1. Housing & Social Work Services Trauma and its effects on health – how we work with it in teenagers Ailsa Clunie Health Liaison Officer Iain Macaulay Service Manager

2. Brain Development

3. Responsibilities of Brain CORTEX LIMBIC DIENCEPHALON BRAINSTEM Abstract thought Concrete Thought Affiliation/reward "Attachment" Sexual Behaviour Emotional Reactivity "Arousal" Appetite/Satiety Blood Pressure Heart Rate Body Temperature Sleep Motor Regulation

7. Things to think about Age of Adoption Money Spent

8. Definition of Attachment We are all born relational with attachment seeking behaviours such as crying, clinging, imitation and smiling; these are designed to keep carers close ensuring our needs for survival, safety and sensitive care are met. The process of how and who we attach to in our early years (0-3) is crucial as to how we grow and develop through childhood and into adulthood – neurologically, physically, emotionally, socially and psychologically. What happens to us in the womb also contributes to our resilience or vulnerability.

9. Stats/ ACE Study/ Harry Burns X4 lung cancer X3 Heart disease X6 Asthma X12 Substance misuse X8 Suicide Pregnancy (25%<16, 50%<18 (Forgotten children report)

10. Health related behaviours Opportunity to escape poverty, decent housing, social networks, self esteem and sense of control Consistent parenting, safe, nurturing early years, supportive education

11. Interventions Nurture these children Try to understand the behaviours before punishment or consequences Parent these children based on emotional age Be consistent, predictable and repetitive Model and teach appropriate social behaviours Listen to and talk with these children Have realistic expectations of these children Be patient with the child's progress and with yourself Sense of Mastery

12. Interventions Cont’d Stress Management Exercise Music/ Dance Sleep Touch

13. Massage/ Touch -Massage is a way to create balance in our nervous system -Touch is a kind of communication. -New ways of touching gives contact and closeness which can help children feel valued and worth loving -Massage can help relieve tension and reduce stress. ( physical and psychological) -Improves circulation Improves elimination ( toxins) Reduces pain Improves body awareness

14. Most Important Increases the level of Oxytocin ( the peace and calming hormone) Decreases the level of Cortisol ( the stress hormone)

15. The Barriers The offender population shows: 10 times the level of learning disability compared to the general population High level of care leavers (25-50%) 7 times the level of head injury 74% have communication difficulties 20% have severe communication difficulties By age 3 a 30 million word gap exists between the most disadvantaged and the best supported children We expect them to behave like adults!

16. Avoid Attack Self Withdraw Attack Others

17. Achieving Desistance Maturation, as young people develop Offending and Chaotic lifestyle stops (gender, attitude and understanding) Social Bonds, as ties to society develop offending stops (social capital) Narrative, “I want to stop” how offenders view their own position (redemption vs condemnation) Engagement – Mainstream adult communication models will often not work (understanding, word gap, brain injury, learning disability)  

18. Working with trauma A c c o u n t a b ili t y Support AR F S

19. Stress Reaction Submit FightFlight Withdraw

20. Don’t Fight

21. Further Reading SAIA. ( Scottish attachment in action) The Connected Baby Dr. Bruce Perry (Child Trauma Centre) Dr. Harry Burns