on constant alert
 Child may over-interpret signs of danger
Perry’s Dominant Response Types
Hyper arousal
 Flight or Fight
 Hyper-vigilant
 Easily Offended
 Over-reactive
 Avoidant
Dissociation
 Freeze/Numb
 Overwhelmed
 Nonresponsive
 Self-Mutilation
 Passing Out
More Effects
 Emotions
 Trouble calming down
 Trouble understanding others’ emotional expressions
 Poor emotional awareness-less “feeling” words
 Cognition
 Learning problems
 Early delays in language development
 Information processing problems
Physically Abused Children See Anger Where Others See Fear
Graphic by: Seth Pollak, courtesy PNAS
More Effects
 Physiological (Body System)
 Trouble regulating body (eating, sleep)
 Physical complaints
 Self mutilation
 Behavior Control
 High risk behaviors (sexualized, aggressive)
 Impulsive Behaviors
 Social Relationships
 Boundary problems with others
 Trouble forming and keeping relationships
More Effects
Exposure to Trauma Increases the Risk for:
 Major Mental Illness
 Substance Abuse
 AIDS and Sexually Transmitted Diseases
 Academic Difficulties
 Impaired Physical Health
Perry’s key concepts
 Resilience: Not everyone exposed to adverse
experiences is traumatized
 Recovery-Brains respond to repeated stimuli (practice
more of the “good stuff”)
 Even as adults, brains are capable of learning and
changing
Create a safe environment
 Be consistent-rewards & consequences
 Be predictable- have a routine and structure
 Reassure them that you a safe person
 “Felt safety”
Support
 Every child needs 3 supportive adults in their lives as
they grow up
 Mentors should stay in the child’s life at least 6 months
to be effective
 Often very helpful for parents to be in a group setting
to have others recognize the complexities of their
children’s behaviors
Help Them Soothe Themselves
 Recognize these youth can be challenging
 Try to keep your emotional reactions in check and stay
calm
 When a child has gone to the primal brain-they will
need your help to regulate
 Praise them for any coping strategies they use to calm
down—even after a meltdown
Soothing Suggestions
 Lollipops, drinking cold drink through the straw
 Chewing gum
 Hydration
 Food every 2 hours
 Deep Pressure/Weights
 Exercise
 Magic Mustache
IDEAL Response®
(Purvis & Cross)
 Immediate
 Direct
 Efficient
 Action-based
 Leveled at the behavior-not at the child
Efficient Response
 Respond using engagement
 Use the least threatening form of engagement possible
 Playful engagement
 Structured engagement-choices/compromise
 Calming engagement
 Protective engagement
Choices
 Give choices to help teach cooperation rather than get
into a power struggle
 Choices should be simple
 Gives child sense of appropriate control
IDEAL Response®
(Purvis & Cross)
 Immediate
 Direct
 Efficient
 Action-based
 Leveled at the behavior-not at the child
Action-Based Response: Behavior
Re-do’s
 Why don’t you try that again, this time with respect?
IDEAL Response®
(Purvis & Cross)
 Immediate
 Direct
 Efficient
 Action-based
 Leveled at the behavior-not at the child