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Traumatic stress, By Caitlin Symons - Coggle Diagram

- - - - Signs
        
        Frequent absenteeism
        
        Difficulties regulating emotions/outbursts
        
        Tired
        
        Unexplainable injuries
        
        Withdrawal from school activities
        
        Disengagement in class or missing work
        
        "Jumpy" or nervous actions in classes
        
        Reluctance to work with certain students
        
        Talk of violence or acting out of scenarios
        
        Defiant behaviors or challenging of authority
        
        Separation anxiety
        
        General anxiety
        
        No visible signs
        
        Numbness
        
        Substance abuse (coming to class high, smell of cigarette smoke or alcohol)
      - Response Strategies
        
        Personal
        
        Educate self on types of trauma (especially trauma that is common in students' community) and learn about signs/symptoms as well as reporting requirements/procedures
        
        Take care of own mental, emotional, and physical needs in order to better meet student needs
        
        School-Wide: **If schools have not already adopted these practices, encourage administration to adopt them
        
        Provide training/education to teachers and other staff about trauma symptoms and response
        
        Link: Community Violence Toolkit
        
        Provide education to parents about services and support options as well as steps to take at home to support their children
        
        Consider running or assisting with an after school program or sport club to help build positive peer relationships
        
        Classroom
        
        Maintain calm environment with predicable routines
        
        Keep classroom interactions positive and supportive
        
        Provide opportunities for choice so students have a greater sense of control
        
        Create calm/safe places
        
        Link: Why every classroom needs a safe space
        
        Do not punish students for trauma symptoms
        
        Build and maintain a trusting relationship with students
        
        Be a non-judgmental active listener
        
        Keep an even temper
        
        Be mindful of images, stories, etc. that are used in classes that could be triggering. Provide warnings.
        
        Link: Classroom triggers and avoidance
        
        Keep communication open
        
        Be clear about when/where students can find you if they want to speak privately
        
        Create alternative ways for students to communicate
        
        Creating a locked box for students to write questions, suggestions, fears, concerns, etc. that they they do not feel comfortable saying
        
        Provide information about services to students or make referrals to counselors
  - - - https://youtu.be/VkUK9juJISQ
        
        School
        
        Monitor bullying “hot spots” in and around the building.
        
        adult monitoring or supervision
        
        Classroom
        
        Keep the lines of communication open
        
        Encourage the child to report bullying
        
        Encourage kids to speak to a trusted adult
        
        Talking about bullying
        
        help students identify it
        
        Reward students when they show thoughtfulness and respect for peers, adults, and the school.
        
        create a safe place
    - - https://youtu.be/gg3_NbBo1og
        
        Academic Symptoms
        
        not wanting to go to school
        
        declining grades
        
        Behavior Symptoms
        
        Self-destructive behaviors
        
        talking about suicide
        
        harming themselves
        
        running away from home
        
        Psychological Symptoms
        
        loss of interest in schoolwork
        
        avoidance of social situations
        
        decreased self esteem
        
        feelings of helplessness
        
        Physical Symptoms
        
        health
        
        difficulty sleeping
        
        frequent nightmares
        
        faking illness
        
        unexplainable injuries
        
        stomach aches
        
        frequent headaches
        
        feeling sick
        
        Lost or destroyed clothing, books, electronics, or jewelry
  - - - School
        
        Value and commit to the students’ well-being
        
        collaborate with other authorities, i.e. social services and police
        
        Provide and avail any necessary resources like counseling or therapy
        
        Provide additional support to students in the form of relationship building programs
        
        Provide professional development opportunities that prepares teachers for situation management
        
        Resources:
        https://files.eric.ed.gov/fulltext/EJ1243200.pdf;
        https://www.tandfonline.com/doi/pdf/10.3402/edui.v6.26417
        
        Create a culture of nonviolence in school
      - Classroom
        
        Recognize signs of domestic violence in students
        
        Resources: https://www.justice.gov/sites/default/files/defendingchildhood/legacy/2011/09/19/tips-teachers.pdf
        
        Be willing to listen
        
        Connect student to additional support or services (trauma, therapy, counseling, etc.)
        
        Create a safe and comfortable environment in class
        
        Build positive relationships with students
        
        Create an emotionally safe place to learn
        
        Report what is seen to those who can help - according to the guidelines of the country/state
    - - Aggressive / bullying / self harm
      - Anxiety / difficulty sleeping
      - 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
      - Resources:
        http://www.ncdsv.org/images/NCDSV_WarningSignsOfChildrenLivingWithDomesticViolence.pdf
      - Property destruction
      - Runaways
      - Unable to express feelings
      - https://youtu.be/I3sezLfn0JM
  - - - Physical problems
        
        Health problems
        
        Infections
        
        Pregnancy or early-age pregnancy
      - Problems at school
        
        Difficulty concentrating
        
        Grades start to drop
        
        Unmotivated
        
        Uninterested
        
        Disengaged
      - Sexually inappropriate behavior
        
        Behave in sexually inappropriate ways
        
        Sexually explicit language
      - Changes in behavior
        
        Agressive
        
        Sleepy (might not be getting enough sleep at home)
        
        Sudden outbursts
        
        Clingy (especially in younger students)
      - Giving clues
        
        Children may start giving hints that something is happening at home
      - Avoid close contact
      - Odd sexual knowledge
    - - If abuse is suspected, it's important to report
        
        Within the family, report to local Child Protection Agency
        
        If outside the family, report to the police
        
        Responding to Child Sexual Abuse
      - Create a safe space space within the classroom
      - Encourage students to talk about any personal issues they might be having by creating a safe space
      - Teach students different ways they can express their emotions
        
        Resources
        
        Resources can be sent to parents to educate them about sexual abuse and ways to prevent it
        
        (https://www.youtube.com/watch?v=i-FRmFBsJxQ)
        
        Calm down zone in the classroom
      - Refer to counseling
      - Provide students with different means of communication with the teacher
        
        If they wish to stay after school to talk with the teacher
        
        Emailing the teacher
        
        Sending letters
      - Provide students with enough resources on what they can do
      - Avoid triggers
      - (https://www.youtube.com/watch?v=XpaM0TTrgkQ)
      - Positive interactions with students
        
        Positive attitude
        
        Positive feedback
        
        Positive environment
        
        (https://www.youtube.com/watch?v=huS7Jrx5OlE)
  - - - stressful life events
        
        Stressful life events are major incidents in the course of life that require major individual adaptive responses. Such events include major changes in work, or residential environment, e.g., beginning a new job, moving to a new residential area, major construction work in the present residential area, or a major perceptible change in the operating conditions of a nearby stressor. The event as such is usually short, but the behavioral consequences may be long, or permanent.
      - cataclysmic events
        
        Cataclysmic events comprise sudden catastrophes that affect many individuals at the same time. For instance, floods, major storms, earthquakes, volcanic eruptions, nuclear power plant accidents, chemical plant accidents, and the discovery of toxic waste dumps belong to this category. Cataclysmic events are seldom predictable, neither with respect to their beginning, nor with respect to their course, but they are usually expected to be rather short.
      - daily hassles
        
        Daily hassles are repeatedly occurring aversive events of ordinary life, such as arguments with colleagues, crowded classrooms, and traffic congestions on the daily route to work. Although they typically are more or less predictable, the individual has little means to avoid such hassles, and the duration is rather short.
      - ambient stressors
        
        Ambient stressors is a term proposed by Campbell (1983), denoting more continuous and intractable background characteristics of the physical environment. They often go unnoticed, like the continuous hum of the air conditioning, the permanent dust in an industrial area, and the faint hiss of the central heating system. Most people believe that they can adapt to ambient stressors, and they consider the costs of coping with such stressors to be higher than simply enduring them.
      - General Signs of Environmental Stress
        
        Increase in stress hormone levels
        
        Increase in blood pressure
        
        Fatigue, headaches
        
        Irritability, reduced tolerance
        
        Feeling of helplessness, lack of control of stressors
        
        Behavioral attempts to change the stressors
        
        Psychological symptoms
        
        Reduced productivity, increased errors
        
        Reduced job satisfaction, or life quality
      - Response Strategies
        
        Create a safe, predictable environment in the classroom
        
        Establish routines. No surprises.
        
        Allow for student directed pace of instruction
        
        Focus on positives in everyday life and in the classroom
        
        Let student know they have a measure of control.
        
        Focus on present and looking forward.
        
        Allow opportunities for success both academically and socially
- - - - Give less homework
      - Avoid putting the student into stressful situation
      - Create safe and peaceful environment on the class
      - Avoid situations that might trigger the memory
      - (https://www.youtube.com/watch?v=TxL5Jw0TcDY)
      - SEL or any other way to teach how to cope with stress
      - Professional support
      - Family involvement
      - Focus on possitive attention
      - Be predictable
      - Remain neutral and not judgmental
    - - Symptoms of PTSD
        
        Avoidance
        
        Trying to avoid thinking or talking about the traumatic event
        
        Avoiding places, activities or people that remind you of the traumatic event
        
        Student stops visiting the school or certain classes
        
        Student stops talking to/ avoids certain people or group of people
        
        Student refuses to do certain activities/ or feels disstressed doing them
        
        Intrusive memories
        
        Recurrent, unwanted distressing memories of the traumatic event
        
        Reliving the traumatic event as if it were happening again (flashbacks)
        
        Student suddenly will act as he/she is scared
        
        Upsetting dreams or nightmares about the traumatic event
        
        Student is constantly sleepy and lacks energy
        
        Student's grades drops
        
        Severe emotional distress or physical reactions to something that reminds you of the traumatic event
        
        Student abnormaly reacts to certain topics/ people/ events
        
        Behaviours that a teacher can notice
        
        Changes in physical and emotional reactions
        
        Being easily startled or frightened
        
        Always being on guard for danger
        
        Student is very cautious
        
        Self-destructive behavior, such as drinking too much or driving too fast
        
        Student seems to be taking drugs
        
        Student seems to be drinling alchohol
        
        Student starts to have a lot of injuries: bruises, scratches, etc
        
        Trouble sleeping
        
        Trouble concentrating
        
        Irritability, angry outbursts or aggressive behavior
        
        Student starts fights
        
        Overwhelming guilt or shame
        
        Negative changes in thinking and mood
        
        Feeling detached from family and friends
        
        Student starts to desociolize
        
        Difficulty maintaining close relationships
        
        Memory problems, including not remembering important aspects of the traumatic event
        
        Student becomes less focused on the lesson. Forgets material and homework
        
        Hopelessness about the future
        
        Negative thoughts about yourself, other people or the world
        
        Student seems depressed
        
        Lack of interest in activities you once enjoyed
        
        Difficulty experiencing positive emotions
        
        Feeling emotionally numb
    - - High-risk sexual behaviour
        
        Student changes group of friends and acts overly sexual
      - Inadequate personal hygiene
      - Sexual promiscuity
        
        Student starts talking on sexual topics
      - Fear of intimacy or closeness
      - Homelessness, running away from home
        
        Student looks untidy and unhygenic
  - - - Classroom Specific
        
        Use social-emotional learning in lesson plans
        
        Incase of punishment, use restorative practices to restore relationships and environments
        
        Teach feelings expression and coping
        
        Build relationships with students - maintain relationships
        
        Provide structure and consistency. Be predictable
        
        Resources:
        https://resilienteducator.com/classroom-resources/trauma-informed-teaching-tips/ ;
        https://resilienteducator.com/classroom-resources/trauma-informed-strategies/ ;
        https://www.edutopia.org/discussion/8-ways-support-students-who-experience-trauma;
        https://achieve.lausd.net/cms/lib/CA01000043/Centricity/Domain/260/Trauma%20Informed%20Approaches%20to%20Classroom%20Management.pdf
      - Overall support
        
        Communicate with counselors or social workers; Connect students to friends, peers, or supportive adults.
        
        Create and promote a safe environment in the classroom
        
        Resources for Overall Support: https://resilienteducator.com/classroom-resources/trauma-informed-strategies/ ; https://www.edutopia.org/discussion/8-ways-support-students-who-experience-trauma
        
        Follow any school policy for trauma: quiet time / alone time / prayers, etc.
        
        Connect to any coping resources in school
        
        School-based group intervention for elementary students: : http://bouncebackprogram.org/
      - https://youtu.be/imu3pRNQnDs
    - - Physical Symptoms
        
        Palpitations, i.e. a pounding heart
        
        Difficulty Breathing
        
        Nausea
        
        Headache
        
        Chest pain
        
        Stomach Ache
        
        Insomnia
      - Psychological Symptoms
        
        Arousal, anxiety, hypervigilance, an inability to focus, sleep disturbances, irritable mood and angry outbursts
        
        Avoidance of memories, people, feelings or places associated with the trauma
        
        Sense of physical displacement, experiencing an altered perception of time, difficulty remembering the event
        
        Recurrent, involuntary flashbacks or nightmares about event
        
        Negative mood / low mood, difficulty expressing positive emotions
      - Resources:
        https://ada.com/conditions/acute-stress-disorder/#:~:text=Symptoms%20of%20ASD%20may%20include,symptoms%20can%20be%20very%20distressing;
        https://www.healthline.com/health/acute-stress-disorder
  - - - Panic/Anxiety Attacks
      - Confusion
      - Re-experiencing the event
        
        Dreams
        
        Memories
      - Being Hypervigilant
      - Disengaged in class
      - Lower than expected level of work
      - Outbursts of emotion (anger/sadness)
      - References: Khiron Clinics. (2020, October 30). Acute Trauma. https://khironclinics.com/blog/acute-trauma/
    - - Letting them know that the community will keep them safe
      - Maintain a steady routine
      - Encourage them to talk about it and ask questions
      - Help them find ways to express themselves (drawing/music/sports)
      - Acknowledge the students ideas and emotions
      - Reference: Morganstein, J. C. (2019, November). Coping After Disaster. American Psychiatric Association. https://www.psychiatry.org/patients-families/coping-after-disaster-trauma
  - - - Nausea (With or Without Vomit)
      - Increased Urination
      - Fatigue
      - Moodiness
      - Bloating
      - Missing School
    - - Build Relationships
      - Safe Environment
      - Accomodate
      - Be Predictable
      - Immediate Emotional Support
      - Short term use of medication to relieve anxiety
      - Short Term Therapy
    - - Lack of Sleep
      - Lack of Concentration
      - Post Partum Depression
      - Mood Changes
      - Lactating
- - - - Lack of supervision at home
      - Steals or hides away food for later
      - Lack of clothing
        
        Dress unaccordingly to the weather
        
        Wear the same clothes to school everyday
      - Frequently absent from school
      - Poor hygiene
        
        Bad odor
        
        Unbrushed hair
        
        Messy looking
      - Parents seemed unconcerned about their academics
      - Alcohol or drug use
      - Suicidal Thoughts
      - [Signs of Neglect and Abuse] (https://www.youtube.com/watch?v=vh4G03DIjvU)
    - - Create a safe environment in the classroom
      - Provide a safe cool down area for student to go to whenever they feel strong, uncontrollable emotions
      - If suspected, it's important it to report it
      - Build trusting relationship with student
      - Discuss with the school if extra food can be provided to the student if they are not getting enough food
      - Have extra warm clothes in case the weather is cold and they are not wearing enough warm clothes
      - Allow students to use the school showers to use after school if they wish to
      - Teacher can also provide a kit with a hairbrush, toothbrush etc that the student can use before the start of the school day
      - (https://www.youtube.com/watch?v=kzvm1m8zq5g)
  - - - Withdrawn from others
      - Disturbed sleep
      - Sadness
      - Inability to focus in class
      - Anxiety
      - Grades drop or they are failing one or more classes
      - Distress
      - Hostile behaviour
      - May become aggressive (physically or verbally)
      - Tends to get in fights with others
      - Might become anti-social
      - (https://www.youtube.com/watch?v=8FXLgmGskgs)
      - (https://www.youtube.com/watch?v=G2ssFwwMH0U)
    - - Keep lines of communication open
      - (https://www.youtube.com/watch?v=kzvm1m8zq5g)
      - Build trusting relationships with students
      - Provide resources such as books, videos, brochures, etc
      - If heavily affected, they can be referred to the school counselor
      - Regular check-ins with the student
      - Create a safe and welcoming environment in the classroom
  - - - Signs/Symptoms
        
        distracted/unable to concentrate
        
        anger/sadness
        
        Missing assignments
        
        unable to work with others effectively
        
        Self hurting
        
        Bullying
        
        Dirty/not properly clothed.
        
        Lack of food/nutrition.
        
        Lack of self-esteem; cannot take praise.
        
        Strong fear of failure.
        
        Wants to be alone/does not seek out other students/friends.
        
        Displays fear at seemingly inconsequential events.
        
        Failure to thrive
      - Response Strategies
        
        Work with the student in an intentially way to build up their self-esteem and self-worth.
        
        Establish communicative relationship with family to gain insight into dynamics and share successes of student.
        
        Refer student to guidance counselor and make sure professional services are available.
        
        Make sure feedback towards student is not hostile or aggressive in any way but builds up their strengths.
        
        Be intentional about which students this individual works with in groups, being mindful of how their interactions may impact the students mental health.
        
        Buiod in positive, uplifting activities/games to allow for the student to enjoy and have fun.
      - Research
        
        https://files.eric.ed.gov/fulltext/EJ1012312.pdf
        
        https://aifs.gov.au/cfca/publications/emotional-abuse-hidden-form-maltreatment