Incorporating Trauma into PBIS & Teacher Management

1. Incorporating Trauma into PBIS & Teacher Management Chris Dunning, Ph.D. Professor Emerita University of Wisconsin-Milwaukee cdunning@uwm.edu

2. Trauma and Learning Who could be the trauma student here? Children who do not feel safe live in a state of emergency. Their energy is consumed by crisis, making it impossible for them to focus on learning. ANSWER: Either From “Too Scared to Learn” by Jenny Horsman, 2000

3. Implications for Learning “Traumatized children often spend so much time in the lower level brain in a state of fear that they consistently focus on non-verbal vs. verbal cues.” • Children who have • experienced trauma also experience: • More school nurse visits/School absences • Referral to school speech pathologist/support services • More Disciplinary Actions/Suspension from school • More aggressive or non-attentive in school • Difficulties with peers, teachers, and staff • Lower performance and grade point averages • Higher drop-out rates

4. “The school setting can be a battleground in which traumatized children’s assumptions of the world as a dangerous place sabotage their ability to develop constructive relationships with nurturing adults. Unfortunately, many traumatized children adopt behavioral coping mechanisms that frustrate educators and evoke exasperated reprisals, reactions that both strengthen expectations of confrontation and danger and reinforce a negative self-image. • Traumatized children’s behavior can be perplexing. Prompted by internal states not fully understood by the children themselves and unobservable by teachers, traumatized children can be ambivalent, unpredictable and demanding. But it is critical to underscore that traumatized children’s most demanding behavior often originates in feelings of vulnerability.” (Helping Traumatized Children Learn, p. 32-33)

5. Trauma-Informed Educator Practice The trauma-informed educator: Understands the impact of trauma on a child’s behavior, development, relationships, and survival strategies Can integrate that understanding into planning for the child and learning Understands his or her role in responding to child traumatic stress 5

6. What Can an Educator Do? Recognize that exposure to trauma occurs to many children, not just those in protective or foster care. Recognize the signs and symptoms of child traumatic stress and how they vary in different age groups. Recognize that children’s “bad” behavior is sometimes an adaptation to trauma. Understand the impact of trauma on different developmental domains. 6

7. What Can an Educator Do? • Understand the impact of trauma and PTSD on learning. • Understand the cumulative effect of trauma. • Gather and document psychosocial information regarding all traumas in the child’s life to make better-informed decisions. • Lessen the risk of system-induced secondary trauma by serving as a protective and stress-reducing buffer for children: • Develop trust with children through listening, frequent contacts, and honesty in order to mitigate previous traumatic stress. • Understand that schools would do well to be proactive about trauma rather than reactive.

8. Trauma-Informed Educator • Offers interventions that increase self worth, • Forms strong relationships to enhance sense of trust, • Emphasizes the relationship consequences of behaviors, • Build up avenues for achievement and hope, • Helps child learn both emotion management skills and relationship skills, • Teaches how to calm biology to increase ability to think. 

9. Essential Elements of Trauma-Informed education Maximize the child’s sense of safety. Assist children in reducing inappropriate hyperarousal and/or dissociation. Address the impact of trauma and subsequent changes in the child’s behavior, learning, development, and relationships. Utilize comprehensive assessment of the child’s trauma experiences and their impact on the child’s development and behavior to guide services. Coordinate services with other agencies. 9

10. Maximizing Safety: Understanding Children’s Responses • Children who have experienced trauma often exhibit extremely challenging behaviors and reactions. • When we label these behaviors as “good” or “bad,” we forget that children’s behavior is reflective of their experience. • Many of the most challenging behaviors are strategies that in the past may have helped the child survive in the presence of abusive or neglectful caregivers. 10

11. Maintaining safety • Behavior management based on self-regulation rather than compliance • Conflict resolution • Problem-solving • Compromise • Create positive peer culture • Reduce or prevent isolation/bullying • Increase social competence • Understand child’s need for containment • Providing positive behavioral supports • Identify triggers that set child off • Consistency and structure • Involve child, especially feedback

12. PBIS • Assumes that approximately 80% of students can and will behave well if • 1) there are clear behavioral expectations • 2) they are taught how to behave in effective and ongoing manners. “Insights from Trauma-Informed Care help us to understand that it is just as important, if not more so, to focus on students’ emotional responses as their behavioral responses. Behavior may often communicate a student’s emotional need.” White and Dibble (2012) Wisconsin DPI Using Positive Behavioral Interventions & Supports (PBIS) to Help Schools Become More Trauma-Sensitive

13. Paradigm Shift • Understanding that trauma is not a cognitive experience, but a sensory one, dictates strategies that immediately restore, to victims, a sense of safety and renewed sense of empowerment/control in the face of fear and uncertainty generated by the incident. • Reduction of the arousal level is critical to the restoration of pre-trauma cognitive processes, learning functions, behavior and performance.

14. Trauma and School • Trauma can trigger (arouse) the activation of the autonomic nervous system to ready itself to resist or solve the real or perceived threat presented by exposure to an incident such as….. • If the response (arousal) is not discharged or deactivated, the sustained arousal state can lead to sustained cognitive and behavioral dysfunction. • Trauma being a sensory experience, arousal is experienced as an absence of the “sense of safety” and as a “sense of powerlessness.” • Aggressiveness, over reactive responses and exaggerated withdrawal are survival behaviors – attempts to feel safe, in control.

15. What This Tells Us • As long as a student is not feeling safe and in control, this aroused state makes it difficult to process verbal information, attend, focus, retain and recall. • Intervention designed to deactivate the arousal state and return the student to a sense of safety and a sense of power or control, helps to restore previous cognitive and behavioral patterns. • The most immediate, short-term and long-term intervention, therefore, must be designed to restore that sense of safety and control.

16. Why use the PBIS Trianglefor Traumatized Students?

17. Hierarchy of Brain Function Bruce Perry M.D., Ph.D. 1997

18. In the brain of someone who has experienced a variety of emotional, behavioral and cognitive stimuli, a “top heavy” ratio develops. In this ratio, the brain matures to moderate the more primitive instincts of the midbrain/brainstem. Bruce Perry M.D., Ph.D. 1997

19. When key experiences (Which develop the cortical/limbic part of the brain) are absent or minimal, the “higher” to “lower” brain ratio is impaired. In this case, the ability of the brain to moderate impulsive, reactive responses and to work through frustration is diminished significantly. Bruce Perry M.D., Ph.D. 1997

20. Children raised in environments characterized by domestic violence, physical abuse or other persistent trauma will develop an excessively active midbrain/brainstem. This results in an overly active and reactive stress response and a predisposition to aggression and impulsiveness. Bruce Perry M.D., Ph.D. 1997

21. When the developing brain is both deprived of sensory stimuli and experiences traumatic stress, the brainstem/ midbrain to cortical/limbic ratio is profoundly altered. Bruce Perry M.D., Ph.D. 1997

22. The Child’s BrainDifferences due to Psychological Trauma

23. Explicit Memory Left Brain Facts Details Who, what, where, when, how Tied to Language Implicit Memory Right Brain Emotional Memory Senses-smells, sounds, etc. Tied to Fight, Flight, Freeze Response MemoryNormally coordinated and cohesive

24. Memory and Traumatic Stress Trauma Uncouples Integration of Memory I feel a certain way and I don’t know why!!

25. Fight/Flight/Freeze • Overdevelopment of regions of the brain involved in anxiety and fear responses And • Underdevelopment of regions of the brain involved in complex thought and those necessary for learning.

26. Implications for Learning • Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs. verbal cues • May be very intelligent but can’t learn easily→must do verbal learning when calm • •Learning needs to be more experience-based ⇒ → when traumatized children are stressed they are reactive/reflexive vs. accessing cognitive solutions

27. Implications for Behavior • During early development, these traumatized children spent so much time in a low-level state of fear that they were focused primarily on non-verbal cues. • Once out of such an environment, it is still difficult for the child's brain to interpret (relearn) these innocent looks and touches as benign.

28. These children are often labeled as learning disabled. • Difficulties with cognitive organization contribute to a more primitive, less mature style of problem solving -- with violence often being employed as a "tool.“ • A traumatized child -- in a persistent state of arousal -- can sit in a classroom and not learn. • The brain of this child has different areas activated -- different parts of the brain controlling his functioning. • The capacity to internalize new verbal cognitive information depends upon having portions of the frontal and related cortical areas activated, which in turn requires a state of attentive calm. • This is a state that the traumatized child rarely achieves.

29. Conduct Disorders • Behavior is the language of trauma. • Most children lack the language skills needed to describe how they are suffering, so they use behavior to express themselves. • Most behaviors used by children to express themselves are considered “negative” behaviors.

30. Cortical Modulation Is Age-Related • The capacity to moderate frustration, impulsivity, aggression, and violent behavior is age-related. • With sufficient motor, sensory, emotional, cognitive, and social experiences during infancy and childhood, the mature brain develops (in a use-dependent fashion) a mature, humane capacity to • tolerate frustration • contain impulsivity • channel aggressive urges.

31. Outcome • When a child is threatened, he or she is likely to act in an "immature" fashion. • Regression, a retreat to a less-mature style of functioning and behavior, is commonly observed in all of us when we are physically ill, sleep-deprived, hungry, fatigued, or threatened. • When we regress -- in response to a real or perceived threat -- our behavior is mediated (primarily) by less-complex brain areas.

32. Baseline State of Arousal • If a child has been raised in an environment of persistent threat, the child will have an altered baseline such that the internal state of calm is rarely obtained. • The traumatized child will have a "sensitized" alarm response, over-reading verbal and non-verbal cues as threatening. • Increased reactivity will result in dramatic changes in behavior in the face of seemingly minor provocative cues. • Over-reading of threat will lead to a "fight or flight" reaction and impulsive violence. • The child will view his violent actions as defensive.

33. Change in “thermostat” • Children exposed to significant threat will "re-set" their baseline state of arousal such that even when no external threats or demands are present, they will be in a physiological state of persistent alarm. • As external stressors are introduced (e.g., a complicated task at school, a disagreement with a peer) the traumatized child will be more "reactive." • Even a relatively small stressor can instigate a state of fear or terror. • The cognition and behavior of the child will reflect his or her state of arousal.

34. The Threat Recurs: Chronic Hyperarousal • Traumatic Reenactment • Damages meaning, conscience, view of self and others • Disrupted attachment – failed trust, failed relationships • Problems with authority figures • Difficulties resolving conflicts • Inability to grieve • Addiction to stress • Resistance to change • Deterioration, alienation

35. Affective or Physiological Dysregulation • Impaired developmental achievement related to arousal regulation: Mood Bodily Functions Diminished awareness of emotional and behavioral states Difficulty describing emotional or bodily states

36. Students who have experienced complex trauma- • Developmentally adverse interpersonal trauma for over one year, and exposure was before the age of 18. • Subjective experiencing of: Rage Betrayal Shame Humiliation

37. Interconnected Framework for School Mental Health Development of an Interconnected Systems Framework for School Mental Health February, 2012 Susan Barrett and Lucille Eber, National PBIS Center Partners; and Mark Weist, University of South Carolina University of Maryland, Center for School Mental Health)

38. Trauma-Sensitive School PBIS Model Tier 1

39. Trauma-Sensitive School PBIS ModelTier 1 TRAUMA SENSITIVE SCHOOL Trauma Proofing Curriculum Compassionate School Emotionally Safe School PFA-Psychological First Aid • School policies, culture & climate • Behavior management • Instructional practices & approaches • Modeling • Classroom consultation

40. The Whole Learner Intellectual (Problem solving / creativity) Emotional Physical (Resiliency / empathy) (Stamina) All components are interdependent

41. What’s “New” In The Context Of What’s “Old”? • A trauma-sensitive school environment is characterized by respect and supports capable of “taking over” when the student’s coping skills fail. • Operationalization • RtI • PBIS • Crisis/Disaster/Active Shooter Interventions • Violence Prevention/Bullying Programs • Character Education/Emotional Intelligence/Service Learning • Stress Management/Yoga • Restorative Discipline/Justice

42. How We Become: Office of the Superintendant of Public Instruction State of Washington

43. Ten Strategies of a Compassionate School • Focus on culture and climate in the school and community. • Train and support all staff regarding trauma and learning. • Encourage and sustain open and regular communication for all. • Develop a strengths based approach in working with students and peers. • Ensure discipline policies are both compassionate and effective (Restorative Practices). • Weave compassionate strategies into school improvement planning. • Provide tiered support for all students based on what they need. • Create flexible accommodations for diverse learners. • Provide access, voice, and ownership for staff, students and community. • Identify vulnerable students and outcomes and strategies

44. Domains of Compassionate Instruction • Domain 1: Safety, Connection, and Assurance • Domain 2 : Emotional and Behavioral Self-Regulation • Domain 3: Competencies of Personal Agency, Social Skills, and Academic Skills

45. The Six Principles • Always Empower, Never Dis-empower • Provide Unconditional Positive Regard • Maintain High Expectations • Check Assumptions, Observe, Question • Be a Relationship Coach • Provide Opportunities for Helpful Participation

46. Another Curriculum for Traumatized Children Connecting 1 Safety 2 Engaging 3 Trusting Processing 4 Managing the self 5 Managing feelings 6 Taking responsibility Adapting 7 Developing social awareness 8 Developing reflectivity 9 Developing reciprocity (Cairns, K. & Stanway, S., 2004.)

47. Step I - Safety First 􀂄􀂄 Stay aware of the terror 􀂄􀂄 Provide and sustain a relaxing environment 􀂄􀂄 Use self appropriately to deal with a terrified student: voice, gestures, expression 􀂄􀂄 Use group work skills to create sense of safety 􀂄􀂄 Bring relaxation into the awareness of the child and encourage practice 􀂄􀂄 Discourage dependence on high stimulus activities • (Cairns, K. & Stanway, S., 2004.)

48. Step II - Engaging 􀂄􀂄 Provide appropriate environmental stimulation for adults and students 􀂄􀂄 Learning about the effects of trauma is part of good classroom management 􀂄􀂄 Stories and metaphors are powerful tools for teaching about overwhelming events 􀂄􀂄 Encourage expression of experience and development of emotional intelligence 􀂄􀂄 Bring dissociation into awareness, develop sense of protector self and observer self

49. Step III - Trusting and Feeling 􀂄􀂄 Accept the level of trust the student has to offer 􀂄􀂄 Encourage open discussion of issues of trust 􀂄􀂄 Encourage the student to express inner states in words, even though they will find this difficult 􀂄􀂄 Notice non-verbal signals of feelings and help student to recognize and name what is happening 􀂄􀂄 Identify self-transcending as well as self-assertive emotions

50. Step IV - Managing the Self 􀂄􀂄 Discuss and practice relaxation and soothing activities with the student 􀂄􀂄 Avoid asking ‘why did you do that?’ Instead invite reflection linking inner state with actions 􀂄􀂄 Encourage the student to be interested in their own inner state with regard to their behavior 􀂄􀂄 Comment on small indicators of self-regulation 􀂄􀂄 Encourage students to build on growing capacity for self-management