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Examples of Traumatic Stress in Students, Screening and Assessing,…

- - - - Compared to those who did not experience the death of a sibling, the children who did had a 71 percent increased risk of death from all causes.
      - Surviving siblings may be troubled throughout life by a vulnerability to loss and painful upsurges of grief around the date that the sibling died. They may develop distorted beliefs about hospitals, doctors and illness.
      - affect the sleeping patterns, making child tired and listless
    - - academic skills deteriorate
    - - mood swings
        
        may display behaviours that appear polar to the behaviours of the child / young person prior to their bereavement.
      - displaying physically or verbally threatening behaviour
      - High-risk behaviours
        
        such as self harm, excessive alcohol consumption, substance misuse
      - compensatory behaviours
        
        such as all consuming academic pursuits or an overly keen engagement in sporting activities
- - - - Stomach aches, headaches
      - Crying a lot
      - Fear or anxiety
      - Sadness or irritability
      - Thoughts about the traumatic event that won't go away
      - Avoiding thinking or talking about anything that reminds him or her of the traumatic event
      - Acting as if the event is happening right now (when it is something that occurred in the past)
      - Trouble managing behavior or emotions
      - Pains in the body that don't seem to have a physical cause
      - Hopelessness
      - Nightmares
      - Trouble paying attention
      - Trouble falling asleep, or sleeping too much
      - Getting upset when things happen that remind him or her of the traumatic event
      - Lack of desire to play with others or take part in activities that her or she used to enjoy
    - - Elementary school children
        
        Changes in their behavior such as aggression, anger, irritability, withdrawal from others, and sadness
        
        Trouble at school
        
        Trouble with peers
        
        Fear of separation from parents
        
        Fear of something bad happening
      - Middle and high school-aged youth
        
        A sense of responsibility or guilt for the bad things that have happened
        
        Feelings of shame or embarrassment
        
        Feelings of helplessness
        
        Changes in how they think about the world
        
        Loss of faith
        
        Problems in relationships including peers, family, and teachers
        
        Conduct problems
      - Preschool children-age
        
        Repetitive playing out of events related to trauma exposure
        
        Not playing with other kids their age
        
        Aggressive behavior like hitting, kicking, throwing things, or biting
        
        Temper tantrums
        
        Trouble separating from their parents
        
        Acting younger than their age
        
        Thumb sucking
        
        Bed wetting
  - - - • teachers and schools can offer refugee children the essential feelings of safety and sense of belonging;
        
        • teachers and schools need to have some degree of understanding on how trauma can influence
        
        children’s behaviour and safeguard them in the classroom by addressing trauma and grievance;
        
        • schools need to raise awareness about the impact of trauma on the pupils’ behaviour;
        
        • teachers and other school staff need to be trained in trauma awareness and trauma-sensitive teaching.
    - - • create safe, nurturing and responsive learning environments;
      - • address emerging and sensitive topics;
      - • enhance the pupil’s capabilities to engage in difficult conversations reflecting on their own prejudices,
      - offering alternatives and paying attention to those who feel left out;
      - • involve pupils in prevention alternatives;
      - • organise activities that encourage critical thinking and promote dialogue;
      - • bridge the gap with other students in the classroom on cultural differences;
      - • learn how to approach families or students with different cultural backgrounds;
      - • raise awareness about trauma with the family, discussing difficult topics (e.g. gender or homosexuality).
- - - - Understanding Nightmares
        https://www.youtube.com/watch?v=YNsPABfXlGQ
- - - - Re-experiencing
        
        What to look for
        
        Thinking a lot about the illness, injury, or procedure (unwanted, intrusive thoughts)
        
        Feeling distressed at thoughts or reminders of it
        
        Having nightmares and "flashbacks"
      - Avoidance
        
        What to look for
        
        Avoiding thoughts or feelings about the illness, injury, or hospital experience, or things associated with it
        
        Avoiding places or activities that are reminders of the illness/ injury/ hospital experience
      - Changes in cognition (thinking) and mood
        
        What to look for
        
        Exaggerated negative thoughts about self, others, the world
        
        Pervasive negative emotions: fear, anger, guilt, shame
        
        Numbness or detachment from emotions, especially positive emotions
    - - Cognitive behavioral principles
        
        • Education about the impact of trauma
        
        • Helping children and their parents establish or re-establish a sense of safety
        
        • Techniques for dealing with overwhelming emotional reactions
        
        • An opportunity to talk about the traumatic experience in a safe, accepting environment
        
        • Involvement, when possible, of primary caregivers in the healing process
      - Positive priming in class
        
        simple priming techniques to foster positive emotions such as contentment, pride, awe, and wonder in class.
        
        Implementing brain breaks. Escalating brain breaks build positive energy and emotions such as joy, happiness, and wonder (e.g., clapping games, thumb wars, laughter yoga, racing around the desk), while de-escalating brain breaks build calm emotions such as contentment and serenity, which help a student to feel safe and focused (e.g., silently tracing the movements of a partner, triangle breathing, playing music or repeating mantras, and body movements such as shoulder shrugging or pumping your toes inside your shoes).
- - - - Look for a change in attitude from your students. Students that were happy, smiling, and excited to be in class, may become sluggish, apathetic, and unwilling to complete assignments. Check the students for signs of discomfort and anxiety.
    - - If you find that students are struggling to cope with the Covid lock-down, and the change to their perception of a normal life, communicate with them. If they don't want to talk to you, refer them to one of the schools, or outside school's, mental health specialists for discourse on their issues. We should be proactive in monitoring and preventing deterioration of student morale during this difficult period. Reach out to parents and work with the school community to amend school policies for students missing assignments and days to account for mental health. Parents and teachers should work together to identify and address problems before they begin to fester and develop.
    - - Helping build social connections for your students is a great way to foster positive mental health. Create peer networks. Host additional Zoom classes so that students can come and socialize about their favorite video games or YouTube videos. Extend one-on-one student/teacher time so that students can be encouraged to finish their assignments. State to students that you are available to talk through Zoom, chat, or email to ensure they feel they have someone to talk to about their situation.
- - - - Effects of Racial Trauma by Age Group
        
        Preschoolers (Ages 3-5):
        Children in this age range may exhibit behaviors in response to trauma that can include re-creating the traumatic event or having difficulties with sleeping, appetite, or reaction to loud sounds or sudden movements. In addition, if they are exposed to media reports of racial trauma (such as a police shooting), they tend to focus on sights and sounds and interpret words and images literally. They may not fully grasp the concept of an image being repeatedly replayed on television and may think each time that the event is happening over and over again.
        
        School Age Children (Ages 6-11):
        Children in this age range often exhibit a variety of reactions to trauma and to racial trauma in particular. Much will depend on whether they have directly experienced an event or have a personal connection with those involved. School-age children tend to view media coverage in personal terms, worrying that a similar event could happen to them. This can lead to preoccupations with their own safety or that of their friends, which in turn can lead to distractibility and problems in school.
        
        Older Students (Ages 12-17) Youth in this age range typically have a better understanding of events and the implications of issues such as racial trauma. They are also often still forming their identities and their views of the world and their place in it. High school-aged students may become fixated on events as a way of trying to cope or deal with the anxiety that they are feeling as a result. Older students may be exposed to a wide range of images and information via social media as well. They may benefit from discussing ways that they can promote positive changes in their communities.
  - - - Create and Support Safe and Brave Environments:
        Establish a safe and brave environment for discussing emotionally charged issues. This provides opportunities to first acknowledge the impact various traumas may have on students’ academic experiences and then to create a safe space to engage academically (Bloom, 1995).
        
        Model and Support Honesty and Authenticity
        
        Honor the Impacts of History and Systemic Racism
- - - - consume harmful amounts of alcohol (for example if their drinking is leading to alcohol-related health problems or accidents)
      - are dependent on alcohol
      - use drugs regularly and excessively
      - are dependent on drugs.
  - - - Neglect
        
        Parents who misuse substances may have difficulty:
        
        staying organised and giving their children effective and consistent support
        
        keeping their home and family clean
        
        recognising and responding appropriately to their own and their children’s physical needs
        
        paying for food, clothing and essential bills (for example if their income is being spent on drugs and alcohol)
        
        keeping harmful substances and equipment such as needles and syringes safely away from their children.
      - Emotional Abuse
        
        less responsive to their babies
        
        less willing to engage in meaningful play
        
        less able to respond in ways which encourage further interaction (Kroll and Taylor, 2003).
      - Physics Abuse: Parents who misuse substances may have difficulty controlling their own emotions. Harmful and excessive drinking can contribute to child physical abuse
  - - - Trouble forming relationships with teachers
      - Poor self-regulation
      - Negative thinking
      - Hypervigilance
      - Executive function challenges
  - - - positive attention includes not only praising them for desired behavior but expressing warmth and kindness that aren’t necessarily earned.
    - - • 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
      - • Set clear, firm limits for inappropriate behavior and develop logical—rather than punitive— consequences.
      - • Recognize that behavioral problems may be transient and related to trauma. Remember that even the most disruptive behaviors can be driven by trauma-related anxiety.
      - • 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.
- - - - with Infants
        
        Irritability and crying Frequently ill Difficulty sleeping
      - with Toddlers and Preschool
        
        Aggressive
        Withdrawn
        Delayed development
        Poor motor skills
        Anxiety/general fearfulness
        Stomachaches
        Nightmares
        Lack of bladder/bowel control
        Lack of confidence to begin new tasks
      - with Teenagers
        
        Withdrawn
        Lack of bladder/bowel control
        Nightmares
        Poor grades / fails or quits schools
        Headaches / ulcers
        Immunity / irresponsible
        Become victim or batterer
        Violent outbursts
        Property destruction
        Runaways
        Unable to express feelings
        Refuses to bring home friends
        Low self-esteem
        Feels responsible for taking care of home and adult victim
        Joining in on beatings of adult victim
        Suicide
        Self harm
      - with School age
        
        Aggressive / bullying
        Anxiety
        Stomach aches
        Nightmares
        Lack of bowel / bladder control
        Poor grades / failure of one or more grades
        Low self-esteem / poor social skills Digestive problems
        Headaches
        Fear of abandonment
        Grief and guilt
    - - Try to give them extra attention but not so obviously that other learners feel that the child is being favoured.
      - Adopt a child-centered approach and assure them that you are available should they need to discuss a problem.
      - Build a trusting relationship and positive self-esteem.
      - Initiate group activities e.g. play, or peer group counseling. Abused children often isolate themselves.
      - Never tell the class what the child may have told you as they will lose their trust in you.
      - Educator may need to gently re-focus the child if day dreaming is noted and offer extra assistance to the child in order for performance to return to earlier levels.
      - If the child's behaviour warrants checking, do so and do not ignore it because you feel sympathetic. Reprimand immediately and deal with the problem on a one-to-one basis later. Sometimes anxiety and trauma may prompt a child to test boundaries.
      - Use relationship-building and interaction strategies. Two by ten rule: talking for two minutes for 10 days about unrelated subjects to academics.
      - Give Supportive Feedback to Reduce Negative Thinking: When giving negative feedback, teachers can use the positive sandwich approach.
      - Create Islands of Competence: It is important that students experience competence to develop a more accurate self-narrative and to begin to create a positive future picture of themselves. Make the student feel good about themselves, let them help out a peer that has difficulty with something that they are strong with, or make them know if they finished something first, this way they will think that I really helped someone today and it helps them with praising themselves.
      - Foster a feeling of safety .
      - Utilize social-emotional learning.
    - - Domestic violence and children. (2019, April 02). Retrieved from https://www.womenshealth.gov/relationships-and-safety/domestic-violence/effects-domestic-violence-children
        Managing an Abused Learner. (n.d.). Retrieved from https://www.childlinesa.org.za/educators/for-educators/child-protection-at-school/managing-an-abused-learner/
        Minahan, J. (n.d.). Trauma-Informed Teaching Strategies. Retrieved from http://www.ascd.org/publications/educational_leadership/oct19/vol77/num02/Trauma-Informed_Teaching_Strategies.aspx
        Trauma-Informed SEL Toolkit. (2020, November 10). Retrieved from https://transformingeducation.org/resources/trauma-informed-sel-toolkit/
        Warning Signs of Children Living with Domestic Violence (Tech.). (n.d.). Retrieved http://www.ncdsv.org/images/NCDSV_WarningSignsOfChildrenLivingWithDomesticViolence.pdf
- - - - withdrawn, antisocial, and/or anxious
      - low self esteem
      - hyperemotional, sudden outbursts or mood swings
      - night terrors
    - - aggressive behaviour
      - problems sleeping / always appearing tired
      - drop in grades / change in participation
      - problematic sexual behaviour or sexual knowledge
      - incontinence
    - - change in physical stature / physical contact
      - bruises in the shape of hands or in strange locations
      - pain when sitting down, bending over, etc.
      - unexplained pain like sudden frequent headaches or stomach aches
  - - - promote social norms from a young age to prevent sexual violence
        
        teach skills to prevent sexual violence (self-defense, communication methods, escape methods)
        
        create protective / safe environments
        
        **it is important to note that preventative measurements have yet to be proven effective
    - - be supportive and LISTEN
        
        remove the child from the endangering situation
        
        involve child services and the police
        
        follow legal safeguarding practices
- - - - The National Child Traumatic Stress Network (no date): https://www.nctsn.org/what-is-child-trauma/trauma-types/community-violence/effects
        
        Edutopia - Making students feel safe (no date)
        https://www.edutopia.org/video/making-students-feel-safe
        Childhood trauma reactions - teacher manual (no date) https://www.schools.aidr.org.au/media/4605/conrod_childhood-trauma-reactions.pdf
        
        BBC - How gang violence affects mental health (2016) https://www.youtube.com/watch?v=CuneeOypj3U
- - - - hitting, slapping, punching, kicking
      - damaging personal property
      - use of weapons
      - refusal of medical care and/or controlling medication
    - - name calling, insulting
      - excessively blaming others
      - extreme jealousy
      - intimidation
      - shaming, humiliating isolation
      - stalking
    - - fear of saying "no" to sexual advances
      - erratic sexual engagement
    - - hacking into another individual's personal email and accounts
      - use of tracking devices to monitor location, phone calls and messages
      - monitor interactions via social media
    - - inflicting physical harm or injury
      - harassment and blackmailing
  - - - Create safe and welcoming spaces
      - Develop codes of conduct
      - Provide easily-accesible, child-sensitive and confidential reporting mechanisms
      - referral to law enforcement and healthcare services
    - - Curriculum approaches that prevent violence and promote gender equality
      - training education staff to give them tools to prevent and respond
      - safe spaces where co-curricular interventions can be a useful entry point for addressing gender-based violence
    - - Provide easily-accesible, child-sensitive and confidential reporting mechanisms
      - provide counseling and support
    - - coordination/collaboration between key ministries as well as as the district level
      - partnerships with teachers' unions
      - participation of girls and boys
      - working with families and the wider communities
      - engage in civil society organizations
    - - formative research to inform policy and programme development
      - comprehensive national data collection systems
      - indicators to track progress
      - evaluations to assess impact
      - take into account ethical, safety, and methodology
    - - observe student behavior
      - collaboration with other teachers regarding behavior, strategies and approaches
      - reach out to parents/guardians
      - coordinate with school stakeholders (e.g. administration, counselors, doctor/nurse)
      - provide a safe space in the class by clearly stating, modeling, and enforcing classroom policy and procedures
      - align classroom policies with school policies; if school does not have a clear policy, discussions with administration and consider district/national policies that are in place
      - approach student and inquiry