1. Jessica Duffel, Psy.D. Clinical Psychologist Family Mental Health Program Oklahoma City VA Medical Center

2. Review the signs and symptoms of PTSD Review of protective and risk factors associated with posttraumatic stress Describe the impact of posttraumatic stress in the school setting for children and adults

4. Exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence Direct exposure or witnessing Indirect exposure Repeated or extreme indirect exposure to gruesome details of the event(s), usually in the course of professional duties

5. Sexual abuse, physical abuse, domestic violence Violent crimes War Natural or man-made disasters Community violence Transportation accidents

6. R e-experiencing A voidance I ncreased arousal N egative thoughts and feelings

7. Symptoms persist for at least one month Negatively impact important areas of life There may be delay in appearance of symptoms

8. Fear Worry Sadness Anger Feeling alone Low self-esteem Difficulty trusting Aggression Self-harm Alcohol or drug misuse

9. Not everyone who experiences trauma develops PTSD Posttraumatic reactions vary by person and age

11. May feel that their parent does not care about or love them May worry their parent cannot take care of them May worry about their parent’s well-being May show similar symptoms as parent May take on the adult role May not learn how to manage their feelings

12. Help children learn what it means for a parent to have PTSD Share information, but do not overshare the details of the parent’s trauma (depends on age and maturity of child) Help the child understand it is not his/her fault Individual therapy for parent and child Family therapy is a good option Be aware of possible violence in the home

13. How severe was the trauma? How close was the trauma? Did the trauma involve interpersonal violence? Were there repeated traumas? For Children: How did the parents react to the trauma? Does the child have a preexisting mental health condition? Are there parental mental health concerns?

14. Family and Social Support Distance from the trauma For children, parents are less upset after trauma

15. Family and Social Support Distance from the trauma For children, parents less upset after trauma

17. Difficulty paying attention Impaired processing of information Learning and memory difficulties Difficulty with problem-solving, planning, organization Negative attitudes toward school

18. Extra time on in-class exams or out-of-class assignments Additional reminders for due dates Allow for audio recording of class lessons/lectures Give seating options Alternative seating arrangements Breaks during class

19. Allow to stand in back of class for brief periods When possible, use of break out groups Tutoring Excused absence procedures for medical and/or mental health appointments Communicate directly to educators about student being a trauma-survivor (if known) and suggestions for accommodations to help the student succeed

20. Speak calmly and gently, yet firm Respectful language Even tone of voice, not shouting Approach from the front Minimize sudden movements Avoid touching the individual Minimize loud, sudden noises Firmly ask the individual to leave the setting if being disruptive

21. OKC VA Med Center Family Mental Health Program: 405-456-5183405-456-2392 National Center for PTSD: http://www.ptsd.va.gov/ National Child Traumatic Stress Network, Psychological First Aid, Appendix E: http://www.nctsn.org/sites/default/files/pfa/english/a ppendix_e.pdf Vet Parenting Toolkit http://www.ouhsc.edu/VetParenting American Psychiatric Association, DSM 5