Please fill out large Post its around the room

1. Please fill out large Post its around the room Thank You!

2. Resiliency Laurie Jeffries- NICAO Head Start Trainer, Area Manager- HS and EHS, Preschool Monitor QPPS

4. Questions Review the post its

5. Objectives for Today • Participants will: • Understand how Adverse Childhood Experiences affect children • Recognize the signs of a child having difficulty coping in certain situations • Have strategies/tools to use to help children build resilience

6. Adverse Childhood Experiences-ACES ACES are serious childhood traumas-that result in toxic stress that can harm a child's brain.

7. Adverse Childhood Experiences can include: • Emotional, • Physical, • Or Sexual Abuse. • Physical and Emotional Neglect. • Mother treated violently.

8. Can also include • Household Substance Abuse. • Household Mental Illness. • Incarcerated household member. • Witnessing violence outside the home

9. Con’t • Bullying, • Witness a brother or sister being abused, • Racism, • sexism, • or any form of discrimination, • Being homeless, • Natural disasters and war

10. ACES • The most important thing to remember is that the ACE score is meant as a guideline: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences.

11. ACE quiz-Prior to your 18th Birthday • Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?No___If Yes, enter 1 __ • Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?No___If Yes, enter 1 __ • Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?No___If Yes, enter 1 __

12. Ace quiz • Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?No___If Yes, enter 1 __ • Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?No___If Yes, enter 1 __

13. Ace quiz • Were your parents ever separated or divorced?No___If Yes, enter 1 __ • Was your mother or stepmother:Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?No___If Yes, enter 1 __

14. Ace quiz • Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?No___If Yes, enter 1 __ • Was a household member depressed or mentally ill, or did a household member attempt suicide?                        No___If Yes, enter 1 __ • Did a household member go to prison?No___If Yes, enter 1 __

15. The first research results were published in 1998, followed by more than 70 other publications through 2015. They showed that: • childhood trauma was very common, even in employed white middle-class, college-educated people with great health insurance; • there was a direct link between childhood trauma and adult onset of chronic disease, as well as depression, suicide, being violent and a victim of violence; • more types of trauma increased the risk of health, social and emotional problems. • people usually experience more than one type of trauma – rarely is it only sex abuse or only verbal abuse.

16. CDC’s ace study results

17. The study’s researchers came up with an ACE score to explain a person’s risk for chronic disease. Think of it as a cholesterol score for childhood toxic stress. You get one point for each type of trauma. The higher your ACE score, the higher your risk of health and social problems. (Of course, other types of trauma exist that could contribute to an ACE score, so it is conceivable that people could have ACE scores higher than 10; however, the ACE Study measured only 10 types.

18. ACES Have Cumulative Stressor Effect It is the number of different categories, not the intensity or frequency that determine health outcomes

19. Consequences As your ACE score increases, so does the risk of disease, social and emotional problems. With an ACE score of 4 or more, things start getting serious. The likelihood of chronic pulmonary lung disease increases 390 percent; hepatitis, 240 percent; depression 460 percent; attempted suicide, 1,220 percent. https://acestoohigh.com/got-your-ace-score/

20. Toxic Stress Toxic Stress can occur when a child experiences strong, frequent , and or prolonged adversity

21. Limits a child • Toxic stress may prevent a child from learning, from playing in a healthy way with other children, and can result in long-term health problems.

22. Survival Mode Response • A survival mode response to toxic stress increases a child’s: *heart rate, *blood pressure, *breathing *and muscle tension.

23. Self-protection Their thinking brain is knocked off-line. Self-protection is their priority. In other words: "I can't hear you! I can't respond to you! I am just trying to be safe!"

24. Toxic stress derails healthy development

25. Affect on the Brain •Abuse and neglect influence the amygdala the part of the brain that regulates emotions, particularly fear and anxiety • Abuse changes how the prefrontal cortex functions: this is the part of the brain responsible for thinking, planning, reasoning and decision making, which can lead to behavioral and academic problems

26. The Brain The Triune Brain model, introduced by physician and neuroscientist Paul D. MacLean, explains the brain in three parts: • Reptilian (brain stem): This innermost part of the brain is responsible for survival instincts and autonomic body processes. • Mammalian (limbic, midbrain): The midlevel of the brain, this part processes emotions and conveys sensory relays. • Neommalian (cortex, forebrain): The most highly evolved part of the brain, this area outer controls cognitive processing, decision-making, learning, memory and inhibitory functions. https://psychcentral.com/blog/the-science-behind-ptsd-symptoms-how-trauma-changes-the-brain/

27. Reptilian Brain During a traumatic experience, the reptilian brain takes control, shifting the body into reactive mode. Shutting down all non-essential body and mind processes, the brain stem orchestrates survival mode. During this time the sympathetic nervous system increases stress hormones and prepares the body to fight, flee or freeze

28. Normal In a normal situation, when immediate threat ceases, the parasympathetic nervous system shifts the body into restorative mode. This process reduces stress hormones and allows the brain to shift back to the normal top-down structure of control

29. The Dysregulated Post-Trauma Brain Throughout the brain several chemical and biological imbalances can present after trauma. Their effects are especially exacerbated by three major brain function dysregulations:

30. Overstimulated amygdala An almond-shaped mass located deep in the brain, the amygdala is responsible for survival-related threat identification, plus tagging memories with emotion. After trauma the amygdala can get caught up in a highly alert and activated loop during which it looks for and perceives threat everywhere.

31. Underactive hippocampus An increase in the stress hormone glucocorticoid kills cells in the hippocampus, which renders it less effective in making synaptic connections necessary for memory consolidation. This interruption keeps both the body and mind stimulated in reactive mode as neither element receives the message that the threat has transformed into the past tense.

32. Ineffective variability The constant elevation of stress hormones interferes with the body’s ability to regulate itself. The sympathetic nervous system remains highly activated leading to fatigue of the body and many of its systems, most notably the adrenal. https://psychcentral.com/blog/the-science-behind-ptsd-symptoms-how-trauma-changes-the-brain/

33. How Healing Happens While changes to the brain can seem, on the surface, disastrous and representative of permanent damage, the truth is that all of these alterations can be reversed. The amygdala can learn to relax; the hippocampus can resume proper memory consolidation; the nervous system can recommence its easy flow between reactive and restorative modes. The key to achieving a state of neutrality and then healing lies in helping to reprogram the body and mind

34. Stress in little kids looks like: *Poor sleep/nightmares *Poor appetite, low weight or other digestive problems *Difficulties with relationships *Fear of separation *Irritability *Regressions in developmental abilities *Excessive temper *Scream or cry excessively *Startle *Anxious, fearful or avoidant

35. Questions? • Take a minute to think of a child in your program, past program, or life who may be/have shown signs of toxic stress. • What Behavior did you see that makes you think this? • Share this with someone sitting next to you.

36. Resiliency • Resiliency is the ability to return to being healthy and hopeful after bad things happen. • Research shows that if parents/caregivers provide a safe environment for children and teach them how to be resilient, that helps reduce the effects of ACEs.

37. Resiliency Quiz https://www.mindtools.com/pages/article/resilience-quiz.htm

38. How Do We Help?Teachers and caregivers can help by: • Gaining an understanding of ACEs Adverse Childhood Experiences are everywhere • Building a relationship with a child, which will help build their capacity to learn. • Helping children identify feelings and manage emotions so they can learn to get along with their peers and others.

39. Research •Bessel van der Kolk (2005): Children can heal when they feel safe and feel joy •Bruce Perry (2006): Children can heal when their sense of safety is enhanced and repetitious they can occur to develop new neuronal models • Jean Ayres (2005): With the “optimum for growth” situation, the child “turns on” with an obvious zest

40. Environment • Creating safe physical and emotional environments at home, in school, and in neighborhoods. • Create an environment where kids feel safe enough to blossom into the natural learning machines that they are.

41. Promoting Resiliency

42. Let’s look at how to build resiliency https://www.sesamestreet.org/toolkits/challenges https://centerforresilientchildren.org/home/webinars/ https://www.apa.org/helpcenter/resilience.aspx https://srhd.org/1-2-3-care-toolkit https://www.beststart.org/resources/hlthy_chld_dev/pdf/BSRC_Resilience_English_fnl.pdf

43. Center on the Developing Child Recommends: • The single most common factor for children who develop resilience is at least one stable and committed relationship with a supportive parent, caregiver, or other adult • Children who do well in the face of serious hardship typically have a biological resistance to adversity and strong relationships with the important adults in their family and community.

44. Why are caring relationships so important Caring relationships provide accepting places where children can learn to regulate their: • bodies • feelings • attention • thoughts • behavior

45. Tips for building caring relationships • Give attention and affection- lots of smiles and hugs • Play with the children • Comfort children • Listen with interest • Show empathy • Help children identify and express their feelings • Read or tell children stories

47. Research has identified a common set of factors that predispose children to positive outcomes in the face of significant adversity. • facilitating supportive adult-child relationships; • building a sense of efficiency and perceived control; • providing opportunities to strengthen adaptive skills and self-regulatory capacities; and • mobilizing sources of faith, hope, and cultural traditions.

48. More recommendations • Learning to cope with manageable threats is critical for the development of resilience. • The capabilities that underlie resilience can be strengthened at any age.

49. Self- Control • Self-control is an inner strength that plays an important part in developing self-regulation. • Self-control skills help us develop our ability to self-regulate. There are simple ways that you can help your children develop self-control skills.

50. Tips for helping children develop self-control to build self-regulation • Pretend to blow up a balloon in their bellies (“belly balloons”). When they take a slow, deep breath “in”, their belly inflates like a balloon. When they let their breath “out”, their belly deflates just like letting the air out of a balloon. • Imagine breathing in their favorite smell (like chocolate) and then slowly blowing out an imaginary candle. “Breathe in chocolate, blow out the candle.” • Blow bubbles together (just mix liquid dish soap and a little water or check the Internet for other “bubble recipes”). • Hold younger children “belly-to-belly” and do deep breathing – this is a wonderful way to calm yourself and the infant or toddler at the same time! Best Start Resource centre