Childhood Trauma & Chronic Stress:

1. Childhood Trauma & Chronic Stress: Effects on the Brain and Learning, and Potential Role of the Schools Wendy Cunningham, Psy.D. Licensed Clinical Psychologist

2. Objectives • Show why it is important for alternative schools to understand trauma and chronic stress • Illuminate current research that links trauma/chronic stress with biology, environment, behavior, and academic performance • Discuss the importance of a systematic approach and why it is important

3. Few Important Numbers • Difficult to get prevalence rates; however, studies estimate between 3.3 and 10 million children witness violence in their home each year • 2003: U.S. Department of Health • Reported approximately 906,000 children in protective custody • 2005: Massachusetts Department of Education • Informal surveys to 450 students of alternative-education programs in 11 school districts that received state funds • 90% of the students surveyed reported trauma history

4. What is a “Traumatic Event” • Many factors involved in what is considered a traumatic event, including: • Threat or perceived threat to well-being of self or other • Individual temperament • Past experiences • Who is involved in the event Why events affect individuals in different ways

5. Factors Impacting Trauma Reaction See Massachusetts Adovcates for Children, (2005). Helping Traumatized Children Learn, Appendix C.

6. Chronic Stress • See similar biological effects as with trauma • Less obvious than a traumatic event

7. ARE THERE BRAIN EFFECTS? “I could see the math teacher’s mouth moving in the classroom but couldn’t hear a thing. It was as if I were in a soundless chamber. She was smiling and clearly talking, I just couldn’t process a word of it. I had been an excellent math student, but the day she told me I was “spacey” and unfocused was the day I stopped connecting to math. My grades dropped and they took me out of the advanced classes.” Massachusetts Advocates for Children, (2005). Helping Traumatized Children Learn, p.24.

8. From http://www.ahaf.org/alzdis/about/AnatomyBrain.htm

9. Emotions: TWO Pathways! Ventral Path (Low Road) Stimulusthalamusamygdala body reactionemotion Dorsal Path (High Road) Stimulusthalamuscortex short-term memory stores representationlong-term memory accessedworking memory integrates amygdala cortical arousal visceral reaction body feedback emotion

10. Evolutionary Favorite Wiring of the brain favors emotions There tends to be more connections directed from the limbic system to the cortex (emotion affects thoughts) versus cortex to limbic system (thought affects emotion) Theories of Evolution Although hypothetical, theories suggest that we may move towards more of a balance LeDoux, J. (1998) The emotional brain. London: Phoenix.

11. Hypothalamic-Pituitary-Adrenal System http://www.cellml.org/models/jelic_cupic_kolaranic_2005_version02

12. What’s the Deal? • Incredible Shrinking Brain: Effects on hippocampus • Decreased hippocampal volume • Lower hippocampal neural connection • To Stress or Not to Stress: Confused stress response • Consistent survival mode • HPA system down-regulates • Unraveling chromosomes • Chronic stress shown to unravel telomeres (ends of chromosomes) • Unorganized brain – unorganized behavior • Imprinting (ex. orbitofrontal cortex) and missed stimuli from environmental experiences compromises structural arrangements for regulation

13. Emotional MemoriesExternal Event Amygdala Hippocampus Implicit memoryExplicit memory --event was awful --who, what, where --body reaction *Occurs together to contribute to the experience of the event as a whole *Not selective in triggers; broad scope

14. Brain Stressed Out • Hippocampus • overwhelmed by glucocorticoids • “Talk” between • neurons disrupted • No new neurons formed • Amygdala • overwhelms hippocampus 5. Prolonged glucocorticoid exposure might damage or kill hippocampal neurons

15. Not to Mention Brain Development Issues! • Poor attachment experiences: • Cognitive deficits • Brain unable to develop self-regulation • Poor sequential memory • Executive functioning poorly developed • Language instrumental vs. social/emotional

16. Implications for Learning • Studies show that when compared to other children, maltreated children have:

17. We Have the Most Difficult Kids!!!! What Behaviors Do You See? (Think Brain Influences!) Awareness important, because it can reduce anger, increase understanding, and improve intervention

18. What Can We Do?

19. Factors Impacting Trauma Reaction See Massachusetts Adocates for Children, (2005). Helping Traumatized Children Learn, Appendix C.

20. Empirically Supported Interventions Include: • Attachment/relationship focus • Training in affect regulation • Systematic desensitization/titrated exposure • Individual therapy • Symbolic play for young children • Age-appropriate group therapy • Caretaker involvement as appropriate POSITIVE AND COLLABORATIVE TEAM SPIRIT is CRITICAL

21. Attachment: Not just a nice idea All research, both biological and psychological, shows that social affiliation and attachment are critical components of mediating effects of trauma and chronic stress

22. Attachment Styles, Brain Development, and Behavior • Attachment style psychologically based on view of self & view of other: • Secure: positive/positive • Preoccupied: negative/positive • Distant: positive/negative • Disorganized/Fearful: negative/negative • Research shows that traumatized kids largely exhibit disorganized attachment style • Brain organization in early development relies upon environment and response of caregivers • Research also shows executive functioning deficits present in disorganized attachment style that differentiates it from other styles

24. Couple of Comprehensive Resources for Schools • Integrative Treatment of Complex Trauma for Children (ITCT-C) – 2008; also manual for adolescents & yg adults Free manual at www.johnbriere.com • Helping Traumatized Children Learn: Supportive school environments for children traumatized by family violence – 2005; from the Massachusetts Advocates for Children: Trauma and Learning Policy Initiative. Download manual at http://www.massadvocates.org/helping_traumatized_children_learn