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Types of Traumatic Stress stress, Cannot validate their childs own…

- - - - "Legal definitions vary from state to state, but broadly, physical abuse occurs when a parent or caregiver commits an act that results in physical injury to a child or adolescent" (nctsn.org)
      - "physical injury inflicted upon the child with cruel and/or malicious intent" (medicinenet.com)
      - "any nonaccidental physical injury to the child" (rnceus.com)
    - - "accounting for 25% of all cases of child abuse" (medicinenet.com)
      - "physical abuse is the second most frequently reported form of child abuse" (medicine.net)
      - "Every 10 seconds a report is made concerning a child being abused" (americanbar.org)
    - - punching
      - kicking
      - shaking
      - biting
      - burning
      - spanking (debatable)
      - slapping (debatable)
  - - - "Has not received help for physical or medical problems brought to the parents’ attention" (americanbar.org)
      - increasingly paranoid behavior
      - parent/guardian abuses alcohol
      - parent/guardian abuses drugs
      - financial issues causing minimum requirements to not be met
      - "housing conditions are substandard, overcrowded, or unsafe
        including homelessness" (rcneus.com)
      - sudden changes in behavior, attitude or academic performance
      - "Comes to school early, stays late and does not want to go home" (americanbar.org)
      - "Is overly compliant, an overachiever or too responsible" (americanbar.org)
    - - Physical
        
        red marks
        
        cuts
        
        bruises
        
        welts
        
        muscle sprains
        
        broken bones
        
        central nervous system injury (from head trauma)
      - Mental and Social
        
        distrust towards authority
        
        increased aggression
        
        "acting out"
        
        loss of normal normal fight or flight reactions
        
        "may stop trying to make friends or succeed at school or plan for the future" (nctsn.org)
        
        high anxiety
        
        depression
        
        feel of loss of control in life
    - - Communication
        
        DON'T confront the abuser
        
        report suspected abuse to the correct administrative officials
        
        talk with the student and your teacher team
        
        ask open-ended questions ("How did you get that bruise?")
        
        avoid direct accusations
      - Intervention
        
        AF-CBT(Alternatives for Families - Cognitive Behavioral Therapy)
        
        CPC-CBT (Combined Parent Child Cognitive-Behavioral Approach for Children and Families At-Risk for Child Physical Abuse)
        
        PCIT (Parent-Child Interaction Therapy)
      - Positivity
        
        Create a trusting and empowered classroom to help students reduce their anxiety and rebuild their trust for authority and others
        
        Provide an outlet for the student to speak to so they can release their aggression and feel more in control of their lives
        
        Empower students to make their own decisions to help rebuild their self-esteem and combat depression
        
        Provide resources
- - - - Intentional use of physical force- kicking, using a weapon, grabbing
    - - Force, coercion, assault/rape, involvement with incapacitated person
    - - Threats, intimidation, isolation, controlling behavior
    - - Insults, put-downs, humiliation
    - - (not in CDC definition): Limiting access to money and resources, identity theft, sabotaging career opportunities, incurring debt
  - - - Rape: 1 in 5 women and 1 in 71 men
      - Emotional IPV: 1 in 2 women and men
      - Severe physical IPV: 1 in 4 women and 1 in 7 men
    - - 30,233 receiving non-residential services such as counseling and court advocacy
      - 20,267 hotline calls answered
      - 36,348 in emergency shelter
      - 9,641 unmet requests for services
      - 66,581 victims served
    - - Physical IPV
        
        19.2% of males are perpetrators
      - Gender of perpetrators
        
        Toward female victims
        
        Physical and emotional IPV: Male
        
        Stalking: Male
        
        Sexual violence: Male
        
        Toward male victims
        
        Physical and emotional IPV: Female
        
        Stalking: Mix of male and female
        
        Sexual violence: Male
  - - - Personality disorders: Borderline personality disorder,antisocial personality disorder
      - Dissociative disorders
      - PTSD
    - - Sexually transmitted diseases
      - Obesity
      - Chronic health issues: Heart disease, cancer, gastrointestinal issues
    - - Physical, sexual, emotional, psychological abuse
  - - - Multiple types of IPV (engaging in an IPV type increases likelihood of other types)
      - Marital dissatisfaction
      - Childhood maltreatment and witnessing of domestic violence
      - Illicit drug use and alcoholism
      - Traditional gender and sex role ideology
      - Implicit attitudes condoning violence
      - Physical health issues: Insomnia, gastrointestinal issues
      - Mental health issues: Personality disorders, depression
      - Insecure/disorganized attachment style
      - (Alexander & Warner, 2003; Eckhardt & Crane, 2014; Heise & Garcia-Moreno, 2002; Singh et al., 2014; Stith et al., 2004; Tjaden & Thoennes, 2000; Whitfield et al., 2003;)
    - - Childhood maltreatment and witnessing of domestic violence
      - Mental health issues: Personality disorders, depression, dissociative disorders  Economic disempowerment
      - Youth: 80% of female sexual assault victims are under 25
      - Insecure/disorganized attachment style
      - Predictors of escalation in abusive relationships
      - Female victims perpetrating violence toward male perpetrators
      - Partner threats to harm and/or kill
      - (Alexander, 2009; CDC, 2011; Goodman & Epstein, 2007; Stith et al., 2004; ; Tjaden & Thoennes, 2000; Whitfield et al., 2003)
- - - - Re-experiencing means that the child keeps thinking a lot about the trauma, even when he does not want to. Some re-experiencing is normal and natural. Thinking a lot about what happened, especially at first, is part of how we help ourselves recover from a scary experience.Too much re-experiencing can be very distressing. A child might have nightmares or “flashbacks” that make her feel like she is going through the trauma all over again. She may feel really upset or even have physical symptoms when something – a sight, a sound, a smell – reminds her of what happened.
    - - Avoidance symptoms can start by trying not to think or talk about the trauma, or anything connected with it. Sometimes kids want to stay away from people, places or activities because these reminders upset them. And children sometimes develop new fears or worries. Of course, it can be good common sense to be more cautious after an injury. Children may become more aware of safety - remembering to wear a seat belt, not running into the street after a ball, or staying away from dogs they do not know. But extreme avoidance or fears can become a real problem. Avoidance can interfere with daily life and stop a child from getting back to enjoying things that she usually likes to do.
    - - Hyper-arousal also starts with a natural and normal response to danger, the “fight or flight response.” After an injury or accident, this “fight or flight” response might not turn off, even when the child is safe. After a scary situation like being injured, a child might have the feeling that something bad could happen again at any time, or he might jump at any loud noise. The physical feelings that go along with hyper-arousal (e.g., heart racing) can feel scary themselves.
  - - - Parents
        
        20%-30%
        
        1.Impair day-to-day functioning
        2.Affect adherence to medical treatment
        3.Impede optimal recovery
      - Children and sibling
        
        15%-25%
  - - - Feeling out of control is one of the hallmarks of traumatic experiences, so adhering to a clear, predictable routine in your classroom provides students with a sense of stability.
    - - Setting up a “safe space” in your classroom, where a child can take a short break to calm down, de-stress, and even take a short nap if they’re tired, can make a world of difference.
    - - You play a critical role in making your students feel welcome in your classroom. “Students have to feel secure and connected, both to adults and to peers, in order to learn
    - - for children who have been affected by trauma, strong connections are vital. Rich relationships with teachers help children form the foundations of resilience
    - - When you adopt a trauma-informed perspective, you approach that student’s behavior with openness and curiosity
        
        Think about strategies for working with a small team and get the support of your principal.You can’t adopt a trauma-informed approach in your classroom all on your own. It takes teamwork and sharing what you know with colleagues. “Meet with the educators and others in your school and start a study group
- - - - Resources
        
        https://www.nctsn.org/what-is-child-trauma/trauma-types/sexual-abuse
        
        Black & Deblassie, 1993; Briere & Elliot, 1994)
  - - - A child may act out running away from a "bad man" over and over again.
      - Abnormal sexual behaviour
        
        The child might engaged in an inappropriate sexual behaviour such as trying to engage another child in oral-genital or simulate intercourse
        
        The child might also talk about her body as being "hurt," or "dirty."
        
        Dissociation
        
        A teenager avoiding traumatic reminders may withdraw socially
        
        Anxiety
        
        Depression
        
        Anger
        
        Such as; panic,
        
        fear
        
        Fobias
  - - - At the level of individual
        
        Someone to turn to, help to overcome harm,prevent victimization,prevent drug/ alcohol abuse and promote healthy relationship.
        
        At the level of family
        
        Safe families and relationships: Family support, response across different setting,alternative care and cash transfer/livelihood.
        
        At the level of the community.
        
        Norms and culture: Mass media and awareness, community mobilization, coordinate child protection and involve men and boys.
        
        At the level of the society.
        
        Enabling National Framework: Legislation and policy, child protection system building, child friendly reporting and planning and coordination.
  - - - Armed conflict, crisis emergency, social norms,migration,rule of law and socio-economic development.
      - Setting
        
        home,school,workplace,online words, neighbourhood,sport and leisure,travel tourism, care system and justice system.
        
        Relationship
        
        family, boyfriend/girlfriend/date, person in authority/position of trust, somebody known, stranger and gang.
        
        Victimization
        
        rape, oral/anal penetration,sexual touching,non-contact abuse, child abuse images,solicitation of child and sexual exploitation.
- - - - Flood
      - Hurricane
      - Landslide
      - COVID19
      - Tornado
      - Wildfire
      - Windstorm
      - Winterstorm
      - Earthquake
      - Tsunami
      - Extreme Heat
    - - War
      - Terrorism
      - Biological Threat
      - Chemical Threat
      - CyberAttacks
      - Crime
      - Civil Disorder
  - - - Children and Adolescent reactions
        
        Young Children (up to age 6)
        
        Sense of Helplesness
        
        Fear
        
        Irritability
        
        Crying
        
        Need for Attention
        
        Seeking Affection/Being Clingy
        
        Older Children (age 6 to 10)
        
        Preoccupied talking about the event
        
        Diminished Concentration
        
        Sadness
        
        Anger
        
        Fear of Recurrence
        
        Adolescence (age 11+)
        
        Sense that the world is less safe
        
        High-Risk Behavior
        
        Social Anxiety
        
        Feelings of being overwhelmed
        
        Response and Strategies
        
        Talk to students about what happened in a way they can understand. Keep it simple and appropriate for each child’s age.
        
        Provide students with opportunities to talk about what they went through or what they think about it. Encourage them to share concerns and ask questions.
        
        Children react, in part, to what they see from the adults around them. When teachers deal with a disaster calmly and confidently, they can provide the best support for their students.
        
        Be aware that children can be upset again about what happened and know what resources are available at your school for children and families, should you need to report concerns to the appropriate people at your school.
        
        Ask for helo from a mental health professional
  - - - Behavioral/Physical
        
        Chills
        
        Shaking/tremor
        
        Shortness of breath
        
        sweating
        
        Restlesness
        
        Change in Sleep
        
        Withdrawal
        
        vomiting
        
        headache
        
        elevated blood pressure
        
        rapid heart rate
      - Cognitive
        
        Re-visualizing Experience
        
        Intrusive thoughts
        
        Reliving Past Trauma
        
        Confusion
        
        Decreased attention/concentration
        
        Hyper Vigilance
        
        Uncertainty
      - Affective/Emotional
        
        Agitation
        
        Panic
        
        Fear
        
        Anger
        
        Shock
        
        Denial
        
        Crying
        
        Depression
- - - - Sudden/Unexpected
        
        Accident (car, injured at work)
        
        Violence (gun, fight, homicide)
        
        War
      - Expected
        
        Illness
        
        Old age
        
        Pre-existing condition
- - - - During step one, teachers or adult school staff should provide students with an opportunity to share their experiences and express feelings of worry, anxiety, fear or other concerns about their safety.
      - Step 2: Protect
        
        For this second step in the LPC—Model & Teach intervention, adults should try to reestablish students’ feelings of both physical and emotional safety.
        
        Step 3: Connect
        
        The third objective of LPC—Model & Teach is to help students reestablish their normal social relationships and stay connected to others in order to experience social support.
        
        Step 4: Model Calm and Optimistic Behavior
        
        Adults can model calm and optimistic behavior in many ways, including the following:
        
        Maintain level emotions • and reactions with students to help them achieve balance;
        
        Take constructive actions to assure student safety, such as engaging in a safety drill to remind them of how to stay safe, or planning a project that improves the physical or social climate of the school;
        
        Express positive thoughts for the future, like “Recovery from this disaster may take some time, but we’ll work on improving the conditions at our school every day;”
        
        Help students to cope with day-to-day challenges by thinking aloud with them about ways they can solve their problems.
        
        Step 5: Teach
        
        To support and facilitate the coping process, it is important to help students understand the range of normal stress reactions. School counselors, nurses, psychologists or social workers can take on this task. They can help students become familiar with the range of normal reactions that can occur immediately after a traumatic event or disaster and teach relevant coping and problem solving skills.
  - - - Preschoolers most often react to their parents’ break-up with fear and guilt.
      - Parents will often see children go back to early behaviors
    - - Children aged six to eight years old respond most often with grief.
      - Young children often hope Mom and Dad will get back together.
      - children are affected when they see their parents ﬁghting. It affects their ideas about how people solve problems with each other.
    - - These children will often hide the distress they are feeling.
      - About 25% of children at this age will take sides in the parents’ battle, most often siding with the mother.
      - Children at this age are likely to feel intense anger, and unlike their younger siblings, they are very aware of their anger.
      - Preteens have developed new thinking skills, which allow them to understand cause-and-effect relationships, but they still lack a larger view of how things work.
      - Children may not have as many friends as before, and they may fear that their peers will reject them.
  - - - When parents are divorcing, communication can become a challenge for a variety of reasons.As a teacher, we need to keep communication on depending on how the student's new family situation has shaped up
    - - As teachers, when we know students are going through a divorce our hearts break. We are trained to be empathetic to students in this situation, and it's easy to slip into a pattern of enabling the child's behavior.
    - - The reality for children whose parents are divorcing is that they might be surrounded by a lot of negativity at home.If you know a child's parents are divorcing, look for opportunities to reinforce their strengths in the classroom.
    - - As a teacher, we can support students by communicating with both parents so that the child's best interests come first. We can be their champion and advocate for their needs with their parents and our administrators when we see the need arise. In that way, we can help students who may be struggling with a divorce and its impact on their home life.
    - - Parents should offer love and support, acknowledge their children’s anger.
      - one or both parents to meet with (or send emails to) the child’s teacher to make sure the child is not falling behind in math.
      - pay an older neighbor or child to engage in some friendly tutoring
      - Internalized Problems
      - Parents must control their anger towards each other.
      - Parents must allow the children to love the other parent.
      - Avoid making children “choose sides.”
    - - arranging one-on-one time with a teacher aide to provide emotional support or to help them settle into the day
      - creating a safe, friendly environment where children feel free to talk
      - communicating with parents about how their child is going emotionally, socially and academically at school
      - referring children to the student welfare coordinator when necessary for additional support
      - being consistent with school routines, rules and expectations
      - arranging tutoring for the child with the teacher, other parents, peers, and teacher aides
      - getting financial support through the school welfare budget or community organisations for resources, food and to help pay for school excursions and camps
- - - - These events are severe and pervasive.
        
        Examples
        
        Emotional abuse and neglect, sexual abuse, and physical abuse, as well as witnessing domestic violence, ethnic cleansing, or war
      - Usually occurs early in life
      - can disrupt many aspects of the child’s development and the formation of a sense of self.
      - often occur with a caregiver, they interfere with the child’s ability to form a secure attachment
  - - - When primary caregivers exploit and abuse a child, the child learns that he or she is bad and the world is a terrible place.
      - have difficulty developing a strong healthy attachment to a caregiver
      - more vulnerable to stress
      - have trouble controlling and expressing emotions
      - likely to react violently or inappropriately to situations
      - may have problems in romantic relationships, in friendships, and with authority figures, such as teachers or police officers.
    - - When a child grows up afraid or under constant or extreme stress, the immune system and body’s stress response systems may not develop normally
      - Stress in an environment can impair the development of the brain and nervous system
      - frequently suffer from body dysregulation, meaning they over-respond or under-respond to sensory stimuli
    - - have difficulty identifying, expressing, and managing emotions, and may have limited language for feeling states
      - may experience significant depression, anxiety, or anger
      - unpredictable or explosive
      - vigilant and guarded in their interactions with others
      - more likely to perceive situations as stressful or dangerous
      - Difficulty managing emotions
    - - When children encounter an overwhelming and terrifying experience, they may dissociate, or mentally separate themselves from the experience
      - dissociate as a defense mechanism they may automatically dissociate during other stressful situations or when faced with trauma reminders
      - can affect a child’s ability to be fully present in activities of daily life and can significantly fracture a child’s sense of time and continuity
      - adverse effects on learning, classroom behavior, and social interactions
    - - may be easily triggered or “set off” and is more likely to react very intensely
      - may struggle with self-regulation (i.e., knowing how to calm down)
      - may lack impulse control or the ability to think through consequences before acting
      - may behave in ways that appear unpredictable, oppositional, volatile, and extreme
      - more likely to engage in high-risk behaviors
      - may also engage in illegal activities
    - - may have problems thinking clearly, reasoning, or problem solving，which result in have learning difficulties that may require support in the academic environment.
      - may be unable to plan ahead, anticipate the future, and act accordingly
      - hard to acquire new skills or take in new information
      - may struggle with sustaining attention or curiosity or be distracted by reactions to trauma reminders
      - may show deficits in language development and abstract reasoning skills.
    - - make a child feel worthless and despondent
      - Shame, guilt, low self-esteem, and a poor self-image are common
      - have trouble feeling hopeful
    - - increased medical conditions throughout the individuals’ lives
      - the connection between childhood trauma exposure, high-risk behaviors (e.g., smoking, unprotected sex), chronic illness such as heart disease and cancer, and early death.
    - - Extreamly high cost on treatment and recovery plans
      - intangible losses” of pain, sorrow, and reduced quality of life to victims and their families
  - - - Predictability - Being predictable with the teaching practices and also how the teacher interacts with the student can be helpful since trauma students come from unpredictable environments. Predictability provides them with a sense of safety.
      - Respect their Privacy - Teachers do not need to know all trauma details to be supportive of them. Focus should be on the student and their perception of the problem and the student's current (anger and worries).
      - Ease transitions - Give warnings before changes in assignments or the daily routine.
      - Break - Allow a student to take a break such as a quick walk in the hallway.
      - Interactive and Supportive classrooms - Balancing assignments with cooperative activities giving them a chance to interact with peers and adults.
      - Managing Behavior -
        Avoid labeling students negatively - they already think negatively about themselves instead help them understand the behavior in the context of the current event
      - Do Not Use Sarcasm - This is simply not recommended in the classroom especially in front of classmates.
      - Negative Voice Tone - Don't recreate what they already experience outside of school.
      - Utilize other staff who can process with the student instead of more punitive behavior modifications such as another referral, we need less interruptions
    - - an intervention that provides practitioners with easy-to-use tools including a life storybook, manual, creative arts activities, and psycho-education resources to engage children and caregivers in trauma-focused services.
    - - a framework for intervention with youth and families who have experienced multiple and/or prolonged traumatic stress
    - - is designed for families living in traumatic contexts with the goal of reducing the symptoms of posttraumatic stress disorder and other trauma-related disorders in children and adult caregivers.
    - - addresses both the individual child’s emotional needs as well as the social environment in which he or she lives.
- - - - In 2018, 70.8 million people were forcibly displaced (due to persecution, war, human rights violations, or violence.
  - - - Compromised immune system
      - Difficulty sleeping
      - Depression
      - Weight loss or gain
      - Psychosomatic symptoms
    - - Anger
      - Constant alertness
      - difficulty understanding cause and effect
      - forgetfulness
      - lack of self understanding
      - PTSD
      - Sucidal thoughts
      - Nightmares and flashbacks
    - - Attachement difficulties
      - Tendency to avoid engaging with others
      - Social isolation
      - Difficulty building relationships
      - distrust and suspicion of others
    - - Agression
      - Anger
      - Defiance
      - Disassociation
      - Startles easily
      - Impulsive and destructive
      - Irritability
      - Tantrums
  - - - You are just one person on a team of people that is supporting refugee students
      - You may need to look outside of school for help and supports
      - You don't need to have all the answers
    - - Reflect on your biases and assumptions about refugees
    - - Use positive language
      - Use neutral and respectful language, do not label your students as victims
      - Use vocabulary your student can understand
      - Acknowledge nonverbal communication and silence
      - Move away from "What's wrong with you" to "What happened to you?"
    - - Students who have experienced trauma need to feel safe
      - Make sure your students know you are a safe person and help them identify external safe people and places
      - Teach them how to ask for help
      - Explain safety and process at school
      - Minimize the number of surprises for the student
    - - Take an interest in their life outside of school, and create opportunities for students to get to know each other in the classroom
      - Find 5 people in school to be "buddies" with each refugee child
      - Teach social skills and emotional intelligence, as well as how to identify and name emotions
      - Use scales to measure emotional intensity
      - Teach coping skills to help decrease emotional intensity
      - Make an effort to get to know their parents
    - - Listen without judgement
      - Help student to find ways to positively contribute to the community
      - Plan low risk activities, in an environment where they can feel accepted
    - - Refugees have often been stripped of control over their own lives
      - Seek input from students and families
      - Encourage active involvement at school
    - - Be specific in your praise
      - Use a 10-1 ratio of positive to negative comments
      - Maintain consistent expectations, based on rewards not punishments
    - - Teach deep belly breathing
      - When students are not engaged, try activities such as movement breaks, yoga and mindfulness
      - When students are agitated, try self calming activities, mindfulness or listening to music
- - - - https://www.youtube.com/watch?app=desktop&v=HtDIFA5KhWo
  - - - Childhood emotional neglect (CEN) is a lack of parental acknowledgement of their child's emotions
- - - - behavioral problems
      - sleep difficulties
      - separation problems,
      - regressive behaviors
      - depression
      - anxiety
      - posttraumatic stress disorder
      - acute stress disorder
  - - - Teachers may find it helpful to structure a limited period of time for discussions,
      - Anger management activities should be infused into class discussions. Students can describe how they successfully managed past frightening situations and identify effective coping strategies for dealing with stress.
    - - We need to safely steer students through the onslaught of emotions and images that have touched them
    - - Teachers need to promote an understanding not only of patriotism for our own country, but also of the love that others feel for their countries
- - - - Have difficulties focusing or learning in school
      - Lack self-confidence
      - Experience stomach aches or headaches
      - Show poor skill development
      - Be verbally abusive
      - Be unable to trust others or make friends
      - Imitate the abusive/traumatic event
      - Develop learning disabilities
      - Act out in social situations
      - Believe they are to blame for the traumatic event
    - - Exhibit memory problems
      - Scream or cry excessively
      - Have poor appetite, low weight, or digestive problems
      - Demonstrate poor verbal skills
  - - - Validate your child’s experience. Let them know that you understand how hard the experience was and that you’re there to help.
    - - Regression
      - Irritability and grumpiness
      - Clinginess and separation anxiety
      - Sleep changes
      - Eating more or less than usual.
- - - - Bullies are more likely to be violent later in life
      - Bullies are more likely to abuse alcohol and drugs
      - Bullies are more likely to become abusive toward romantic partners and family members
      - More likely to have a criminal history during adult life
    - - Students that are bullied often start to perform worse at school
      - Mental health issues such as depresson and anxiety are very common in bullied students. This can last for the rest of the student's life.
      - Students that are bullied may eventually lash out in a very violent manner. There has been a noticed link between bullying and school shootings in the United States.
    - - Bystanders often have an increased risk of alcohol, drug and tobacco abuse.
      - Increased mental health problems
      - Missed/skipped school