1. Trauma Informed Organizational Change Creating a Community of Caring: Then Making it Real in the Trenches Tim Schaffner, TCCSB Executive Director Margie Alexander, FCFC Coordinator Kelly Bako, TCCSB Clinical Coordinator

2. Overview of Trumbull County Family and Children First Council Members ◦39 members of Trumbull County Council ◦Open Door Policy Membership Includes: ◦Parent Representatives ◦Government and Government Agencies, e.g. Commissioners, Children’s Services, Mental Health and Recovery Board, Family Court, Trumbull County Board of Developmental Disabilities, Job and Family Services

3. Overview of Trumbull County Family and Children First Council ◦Non-Profits, e.g. mental health agencies, adoption agencies, autism services, housing services, domestic violence services, United Way ◦211 ◦Schools ◦Health Care Providers

4. Trumbull County Family and Children First Council Collaborative Projects ◦Hi-Fidelity Wraparound ◦Trauma Informed Care Committee ◦Infant Safe Sleep ◦Youth and Young Adults in Transition ◦Voices of Youth Closet ◦Bridges Out of Poverty ◦ASAP

5. Introducing Trauma FCFC ◦Brief History of Trumbull County Council ◦Pooled Fund as example of Collaboration ◦Planning Retreat ◦Insert blackmail story lol

6. Trauma in Schools Video http://www.ciscentraltexas.org/Trauma_Train ing_For_Educators/http://www.ciscentraltexas.org/Trauma_Train ing_For_Educators/ Explanation of behavior; How Adults could have responded to behavior using Trauma Informed Care Principles to reduce trauma reactions and/or re- traumatizing children

7. The Adverse Childhood Experiences (ACE) Study THE LARGEST STUDY OF ITS KIND EVER DONE TO EXAMINE THE HEALTH AND SOCIAL EFFECTS OF ADVERSE CHILDHOOD EXPERIENCES OVER THE LIFESPAN (18,000 PARTICIPANTS) THE MAJORITY OF PARTICIPANTS WERE 50 OR OLDER (62%), WERE WHITE (77%) AND HAD ATTENDED COLLEGE (72%)

8. Categories of Adverse Childhood Experiences Abuse, by Category Psychological (by parents)11% Physical (by parents)11% Sexual (anyone) 22%22% Household Dysfunction, by Category Substance Abuse26% Mental Illness19% Mother Treated Violently13% Imprisoned Household Member3% Death of a Parent

9. Adverse Childhood Experiences Score ACE ScorePrevalence 048% 125% 213% 37% 4 or more7% More than half have at least one ACE If one ACE is present, the ACE Score is likely to range from 2.4 to 4

10. One in four was exposed to two categories of abusive experience One in 16 to four categories Smoking COPD Hepatitis Fractures Diabetes Obesity Alcoholism Other Substance Abuse Depression and attempted suicide Teen pregnancy – including paternity Sexually transmitted diseases Occupational health Job performance ACE’s Study

11. Adverse Childhood Experiences determine the likelihood of the ten most common causes of death in the United States. With an ACE Score of 0, the majority of adults have few, if any, risk factors for these diseases. However, with an ACE Score of 4 or more, the majority of adults have multiple risk factors for these diseases or the diseases themselves. ACE’s Study

12. Disrupted Neurodevelopment Adverse Childhood Experiences Early Death Disease, Disability & Social Problems Adoption of Health Risk Behaviors Death Conception Mechanism by Which Adverse Childhood Experiences influence Health & Wellbeing Throughout the Lifespan

13. CORTEX HIPPOCAMPUS SENSORY THALAMUSAMYGDALA

14. HIPPOCAMPUS SENSORY THALAMUS AMYGDALA CORTEX

15. HIPPOCAMPUS SENSORY THALAMUS AMYGDALA

16. ACES Study Aces Brain

17. Daily Impact Assessment Conceptualization Language Interventions

18. Daily Impact Assessment ◦LOC Tool ◦Thorough assessment of GMC’s ◦Brain Mappings ◦Underlying basic need Conceptualization ◦FBA’s ◦Behavior is Purposeful ◦Trauma Response -vs- oppositional ◦Conceptualization Staffing Meetings ◦Hypothesizing ◦“Marveling”

19. Daily Impact Language ◦Hypervigilance ◦Startle response ◦Re-enactments ◦Crisis Cycle ◦What has happened to you? -Vs- What is wrong with you? Why are you acting like this?! ◦Reprocessing ◦Trauma Narrative ◦“Safety” ◦Mantras ◦Etc. Intervention ◦Intense observation and monitoring of symptoms, behaviors, patterns, themes ◦Data Tracking ◦Sensory Interventions ◦Safety Plans & Safety Planning ◦Individualized Behavior Modification Target Trackers and Behavior Plans ◦Creative Use of space, lighting, sound, and motion ◦Debriefing

20. Interventions Continued ◦Mindfulness of Stance, Space ◦Dorm Processing Group ◦Safety Level System ◦WJH Sheets

21. Resources http://www.ciscentraltexas.org/Trauma_Training_For_Educators/ Dr. Bruce D. Perry; https://childtrauma.org/https://childtrauma.org/ Dr. Dan Siegel; https://www.mindsightinstitute.com/https://www.mindsightinstitute.com/ Dr. Bessel van der Kolk; http://www.traumacenter.org/about/about_bessel.php http://www.traumacenter.org/about/about_bessel.php Dr. Rick Hanson; The Wellspring Institute for Neuroscience http://www.wisebrain.org/wellspring-institute

22. Contact Information Margie Alexander Trumbull County Family and Children First Coordinator Help Me Grow Contract Manager 4076 Youngstown Road, Suite 201 Warren, Ohio 330.675.2765, ext. 109 Tim Schaffner Executive Director Trumbull County Children Services 2282 Reeves Road NE Warren, Ohio 44484 330-372-2010 ext. 1104

23. Contact Information Kelly Bako, MS. Ed.,LPC Skill Builder Residential Coordinator 2282 Reeves Road Warren, Ohio 44483 Kelly.Bako@jfs.ohio.gov 330.372.2010 Ext. 1118