Archives: Lessons
Resources and references
Check out these additional resources to support Trauma-Informed Care. Links will open in a new tab or window.
- 7 Positive Childhood Experiences (PCEs) that Shape Adult Health and Resiliency | Lindsay Braman
- For Better Adult Mental and Relational Health, Boost Positive Childhood Experiences | Johns Hopkins
- CSEFEL: Center on the Social and Emotional Foundations for Early Learning | Vanderbilt
- Child & Adolescent Behavioral Health – Improving Lives Since 1976 with Health, Hope and Happiness
- Kentucky Child Care Health Consultants
- Conscious Discipline: Social and Emotional Learning
- Creating Positive Childhood Experiences | CDC.gov
- Devereux Advanced Behavioral Health
- Effects: How Early Childhood Trauma Is Unique | NCTSN.org
- FLIP IT: Strategy for Challenging Behavior
- Love and Logic: Positive Parenting Solutions & Educational Resources
- Nurturing Parenting: Family Development Resources
- Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample | JAMA Pediatrics
- PCIT: Parent-Child Interaction Therapy
- What Are the 3 Types of Trauma? | MedicineNet
References
Allen, K. (2019, August 9). 5 Ways to Boost Students’ Sense of School Belonging. Monash University. https://www.monash.edu/education/teachspace/articles/5-ways-to-boost-students-sense-of-school-belonging
Bailey, B. Conscious Discipline Website (2015). Brain State Model. Study Portal. Retrieved January 22, 2024 from https://consciousdiscipline.com/free-resources/book-portal/chapter-2-brain-state-model/
Carpenter-Williams, J. (2017). Youth Thrive: Promoting Youth Resilience. Center for the Study of Social Policy. Retrieved from https://cssp.org/wp-content/uploads/2018/08/youth-thrive-promoting-youth-resilience.pdf
Center on the Developing Child at Harvard University. (2013, January 1). Building adult capabilities to improve child outcomes: A theory of change [Video]. Retrieved January 22, 2024, from http://developingchild.harvard.edu/resources/multimedia/videos/theory_of_change/
Child Welfare Information Gateway. (n.d.). ACES Study [PPT]. Retrieved Dec. 1, 2014 from https://www.childwelfare.gov/calendar/cbconference/fourteenth/presentations/ahdc/index.cfm
Child Welfare Information Gateway. (n.d.). Positron Emission Tomography (PET) scan [Image]. Retrieved November 10, 2014, from https://www.childwelfare.gov/calendar/cbconference/fourteenth/presentations/ahdc/sld046.cfm
National Alliance of Children’s Trust and Prevention. (2014). Bringing the protective factors framework to life in your work: A resource for action [Online Training]. Retrieved January 22, 2024 from https://www.prosolutionstraining.com/store/product/index.cfm?tDisplayAdd=1&tProductVersion_id=1517&CatalogFilter_id=266&tCatalogFilterType_id=
National Scientific Council on the Developing Child (2015). Supportive Relationships and Active Skill-Building Strengthen the Foundations of Resilience. Retrieved January 22, 2024 from https://developingchild.harvard.edu/wp-content/uploads/2015/05/The-Science-of-Resilience.pdf
Nelson, C. (2000) Core concepts in the science of early childhood [PDF. Pg. 3]. Retrieved November 10, 2014, from http://developingchild.harvard.edu/index.php/download_file/-/view/1110/
Palix Foundation: The Brain Architecture Game (2018) About the game | The Brain Architecture Game. Purchased on August 27th 2018 from https://dev.thebrainarchitecturegame.com/about-the-game/team-history/
Palmiter, D., Glenn, R., Saakvitne, K., O‘Neil, H. K., Maddi, S., Luther, S., … Alvord, M. (2012). Building your resilience. Retrieved January 22, 2024 from https://www.apa.org/topics/resilience/building-your-resilience.
Shonkoff, J. P. (2008, June 26). The Science of Child Development and the Future of Early Childhood Policy [PDF, Pg. 19]. Retrieved November 10, 2014, from http://developingchild.harvard.edu/resources/multimedia/symposium_presentations_and videos/
National Research Council (US) and Institute of Medicine (US) Committee on Integrating the Science of Early Childhood Development, Shonkoff, J. P., & Phillips, D. A. (Eds.). (2000). From Neurons to Neighborhoods: The Science of Early Childhood Development. National Academies Press (US). Retrieved January 22, 2024 from https://pubmed.ncbi.nlm.nih.gov/25077268/
Shonkoff, J. P., Garner, A. S., Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, & Section on Developmental and Behavioral Pediatrics (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246. https://doi.org/10.1542/peds.2011-2663
Positive Childhood Experiences (PCEs)
Young children experience the world through their relationships with their family and other caregivers. Children and families thrive when they have access to safe, stable, nurturing relationships and environments. These relationships and environments are key to creating Positive Childhood Experiences (PCEs). When we change our lens, replacing the deficit-focused lens with a strength-based lens, we shift from focusing on ACEs to PCEs.
ACEs are early negative events that impact the health and wellbeing of children and the adults they become.
PCEs are activities and experiences that enhance a child’s life resulting in successful mental and physical health outcomes.
A 2019 study led by Johns Hopkins concluded that “positive childhood experiences [can even] counter the damaging effects of adverse experiences.” There has been a significant connection found between positive childhood experiences and an adult’s mental and emotional health. Both positive and adverse experiences will shape brain development, but positive childhood experiences are a key factor in influencing health and wellbeing throughout the lifespan.
Even as society continues to address ACEs, more attention should be given to creating PCEs that generate resilience in children, families, and communities.
Let’s look at the seven PCEs and ways that they can be incorporated in your work with families and children.
Reference:
Bethell C, Jones J, Gombojav N, Linkenbach J, Sege R. Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels. JAMA Pediatrics 2019;173(11):e193007. doi:10.1001/jamapediatrics.2019.3007. Accessed 01/08/2024 at https://jamanetwork.com/journals/jamapediatrics/fullarticle/2749336
Building Resilience
According to the Resilience Research Centre, resilience is more likely to occur when we provide the services, supports and health resources that make it more likely for every child to do well in ways that are meaningful to their family and community. In this sense, resilience is the result of both successful navigations to resources and negotiation for resources to be provided in meaningful ways. When talking about resiliency, we are talking about it as a way to combat ACEs and trauma.
References:
Resilience Research Centre. (2022). CYRM and ARM user manual v2.5. Halifax, NS: Resilience Research Centre, Dalhousie University. Retrieved from https://cyrm.resilienceresearch.org/files/CYRM_&_ARM-User_Manual.pdf
Bottom Up Approach
The Bottom Up approach to brain development is based on how the brain is structured. This visualization of the brain shows the states along with the part of the brain that controls each one. The system acts as a hierarchy which means that the brain can’t focus on the needs of a state unless the underlying need is met. For example, a person cannot think cognitively (executive state) if their survival and emotional state needs are not met.
The first and most basic state is the Survival state. It is controlled by the brain stem which is represented by red in the graphic. The Survival part of the brain is focused on looking at the situation, people, and events in the environment and deciding whether the person is safe from danger.
The Emotional state needs safety and security, too. The graphic shows the limbic system, which manages our Emotional state, in blue. The limbic system keeps tabs on whether we feel loved, supported, and comfortable in the current situation. A student who feels shy or doesn’t want to disappoint the teacher with a wrong answer might seem less engaged in the classroom, for example.
Only when our survival and emotional needs are met can we begin to use Executive state thinking. Executive functions happen in the brain’s prefrontal lobes which are shown as green in the graphic. This is when the brain starts to process incoming information. Our brains can use their energy to explore and learn without the distractions of lower-state needs.
Watch this short video of a second grader explaining the 3 brain states. Video must be watched entirely in order to progress through the course. You do not need to watch any recommended videos that pop up at the end.
References:
The Conscious Discipline Brain State Model. (n.d.). Conscious Discipline. https://consciousdiscipline.com/methodology/brain-state-model/
Trauma-Informed Care. (n.d.). The Village Network. https://thevillagenetwork.org/nmt/
Trauma-Informed Approach: The 4 Rs
The 4 Rs were developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) as a guide for trauma-informed systems, programs, and organizations.
The 4 Rs remind us of why a “universal precautions” approach is necessary. These elements apply to all levels of service and systems. They also apply to staff at all levels, even those we think of as not being direct service. The 4 Rs should became the culture of the organization.
Reference:
SAMHSA’s Trauma and Justice Strategic Initiative. (2014) SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf
Create a Trauma-Informed Culture: The Basics
Many systems – schools, public agencies and service providers – have already begun to rethink how they operate under the framework of using a trauma-informed approach. Starting trauma-informed practices within a childcare setting is easier than you might think. Let’s take a look at some of the basics when creating a trauma-informed culture. Later, we will also review different approaches that can be taken to build on trauma-informed practices.
Building blocks of a trauma-informed program
References:
Oleski, V. LCSW. (n.d.). A Preschool Guide to Trauma Informed Care. [PowerPoint slides]. http://cfyetf.org/summit/2019/dmyfv_A_Preschool_Guide_to_Trauma_Informed_Care.pdf
SAMHSA’s Trauma and Justice Strategic Initiative. (2104, July). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. U.S. Department of Health and Human Services. https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf
Why should we be Trauma-Informed?
Unaddressed trauma significantly increases the risk of mental and substance use disorders and chronic physical diseases.
There is strong evidence that traumatic stress increases the risk for behavioral health and substance use disorders, and the severity of symptoms of those disorders, especially in populations with high rates of trauma history.
Reference:
SAMHSA’s Trauma and Justice Strategic Initiative. (2014) SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf
Stress
Everyone will experience stress, but depending on our exposure, experience, and the effect of the event, the level at which we experience the stress will vary.
Adverse Childhood Experiences (ACEs)
In the 1990s, Kaiser Permanente and the CDC conducted a study of more than 17,000 people. The study’s purpose was to examine the connection between childhood trauma and adversity and health and well-being across the lifespan. The results were astonishing and clearly demonstrated a connection between childhood trauma and mental health, substance abuse, educational attainment, and physical/medical well-being. More than 2/3 of participants reported at least one ACE, and 1/6 reported exposure to 4 or more ACEs.
Further, the ACE study made it clear that the more exposure to trauma and adversity in childhood, the greater the risk of negative impacts on functioning and development. Four ACEs is considered to be the point at which risk increases dramatically for negative behavioral health and health care impacts.
Read more about the original study and ongoing research on the CDC’s Violence Prevention website.
What is Trauma-Informed?
Trauma-Informed is not “What’s wrong with you?”
Trauma-Informed is “What’s happened to you?” or “What’s your story?”
Trauma-informed care refers to the recognition of the pervasiveness of trauma and a commitment to identifying and addressing it early, whenever possible. Trauma-informed care also involves seeking to understand the connection between presenting symptoms and behaviors and the individual’s past trauma history. It involves the provision of services and interventions that “do not inflict further trauma on the individual or reactivate past traumatic experiences” (Hodas, 2006).
People are best supported by providers who understand the need to use trauma-informed practice methods. Trauma response focuses on building resiliency.
What do trauma-informed practices look like in the child care setting?
- Provide a safe place, like a coping corner, for children to be able to be alone.
- Provide mindfulness activities throughout the day.
- Use trauma-informed language such as “I hear you”, “I believe in you” or “I support you”.
- Help children learn how to recognize and control their emotions effectively.
- For example, you can ask the child if you can hold their hand while they calm down. Teach them breathing techniques and model appropriate words, rather than yelling.
References:
Hodas, G.R. (February 2006). Responding to Childhood Trauma: The Promise and Practice of Trauma Informed Care. Pennsylvania Office of Mental Health and Substance Abuse Services. https://www.nasmhpd.org/sites/default/files/Responding%20to%20Childhood%20Trauma%20-%20Hodas.pdf
The 6 Protective Factors
The Kentucky Strengthening Families Initiative encompasses 6 Protective Factors.
This Initiative supports the use of these Protective Factors which helps providers shift their practice to better align with developmental science, to be more responsive to trauma, pay attention to developmental issues and support families and caregivers in nurturing the children in their care.
Protective Factors are conditions or attributes that mitigate risk and promote healthy development. Protective Factors reduce the impact of adversity and support an individual’s well-being to bounce back in order to move forward!
Kentucky Strengthening Families Initiative:
6 Protective Factors
Welcome to ECE 119
Welcome to the Trauma-Informed Care and Resiliency Training.
I am LaTanya, the trainer, and I will be taking you through this training. Before we begin, it is important to mention that we will be discussing trauma and its impacts. Please be aware that certain words, phrases, pictures or scenarios may trigger some individuals as we discuss trauma.
A note on self-care
Talking about trauma is difficult and may elicit a range of emotions and thoughts. We all respond to material differently at different times. As you take this training, pay attention to your own needs and respond as needed. Feel free to pause the training and return at a later date if necessary. You may also feel impacted after you leave this training.
Use coping strategies, as needed, to help process any responses. Coping strategies could include:
- Physical activity
- Talking to friends, family or colleagues
- Journaling
If you find you are impacted in ways that feel bigger than the coping skills suggested, please talk to a professional. Being impacted does not mean you cannot do the work or are not cut out for the work – it is just confirmation that the work is hard. We will talk more about this later in the training.
Social Connections