Presented by C. Lynne Edwards, LCSW Home Visiting Consortium October, 2013 Impact of Trauma on Children and Families Part One 1 HANDOUT: MY NOTES Presented

Presented byC. Lynne Edwards, LCSW

Home Visiting ConsortiumOctober, 2013

Impact of Trauma on Children and Families

Part One

1

HANDOUT: MY NOTES Presented by C. Lynne Edwards, LCSW

#1: The effects of abuse/neglect, removal and other traumas that occur when children are young have fewer consequences than for older children.

#2: There is nothing that parents or caregivers can do to change the impact of their child’s early traumatic experiences.

#3: Children’s behaviors can best be managed by rules and consequences.

#4: Parent education classes are the most effective way to teach parents how to keep their children safe and meet their needs

2Presented by C. Lynne Edwards, LCSW

Feeling safe positivelyaffects the nervous system

and provides stimulation forhealthy development.


ACUTE

CHRONIC

COMPLEX


5

•Multiple, chronic and prolonged, developmentally adverse events

•Often of an interpersonal nature with early life onset

•Effects are cumulative

•Toxic stress

Presented by C. Lynne Edwards, LCSW

◦Child’s chronological age and developmental stage

◦Child’s perception of the danger◦Whether the child was a victim or

witness◦Child’s past experience with trauma◦Child’s relationship to the perpetrator◦Presence/availability of adults to help


The physical and emotional responses of a child to events that threaten the life or physical integrity of the child or someone important to the child.

Traumatic events overwhelm a child’s capacity to cope and elicit feelings of terror, helplessness, powerlessness, and out of control physiological arousal.


Trauma is experienced through the body, mind and spirit and has a long term impact.


Adverse Childhood Experiences Study

Adverse childhood experiences:◦ are a major health issue◦ result in social, emotional and cognitive

impairment◦ linked to higher risks for medical conditions

(heart disease, severe obesity, COPD)◦ linked to higher risk for substance abuse,

depression and suicide attempts


Studies with antisocial youth have found self-reported trauma exposure ranging from 70% to 92% (Greenwald, 2002)

Antisocial youth have a high rates of Post Traumatic Stress Disorder (Greenwald, 2002)

Research suggests that anger and violent acting out often are symptoms of PTSD (Chemtob, Novaco, Hamada, Gross, & Smith, 1997)

Study of Foster Care Alumni revealed higher levels of PTSD in the alumni than in war veterans. (NC Children’s Practice Notes, Vol.10, No 3, June 2005)


BRAIN DEVELOPMENT

BIOLOGY

MOOD REGULATION

COGNITION AND LEARNING

BEHAVIORAL CONTROL

DISSOCIATION

MEMORY

ATTACHMENT

SELF CONCEPT AND WORLD VIEW

Presented by C. Lynne Edwards, LCSW 11

• Neurological pathways or patterns that begin to form are based on what infants SEE, HEAR,TOUCH, SMELL and FEEL

• Your first set of associations becomes your template


Physical sensations such a rapid heart rate, trembling, dizziness or loss of bladder or bowel control

Movement and sensation Hypersensitivity/insensitivity Coordination, balance and body tone Unexplained physical symptom Increased medical problems


Difficulty knowing and describing their feelings

Brain can’t shift from feeling to thinking State dependent responses to experiences Communication impaired


Focusing on and completing tasks Anticipating and planning for future events Absence of cause and effect thinking Range of learning difficulties Adaptive development impaired


Children’s behavior is state dependent-fear driven

It’s a message-an indication of an unmet, underlying emotional need

Interventions require the use of relational rather than confrontational approaches

Behavior problem is a relationship problem


The younger the trauma, the more likely to use dissociation, rather than the flight or flee response

Babies can’t do either


Lack cognitive memory of events Memory of trauma stored in the senses, the

body State dependent memory


Rooted in biologyMutual psychological process

Learned after birth


Trust/NeedNeeds

Arousal Displeasure

Relief Relaxation

Gratification: eye contact touch smile movement feeding


Initiating Positive Interactions

Parent Initiates Positive Interaction

Gratification Parent Responds

Gratification Child Responds


Structure



Lack of a continuous, predictable sense of self

World is not a safe place to be I’m a bad child; everything bad is my

fault People who love you, hurt you and/or

abandon you My feelings don’t matter No one listens




Pervasive feelings-Fear and anxiety Core issues-grief, loss, rejection,

attachment, control, guilt, identity Internalized beliefs-I’m a bad kid, I can’t

trust adults, people who say they love you, hurt and/or leave you, the world is not a safe place to be, etc.

Control issues-children feel so out of control they try to control everything in whatever way they can


Sensory issues-sensitive to touch, loud noises,

Delayed adaptive development Regulation of emotions-their brains can

not shift from their emotions to their thought processes

Pull/Push-come close, now go away; afraid of getting close

High risk behaviors


Children’s learned solutions become caregivers problems


Pervasive feelings-Fear and anxiety Core issues-grief, loss, rejection,

attachment, control, guilt, identity Internalized beliefs-I’m a bad

person/parent, I can’t trust adults, the world is not a safe place to be, etc.

Control issues Delayed adaptive development Regulation of emotions High risk behaviors


PLUS: Parents’ ability to make appropriate

judgments about safety is compromised Trauma reminders presented in children’s

behaviors trigger extreme reactions. Tendency for parents to personalize their

children’s negative behavior which challenge attachment and can lead to ineffective or inappropriate discipline.


Parents’ capacity to regulate their emotions is impaired.

Parent’s executive functioning is impaired which results in poor decision-making, problem solving or planning.

Parent is more vulnerable to other life stressors.


It’s hard for them to form and maintain secure, trusting relationships◦ Disruptions in relationships due to negative

feelings about parenting, personalizing children’s negative behaviors

◦ Challenges in relationships with caseworkers, foster parents and services providers


Parents’ learned solutions to their situation are our

challenges in working with them


ManipulationTriangulationAggressionControlResistance

Presented by C. Lynne Edwards, LCSW 35

The brains of children who experience trauma

are wired differently and

the impact carries into adulthood.


So what?

37HANDOUT: TRAUMA INFORMED PRACTICE

Presented by C. Lynne Edwards, LCSW

Child Welfare Information Gateway: Supporting Brain Development in Traumatized Children and Youth http://www.childwelfare.gov/pubs/braindevtrauma.cfm

National Child Traumatic Stress Network-newsletter and developed the Child Welfare Trauma Training Toolkit. http://www.nctsnet.org/ nctsn.org/products/child-welfare-trauma-training-toolkit-2008

Creating Trauma-Informed Child Welfare Systems: A Guide for Administrators http://www.chadwickcenter.org/CTISP/images/CTISPTICWAdminGuide.pdf

Child Trauma Academy http://childtrauma.org/


Adverse Childhood Experiencescds.gov/ace/pyramid.htm

Child Welfare Trauma Referral Tool http://www.nctsnet.org/products/child-welfare-trauma-training-toolkit-2008#q4

Trauma Symptom Checklist for Children www.johnbriere.com/tsc.htm

Zero to Three http://zerotothree.org/ Brain Connection

http://brainconnection.positscience.com/


Resilience Trumps Aces http://resiliencetrumpsaces.org/

Trust Based Relational Interventions developed by Dr. Karyn Davis and Dr. David Cross at the TCU Institute of Child Developmenthttp://www.child.tcu.edu/training.asp


C. Lynne Edwards, LSCWTrauma and Attachment Therapist

Consultant and [email protected]

804-221-4658

What we do today can help improve others’ tomorrow.


Documents

Presented by C. Lynne Edwards, LCSW Home Visiting Consortium October, 2013 Impact of Trauma on Children and Families Part One 1 HANDOUT: MY NOTES Presented