1. Creating Trauma Sensitive Schools

2. Acknowledgements These materials have been gathered & created by a work group organized by the Wisconsin Department of Public Instruction. This group came together around a shared passion for helping to heal children who have been victims of trauma. These people shared their time & expertise to:  support schools in their journey to become more aware of the impact that trauma has on learning, behavior & development and  foster school environments where all students can grow & learn. Pamela Black, Kenosha Unified School District Paula Buege, Wisconsin Family Ties Sara Daniel, School Based Services - St. Aemilian-Lakeside, Inc. Nic Dibble, Wisconsin Department of Pubic Instruction Christine Dunning, University of Wisconsin-Milwaukee Elizabeth Hudson, Wisconsin Department of Health Services Supported in part by a grant from the Wisconsin Department of Health Services.

3. Sources of Information  Helping Traumatized Children Learn Massachusetts Advocates for Children 2005 http://www.massadvocates.org/helping_traumatized_children_learn http://www.massadvocates.org/helping_traumatized_children_learn  The Heart of Learning & Teaching Compassion, Resiliency & Academic Success http://k12.wa.us/CompassionateSchools/HeartofLearning.aspx http://k12.wa.us/CompassionateSchools/HeartofLearning.aspx Wolpow, Ray; Johnson, Mona M.; Hertel, Ron; Kincaid, Susan O. 2009 http://k12.wa.us/CompassionateSchools/HeartofLearning.aspx http://k12.wa.us/CompassionateSchools/HeartofLearning.aspx  Creating Sanctuary in Schools 1995 Bloom, Sandra http://www.sanctuaryweb.com/Documents/Sanctuary%20in%20the%20S chool.pdf http://www.sanctuaryweb.com/Documents/Sanctuary%20in%20the%20S chool.pdf http://www.sanctuaryweb.com/Documents/Sanctuary%20in%20the%20S chool.pdf  Child Trauma Toolkit for Educators National Child Traumatic Stress Network http://www.nctsnet.org/nctsn_assets/pdfs/Child_Trauma_Toolkit_Final.pdf http://www.nctsnet.org/nctsn_assets/pdfs/Child_Trauma_Toolkit_Final.pdf

4. Overview  Trauma defined  Prevalence of trauma  Impact of trauma  Steps to creating trauma-sensitive schools  Self care  Next steps

5. Trauma-Specific Therapy vs. Trauma-Sensitive School Therapy  Licensed clinical mental health professionals  Intervention occurs in therapist’s office in 1:1 or group sessions  Focus is on addressing trauma reactions & reducing symptoms School  Licensed educators & student services professionals with varied mental health training  Sensitivity & accommodations occur throughout the school  Focus is on students’ educational success through emotional & physical safety, empowerment, trust, choice, & collaboration

6. Trauma Defined 1. Trauma exposure vs. trauma reaction 2. Acute trauma - PTSD 3. Complex/developmental trauma

7. What about our school/district?  Do we have students who …. witness domestic violence? are physically, emotionally or sexually abused? are neglected? are homeless? have family members who are fighting overseas in Iraq or Afghanistan? have experienced a natural disaster (e.g., tornado, house fire)?

8. What about our school/district?  Do we have students who …. have been in a serious accident (e.g., car accident)? have been a victim of physical or sexual assault? have lost a loved one? live in homes with family members who abuse alcohol or other drugs? live in homes with family members with untreated mental illness?

9. Prevalence Adverse Childhood Experiences (ACE) Study Centers for Disease Control & Prevention Household dysfunction  Substance abuse27%  Parental separation/divorce 23%  Mental illness19%  Battered mother13%  Incarcerated household member 5% Abuse  Psychological 11%  Physical28%  Sexual21% Neglect  Emotional 15%  Physical 10% Centers for Disease Control and Prevention

10. Health risks associated with ACEs Behaviors School Absenteeism — tardies & truancy Dysregulated eating (under & overeating) Smoking Suicide attempts Illicit drug use & substance abuse Multiple sexual partners Self-injurious behaviors (e.g., cutting) Outcomes Autoimmune disorders Obesity & eating disorders Substance use disorders Chronic obstructive pulmonary disease (COPD) Depression Fetal death Health-related quality of life Ischemic heart disease (IHD) Liver disease Risk for intimate partner violence Sexually transmitted infections (STIs) Unintended pregnancies

11. Impact of Trauma over the Life Span Effects of childhood adverse experiences  neurological  biological  psychological  social

12. Adverse Childhood Experiences (ACE) Study Summary of Findings Adverse Childhood Experiences (ACEs) are very common ACEs are strong predictors of health risks & disease from adolescence to adulthood This combination of findings makes ACEs one of the leading, if not the leading determinant of the health & social well-being of our nation CDC

13. ACE & School Performance  Traumatized children are: 2.5x more likely to fail a grade in school score lower on standardized achievement tests have more struggles in receptive & expressive language are suspended & expelled more often more frequently placed in special education

14. Impact of Trauma on the Child  Cognitive/academic  Physical  Emotional  Spiritual  Developmental

15. Impact on Relationships  Relationships are developed through the emotional bond between the child & primary caregiver. It is through this relationship we learn to: Regulate emotions/“self soothe” Develop trust in others Freely explore our environment Understand ourselves & others Understand that we can impact the world around us

16. Impact on Worldview Typical Development vs. Developmental Trauma  Nurturing & stable attachments with adults  Belief in a predictable & benevolent world/ generally good things will happen to me  Feeling of positive self-worth /others will see my strengths  Optimism about the future  Feeling that I can have a positive impact on the world  Basic mistrust of adults/inability to depend on others  Belief that the world is an unsafe place/bad things will happen & they are usually my fault  Assumption that others will not like me  Fear & pessimism about future  Feelings of hopelessness & lack of control

17. Impact on Learning  Organizing narrative material  Cause & effect  Taking another's perspective  Attentiveness  Regulating emotions  Executive functioning  Engaging in curriculum

18. Impact on Classroom Behavior  Reactivity & impulsivity  Aggression  Defiance  Withdrawal  Perfectionism

19. Impact on the Brain  If there is danger, the “thinking” brain shuts down, allowing the “doing” brain to act  Traumatized children experience changes in brain structures, neuro-chemistry & genetic expression

20. Trauma-Sensitive Schools Trauma-sensitive schools acknowledge the prevalence of traumatic occurrence in students’ lives & create a flexible framework that provides universal supports, is sensitive to unique needs of students, & is mindful of avoiding re-traumatization. re-traumatization.

21. Steps to Create a Trauma- Sensitive School 1. Engage leadership 2. Perform assessment 3. Review literature 4. Provide training 5. Implement classroom strategies

22. Step 1: Engage Leadership  Administrative direction & commitment  Priority for school improvement  Necessary resources allocated  Tie into existing related initiatives (e.g., RtI/PBIS)

23. Tier 3/Targeted Strategies 1-5% Intensive FBA & BIP Wrap-around services Intensive case management IEPs/504 plans Parent & caregiver training & support 1-5% Tier 3/Targeted Descriptors Individual students Assessment-based Intense, durable procedures Tier 2/Selective Strategies 5-15% BCT process Screening Monitoring, e.g., Check & Connect Community referrals Parent & caregiver education Classroom supports 504 plans/IEPs Brief FBA & BIP Small group interventions Some individualizing 5-15% Tier 2/Selective Descriptors Some students (higher-risk) High efficiency Early detection Rapid response Tier 1/Universal Strategies 80-90% School policies, culture & climate Behavior management Instructional practices & approaches Modeling Classroom consultation Comprehensive School Counseling Model 80-90% Tier 1/Universal Descriptors All settings, all students, all staff Preventive, proactive Trauma-sensitive Using Trauma-Sensitive Strategies to Improve Learning: A Response to Intervention (RtI) Model

24. Step 2: Assessment  School culture  School climate  Strengths/needs Current programs & strategies Current programs & strategies Gaps in services Gaps in services  Policy & procedures  Resources

25. Step 3: Review Literature & Explore Model Implementation Massachusetts Advocates of Children http://www.massadvocates.org/helping_traumatized_ch ildren_learn Massachusetts Advocates of Children http://www.massadvocates.org/helping_traumatized_ch ildren_learn http://www.massadvocates.org/helping_traumatized_ch ildren_learn http://www.massadvocates.org/helping_traumatized_ch ildren_learn Washington State The Heart of Learning and Teaching http://k12.wa.us/CompassionateSchools/HeartofLearnin g.aspx Washington State The Heart of Learning and Teaching http://k12.wa.us/CompassionateSchools/HeartofLearnin g.aspx http://k12.wa.us/CompassionateSchools/HeartofLearnin g.aspx http://k12.wa.us/CompassionateSchools/HeartofLearnin g.aspx Creating Sanctuary in Schools by Sandra Bloom http://www.sanctuaryweb.com/Documents/Sanctuary% 20in%20the%20School.pdf Creating Sanctuary in Schools by Sandra Bloom http://www.sanctuaryweb.com/Documents/Sanctuary% 20in%20the%20School.pdf http://www.sanctuaryweb.com/Documents/Sanctuary% 20in%20the%20School.pdf http://www.sanctuaryweb.com/Documents/Sanctuary% 20in%20the%20School.pdf Child Trauma Toolkit for Educators Child Trauma Toolkit for Educators http://www.nctsnet.org/nctsn_assets/pdfs/Child_Traum a_Toolkit_Final.pdf http://www.nctsnet.org/nctsn_assets/pdfs/Child_Traum a_Toolkit_Final.pdf Visit or consult with schools that are trauma-sensitive Visit or consult with schools that are trauma-sensitive

26. Step 4: Provide Staff Training  Today’s In-service  Additional training to encourage…  Relationships that enhance learning Attention Attention Affection Affection Attunement Attunement  Classroom strategies to establish … Safety Safety Empowerment Empowerment Collaboration Collaboration Choice Choice Trust Trust  Understanding the dynamics of interpersonal, community & historical violence

27. Step 5: Classroom Strategies to establish SAFETY Clear & consistent rules Clear & consistent rules for managing behavior & for managing behavior & setting limits setting limits Accommodations to meet Accommodations to meet individual strengths & needs individual strengths & needs Predictable structure, relationships, & environment Predictable structure, relationships, & environment Reduce bullying & harassment Reduce bullying & harassment Use seclusion/restraint only as a last resort Use seclusion/restraint only as a last resort

28. Step 5: Classroom Strategies to establish EMPOWERMENT  Embed mental health instruction into curriculum by teaching Coping skills Coping skills Self-regulation skills Self-regulation skills  Provide guided opportunities for meaningful participation  Maintaining high behavioral & academic expectations  Build on strengths  Build competency

29. Step 5: Classroom Strategies to establish COLLABORATION  School Staff Building Consultation Team (BCT) Building Consultation Team (BCT)  Identify triggers (FBA) Classroom consultation Classroom consultation  Students  Family Family education Family education Family training & support Family training & support  Community Community referrals Community referrals Wrap around services Wrap around services Community partnerships Community partnerships

30. Step 5: Classroom Strategies to establish CHOICE  Adult works with student to create self-care plan to address triggers Identify triggers Eliminate trigger or create coping strategies to deal with triggers  Collaborative Problem Solving (Lost at School - Greene, R.)  Giving choices & alternatives “Comfort rooms” “Comfort rooms” Learn about lower brain interventions Learn about lower brain interventions Sensory diets Sensory diets Safe & acceptable expression of feelings Safe & acceptable expression of feelings

31. Step 5: Classroom Strategies to establish TRUST Relationship with the educator based on…  Unconditional positive regard for all students  Checking assumptions, observing & questioning  Being a relationship coach

32. Self Care as an Ethical Obligation “We can’t teach what we don’t know. We can’t lead where we won’t go.” Malcolm X “You cannot give away that which you do not have.” Juli Alvarado Coaching For Life

33. Progression of Burnout Compassion ↓ Empathy ↓ Vicarious/Secondary Trauma ↓ Compassion Fatigue ↓ Burnout

34. Cycle of Compassion Compassion and Empathy Self Care Compassion Satisfaction

35. Next Steps…  What would we like to start doing?

36. For more information on Creating Trauma-Sensitive Schools  Toolkit http://www.dpi.wi.gov/sspw/mhtrauma.html http://www.dpi.wi.gov/sspw/mhtrauma.html  Contact: Nic Dibble, Education Consultant, School Social Work Services Wisconsin Department of Public Instruction nic.dibble@dpi.wi.gov nic.dibble@dpi.wi.gov Sara Daniel, School Based Services Coordinator at St. Aemilian-Lakeside, Inc. sdaniel@st-al.orgsdaniel@st-al.org Sara provides training & consultation on trauma-sensitive schools & direct service to children & families to support success at school Christine Dunning University of Wisconsin-Milwaukee cdunning@uwm.edu cdunning@uwm.edu Chris provides training, education & consultation on trauma & trauma-sensitive schools

37. Credits  Child Trauma Academy (Dr. Bruce Perry), http://childtrauma.org http://childtrauma.org  National Child Traumatic Stress Network, http://www.nctsnet.org http://www.nctsnet.org  National Center for Trauma Informed Care, http://mentalhealth.samhsa.gov/nctic/ http://mentalhealth.samhsa.gov/nctic/  The Emotional Brain, J LeDoux  Affective Neuroscience: The Foundation of Human and Animal Emotions, J.P. Panksepp  Bessel van der Kolk, http://www.traumacenter.org http://www.traumacenter.org  Juli Alvarado, http://www.coaching-forlife.com/ http://www.coaching-forlife.com/  Dr. Robert Anda, CDC (ACE Study)  Helping Traumatized Children Learn, Massachusetts Advocates for Children 2005  Understanding Traumatic Stress in Children Bassuk M.D., Ellen L.: Konnath LICSW, Kristina, Volk MA., Katherine T.  The Heart of Learning and Teaching Compassion, Resiliency & Academic Success  The Heart of Learning and Teaching Compassion, Resiliency & Academic Success Wolpow, Ray; Johnson, Mona M.; Hertel, Ron; Kincaid, Susan O. 2009