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Trauma Cohort 10 -2021, REFERENCES, https://www.childwelfare…

- - - - Music Techniques: The use of tones, rhythm sounds, and melodies can be very useful in expressing grief.
      - Art Techniques: Pictures depicting grief can be an easier way for a student to express their emotions.
      - Play Therapy: The use of puppets, dolls or stuffed animals to allow children to express their emotions through play they create will help the child to feel a sense of control over their feelings.
      - Body Movement: With music children can express feelings by imitating the sort of animal they feel like they are (a lion or mouse) by asking them to move in the way they are feeling.
      - Bibliotherapy: Stories about loss and death can help children express their feelings through identifying with characters in the stories. These books also help the child to feel less sore.
- - - - EDUCATIONAL NEGLECT: Failure to educate a child or adolescent or attend to special educational needs.
      - EMOTIONAL NEGLECT: Lack of attention to emotional needs or exposure to domestic violence
      - PHYSICAL NEGLECT: Lack of appropriate supervision or failure to provide food, shelter, or medical care.
    - - Frequent school absences or lateness
      - Spending extra time at school; arriving early and/or leaving late
      - Hygiene issues such as body odour, lice
      - Displays fatigue, listlessness sleeping in class time
      - Attention seeking or “clinginess”
      - Hunger, taking food from others
      - Lack of appropriate clothing - no waterproof jacket or umbrella when its raining
      - Untreated injuries
    - - School should have a Student Safeguarding Policy & Child Protection Officer
      - All school stakeholders must protect children from and report suspected incidences of child abuse or neglect.
      - There must be school administrative regulations guiding reporting and follow up of all suspected incidents of child abuse or neglect.
      - SUPPORTING STUDENTS WHO ARE (OR ARE SUSPECTED TO BE) VICTIMS OF NEGLECT
        
        Manage emotions and communication appropriately: Student may have strong negative feelings of shame, guilt etc. while teacher may have feelings such as outrage or disgust. Teacher must demonstrate care, concern and support in a calm manner.
        
        Let student know that a report is necessary and will help them. Avoid promises which it is not possible to keep i.e. that you will not tell anyone.
        
        Primarily listen. Do not ask for more information than the student wants to volunteer.
        
        Do not discuss with any party not directly involved in helping the student.
    - - The Role of Educators in Preventing and Responding to Child Abuse and Neglect (Click for PDF from U.S. Dept. of Human Services, Children’s Bureau on roles that teachers and other education professionals have in helping maltreated children, including recognizing, reporting, and preventing child abuse and neglect.)
      - Child Protection: Children's Rights in Theory and Practice Free online course from Harvard University
      - Contact information for local Child Protective Agencies the USA
      - Caring for Vulnerable Children Free online course from University of Strathclyde, Glasgow
- - - - Example for students in upper elementary and middle school https://www.youtube.com/watch?v=s0bqT_hxMwI
- - - - https://www.youtube.com/watch?v=xYBUY1kZpf8
      - Relevant videos to better understanding of Domestic Violence and Childhood Traumas in general.
    - - • Talking about or attempting suicide
      - • Symptoms of depression
      - • Seeming fearful
      - • Low self-esteem
      - • Loss of interest in daily activities
      - • Extremely apologetic or meek
      - • Developing a drug or alcohol problem
      - • Changes in sleep habits (sleeping too much or not enough)
      - • Agitation, anxiety, or constant apprehension
      - Emotional Signs
      - • Wearing clothes that don’t fit the season, like long sleeves in summer to cover bruises
      - • Excuses for injuries
      - • Sprained wrists
      - • Red or purple marks on the neck
      - • Busted lips
      - • Bruises on the arms
      - • Black eyes
      - Physical Signs
      - • Overly worried about pleasing their partner
      - • Never having money on hand
      - • Constantly checking in with their partner
      - • Low self-esteem in someone who was always confident and other personality changes
      - • Is often late and skipping school
      - • Drops out of activities they would usually enjoy
      - • Begins isolating themselves by cutting off contacts with friends and family members
      - • Becomes reserved and distant
      - Behavior Changes and other Signs
      - *Not penalizing a student for misbehaving, but instead talking to him privately about the situation. Making clear is not a correct action to take and guiding the student to face this difficult phase.
        
        *Offer a private space in the school for the student to rest, relax and have their own time if they need it.
        
        *Treat the student with patience and respect. Get to know the student’s situation, he may live in an unstable place, moving frequently, not having space to study or make his homework, be far from school, have no access to the internet, etc. The children's learning capacity will reduce, the teacher can accept some missing homework and allow the student to retake tests with low grades.
        
        *School procedure to activate the Guardianship Council, because talking to parents directly would force them to be closer to their children. Differently from other emotional and social behavior school-parent cooperation may not be possible if the parents are the ones involved in the violence.
        
        *Spaces with an emphasis on reception and listening, direct open channel to students to contact the teacher or staff they feel more comfortable with.
        
        *School must keep records and must-have information sharing among staff and with external agencies.
        
        *School staff, not only the teachers, must receive training to be familiar with their role in the child protection process. They should know how to identify the symptoms of a student that could be suffering domestic violence and how to act in this situation.
        
        Strategies:
        
        References:
        
        https://www.webmd.com/mental-health/mental-domestic-abuse-signs
        
        https://www.verywellmind.com/signs-someone-is-being-abused-66535
        
        https://www.frontiersin.org/articles/10.3389/fpsyg.2018.02094/full
        
        http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S1657-59972019000300008
        
        https://gov.wales/sites/default/files/statistics-and-research/2019-08/110315schoolbasedworktoaddressdomesticabuseen.pdf
      - A real case of domestic violence that unfortunately was fatal. Schools had a lot to learn from it, the reports shown that lack of integrated working between school and external agencies and non-consistent recording by the school were some of the reasons this tragedy wasn't avoided. https://www.bbc.com/news/uk-england-coventry-warwickshire-24106823
- - - - Hungry & thirsty
        
        Poor hygiene
        
        Lack of shelter
    - - loud & boisterous
    - - poor nutrition
        
        tooth decay
        
        weight loss
        
        Fatigue
    - - Attention deficit disorder
        
        depression
        
        sleep disorder
        
        eating disorder
        
        hyper vigilance
  - - - Breathing exercises
        
        Meditation
        
        Practicing mindfulness
  - - - A TED talk on the psychological consequences of poverty
        https://www.youtube.com/watch?v=FdR0NqrlRZo
- - - - Sudden and serious changes in childrens' lives due to a pandemic can be defined as an ACE. A number of support networks and necessary development opportunities that they may have otherwise had may be lost, and this can be very hard to substitute. It also risks exacerbating any other adverse situations the child is already facing.
        
        Emergency rooms in the US have had a 24% increase in mental health-related visits from children between the ages of 5 to 11 since the COVID pandemic began. Older children show an even higher rate of increase.
        
        See this quote from the CDA (https://www.cdacouncil.org/en/air-hugs-and-aces-trauma-in-young-children-during-the-pandemic/)
        
        A CDA website (see references) puts it very well:
        COVID-19 closed down a big part of children’s lives when it forced many of our preschools to close. Besides being places where children learn, preschools provide children with chances to make friends and build their social-emotional skills. Preschools also give some children a haven from troubled family lives, and the problems that many children face at home have grown worse during the COVID crisis. In the past year, loss of jobs, financial pressures and stay-at-home orders have combined to put a strain on family life across the board.
    - - nightmares
      - disturbing thoughts
      - anxiety
      - difficulty concentrating
      - impaired social skills
      - technology saturation
      - developmental regression
      - problems sleeping
      - depression
      - academic performance and learning issues
        
        This quote is from NBC news (see references): One national testing organization reported that the average student in grades 3-8 who took a math assessment this fall scored 5 to 10 percentile points behind students who took the same test last year, with Black, Hispanic and poor students falling even further behind.
    - - *Try to find virtual analogues for experiences children are missing.
        *Provide regular chances to discuss feelings and fears in a safe environment
        *Provide a reassuring learning climate where students' wellbeing comes first
        *Promote mindfulness techniques to help deal with stress
        *Be extra vigilant for signs that the child may be facing other ACEs
        *Promote positivity and resilience by providing good examples - both within academic work and adult's behaviour
        *Work with school counsellors and professionals who can offer support and ideas
        *Acknowledge that lessons will have to change, and reset your expectations of what can be achieved
    - - https://www.cdacouncil.org/en/air-hugs-and-aces-trauma-in-young-children-during-the-pandemic/
        https://www.centerforchildcounseling.org/pandemic-trauma-and-schooling-supporting-kids-in-crisis/
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306718/
        https://www.highgroundnews.com/features/Pandemic_ACEs_Future_Research.aspx
        https://www.nbcnews.com/news/education/covid-having-devastating-impact-children-vaccine-won-t-fix-everything-n1251172
        https://www.nctsn.org/sites/default/files/resources/resource-guide/trauma_informed_school_strategies_during_covid-19.pdf
        
        Resources
        This article looks at a study showing the impact of the pandemic on students mindfulness:
        https://www.frontiersin.org/articles/10.3389/fpsyt.2021.619128/full
        THis article has a number of useful stratgies that can be employed in the classroom:
        https://www.nctsn.org/sites/default/files/resources/resource-guide/trauma_informed_school_strategies_during_covid-19.pdf
        This site has useful information for teachers to look after themselves while facing their own pandemic stresses - important if they're going to be able to look after others.
        https://resilienteducator.com/collections/trauma-informed-school-practices/
- - - - Trauma can look very different across the developmental stages. Here are some of what we know are danger signs:
        
        Up to five years. Young children have difficulty explaining their trauma, but display their trauma by clinging to their mothers, trembling and uncalled for crying. They may also show their trauma through play and inappropriate behaviors for their age like thumb-sucking, nail-biting, bedwetting, frightened facial expressions, fear of darkness or sleeping alone, and little social interaction. According to the research, parents may not recognize possible trauma, because they mistakenly assume “the child wasn’t looking when it happened” or “was too little to know.”
        
        Six to 11 years. Children at this age may become anxious, depressed, angry, unable to concentrate or socialize with peers, and may refuse to go to school. Others may experience sleeping difficulties, nightmares, fear of the dark, and physical ailments like vomiting, headaches, or stomach aches. This age group is three times more likely to suffer from PTSD than adolescents, because they are at a younger stage of development.
        
        Adolescents. Adolescents may be affected for a long time. They can feel as if they are frozen in the past, with no prospect of a future. Their trauma shows in school difficulties, eating disorders, alcohol abuse, teenage pregnancy, thoughts about suicide, or general ‘acting out.’ Most at risk are those who have lost family and community connections.
        
        Girls tend to internalize the trauma and become anxious, withdrawn, and depressed. Boys tend to externalize trauma and are more likely to and be inattentive, impulsive, and hyperactive, or to engage in violent activities.
        
        More important than gender, however, for youngsters is family separation, the murder of a parent (more likely to be the father, since more refugee men are murdered than women), parents’ emotional well-being, experience of torture by a family member, or the number and intensity of traumas
      - These students bring their unique individual cultures and backgrounds while bearing some of the challenges and stresses of the refugee experience.
        
        Teachers and stuff must
        
        Understand the effect of trauma on school functioning. Extreme stress, adversity, and trauma can impede concentration, cognitive functioning, memory, and social relationships. Additionally, stress can contribute to both internalized symptoms—such as hypervigilance, anxiety, depression, grief, fear, anger, isolation—and externalized behaviors—such as startle responses, reactivity, aggression, and conduct problems. Given the often chronic and significant stress placed on refugee students, many are at increased risk for developing trauma and other mental health disorders, undermining their ability to function effectively in school. Further, given the environment of their previous schooling and the immigration to a new country, many have experienced significantly interrupted schooling; coupled with language gaps, many students arrive unprepared to participate in school with their same-age peers.
        
        Creating trauma-sensitive schools greatly enhances supports for all traumatized students, including refugees. A trauma-sensitive school views behaviors as a potential outcome of life circumstances rather than willful disobedience or intentional misbehavior. Trauma-sensitive approaches emphasize helping school staff understand the impact of trauma on school functioning and seeing behavior through this lens; building trusting relationships among teachers and peers; helping students develop the ability to self-regulate behaviors, emotions, and attention; supporting student success in academic and nonacademic areas; and promoting physical and emotional health
        
        http://traumasensitiveschools.org/
        
        Understand the challenges of relocation and acculturationn. Refugee children and youth often have significant adjustments to life in their new communities and schools. This includes language differences, not understanding how schools function, not knowing where to go for help, little familiarity with the curriculum and difficulty making friends. They may be the only people from their country, heightening the sense of isolation. Also note that children frequently adapt culturally and linguistically more quickly than their parents. Over time, this can cause conflict when children deviate from tradition and can increase the burden on children when parents rely on them to navigate their new environment and to act as language translators.
        
        Understand cultural views regarding mental health. It is important that mental health professionals be aware of attitudes toward mental illness and the role of mental health services when providing assistance to students. Many cultures may have a minimal understanding of mental illness, and in some cultures and faith communities, mental health problems are greatly stigmatized. Some cultures may view emotional problems as a weakness in character as opposed to a natural response to adversity. Understanding these barriers is an essential first step to reassuring and engaging students and their families and ultimately building the trust necessary to provide effective services and supports.
        
        Focus on student strengths. Many refugee students bring many unique skills, strengths, and knowledge into the classroom. Build on those strengths of resilience, and consider having them share their knowledge about their country, customs, and culture. Educators should also support maintaining the home culture and language, while also balancing the importance of developing the skills and knowledge to succeed
        
        Stop any type of harassment or bullying immediately. Refugee children may be at risk for harmful behavior by others if classmates or even teachers unfairly stigmatize them. Make it clear that such behavior, in any form (in person, online, on social media) is unacceptable. Promote acceptance and actively teach conflict resolution skills to both the perpetrators and the refugee student(s).
        
        Engage and empower families. Families from other countries may have different views about education, including the assumption that education remains the duty of the school and any involvement would encroach on that responsibility. Some families may not be proficient enough in English to know how to engage, despite a desire to do so. Additionally, many families may experience practical barriers, such as not having a car or employment that does not allow for active engagement during school hours. Schools can work with cultural liaisons and the families to find ways to connect with parents and ensure they have opportunities to participate in their child’s schooling.