Children’s Relief Nursery The Dis-regulated Child: children who lose control of their emotions, behaviors and bodies Leslie Brown, LCSW March 9 th, 2010

Children’s Relief Nursery Introduction Agenda Introductions

Children’s Relief Nursery Course Goals Participants will be able to 1.Understand the needs of overwhelmed children and be able to identify evidence based therapeutic prevention strategies. 2.Recognize children who are in the peak phase of being out of control and be able to identify therapeutic intervention strategies including how to positively re-engage the child back into the classroom. 3.Identify the importance of building positive relationships with children and their families to construct positive behavior supports.

Children’s Relief Nursery Definition of the ‘Traumatized Child’ Has experienced a traumatic event Shows signs of being overwhelmed Shows distress through their words, behavior and play Shows behaviors that seem out of control, fearful, disruptive, excessively aggressive. Child becomes “flooded” with feelings of fear and anxiety. Child cannot control these behaviors without help

Children’s Relief Nursery Traumatic stress as a cause of dis-regulation Definition of a traumatized child Early childhood trauma types Rationale for prevention and early response to trauma

Children’s Relief Nursery The impact of trauma Body’s trauma response & the brain Impact of early childhood development Attachment & trauma Culture & trauma

Children’s Relief Nursery Effects of trauma Trauma reminders Reenactment Traumatic expectations Projections Difficulty differentiating past/present Long term effects of untreated trauma

Children’s Relief Nursery Behaviors associated with trauma How trauma impacts relationships How it manifests in peer group settings

Children’s Relief Nursery What you might observe in young traumatized children Signs & symptoms in children 0-3 years Signs & symptoms in children 3-5 years Behaviors that warrant concern

Children’s Relief Nursery Behaviors that Warrant Concern (Infants and Toddlers 0-3 yrs.) Chronic feeding or sleeping difficulties Inconsolable “fussiness” or irritability Incessant crying with little ability to be consoled Extreme upset when left with another adult Inability to adapt to new situations Easily startled or alarmed by routine events Inability to establish relationships with other children or adults Excessive hitting, biting and pushing of other children or very withdrawn behavior Flat affect

Children’s Relief Nursery Behaviors that Warrant Concern (Preschoolers ages 3-5 yrs.) Engages in compulsive activities (e.g. head banging) Throws wild, despairing tantrums Withdrawn; shows little interest in social interaction Displays repeated aggressive or impulsive behavior Difficulty playing with others Little or no communication; lack of language Loss of earlier developmental achievements

Children’s Relief Nursery Understanding what traumatized children need Sensory body based prevention strategies Feelings identification Affect regulation/Tucker the Turtle Safety planning Therapeutic environment Relaxation skill building Building a narrative or story

Children’s Relief Nursery Setting up a therapeutic environment Planning ahead Being proactive Sound reduction Reducing stimulation Limiting transitions Dividing children & sections in the room Predictable classroom rules & routines

Children’s Relief Nursery Therapeutic environment Increasing levels of support: designating adults anticipating difficult times: trauma reminders Helping reduce or explain other children’s reactions to the child Role playing Giving words to use Establishing teacher's as safe base Coaching Choices Communication between teachers/emotional tone

Children’s Relief Nursery Prevention strategies Find helping jobs Use 3 minute warning & pre-warn children when doing something out of the ordinary Describe when you see the child doing what you want Scheduled one on one time Feeding the meter Avoiding problem situations

Children’s Relief Nursery Prevention strategies: teaching emotional skills Feelings identification Regulation activities Relaxation games Calming activities Expressing feelings in words Understanding triggers: child & caregivers

Children’s Relief Nursery Prevention strategies: teaching social skills Role playing Conflict resolution: use of humor Story telling games Boundary setting games Teaching helping behaviors

Children’s Relief Nursery 7 phases of escalating behavior in children CalmPrevention strategies TriggerPrevention strategies AgitationPrevention strategies AccelerationPrevention strategies PeakIntervention strategies De-escalationIntervention strategies RecoveryIntervention strategies

Children’s Relief Nursery Work Sheet Prevention Strategies Please follow along on activity sheet

Children’s Relief Nursery Responding: when child is out of control Self check in/emotional environment Cycles of a melt down Resisting child’s efforts to draw you into “reenactments” Containment: moving child or others out of harms way Offering choices, reflecting child’s choice, choosing a choice for the child Describing child’s need & intention Empathic mirroring & body matching

Children’s Relief Nursery When Child is out of control Use of the “skying down” area Distraction: washing a table, chairs, scrub brush Using sensory materials: soft & rough fabrics, tornado, egg timer, blowing a pretend candle, sensory tables Soft Voice, slow body movements

Children’s Relief Nursery Positively re-engaging the child back into the group Resolve unresolved issues Provide ways for atonement Make a plan for next time Follow up with teaching team

Children’s Relief Nursery Coming full circle How to resolve the problem Involving parents Long term prevention planning

Children’s Relief Nursery The Magic Box What do have in your box now? What would you like in your box? Suggestions

Children’s Relief Nursery Question and Answer