1. Effects of Trauma on children

2. Trauma-Definition A wound, hurt, or injuryA wound, hurt, or injury Physical stress including abuse or neglectPhysical stress including abuse or neglect Emotional/psychological neglect or abuseEmotional/psychological neglect or abuse

3. Trauma-types One-time incidents like accidents, natural disasters, crimes, surgeries, deaths, and other violent events.One-time incidents like accidents, natural disasters, crimes, surgeries, deaths, and other violent events. Chronic or repetitive experiences such as child abuse, neglect, combat, urban violence, concentration camps, battering relationships, and deprivation.Chronic or repetitive experiences such as child abuse, neglect, combat, urban violence, concentration camps, battering relationships, and deprivation. As traumatic as single-blow traumas are, the traumatic experiences that result in the most serious mental health problems are prolonged and repeated.As traumatic as single-blow traumas are, the traumatic experiences that result in the most serious mental health problems are prolonged and repeated. The loss of parents, siblings, relatives, friends and neighborsThe loss of parents, siblings, relatives, friends and neighbors Institutionalization is a particular type of trauma.Institutionalization is a particular type of trauma.

4. Simple vs. compounded Single—one eventSingle—one event Compounded-many eventsCompounded-many events –Problematic family life + –Institutional life + –Violence or maltreatment in the institution =

5. Emotional/Psychological Effects of Trauma Overwhelms the individual's perceived ability to cope.Overwhelms the individual's perceived ability to cope. –Daily tasks of living –Changes. –Life tasks. Does not allow a person to grow and develop to their maximum potential.Does not allow a person to grow and develop to their maximum potential. A person feels emotionally, cognitively, and physically overwhelmed by life experiences.A person feels emotionally, cognitively, and physically overwhelmed by life experiences.

6. Effects of Trauma of Attachment Behaviors persistent frequent tantrumspersistent frequent tantrums resistance to being held (arches back or is stiff when held)resistance to being held (arches back or is stiff when held) indiscriminately affectionate with strangersindiscriminately affectionate with strangers cruelty to animals and other vulnerable beingscruelty to animals and other vulnerable beings lack of empathy and remorse (no conscience)lack of empathy and remorse (no conscience) Prefers crib or isolation to being held or interacting with othersPrefers crib or isolation to being held or interacting with others Very rarely cries, too quiet... too good?Very rarely cries, too quiet... too good? Cries incessantly - very demanding, easily enragedCries incessantly - very demanding, easily enraged

7. What can we do to prevent truama? System Interventions Preserve the biological family when ever possible—even children from multi-problem families do better than children in institutionsPreserve the biological family when ever possible—even children from multi-problem families do better than children in institutions When not possible, promote kinship family careWhen not possible, promote kinship family care If neither of these options can work, foster family care or adoptionIf neither of these options can work, foster family care or adoption

8. What can we do?—Child centered interventions (non medical)* Family placementFamily placement Establish safety and securityEstablish safety and security Allow children to talk about any eventAllow children to talk about any event Prepare children for a futurePrepare children for a future * Some traumas have such a negative effect that it can cause significant mental health problems requiring medical as well as psychosocial interventions.

9. Establish safety and security Respond to and provide opportunities for children to receive positive human physical contact to reaffirm needs for sensory comfort and care.Respond to and provide opportunities for children to receive positive human physical contact to reaffirm needs for sensory comfort and care. Help children get enough sleep and nutrition.Help children get enough sleep and nutrition. Provide them with physical symbols of nurturing, love, or remembrance (life books)Provide them with physical symbols of nurturing, love, or remembrance (life books)

10. Small group discussion What can you do to help children feel safe and secure in your community?What can you do to help children feel safe and secure in your community?

11. Allow children to talk about any event Encourage them to tell or develop stories that help them explore intense reactions such as anger or fear.Encourage them to tell or develop stories that help them explore intense reactions such as anger or fear. Reassure them that sadness and grief are a necessary part of surviving.Reassure them that sadness and grief are a necessary part of surviving. Only works for older children with language ability; since the language of younger children is behavior, positive behavior management and therapy-based play are better interventions for young children.Only works for older children with language ability; since the language of younger children is behavior, positive behavior management and therapy-based play are better interventions for young children. Understand grief and loss in childrenUnderstand grief and loss in children

12. Components of Grief and Loss (not really stages) 1. SHOCK & DENIAL1. SHOCK & DENIAL 2. PAIN & GUILT2. PAIN & GUILT 3. ANGER & BARGAINING3. ANGER & BARGAINING 4. DEPRESSION, REFLECTION, LONELINESS4. DEPRESSION, REFLECTION, LONELINESS 5. ACCEPTANCE5. ACCEPTANCE

13. Small Group Discussion How can you help children dealing with loss and grief?How can you help children dealing with loss and grief?

14. Prepare children for the future Encourage the establishment of comforting routines.Encourage the establishment of comforting routines. Provide them with tangible comfort items: a photograph of a loved one, a stuffed animal, or a favorite blanket.Provide them with tangible comfort items: a photograph of a loved one, a stuffed animal, or a favorite blanket. Help them take time to think about their future.Help them take time to think about their future. Support adult caregivers in their efforts to react appropriately.Support adult caregivers in their efforts to react appropriately. Work to help children solve problems they face because of the trauma.Work to help children solve problems they face because of the trauma.

15. Small group discussion In your community, how do you help children prepare for the future?In your community, how do you help children prepare for the future?

16. Resilient Children Resilient children develop strategies for finding older children or adults who might help them.Resilient children develop strategies for finding older children or adults who might help them. They will gravitate towards people who seem to provide stability and comfort.They will gravitate towards people who seem to provide stability and comfort. Only a few percent of children are resilient; many will need some helpOnly a few percent of children are resilient; many will need some help

17. Conclusion The best way to deal with trauma is to develop a system and services to avoid itThe best way to deal with trauma is to develop a system and services to avoid it A family-based system of care is better than an institutional-based system of care.A family-based system of care is better than an institutional-based system of care.