1. Children’s Relief Nursery www.crn4kids.org The Dis-regulated Child: children who lose control of their emotions, behaviors and bodies Leslie Brown, LCSW March 9 th, 2010

2. Children’s Relief Nursery www.crn4kids.org Introduction Agenda Introductions

3. Children’s Relief Nursery www.crn4kids.org Course Goals Participants will be able to 1.Understand the needs of overwhelmed children and be able to identify evidence based therapeutic prevention strategies. 2.Recognize children who are in the peak phase of being out of control and be able to identify therapeutic intervention strategies including how to positively re-engage the child back into the classroom. 3.Identify the importance of building positive relationships with children and their families to construct positive behavior supports.

4. Children’s Relief Nursery www.crn4kids.org Definition of the ‘Traumatized Child’ Has experienced a traumatic event Shows signs of being overwhelmed Shows distress through their words, behavior and play Shows behaviors that seem out of control, fearful, disruptive, excessively aggressive. Child becomes “flooded” with feelings of fear and anxiety. Child cannot control these behaviors without help

5. Children’s Relief Nursery www.crn4kids.org Traumatic stress as a cause of dis-regulation Definition of a traumatized child Early childhood trauma types Rationale for prevention and early response to trauma

6. Children’s Relief Nursery www.crn4kids.org The impact of trauma Body’s trauma response & the brain Impact of early childhood development Attachment & trauma Culture & trauma

7. Children’s Relief Nursery www.crn4kids.org Effects of trauma Trauma reminders Reenactment Traumatic expectations Projections Difficulty differentiating past/present Long term effects of untreated trauma

8. Children’s Relief Nursery www.crn4kids.org Behaviors associated with trauma How trauma impacts relationships How it manifests in peer group settings

9. Children’s Relief Nursery www.crn4kids.org What you might observe in young traumatized children Signs & symptoms in children 0-3 years Signs & symptoms in children 3-5 years Behaviors that warrant concern

10. Children’s Relief Nursery www.crn4kids.org Behaviors that Warrant Concern (Infants and Toddlers 0-3 yrs.) Chronic feeding or sleeping difficulties Inconsolable “fussiness” or irritability Incessant crying with little ability to be consoled Extreme upset when left with another adult Inability to adapt to new situations Easily startled or alarmed by routine events Inability to establish relationships with other children or adults Excessive hitting, biting and pushing of other children or very withdrawn behavior Flat affect

11. Children’s Relief Nursery www.crn4kids.org Behaviors that Warrant Concern (Preschoolers ages 3-5 yrs.) Engages in compulsive activities (e.g. head banging) Throws wild, despairing tantrums Withdrawn; shows little interest in social interaction Displays repeated aggressive or impulsive behavior Difficulty playing with others Little or no communication; lack of language Loss of earlier developmental achievements

12. Children’s Relief Nursery www.crn4kids.org Understanding what traumatized children need Sensory body based prevention strategies Feelings identification Affect regulation/Tucker the Turtle Safety planning Therapeutic environment Relaxation skill building Building a narrative or story

13. Children’s Relief Nursery www.crn4kids.org Setting up a therapeutic environment Planning ahead Being proactive Sound reduction Reducing stimulation Limiting transitions Dividing children & sections in the room Predictable classroom rules & routines

14. Children’s Relief Nursery www.crn4kids.org Therapeutic environment Increasing levels of support: designating adults anticipating difficult times: trauma reminders Helping reduce or explain other children’s reactions to the child Role playing Giving words to use Establishing teacher's as safe base Coaching Choices Communication between teachers/emotional tone

15. Children’s Relief Nursery www.crn4kids.org Prevention strategies Find helping jobs Use 3 minute warning & pre-warn children when doing something out of the ordinary Describe when you see the child doing what you want Scheduled one on one time Feeding the meter Avoiding problem situations

16. Children’s Relief Nursery www.crn4kids.org Prevention strategies: teaching emotional skills Feelings identification Regulation activities Relaxation games Calming activities Expressing feelings in words Understanding triggers: child & caregivers

17. Children’s Relief Nursery www.crn4kids.org Prevention strategies: teaching social skills Role playing Conflict resolution: use of humor Story telling games Boundary setting games Teaching helping behaviors

18. Children’s Relief Nursery www.crn4kids.org 7 phases of escalating behavior in children CalmPrevention strategies TriggerPrevention strategies AgitationPrevention strategies AccelerationPrevention strategies PeakIntervention strategies De-escalationIntervention strategies RecoveryIntervention strategies

19. Children’s Relief Nursery www.crn4kids.org Work Sheet Prevention Strategies Please follow along on activity sheet

20. Children’s Relief Nursery www.crn4kids.org Responding: when child is out of control Self check in/emotional environment Cycles of a melt down Resisting child’s efforts to draw you into “reenactments” Containment: moving child or others out of harms way Offering choices, reflecting child’s choice, choosing a choice for the child Describing child’s need & intention Empathic mirroring & body matching

21. Children’s Relief Nursery www.crn4kids.org When Child is out of control Use of the “skying down” area Distraction: washing a table, chairs, scrub brush Using sensory materials: soft & rough fabrics, tornado, egg timer, blowing a pretend candle, sensory tables Soft Voice, slow body movements

22. Children’s Relief Nursery www.crn4kids.org Positively re-engaging the child back into the group Resolve unresolved issues Provide ways for atonement Make a plan for next time Follow up with teaching team

23. Children’s Relief Nursery www.crn4kids.org Coming full circle How to resolve the problem Involving parents Long term prevention planning

24. Children’s Relief Nursery www.crn4kids.org The Magic Box What do have in your box now? What would you like in your box? Suggestions

25. Children’s Relief Nursery www.crn4kids.org Question and Answer