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Working with Traumatized Youth, Strategies for dealing with students who…

- - - - Re-experiencing
        
        Nightmare
        
        Flashbacks - feeling that the experience is reoccurring
        
        Intrusive Thoughts-the unwanted thoughts/images that “pop” into mind
      - Avoidance:
        
        People, places, or things that trigger memories of the event
        
        Efforts to avoid thoughts, feelings or conversations associated with the trauma
        
        Feeling detached or estranged from others
        
        Sense of shortened future
      - Impact of development
        
        Preschool children who have experienced a trauma may have more difficulty separating or may regress behaviorally
        (i.e., begin having accidents, become more clingy, or start using baby-talk).
        
        School-aged children may experience significant guilt or believe that they caused the trauma to occur (i.e., I did not wear my helmet like my mom told me and now I’m being punished). They tend to become more concerned for their own and loved one’s health and safety. School-aged children are also likely to have increased somatic complaints following a trauma (i.e., headaches, stomachaches, general pain) as they show their emotional pain through physical symptoms.
        
        Adolescents often struggle with trying to “fit in” and may feel self-conscious about their experience. They may isolate themselves more and struggle with ways to be more independent in the face of a medical condition requiring them to be more dependent on parents and caregivers.
        
        Preschool, school-aged children, and adolescents may all have difficulty concentrating and learning once they return to school following the experience of a medical trauma.
        
        Strategies
        
        Parents awareness and support
        parents need to recognize that their child is having difficulty or impairment in some area of functioning as a result of medical trauma.
        
        Once parents are aware
        
        The best ways to manage these symptoms is to
        
        talk to your child about how they are feeling or what they experienced.
        
        Drawing a picture , playing out the experience or telling a story for younger children who tend to have more difficulty describing what they are experiencing emotionally
        
        Psychosocial interventions
        after pediatric injury
        
        post injury
        
        Address child’s acute symptoms (including ASD) in the first few weeks postinjury
        
        Help manage child’s pain
        
        Decrease social isolation
        
        Help parents to:
        – accurately assess child’s symptoms and needs
        – help child manage psychological symptoms and pain
        – promote positive social interactions for child
        – manage their own reactions
        
        At school
        
        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.
        
        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.
        
        Anticipate difficult times and provide additional support. 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.
        
        Protect the traumatized child from peers’ curiosity and protect classmates from the details of a child’s trauma. Be aware of other children’s reactions to the traumatized child and to the information they share.
        
        Making accommodations and modifications to academic work for a short time, even including these in a 504 plan.
        Like :
        • Shorten assignments
        • Allow additional time to complete assignments
        • Give permission to leave class to go to a designated adult (such as a counselor or school nurse)If feelings become overwhelming
        • Provide additional support for organizing and remembering assignments
        
        Increase the level of support and encouragement given to the traumatized child. Designate an adult who can provide additional support if needed.
      - Arousal:
        
        Difficulty falling/staying asleep
        
        Increased irritability
        
        Difficulty concentrating
        
        Hypervigilance
        
        Exaggerated startle response
- - - - Very Withdrawn
      - Hyper Aggressive
      - No Eye Contact
      - Lack of Empathy
      - Age Un-Appropriate Behavior
      - Bouts with Acute Distress
      - Avoidance Behavior
      - Violent Speech or Mature Language
      - No Regard for Authority
    - - Depression
      - Low Self-Esteem
      - Sudden Out Bursts: Angry or Sad
      - High Anxiety
      - Adaptive Disorder
      - Acute Paranoia
      - Mood Swings
    - - Scars, Burn Marks, Malnourishment
      - Broken Bones
      - Unusual Bruises
    - - Inability to Focus: Thousand Yard Stare
      - Easily Forgetful
      - Delayed Learning
      - Constantly Testing the Teacher
      - Apathetic
      - Indifferent
- - - - Connect students with mental health experts;
        Create student advisory boards;
        build relationships within schools;
        emphasize welcoming school environments;
        Create space to share and build coping skills within student body;
        identify steps and processes for teachers AND classmates who witness/sense troubling signs with a student
- - - - https://www.youtube.com/watch?v=t0I1RzM15oM
    - - Child
        
        Health presentation
        
        Non-organic failure to thrive (growth faltering)
        
        Poor weight gain (improvement when away from the care of the parents.
        
        Poor height gain
        
        Unmet medical needs
        
        Untreated head lice/other infestations
        
        Frequent attendance at 'accident and emergency'
        and/or frequent hospital admissions
        
        Tired or depressed child, including a child who is anemic or has rickets
        
        Poor hygiene poor or inappropriate clothing for the time of year
        
        Abnormal eating behavior (bingeing or hoarding)
        
        Emotional and behavioral
        
        Developmental delay/special needs
        
        Present as being an under-stimulated abnormal
        
        Reaction to separation/ or attachment, disorder
        
        Over-active and/or aggressive
        
        Soiling and/or wetting
        
        Repeated running away from home
        
        Substance misuse
        
        Offending behavior, including stealing food
        
        Teenage pregnancy
        
        Family and social relationship
        
        High criticism
        
        Excluded by family
        
        Sibling violence
        
        isolated child
        
        Left unattended or to take care of other children
        
        Left to wonder alone day or night
        
        Not wanting to go home from school, or refusing to go to school
        
        Frequent name changes and/or change of addresses
      - Parents
        
        Lack of emotional warmth
        
        unrealistic expectations for the child
        
        Inability to consider or to put child's needs first
        
        Name-calling/ degrading remarks
        
        lack of appropriate affection for the child
        
        Failure to provide basic care for the child
        
        Lack of stability
        
        Frequent changes of partners
        
        Poor family support/ inappropriate support
        *lack consistent relationships
        
        enforced unemployment
        
        Issues relating to providing guidance and setting
        
        poor boundary setting
        
        Inconsistent attitude and reactions, especially to
        child's behavior
        
        continuously failing appointments
        
        refusing offers of help
        
        Failure to provide a safe environment
        
        Social presentation
        
        aggressive/ threatening behavior towards professionals and volunteers
        *low self-esteem
        *lack of self-care
        
        Heath
        
        mental ill-health
        
        substance misuse
        
        (post-natal) depression
        
        physical health
      - Home and environment
        
        Home and environment
        
        poor housing condition
        
        overcrowding
        
        unsafe environment
        
        rural isolation
        
        Little or no food
        
        lack of water, heating, and sanitation
        
        referrals to environmental health
        
        Impediment to ongoing assessment and appropriate support
        
        failure to see the child
        
        failure to seek support and advice or consultation
        
        failure to record concern and
        
        initial impact
        
        inability to retain objectivity
        
        child view is lost
        
        minimizing concern
        
        poor network amongst professionals
    - - :check: Expectations -it is important to set reasonable goals and to provide the support needed for the child to feel confident in his or her abilities.
        :check: Structure - Allowing expression of feelings when appropriate through art, music, drama, and/or creative writing will also help the child to feel less controlled by pent-up emotion.
        :check: Identity - Teachers can help by pointing out the child's strengths. Statements such as “You are a hard worker,” “You are a good friend when you help a classmate with a problem,” and “People in this classroom like you because you are fun to be with” will help the child understand how others perceive him or her.
        :check: Self-esteem - Teachers can help them learn that they are valued, accepted, and capable by fostering an environment that honors each child's uniqueness.
        :check: Sense of belonging - To facilitate a sense of belonging, the teacher may provide designated places for possessions, display work in the classroom, and make a conscious attempt to include these children in classroom activities. Support through teaching social skills individually, in small group settings, and through cooperative learning will also help abused children practice interacting in a nonthreatening atmosphere.
        :check: Social skills - A classroom climate that fosters caring, appreciation for differences, consistent rules and boundaries, and recognition for small successes will nurture a child who has been discounted at home.
        :check: Tolerance of differences - The checklist (fig. 1) may help teachers identify emotions and behaviors that might be explained by abuse. Consultation with a school psychologist, social worker, counselor, or nurse may also help teachers understand the unexplainable behaviors and emotions of their students.
        :check: Consistency - Teachers can support a child's need for structure by maintaining a consistent daily schedule, by having clear expectations for performance in both behavioral and affective areas, and by allowing the child to provide structure in his or her own way.
      - https://www.youtube.com/watch?v=tVZ5jPbc0i
    - - Ascd. (n.d.). Supporting Victims of Child Abuse. Retrieved December 02, 2020, from http://www.ascd.org/publications/educational-leadership/dec92/vol50/num04/Supporting-Victims-of-Child-Abuse.aspx
        Definitions of Child Abuse and Neglect. (n.d.). Retrieved December 02, 2020, from https://www.childwelfare.gov/topics/systemwide/laws-policies/statutes/define/
        Massey-Stokes, M. (2018, December 27). What Is Neglect And What Types Of Neglect Are There? Marilyn Massey-Stokes. Retrieved December 02, 2020, from https://www.continued.com/early-childhood-education/ask-the-experts/what-neglect-and-types-there-23084
- - - - Response strategies
        
        individual or group counseling with targeted
        students and parents,
        
        teacher/staff education programs
        
        facilitation of outside
        referrals
        
        Teachers creates a safe environment an builds a trusting, rapport with the student.
- - - - What it looks like in school:Anger, avoidance, defiance, lack of focus, negativity, disruptive behavior, trouble answering questions, frequent trips to the nurse, feeling nervous, on edge, breathing rapidly, appear tired, stomach problems, not turning in homework, avoiding socializing or group work.
    - - What is looks like in school: Self deprecating comments, argumentative, suicidal thoughts, isolation, frequent change in friends, frequent absences, school refusal, difficulty concentrating.
    - - What it looks like in school: They can throw tantrums, whine, suck their thumb or pen/pencil, demand help and support (I cannot do it, I do not know how, etc).
    - - What is looks like in school: Refusing to go to school, fearful and reluctant to be alone, frequent stomachaches, headaches or other physical complaints, being very clingy even when at home, panic or temper tantrums at times of separation from parents or caregivers.
- - - - Agressive behavior / anti-social behavior / vandalism
      - anxiety / depression
      - suicidal thoughts
      - attention seeking
      - drug / alcohol abuse
      - regular sicknesses: colds, mouth sores, headaches
      - eating disorders
      - trouble concentrating in school
      - tantrums
      - withdrawal
- - - - Others may have to deal with a parent’s substance abuse, personality changes, depression, unemployment.
      - other emotional disorders that happen as a result of the military parent’s experiences during deployment.
      - Some families must deal with the trauma of having a parent who is seriously injured or killed.
    - - Listen. Children need to be heard. It is important that parents take the time to listen, especially when the
        child is fearful. Your children may have no concept of the trauma the parent experienced.
      - Empathize with how your children are feeling and validate their fears. Children need to know that their
        feelings are real. It frightens them if you tell your children that “they are fine” when they know they do not feel fine. Agree with their feelings and take them seriously.
      - Talk to your children about their fears. Once you have listened to your children and told them that their feelings are real and understandable, talk with them about the trauma. Don’t ignore or minimize your children’s feelings. Be honest with them about what is happening. Younger children need to feel safe, and older children will be developing their own opinions and explanations about what is happening. Even if their feelings are not in agreement with yours, hear and respect them.
      - Share what is being done to help support the struggling parent. For younger children, just sharing with them
        that you are seeking help from a trusted family physician may be enough to help lessen their anxiety. Older children may need more specific information and may even want to be part of an actual plan of support.
    - - Give your children extra attention and offer more physical closeness.
        Supporting your children with actions rather than words may be the best relief you can give. Hugging, touching,
        spending extra time – all of these are simple yet meaningful ways to offer support.
      - Stick to routines.Do not cancel an outing or event because the struggling parent is not able to attend. Changing normal routines is disruptive and can contribute to more worries. Let your children know that there will be another time to include the other parent and stick to your original plans.
      - Check in with your children regularly. It is easy to get caught up in the work it takes to manage everyday family life and work. Add to that the needs of a parent with combat-related trauma, and you may feel overwhelmed. If you feel that way, imagine how your children feel! Make a regular time to check in with your children so that they can count on being heard.
      - Allow your children to be angry, but suggest positive ways to cope. Help younger children create a scrapbook or a picture directory of how they are feeling. Encourage older children to text their parent or include them in other social networks to keep them informed about their everyday life.
      - Honor your children’s way of coping. Most children just want their lives to be normal. Each child processes information differently, and your children will learn to adjust in their own way and on their own timeline. Don’t be anxious about how long a child is taking to adjust or to get over feeling angry or bad. On the other hand, don’t encourage the child to stay “stuck” in an emotion. Everyone has a unique temperament, tolerance level, and coping strategy. Your job as the parent or caregiver is to help that child cope where they are, and offer alternatives to promote a healthy response to the struggling parent.
- - - - Schools can be confronted with violent, brutal events (suicide, sudden death, disaster, accident, assault, etc.) that can generate trauma in adults and children and a shock wave in the institution. We talk about trauma in the event of a violent, brutal, unanticipated event that poses a threat to the physical or psychological integrity of an individual or a group
      - Symptoms
        
        threaten or attack personnel psychologically or physically.
        
        Contact the family and have an intervention
        
        Social worker help
        
        help find the tools and positions to channel this violence
        
        Out of control students
        
        reintroduce a relationship with the Law, a tutelary figure to manage to do without
        
        help find the tools and positions to channel this violence
        
        Insulting other students or staff
        
        help him channeling his urge to insult people by doing brething exercises
        
        Talking to the students
        
        Harassments
        
        Discussions with a professional and with parents
        
        channeling his needs to harass people by let him do what he likes (sport, drawing,etc)
        
        self-mutilation
        
        Don't be judgmental. Listen. Let him/her know that you are there to help him/her
        
        Social Worker help
        
        Breaking school materials
        
        recognize their individual needs
        
        Listen and discuss with the student
        
        Reinforce the school rules by emphasising on rewards for good behaviour