1. Childhood Trauma & Chronic Stress:
Effects on the Brain and Learning, and Potential Role of the Schools
Wendy Cunningham, Psy.D.
Licensed Clinical Psychologist

2. Objectives
Show why it is important for alternative schools to understand trauma and chronic stress
Illuminate current research that links trauma/chronic stress with biology, environment, behavior, and academic performance
Discuss the importance of a systematic approach and why it is important

3. Few Important Numbers
Difficult to get prevalence rates; however, studies estimate between 3.3 and 10 million children witness violence in their home each year
2003: U.S. Department of Health
Reported approximately 906,000 children in protective custody
2005: Massachusetts Department of Education
Informal surveys to 450 students of alternative-education programs in 11 school districts that received state funds
90% of the students surveyed reported trauma history

4. What is a “Traumatic Event”
Many factors involved in what is considered a traumatic event, including:
Threat or perceived threat to well-being of self or other
Individual temperament
Past experiences
Who is involved in the event
Why events affect individuals in different ways

5. Factors Impacting Trauma Reaction
Characteristics of the Individual
Characteristics of the Environment
Characteristics of the Traumatic Event
See Massachusetts Adovcates for Children, (2005). Helping Traumatized Children Learn, Appendix C.

6. Chronic Stress See similar biological effects as with trauma
Less obvious than a traumatic event

7. ARE THERE BRAIN EFFECTS?
“I could see the math teacher’s mouth moving in the classroom but couldn’t hear a thing. It was as if I were in a soundless chamber. She was smiling and clearly talking, I just couldn’t process a word of it. I had been an excellent math student, but the day she told me I was “spacey” and unfocused was the day I stopped connecting to math. My grades dropped and they took me out of the advanced classes.”
Massachusetts Advocates for Children, (2005). Helping Traumatized Children Learn, p.24.

8. From http://www.ahaf.org/alzdis/about/AnatomyBrain.htm

9. Emotions: TWO Pathways!
Ventral Path (Low Road)
Stimulusthalamusamygdala
body reactionemotion
Dorsal Path (High Road)
Stimulusthalamuscortex
short-term memory stores
representationlong-term
memory accessedworking
memory
integrates
amygdala
cortical
arousal
visceral
reaction
body
feedback
emotion

10. Evolutionary Favorite
Wiring of the brain favors emotions
There tends to be more connections directed from the limbic system to the cortex (emotion affects thoughts) versus cortex to limbic system (thought affects emotion)
Theories of Evolution
Although hypothetical, theories suggest that we may move towards more of a balance
LeDoux, J. (1998) The emotional brain. London: Phoenix.

11. Hypothalamic-Pituitary-Adrenal System

12. What’s the Deal? Incredible Shrinking Brain: Effects on hippocampus
Decreased hippocampal volume
Lower hippocampal neural connection
To Stress or Not to Stress: Confused stress response
Consistent survival mode
HPA system down-regulates
Unraveling chromosomes
Chronic stress shown to unravel telomeres (ends of chromosomes)
Unorganized brain – unorganized behavior
Imprinting (ex. orbitofrontal cortex) and missed stimuli from environmental experiences compromises structural arrangements for regulation

13. Emotional Memories External Event
Amygdala Hippocampus
Implicit memory Explicit memory
--event was awful --who, what, where
--body reaction
*Occurs together to contribute to the experience of the event as a whole
*Not selective in triggers; broad scope

14. Brain Stressed Out Hippocampus overwhelmed by glucocorticoids
“Talk” between
neurons disrupted
No new neurons formed
Amygdala
overwhelms hippocampus
5. Prolonged
glucocorticoid
exposure might
damage or kill
hippocampal neurons

15. Not to Mention Brain Development Issues!
Poor attachment experiences:
Cognitive deficits
Brain unable to develop self-regulation
Poor sequential memory
Executive functioning poorly developed
Language instrumental vs. social/emotional

16. Implications for Learning
Studies show that when compared to other children, maltreated children have:

17. We Have the Most Difficult Kids!!!!
What Behaviors Do You See?
(Think Brain Influences!)
Awareness important, because it can reduce anger, increase understanding, and improve intervention

18. What Can We Do?

19. Factors Impacting Trauma Reaction
Characteristics of the Individual
Characteristics of the Environment
Characteristics of the Traumatic Event
See Massachusetts Adocates for Children, (2005). Helping Traumatized Children Learn, Appendix C.

20. Empirically Supported Interventions Include:
Attachment/relationship focus
Training in affect regulation
Systematic desensitization/titrated exposure
Individual therapy
Symbolic play for young children
Age-appropriate group therapy
Caretaker involvement as appropriate
POSITIVE AND COLLABORATIVE TEAM SPIRIT is CRITICAL

21. Attachment: Not just a nice idea
All research, both biological and psychological, shows that social affiliation and attachment are critical components of mediating effects of trauma and chronic stress

22. Attachment Styles, Brain Development, and Behavior
Attachment style psychologically based on view of self & view of other:
Secure: positive/positive
Preoccupied: negative/positive
Distant: positive/negative
Disorganized/Fearful: negative/negative
Research shows that traumatized kids largely exhibit disorganized attachment style
Brain organization in early development relies upon environment and response of caregivers
Research also shows executive functioning deficits present in disorganized attachment style that differentiates it from other styles

23. System Approach Administration& Planning Staff Needs & Training
Staff Collaboration
Appropriate
Teaching
Evaluation of Program
Success

24. Couple of Comprehensive Resources for Schools
Integrative Treatment of Complex Trauma for Children (ITCT-C) – 2008; also manual for adolescents & yg adults Free manual at
Helping Traumatized Children Learn: Supportive school environments for children traumatized by family violence – 2005; from the Massachusetts Advocates for Children: Trauma and Learning Policy Initiative. Download manual at