What brings you to this talk?



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What brings you to this talk?

  • What brings you to this talk?

  • What is your role in a school and/or the community?

  • Do you work with parents? Children?



Gain an understanding of how trauma impacts a child’s development, functioning, ability to learn, and experience of the world.

  • Gain an understanding of how trauma impacts a child’s development, functioning, ability to learn, and experience of the world.

  • Develop ideas regarding how learning environments can work to become trauma informed.



Some of the information presented may be triggering for certain individuals.

  • Some of the information presented may be triggering for certain individuals.

    • If at any time you are uncomfortable, you are invited to leave the presentation.
  • Special thanks to The Children’s Center’s Executive Director, Douglas Goldsmith, PhD, and prior Trauma Director, Brian Miller, PhD, for some materials presented in this slideshow.



Non-profit agency serving Salt Lake, Kearns, and surrounding areas for over 50 years

  • Non-profit agency serving Salt Lake, Kearns, and surrounding areas for over 50 years

  • Provide therapy for children and their families from birth to 6 years old

  • Outpatient groups for children on the autism spectrum

  • Group therapy for children and parents

  • Early Childhood Consultation and Training Program

  • Therapeutic Preschool Program

  • Affiliate with NCTSN – provide trauma-focused, evidenced based treatments



Abuse & Neglect (including emotional abuse)

  • Abuse & Neglect (including emotional abuse)

  • Exposure to Domestic Violence (e.g., victim or witness)

  • Exposure to Community Violence (e.g., gangs, interracial violence)

  • School Violence (e.g., school shootings, student suicide)

  • Bullying (e.g., real or perceived threat/power differential)

  • Medical Procedure (e.g., chronic illness, birth complication)

  • Serious Accident or Injury (e.g., car crash, bike accident)

  • Natural (or Manmade) Disasters (e.g., hurricanes, Gulf oil spill)

  • Military-Related Trauma (e.g., deployment & returning home)

  • Personal/Interpersonal Violence (e.g., homicide, suicide)

  • Historical trauma (e.g., intergenerational losses and assaults)

  • War, Terrorism, or Political Violence (e.g., bombings, shootings)

  • Forced Displacement (e.g., political asylum)

  • Traumatic Grief or Separation (e.g., death, deportation, incarceration)

  • System-Induced Trauma (e.g., foster care, seclusion or restraint)



The Adverse Childhood Experiences (ACE) Study (1988)

  • The Adverse Childhood Experiences (ACE) Study (1988)

  • The largest study of its kind ever done to examine the health and social effects of adverse childhood experiences over the lifespan (over 9,500 participants)

  • Compared exposure to ACEs to adult risk behaviors, disease, and health status

  • (Felitti et al, 1998)





ACE score Prevalence

  • ACE score Prevalence

  • 0 48%

  • 1 25%

  • 2 13%

  • 3 7%

  • 4 or more 7%

  • More than half respondents have at least one ACE – 52%





The ACE Score is used to assess the total amount of stress during childhood and has demonstrated that as the ACE number increases, the risk for the following health problems increases in a strong and graded fashion:

  • The ACE Score is used to assess the total amount of stress during childhood and has demonstrated that as the ACE number increases, the risk for the following health problems increases in a strong and graded fashion:



Sexually transmitted diseases

  • Sexually transmitted diseases

  • Multiple sexual partners

  • Smoking

  • Suicide attempts

  • Unintended pregnancies

  • Early initiation of smoking

  • Early initiation of sexual activity

  • Adolescent pregnancy

  • Risk for intimate partner violence

  • Alcoholism and alcohol abuse

  • Chronic obstructive pulmonary disease



If you are a child and have experienced 4 or more ACEs, your chances of having learning or behavioral problems at school increase by 3,200%

  • If you are a child and have experienced 4 or more ACEs, your chances of having learning or behavioral problems at school increase by 3,200%

  • If you are a child and have experienced 4 or more ACEs, you life expectancy is reduced by 20 years











Being in survival mode changes:

  • Being in survival mode changes:

  • How we think: distortions, thinking errors, worries

  • How we feel: over or under reactive, angry or irritable, panicked

  • How we behave: withdrawal, aggression, rigidity

  • When exposed over and over, these reactions can persist and impact our day to day lives



Response to trauma depends on:

  • Response to trauma depends on:

  • Event Characteristics

  • 1. nature of the event

  • 2. whether there was direct physical harm

  • 3. proximity to threat

  • 4. Pattern and duration of exposure to trauma

  • 5. Relationship to the perpetrator



Response to trauma depends on:

  • Response to trauma depends on:

  • Family Characteristics:

  • 1. Caregiver response during the event

  • 2. Caregiver response after the event

  • 3. Caregiver ability to believe, protect, and assure future

  • safety

  • 4. Child and caregiver relationship to the rest of the family

  • and community



Ages birth to 6:

  • Ages birth to 6:

  • Sleep disruptions and/or nightmares

  • Eating disruptions

  • Withdrawal or lack of responsiveness

  • Intense separation anxiety

  • Inconsolable crying (typically younger children)

  • Aggression and difficulty with peer relationships

  • Developmental regression, loss of skills

  • Intense anxiety, worries, and new fears

  • Difficulty with concentration and task completion

  • Hyperarousal

  • Interpersonal relationships

  • TRAUMA CHANGES A CHILD’S VIEW OF SELF BUT ALSO OF OTHERS AND THE WORLD



“Although many of us may experience reactions to stress from time to time, when a child is experiencing child traumatic stress, these reactions interfere with his or her daily life and ability to function and interact with others.

  • “Although many of us may experience reactions to stress from time to time, when a child is experiencing child traumatic stress, these reactions interfere with his or her daily life and ability to function and interact with others.

  • NCTSN



Anxious, withdrawn

  • Anxious, withdrawn

  • -concern over their own safety and the safety of others -preoccupied with thoughts about their actions during the event

  • Difficulty with impulse control

  • -constant re-telling of the event

  • - defiance

  • Impaired short term memory

  • -distractability, daydreaming

  • -impaired attention



Confusion, disorientation

  • Confusion, disorientation

  • -overwhelmed with feelings of fear or sadness

  • On edge

  • -increased irritability, anger, acting out

  • More School absences

  • Changes in school performance

  • -increased irritability, anger, acting out



Family separations

  • Family separations

  • Financial hardships

  • Legal proceedings

  • These adversities may be a source of stress in their own right

  • Trauma reminders and loss reminders may further increase the impact of trauma



“Schools are children’s communities. A school should be a welcoming environment where staff understands the impact of trauma on relationships, behavior and learning. Schoolwide trauma sensitive approaches should be woven in throughout the school day.”

  • “Schools are children’s communities. A school should be a welcoming environment where staff understands the impact of trauma on relationships, behavior and learning. Schoolwide trauma sensitive approaches should be woven in throughout the school day.”

          • (Cole, et al., 2009)


Trauma- informed practices often involve a fundamental shift in thinking and practice.

  • Trauma- informed practices often involve a fundamental shift in thinking and practice.

    • Understand how trauma affects student behavior
    • Understand symptoms as an attempt to cope
    • Avoids re-traumatizing
    • Trauma informed practices throughout the school


Being trauma informed includes having a plan for when you feel a child is in need of treatment, is receptive to help, or self-discloses trauma or abuse to you.

  • Being trauma informed includes having a plan for when you feel a child is in need of treatment, is receptive to help, or self-discloses trauma or abuse to you.

  • What’s your comfort level in talking with young people about trauma they may have experienced?

  • Do you know referral sources for mental health treatment, how to make referrals, connect the youth to the resources, and follow up if appropriate?



Maintain usual routines. A return to normalcy tells children they are safe and life will go on.

  • Maintain usual routines. A return to normalcy tells children they are safe and life will go on.

  • Give choices. Trauma involves the loss of control and experience of chaos.

  • Set clear, firm limits for inappropriate behavior.

  • Use logical consequences—not punishment.

  • Provide a safe place for talking about what happened.

  • Answer questions about trauma to clarify distortions and misconceptions.



Recognize cues in the environment that may cause a reaction in the child.

  • Recognize cues in the environment that may cause a reaction in the child.

  • Provide peer partners to increase a sense of safety and security walking around school campus.

  • Help child anticipate changes and transitions before they happen.

  • Protect child from peers’ curiosity.

  • Protect classmates from details.



Make teachers aware of children’s need to draw them into trauma reenactment, eg. replay of abusive situation at home.

  • Make teachers aware of children’s need to draw them into trauma reenactment, eg. replay of abusive situation at home.

  • Be attentive to feelings of anger, guilt, shame, or punishment that have religious or cultural basis and make appropriate referral for support.

  • Make accommodations when needed, eg. Shorter assignments, additional time for homework, ability to leave class when feeling overwhelmed, support for organizing homework and remembering assignments.

  • Build relationships with parents/caregivers.



Help the school community understand trauma and its impact on students

  • Help the school community understand trauma and its impact on students

  • Focus on prevention of future trauma exposure

  • See learning-interfering behaviors as coping with trauma symptoms

  • Promote skill building and resiliency

  • Support student empowerment

  • Build on student strengths

  • Make appropriate referrals



A trauma informed lens helps school staff to understand the link between trauma and functioning, so that they can begin to provide a sense of containment to these families when the arrive in a time of vulnerability and need.

  • A trauma informed lens helps school staff to understand the link between trauma and functioning, so that they can begin to provide a sense of containment to these families when the arrive in a time of vulnerability and need.

  • In order for staff to support families they need:

    • An understanding of the what may drive the child’s behavior
    • Ability to help the parent see child’s behavior as trauma driven
    • Skills to support teachers’ and parents’ increased ability to provide stability and a sense of safety for the child




Gain an understanding of how trauma impacts a child’s development, functioning, ability to learn, and experience of the world.

  • Gain an understanding of how trauma impacts a child’s development, functioning, ability to learn, and experience of the world.

  • Develop ideas regarding how learning environments can work to become trauma informed.



Centers for Disease Control and Prevention. (2016). Injury Prevention and Control: Division of Violence Prevention. Retrieved from: https://www.cdc.gov/violenceprevention/acestudy/about.html

  • Centers for Disease Control and Prevention. (2016). Injury Prevention and Control: Division of Violence Prevention. Retrieved from: https://www.cdc.gov/violenceprevention/acestudy/about.html

  • Cole, Susan, et. al. (2009). Helping Traumatized Children Learn Supportive school environments for children traumatized by family violence. Massachusetts Advocates for Children. Retrieved from https://traumasensitiveschools.org/wp-content/uploads/2013/06/Helping-Traumatized-Children-Learn.pdf

  • Felitti, V. J., Anda, R. F.,Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V. E., Koss, M. P., Marks, J. S. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventative Medicine, 14 (4), 245-258. http://dx.doi.org/10.1016/S0749-3797(98)00017-8

  • National Child Traumatic Stress Network. (2016). The 12 Core Concepts: Concepts for Understanding Traumatic Stress Responses in Children and Families. Retrieved from http://www.nctsn.org/resources/audiences/parents-caregivers/what-is-cts/12-core-concepts

    • National Child Traumatic Stress Network. (2016). Understanding Child Traumatic Stress. Retrieved from http://www.nctsn.org/resources/audiences/parents-caregivers/understanding-child-traumatic-stress
    • National Child Traumatic Stress Network. (2016) What is Child Traumatic Stress?. Retrieved from http://www.nctsn.org/resources/audience/parents-caregivers/what-is-cts


SAMHSA. (July 2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. Prepared by SAMHSA’s Trauma and Justice Strategic Initiative. Retrieved from http://store.samhsa.gov/shin/content/SMA14-4884/SMA14-4884.pdf

  • SAMHSA. (July 2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. Prepared by SAMHSA’s Trauma and Justice Strategic Initiative. Retrieved from http://store.samhsa.gov/shin/content/SMA14-4884/SMA14-4884.pdf

  • SAMSHA. (2016). SAMHSA’s Efforts to Address Trauma and Violence. Retrieved from http://www.samhsa.gov/topics/traumaviolence/samhsas-trauma-informed-approach

    • Substance Abuse and Mental Health Services Administration. (2016a). Types of Trauma and Violence. Retrieved from: http://www.samhsa.gov/trauma-violence/types
    • Substance Abuse and Mental Health Services Administration. (2016b). SAMHSA’s Efforts to Address Trauma and Violence. Retrieved from: http://www.samhsa.gov/topics/trauma-violence/samhsas-trauma informed-approach\


Thank you for your attention and interest!

  • Thank you for your attention and interest!

  • Please feel free to contact me with any questions!

  • Devon Musson Rose, LCSW dmussonrose@tccslc.org

  • The Children’s Center

  • Salt Lake City, UT



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