1. Trauma-Informed Practices
Mitch Demers, Katie Goulet
and Anne Meyer
Paraprofessional Conference 8/2017
All introduce ourselves - where from, our job
Mitch: Ask Population working from and location: Preschool, Elementary, Middle, High

2. Agenda What is Trauma? How can trauma manifest in school?
Tools to support kids who have experienced trauma
Anne
Take ACE now - 5 min

3. WHAT IS TRAUMA?
Katie

4. Stress
Positive Stress Response: Normal part of development, brief increase in heart rate, mild elevation in hormone levels
Tolerable Stress Response: Activates alert system to greater degree. If time- limited and buffered by relationships with adults who can help child adapt, can be OK
Toxic Stress Response: Strong, Frequent, and/or Prolonged. Disruptions in typical brain and neural development.
Constant state of Fight, Flight, Freeze
“Wired” to be in high alert, constant threat assessment
Katie
Stress is adaptive

5. Katie

6. Adverse Childhood Experiences (ACE) are caused by toxic stress.
Mitch

7. ACE Categories
Mitch

8. Mitch

9. Mitch

10. Mitch

11. With an ACE score of 4 or more, things start getting serious.
The likelihood of the following increases...
Chronic pulmonary lung disease: 390%
Hepatitis: 240%
Depression: 460%
Suicide: 1,220%
Mitch

12. Mitch

13. Trauma Facts
Anne

14. FACT: One out of every 4 children attending school has been exposed to a traumatic event that can affect learning and/or behavior.
FACT: Trauma can impact school performance.
• Lower GPA
• Higher rate of school absences
• Increased drop-out
• More suspensions and expulsions
• Decreased reading ability
FACT: Trauma can impair learning. Single exposure to traumatic events may cause jumpiness, intrusive thoughts, interrupted sleep and nightmares, anger and moodiness, and/or social withdrawal—any of which can interfere with concentration and memory.
Chronic exposure to traumatic events, especially during a child’s early years, can:
• Adversely affect attention, memory, and cognition
• Reduce a child’s ability to focus, organize, and process information
• Interfere with effective problem solving and/or planning • Result in overwhelming feelings of frustration and anxiety
FACT: Traumatized children may experience physical and emotional distress. • Physical symptoms like headaches and stomachaches • Poor control of emotions • Inconsistent academic performance • Unpredictable and/or impulsive behavior • Over or under-reacting to bells, physical contact, doors slamming, sirens, lighting, sudden movements • Intense reactions to reminders of their traumatic event: • Thinking others are violating their personal space, i.e., “What are you looking at?” • Blowing up when being corrected or told what to do by an authority figure • Fighting when criticized or teased by others • Resisting transition and/or change
FACT: You can help a child who has been traumatized. • Follow your school’s reporting procedures if you suspect abuse • Work with the child’s caregiver(s) to share and address school problems • Refer to community resources when a child shows signs of being unable to cope with traumatic stress • Share Trauma Facts for Educators with other teachers and school personnel

15. FACT: Trauma can impair learning.
Single exposure to traumatic events may cause jumpiness, intrusive thoughts, interrupted sleep and nightmares, anger and moodiness, and/or social withdrawal— any of which can interfere with concentration and memory.
Chronic exposure to traumatic events, especially during a child’s early years, can:
• Adversely affect attention, memory, and cognition
• Reduce a child’s ability to focus, organize, and process information
• Interfere with effective problem solving and/or planning
• Result in overwhelming feelings of frustration and anxiety
Anne

16. • Physical symptoms like headaches and stomachaches
FACT: Traumatized children may experience physical and emotional distress.
• Physical symptoms like headaches and stomachaches
• Poor control of emotions
• Inconsistent academic performance
• Unpredictable and/or impulsive behavior
• Over or under-reacting to bells, physical contact, doors slamming, sirens, lighting, sudden movements
• Intense reactions to reminders of their traumatic event: • Thinking others are violating their personal space, i.e., “What are you looking at?”
• Blowing up when being corrected or told what to do by an authority figure • Fighting when criticized or teased by others • Resisting transition and/or change
Anne

17. Katie

18. Length 12:47
Katie

19. HOW CAN THIS MANIFEST AT SCHOOL?
Katie

20. We Adapt to our Environment
Playground World
Rollercoaster World
Katie
Which fits with school? ...Clash between adaptations to life and expectations of school

21. Perception - Faces Study
Asked to report when saw first threatening face
“Rollercoaster”: didn’t even get to neutral face before reported
“Playground”: Went past neutral before reported
Significant impact on how people view/act in social situations
Katie

22. What you might observe in Preschool Children:
Young children do not always have the words to tell you what has happened to them or how they feel. Behavior is a better gauge and sudden changes in behavior can be a sign of trauma exposure.
• Re-creating the traumatic event (e.g., repeatedly talking about, “playing” out, or drawing the event)
• Increased somatic complaints (e.g., headaches, stomachaches, overreacting to minor bumps and bruises)
• Changes in behavior (e.g., appetite, unexplained absences, angry outbursts, decreased attention, withdrawal)
• Over- or under-reacting to physical contact, bright lighting, sudden movements, or loud sounds (e.g., bells, slamming doors, or sirens)
• Increased distress (unusually whiny, irritable, moody)
• New fears (e.g., fear of the dark, animals, or monsters)
• Statements and questions about death and dying
Katie , Case Example
• Separation anxiety or clinginess towards teachers or primary caregivers
• Anxiety, fear, and worry about safety of self and others
• Regression in previously mastered stages of development (e.g., baby talk or
bedwetting/toileting accidents)
• Lack of developmental progress (e.g., not progressing at same level as peers)
• Difficulty at naptime or bedtime (e.g., avoiding sleep, waking up, or nightmares)
• Worry about recurrence of the traumatic event

23. What you might observe in Elementary School Students:
• Changes in behavior:
• Increased distress (unusually whiny, irritable, moody)
• Increase in activity level
• Decreased attention and/or concentration
• Withdrawal from others or activities
• Angry outbursts and/or aggression
• Absenteeism
• Changes in school performance
• Increased somatic complaints (e.g., headaches, stomachaches, overreaction to minor bumps/bruises)
• Distrust of others, affecting how children interact with both adults and peers
• A change in ability to interpret and respond appropriately to social cues
• Recreating the traumatic event (e.g., repeatedly talking about, “playing” out, or drawing the event)
• Over- or under-reacting to bells, physical contact, doors slamming, sirens, lighting, sudden movements
• Statements and questions about death and dying
• Difficulty with authority, redirection, or criticism
Katie , Case Example
• Anxiety, fear, and worry about safety of self and others (more clingy with teacher or parent)
• Worry about recurrence of violence
• Changes in school performance
• Re-experiencing the trauma (e.g., nightmares or disturbing memories during the day)
• Hyperarousal (e.g., sleep disturbance, tendency to be easily startled)
• Avoidance behaviors (e.g., resisting going to places that remind them of the event)
• Emotional numbing (e.g., seeming to have no feeling about the event)

24. What you might observe in Middle School Students:
• Changes in behavior:
• Decreased attention and/or concentration
• Increase in activity level
• Change in academic performance
• Irritability with friends, teachers, events
• Angry outbursts and/or aggression
• Withdrawal from others or activities
• Absenteeism
• Increased somatic complaints (e.g., headaches, stomachaches, chest pains)
• Repeated discussion of event and focus on specific details of what happened
• Over- or under-reacting to bells, physical contact, doors slamming, sirens, lighting, sudden movements
• Re-experiencing the trauma (e.g., nightmares or disturbing memories during the day)
• Hyperarousal (e.g., sleep disturbance, tendency to be easily startled)
Anne - give case example
Anxiety, fear, and worry about safety of self and others
• Worry about recurrence or consequences of violence
• Avoidance behaviors (e.g., resisting going to places that remind them of the event)
• Emotional numbing (e.g., seeming to have no feeling about the event)
• Discomfort with feelings (such as troubling thoughts of revenge)

25. What you might observe in High School Students:
• Changes in behavior:
• Withdrawal from others or activities
• Irritability with friends, teachers, events
• Angry outbursts and/or aggression
• Change in academic performance
• Decreased attention and/or concentration
• Increase in activity level
• Absenteeism
• Increase in impulsivity, risk-taking behavior
• Increase in substance abuse
• Negative impact on issues of trust and perceptions of others
• Over- or under-reacting to bells, physical contact, doors slamming, sirens, lighting, sudden movements
• Repetitive thoughts and comments about death or dying (including suicidal thoughts, writing, art, or notebook covers about violent or morbid topics, internet searches)
• Heightened difficulty with authority, redirection, or criticism
• Re-experiencing the trauma (e.g., nightmares or disturbing memories during the day)
Mitch
Give Case Example
• Hyperarousal (e.g., sleep disturbance, tendency to be easily startled)
• Avoidance behaviors (e.g., resisting going to places that remind them of the event)
• Emotional numbing (e.g., seeming to have no feeling about the event)
•Anxiety, fear, and worry about safety of self and others
• Worry about recurrence or consequences of violence
• Discomfort with feelings (such as troubling thoughts of revenge)
• Increased risk for substance abuse

26. WHAT CAN YOU & I DO TO SUPPORT CHILDREN WITH ACEs (TRAUMA)?
Mitch

27. According to research about childhood trauma, all of the risk factors for adverse experiences can be offset by one thing:
the presence of a stable, caring adult in a child’s life. - Paper Tigers, 2015
Mitch

28. “What’s wrong with you” to “What’s happened to you”
Changing Focus
“What’s wrong with you” to
“What’s happened to you”
Mitch

29. Nonverbal Communication
Supportive Stance: Keeping distance of one leg-length & remain at angle
Position: Where we are in relation to others - our orientation
Approaching from the side vs. directly in front or from the back
Posture: How we hold & move our body
Facial expressions, eye contact, head movement, gestures, etc.
Feet shoulder-width apart helps you remain balanced & nonthreatening
Proximity: Distance between individuals
Consider gender, culture, relationships, activity, context, etc.
Katie
Haptics: Communication through touch Handshakes, holding hands, backslaps, high fives, pat on the back, brushing against arms

30. Paraverbal Communication
The vocal part of speech, excluding the actual words one uses.
Tone: Inflection of voice
Sarcasm, impatience, etc.
Use caring, supportive tones
Volume: How loud or soft we speak
Shouting, whispering, etc.
Keep volume appropriate for the situation
Cadence: The rate or rhythm of speech
How fast or slow we speak
Deliver messages with even cadence
Katie
Two sentences containing ID words can convey completely different meanings.
Students with trauma are hypersensitive to threat -- trigger fight or flight mode if perceived threat

31. Verbal Communication Limit-Setting Communicate naming emotions
Simple/Clear: Keep the limit statement short & simple
Use a clear, calm, and even tone
Reasonable: Avoid placing too many requests/demands at same time
Enforceable: Ensure you can make it happen
Communicate naming emotions
Katie

32. Safe & Predictable • Maintain usual routines • Give children choices
• Increase the level of support and encouragement given
• Set clear, firm limits for inappropriate behavior and develop logical—rather than punitive— consequences
• Recognize that behavioral problems may be transient and related to trauma
Even the most disruptive behaviors can be driven by trauma-related anxiety
• Provide a safe place for the child to talk about what happened
• Give simple and realistic answers to the child’s questions about traumatic events
Anne
• Maintain usual routines. A return to “normalcy” will communicate the message that the child is safe and life will go on.
• Give children choices. Often traumatic events involve loss of control and/or chaos, so you can help children feel safe by providing them with some choices or control when appropriate.
• Increase the level of support and encouragement given to the traumatized child. Designate an adult who can provide additional support if needed.
- Provide a safe place for the child to talk about what happened. Set aside a designated time and place for sharing to help the child know it is okay to talk about what happened.
• Give simple and realistic answers to the child’s questions about traumatic events. Clarify distortions and misconceptions. If it isn’t an appropriate time, be sure to give the child a time and place to talk and ask questions.

33. • Anticipate difficult times and provide additional support
• Be sensitive to the cues in the environment that may cause a reaction
• Anticipate difficult times and provide additional support
• Be aware of other children’s reactions to the child and to the information they share
• Understand that children can cope by re-enacting trauma through play or through their interactions with others
• Although not all children have religious beliefs, be attentive if the child experiences severe feelings of anger, guilt, shame, or punishment attributed to a higher power
Refer the child to appropriate support
Anne
Be sensitive to cues: For example, victims of natural storm-related disasters might react very badly to threatening weather or storm warnings. Children may increase problem behaviors near an anniversary of a traumatic event.
Anticipate difficult times: Many kinds of situations may be reminders. If you are able to identify reminders, you can help by preparing the child for the situation. For instance, for the child who doesn’t like being alone, provide a partner to accompany him or her to the restroom.
Warn children if you will be doing something out of the ordinary, such as turning off the lights or making a sudden loud noise.
Be aware of other children: Protect the child with trauma from peers’ curiosity and protect classmates from the details of a child’s trauma.
Understand children cope: Resist their efforts to draw you into a negative repetition of the trauma. For instance, some children will provoke teachers in order to replay abusive situations at home.
Religious beliefs: Do not engage in theological discussion.

34. Helping Students Regulate
Never talk to student until CALM, de- escalated (brain shuts off to redirect energy to body for fight/flight) - Check in (for both of you)
Questions to Avoid:
What happened?/What did you do? (can lead to argument or trigger)
What were you thinking? (Not effective in the moment)
Katie

35. The Fantastic, Elastic Brain
“You can’t change what’s in your students’ bank accounts, but you can change what’s in their emotional accounts” (Jensen, 2009) - Repeated experiences rewire: It takes many, many, many times Relationships are EBP! We are human, but our patterns matter
Katie

36. Know Yourself Know your own triggers & limitations
Relation Detachment: The ability to manage your own behavior and attitude
Not take the behavior of others personally
Importance of Self-Care
Mitch
Reference ACEs. Knowing our ACEs

37. Self-Care
“Self-care is not selfish. You cannot serve from an empty vessel.” — Eleanor Brownn
People who are able to meet their own physical/emotional/spiritual/psychological needs are better able to meet the needs of others
What are some healthy ways you restore/replenish outside of work?
What are some tools you use DURING the work day?
Anne

38. Take Away
What are 3 big ideas you’d like to take away from this presentation?
What might you implement in your daily work?
Pair & Share
Katie

39. Katie