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Traumatic Stress in Children - Coggle Diagram

- - - - The first is a direct effect on family morbidity and mortality.
      - The second effect is through the disaster’s impact on the supply of health care.
      - The third effect is through the disaster’s impact on the demand for health inputs, either through lost income or increased expenditures needed to cope with damage.
    - - How can parents and teachers help children cope with a disaster?
        
        Before
        
        Discuss plans for emergencies and include your child/student in creating emergency supply kits and emergency action plans.
        
        Learn about school safety drills and communicate procedures with families.
        
        After
        
        Answer questions truthfully in a way that he or she can understand. You can also correct misinformation about the event.
        
        Set an example for your student by managing your stress and returning to normal classroom routine and encouraging children to do the same.
        
        Give students opportunities to talk about what he or she went through, or what he or she thinks about it. Encourage student to share concerns and ask questions.
  - - - Keep to regular routines and schedules as much as possible, or help create new ones in a new environment, including school/learning as well as time for safely playing and relaxing.
      - Provide facts about what has happened, explain what is going on now, and give them clear information about how to reduce their risk of being infected by the disease in words that they can understand depending on their age. This also includes providing information about what could happen in a re-assuring way.
      - Prioritize Relationships: To signal that you value students' well-being above their academic performance, begin every interaction with an open-ended, personal inquiry such as, "What was the biggest surprise this week?" "What has been particularly challenging?" "Do you think your friends share any of the same concerns?" "Have there been moments of unexpected joy or relief?"
      - Tamp Down the Pressure: No two kids are going to have the same backstory. One student may have a history of trauma, be responsible for caring for younger siblings, or be home alone all day while their parents work. Another may be sharing one computer with four siblings, struggling with depression or anxiety, or dealing with a sick relative. Regardless of the situation or resources, every child's life has been turned inside out, and the primary focus should be on emotional safety, not mastering content.
      - Empower Students: If the recipe for stress includes uncertainty, insecurity, and absence of control, the antidote is to give kids a sense of empowerment.
      - Promote Self-Care: You can't give from an empty vessel. Sleep and get exercise, make time to connect with friends and family, and carve out time to catch your breath.
      - Focus on Joy and Simplicity:
        To lift kids' spirits, educators across the country have gotten creative. They've done "car parades" through students' neighborhoods, held online talent shows, and organized virtual Spirit Weeks.
        
        https://www.youtube.com/watch?v=udr848gf6d4
      - (Fagell, 7 Ways Educators Can Help Students Cope in a Pandemic 2020)
- - - - Symptoms
        
        upset stomach
        
        headaches
        
        vague aches and pains
        
        bedwetting
        
        nightmares
        
        anxiety
        
        nail biting
        
        refusing to go to school
        
        physical aggression
        
        crying often
        
        difficulty sleeping
        
        Students With Special Needs
        
        Students with learning disabilities, when compared with the subgroup without school problems, reported more physical illnesses and symptoms, headache complaints, mainly, and behaviors indicative of stress, anxiety and depression, more often fears and nightmares. Crenitte, P (2016)
        
        It should not come as a surprise students with special needs would be more likely to exhibit more stress related symptoms. They have it way harder than their peers without learning needs or disabilities. They need to work hard and get used to functioning in the school environment. On top of their needs, some of them face bullying, isolation, rejection and more.
        
        Teachers can support students with special needs by getting to know them better and identify how the child learns best.
        
        Effective stress management requires a "whole child" approach which addresses the child's attitude, behavior (skills), and circumstances. Rubenzer, R. (2020).
        
        a change of attitude or temperament (irritability, lack of enthusiasm, carelessness).
        
        Drug use or abuse
        
        Antisocial or disruptive behaviors
        
        https://www.youtube.com/watch?v=H-kl36yQN1U
    - - What exactly causes children to be stressed in school? Stress might be caused by different factors, depending on the child’s age.
        
        Elementary School
        
        common stress causes in elementary school students.
        
        Taking important tests – some children do not cope well with tests or exams. Their extreme anxiety may result in low academic performance.
        
        Oral presentation – Some students are afraid of getting up in front of the class.
        
        Bullying – Bullying affects children of all ages. It is a major cause of stress and it can have devastating effects on a child’s mental and physical health. Bullying can lead to depression, shatter the child’s confidence and even to suicide. Schools need to have measures in place to deal with bullying.
        
        Middle School
        
        common stress causes in middle school students.
        
        Busy schedules – some middle schoolers get overwhelmed with the amount of homework and extra-curricular activities.
        
        Peer pressure – in middle school, peer pressure is likely to cause stress and result in exposure to alcohol and drugs. Peer pressure can be also linked with bullying.
        
        high School
        
        common stress causes in high school students.
        
        Social acceptance – those students who don’t have established peer groups might struggle with making friends and trying to be socially accepted to try to avoid bullying.
        
        Parent pressure – parents can also be a cause of stress to high school children because they have high expectations for them. Therefore, they might struggle to live up to their parents’ expectations, trying to establish their independence, and keeping their grades up to get into a good college.
      - https://www.youtube.com/watch?v=69MLx9m1ctQ
      - Bullying social, and peer pressure main factors that cause stress in school. According to Huljich, P. (2012), Bullying is a major cause of stress and can leave anyone feeling hurt, angry, frightened, and even depressed. By learning about why some people bully and why others are bullied, you can help yourself or a loved one cope with bullying, and develop the resilience and self-confidence to overcome such trauma and sail onward in life.
        
        Bullying
        
        It may cause anxiety, depression, poor self-esteem, and drug abuse. As it affects the brain, it can compromise the developing brain and leave scars on a child that can get carried into adulthood.
        
        it is a risk factor for drug abuse
        
        Social Stress
        
        It affects the immune system functioning. This can also affect brain function. "When you experience chronic social stress, you have the immune response, but it doesn't turn off properly," says Russo (2015), a neuroscientist at the Icahn School of Medicine at Mount Sinai. "The immune system ramps up and doesn't shut down, and that then causes damage such as nerve cell death."
        
        Russo’s research suggests that dysregulation of the immune system, like that linked to chronic social stress, can lead to psychiatric disorders, such as depression and anxiety.
    - - How Teachers Can Help Minimize Stress in Students
        
        According to Juliano, S. (2019), there are a number of strategies teachers can use in the classroom to help reduce stress.
        
        allow students to use standing desks.
        
        sit on exercise balls.
        
        work on the floor.
        
        create a quiet, serene corner by adding a beanbag
        
        relaxing pictures and positive sayings.
        
        limit homework overload.
        
        keep students moving in the classroom.
        
        play music
        
        schedule time to organize the classroom
        
        listen and talk to students
        
        https://www.youtube.com/watch?v=MAnQC1Sb530
      - A referral to a school psychologist or counselor may be needed if the quantity or intensity of the symptoms displayed by the child raises concern.
- - - - Solutions for assisting students include:
        
        Maintaining structure, norms and routines.
        
        Providing pull-out sessions with the school counselor.
        
        Encourage students to express their emotions with appropriate adults.
        
        Develop an open line of communication between parents and teachers but be careful not to fall into the position of mediator between the parents.
        (Afifi, 2020)
  - - - Responses may include therapeutic interventions like family or individual counseling. Other supports might be:
        
        maintaining a regular routine, both at home and at school.
        
        Encouraging students to express emotions/normalizing the wide range of emotions that they may feel.
        
        Giving them age appropriate opportunities to memorialize the individual lost.
  - - - How can educators help:
        
        be careful of making promises. Example, "Mom will be fine as soon as she finishes chemotherapy."
        
        Reach out to the school counselor for student support.
        
        Educate yourself on the illness, so that you know what to expect. Do not share this information with your student. It is not your place.
        
        Continue to maintain a schedule or routine as much as is possible.
        
        Make yourself available to the student for check-ins throughout the day.
        (Reece & Reece, 2013)
  - - - Like many other ACE's students need to have life be as routine and predictable as possible. Other interventions might include:
        
        In school counseling.
        
        Therapy outside of school.
        
        Regular check-ins throughout the day.
        
        Opportunities to reflect and journal, maybe even through art or music therapy.
        
        Regular communication with the caregiver.
        
        Regular affirmations and self-esteem development.
  - - - Students that have not had a stable caregiver are much more likely to have intense emotions, violent behavior and destructive tendencies. This is called Reactive Attachment Disorder
        Solutions for this involve:
        
        Ensuring a stable caregiver can provide for the child.
        
        Family and individual therapy as children get older.
        
        Encouraging routines and predictability at home.
        
        Addressing child's housing and nutrition needs.
        
        Parent education classes either in the home or a group clinical setting.
        (Mayo, 2017)
- - - - Symptoms
        
        Posttraumatic stress disorder(PTSD)
        
        Reminders of intrusive thoughts and traumatic experiences
        
        avoidance of traumatic cues
        
        negative mood and cognition related to traumatic experiences
        
        difficulty in concentrating,
        
        difficulty in concentrating
        
        a sense of hopelessness about the future
        
        daily intrusive flashbacks of the traumatic events
        
        fear, insecurity and bitterness.
        
        extreme nightmares
        
        outbursts of anger
      - Response
        
        Community-based interventions that promote resilience, skill building, functioning, and a sense of productivity to enhance well being are important. Helping young survivors to put things into perspective and by acknowledging the difficulty to think beyond the moment can assist them in moving on. This concept can be explained at individual, family, or a small group level, and can be arranged in refugee camps.
        
        Actively learning about trauma and its effects by attending educational sessions, where possible, computer-based information, and reading leaflets, and this can help survivors be better informed of what to expect. Improving patient health literacy help people make appropriate decisions about their health care
        
        Re-establishing some daily or weekly routine is important as there is comfort in the familiar, for example, encouraging exercise such as walking where safe to do so, i.e., in refugee camps
        
        Challenging own sense of helplessness and negative thoughts, i.e., survivors probably cannot control war activities but can control things in their daily lives
        
        Talking to family and friends and accepting help when offered, can reduce the sense of isolation and alienation.
        
        Being kind and helping others, where possible, may be as a volunteer, and participation in social activities such as attending funerals, assist others when possible can help survivors connect with reality
        
        Self-help books can be of benefit as they address a wide range of problems that survivors might experience. These books provide tips and can teach various coping and problem-solving skills
        
        Child Friendly Spaces (CFS) are safe spaces set up in emergency settings to help support and protect children. They provide children with opportunities to develop, play, learn, and strengthen resiliency either after a crisis or during a protracted emergency in a safe, child friendly, and stimulating environment. CFS give children an opportunity to escape the crowded living conditions they may be subject to during crises. As they are supervised, they also provide parents child-free time that can be necessary for fetching water, earning a living, or other activities.
        
        https://www.youtube.com/watch?v=vn5EbcBuFcg
        
        Parent intervention
        
        social support from family
        
        parents can lead children to be affected positively by changes in parenting skills or family functioning.
        
        parents in a better physical and mental condition
        
        https://www.youtube.com/watch?v=ewbD2Dw0NLo
        
        trauma-focused cognitive-behavioral therapy, TF-CBT. It is a mode in which children and parents (or main caregivers) are treated separately at the same time.
        
        Treatment modalities include individual treatment, simultaneous treatment of children and parents (or caregivers, collectively referred to as “parents” hereinafter), and parent-child joint treatment
        
        Social intervention treatment.
        
        Establish a service system connecting families, communities and schools, and develop school social work.
        
        It can cultivate children's ability to adapt to social life, and achieve the school's educational goals.
        
        Let traumatized students come into contact with society, re-perceive society, and integrate into society
        
        international interventions are being established with a focus on the complex interplay between children’s psychological and social development. These “psychosocial” interventions support not just the emotional healing and development of compassion and empathy, but recognize the important dynamics between children and the social environment in which they form attachments, acquire a sense of belonging, and learn codes of pro-social behaviour.
        
        WHO mental health Gap Action Program that can help train health professionals and volunteers to adopt some components of this approach. This focuses the training on nonspecialized health settings to increase capacity in meeting the mental health needs of people and help them find ways to cope with the consequences of trauma. Programs like the one developed by Trauma Survivors Network, TSN NextSteps for trauma survivors help people become good self-managers. The goal is to build their confidence and skills to better manage problems such as pain, anxiety, and depression, and it helps them have better relationships with family, friends, and clinicians by improving their communication skills.
        
        https://www.youtube.com/watch?v=TqlafjsOaoM
        
        School based intervention treatment
        
        Schools offer a promising site for helping children exposed to trauma because school-based treatment can reduce barriers to seeking mental health care.
        
        Identification of trauma: Some changes in behavior that may be observed at school include: decreased attention, increased activity level, lower grades, greater absenteeism, irritability, angry outbursts, impulsive behavior, and withdrawal (NCTSN, 2008)
        
        First, children with trauma histories that have not been previously disclosed may be first identified for mental health intervention by school personnel.
        
        Secondly, schools are often the sensible place for screening for traumatic stress reactions after traumatic events impacting whole communities. With proper referral and adequate screening for trauma history, children with severe acute or ongoing psychological symptoms related to trauma exposure can be identified, referred, and offered treatment with evidenced-based interventions for persistent trauma reactions.
        
        Finally, in some cases, evidence-based clinical treatment interventions are being offered in school settings, thus making mental health care more accessible
        
        trauma-informed practices
        
        Adhering to a strengths-based approach in working with students
        
        Ensuring that discipline is logical and restorative rather than punitive and rejecting of children
        
        Educating and supporting all staff regarding the impact of trauma on learning and school behaviors
        
        Using data to identify vulnerable students and to determine outcomes and strategies for continuous quality improvement.
        
        Creating a school culture and climate where safety is the priority