Understanding Trauma in the ClassroomChris TactoSchool Social Work InternEast Whittier City School District@ Leffingwell Elementary

Presentation Outline

• EWCSD Overview• Schools• Philosophy

• Leffingwell Elementary School (by the numbers)• Number of Cases• Types of Cases• Presenting issue

• Childhood Trauma Training• Hallway Experience• Goals

East Whittier City School DistrictElementary Schools

• Ceres• Evergreen• La Colima• Laurel• Leffingwell• Mulberry• Murphy Ranch• Oceanview• Orchardale• Scott

Early Childhood

• Mar Vista

Middle Schools• East Whittier• Granada • Hillview

East Whittier City School District• Philosophy

– It is the aim of the East Whittier City School District to provide students with the knowledge of those academic skills and concepts which they must learn and apply to function in our society. The District, in partnership with parents, endeavors to motivate, inspire, and encourage all students to use their unique potentials to reach their highest level of academic achievement, emotional and physical well-being.

Leffingwell Elementary School CounselorWho am I seeing?• By the Numbers…

– 35 referrals– 30 counseling

services

– All grade levels– Boys: 53%– Girls: 47%

– Ages 6-12 years old

5

4

66

5

4

Grade Levels

Kinder.1st 2nd 3rd 4th 5th

(n=30)

Leffingwell Elementary

Why they see me?• Reasons for

Referral– Divorce/Family

Concern– Social Skills– Anxiety– Anger– Grief/Loss

Divor

ce/F

amily

Social

Skills

Anxiet

y

Ange

r

Grief/L

oss

0

2

4

6

8

10

12

BoysGirls

(n=30)

Understanding Trauma in the Classroom:A Training on Childhood Trauma

Childhood Trauma Training

• Hallway Experience…

Goals of the Training

• Focus on true understanding of the experience of those who have experienced trauma

• Review PTSD and learn the difference between Acute and Complex trauma

• New DSM-V PTSD Pre-school SubType• Discuss potential misdiagnosis• Role of Teachers• Teacher Self-Care Practices

What is Childhood Trauma?

– “The result of one sudden, external blow or a series of blows renduring the person temporarily helpless breaking past ordinary coping and defense operations."

- Lenore C. Terr, M.D.

• “We all have been exposed to trauma, but some surpass our threshold to cope.”

What are examples of events that may lead to a trauma reaction?• Interpersonal Trauma

– Abuse: physical, sexual, emotional (yelling, swearing, shaming)

– Witnessing domestic violence– Severe Neglect – Extreme bullying– Betrayal by someone

• Medical Trauma– Physical injury– Painful medical conditions & procedures

(burns, cancer, etc.)

More Examples of Traumatic Events • Environmental Trauma

– Gang violence on streets– Exposure to war– Abrupt, frightening immigration situations– Frightening events (e.g., near drowning)

• Natural Disaster– Flood, earth-quake, hurricane

• Separation, Loss, and Attachment Trauma– Parental instability – Family Chaos (homelessness, substance abuse– Multiple separations & abandonment

Lisa’s 9-1-1 Call

Scope of the Problem for Inner City Youth• Estimated 1/3

children living in urban “war” zones have PTSD

• Few diagnosed or treated

• Predominantly youth of color

• High risk of drop-out• Cycle of violence• Epidemiological

estimates:– Combat Vets: 20%– Inner City Youth: 23%

Post Traumatic Stress Disorder: DSM-IV Definition

• The person exposed to a traumatic event in which BOTH of the following were present:– The person experienced, witnessed, or was

confronted with an event or events that involved actual threat or threatened death or serious injury, or a threat to the physical integrity of SELF or OTHERS

– The person’s response involved intense fear, helplessness, or horror. Note: In children this may be expressed instead by disorganized or agitated behavior

Symptoms of PTSD According to the DSM-IV• Symptoms must cause

significant distress or impairment in functioning

• Must endure for more than one month, beginning within 3 months after the stressor, but may be delayed for months or even years

• Must experience one or more of the following:– Re-experiencing

• Distressing recollections

– Avoidance• Efforts to avoid

thoughts/feelings associated with trauma

– Hyperarousal• Irritability or outbursts

of anger; difficulty concentrating

PTSD cont’d

• Acute vs. Chronic Stress Disorder– Acute

• Duration is less than 3 months

– Chronic• If duration of

symptoms is 3 months or more

• Derealization vs. Depersonalization– Derealization

• Subjective experience of unreality of the outside world

– Depersonalization• Feeling of watching

oneself act from outside of one’s body, while having no control of situation.

• 70% of people felt this at one time in their lives, but if chronic, can be a Dissociative Disorder

DSM-V – Post Traumatic Stress Disorder• From Anxiety Disorder to Trauma and Stress-

Related Disorders– Reactive Attachment Disorder, Acute Stress

Disorder, PTSD, Adjustment Disorder– PTSD specifier

• With depersonalization• With derealization• With delayed expression: criteria not met until 6

months after traumatic event

DSM-V: PTSD (Preschool Subtype)• PTSD for children under 6 years old

– Recurrent, involuntary, intrusive distressing memories

– Recurrent distressing dreams– Flashbacks– Distress at exposure– Reactions to reminders of the event

DSM-V: PTSD Behavioral Symptoms

• Behavioral Symptoms:– Irritable behavior– Angry outbursts– Exaggerated startle

responses– Problems with

concentration– Sleep disturbances

• Negative Alterations in Cognitions– Increase in fear, guilt,

sadness, shame, confusion, etc.

Most Common Mis-Diagnosis of PTSD and ASD

– Conduct disorder– Oppositional Defiant Disorder– Attention-Deficit/Hyperactivity Disorder– Anxiety or Phobic Disorder– Major Depressive Disorder– Borderline Personality Disorder– Dissociative Disorders (Depersonalization

d/o, Dissociative Amnesia d/o, Dissociative Identity d/o)

– Panic Disorder– Obsessive-Compulsive Disorder

Role of Teachers

• Monitor symptoms over time– Remain curious about

changes of behavior

• Maintain routines– Helps child feel safe

and maintain consistency

• Set Clear and Firm Limits/Expectations– Logical vs. punitive

consequences

• Provide Choices– Helps restore child’s

feeling of control

• Focus on Strengths & Positives– Helps child feel good

about themselves

• Help students build a support system– Helps child feel

comfortable talking about difficult situations or other problems

Teacher Self-Care

• Signs that may indicate teacher distress:– Decreased

concentration and attention

– Increased irritability or agitation with students

– Problems planning classroom activities

– Feeling numb or detached

– Intense feelings, intrusive,

Teacher Self-Care

• Tips for teacher:– Monitor your own

reactions– Seek out support for

yourself – Seek help for your

own trauma-related distress ‘compassion fatigue’

– Use positive coping strategies

– Maintain a structured classroom

– Make time for yourself, family, and friends

– Spend time with students who have not experienced traumatic stress

– Plan ahead – Maintain a healthy

lifestyle

Questions?

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