trauma early intervention

Information about trauma early intervention

Published on July 29, 2014

Author: CPEIP

Source: authorstream.com

Content

Trauma-Informed Early Intervention: A Vision, A Challenge, A Needed Reality Trauma-Informed Early Intervention Trauma-Informed Early Intervention: Trauma-Informed Early Intervention Trauma Informed Care : Trauma Informed Care 3 Have I considered whether trauma has played a role? Ask trauma informed questions Use a trauma lens to understand behavior Screen as part of services Ensure emotional safety Avoid re - traumatization Consider trauma in all decisions (childcare placement, referrals, etc). Trauma Informed Early Intervention IDEA Part C: Ages 0-3 IDEA, Part B: Ages 3-18 : Trauma Informed Early Intervention IDEA Part C: Ages 0-3 IDEA, Part B: Ages 3-18 4 PowerPoint Presentation: Gilkerson , L., Graham, M., Harris, D., Oser , C., Clarke, J., Hairston-Fuller, T. & Lertora , J. (2013) Trauma -Informed Part C Early Intervention: A Vision, A Challenge, A New Reality. Zero to Three, 34:2. 1. The Need for Trauma Informed Early Intervention: 1. The Need for Trauma Informed Early Intervention 6 Drivers of Developmental Trajectories: Nurturing & Responsive Care PreK & Quality Child Care Targeted Supports Health Services Early Intervention Healthy At-Risk Delayed or Disordered Ready to Learn Drivers of Developmental Trajectories Poverty Lack of Health Services Trauma & Toxic Stress Impact of Trauma & Toxic Stress on Developmental Trajectories: Trauma & Toxic Stress Healthy At-Risk Delayed or Disordered Ready to Learn Impact of Trauma & Toxic Stress on Developmental Trajectories Early Adverse Experiences: Early Adverse Experiences Physical Health Problems Mental Health Problems Crime & Delinquency Addictions Poor Parenting Capacity Academic & School Problems …lead to a multitude of societal problems: Lifespan Impacts of ACEs: Chronic Disease Alcohol, Tobacco, Drugs Psychiatric Disorders Risky Sex Impaired Cognition Work/School Attendance, Behavior, Performance Genetics Experience triggers gene expression (Epigenetics) Critical & Sensitive Developmental Periods Adverse Childhood Experience MORE CATEGORIES – GREATER IMPACT Physical Abuse, Sexual Abuse Emotional Abuse, Neglect Witnessing Domestic Violence Depression/Mental Illness in Home Incarcerated Family Member Substance Abuse in Home Loss of a Parent Brain Development Electrical, Chemical, Cellular Mass Crime Obesity Poverty Intergenerational Transmission, Disparity Source: Family Policy Council, 2012 Lifespan Impacts of ACEs Adaptation Hard-Wired Into Biology Prevalence of Adverse Childhood Experiences Among Young Children in US: National Survey of Children's Health. NSCH 2011/12 All Children 0-5 Years Old Prevalence of Adverse Childhood Experiences Among Young Children in US “Trauma can be a single event, connected series of traumatic events, or chronic lasting stress.” Diagnostic Classification: 0-3R : “ Trauma can be a single event, connected series of traumatic events, or chronic lasting stress. ” Diagnostic Classification: 0-3R Illness or medical procedure Serious accident or hospitalization Traumatic grief or separation Fire, hurricane, flood, earthquake, or other disaster War, terrorism, political violence Physical, sexual, emotional or psychological maltreatment Witness to violence at home, school, or neighborhood Neglect Family disruption (moves, loss of job, illness, death, divorce, incarceration) Trauma in Young Children In EI: 13 Trauma is an event that is unpredictable, produces a feeling of helplessness, and overwhelms one ’ s capacity to cope. Trauma in Young Children In EI Lack of a Trauma Sensitive Approach: Lack of a Trauma Sensitive Approach Examples: A brupt separation of a child who was recently removed from the home and from caregivers to complete an assessment task. A sking biological or foster parents to leave the room, so the provider can work with the child alone. R outine procedures can be intrusive such as an oral exam of a child’s mouth if conducted without awareness of a child’s trauma experience. 14 Barriers to Addressing Early Childhood Trauma in EI: Barriers to Addressing Early Childhood Trauma in EI Beliefs about young children--too young to remember Parents’ reticence about mental health Need for training, supervision, support System capacity — open floodgates 15 Gilkerson et al, 2011 2. The Vision for a Trauma-Informed System: 2. The Vision for a Trauma -Informed System “One in which all parties involved recognize and respond to the impact of traumatic stress on those who have contact with the system including children, caregivers, and service providers. Programs and agencies within such a system infuse and sustain trauma awareness, knowledge, and skills into their organizational cultures, practices, and policies. They act in collaboration with all those who are involved with the child , using the best available science, to facilitate and support the recovery and resiliency of the child and family.” 16 NCTSN Trauma-Informed Service Systems Working Group Elements of a Trauma-Informed Early Intervention System: Elements of a Trauma -Informed Early Intervention System 17 For all children in EI and their families: EI Values Social/Emotional Competence For children exposed to trauma and their families Unique Needs Broad Eligibility Trauma Screening Priority on Emotional Safety EI Trauma Specialists Trauma Training, Consultation, & Reflective Supervision Involvement of All Caregivers Coordination of EI Services Interagency Agreements Community Partnerships Secondary Trauma The Child’s Developmental Needs are Considered in Context of their Attachment Relationships and the Trauma History of Child and Parents.: The Child’s Developmental N eeds are Considered in C ontext of their Attachment Relationships and the Trauma History of Child and Parents . 18 Elements of A Trauma Informed E.I. System : Trauma Screening Integrated in Assessments: Trauma Screening Integrated in Assessments 19 Comprehensive Developmental and Infant Mental Health assessments help to: Identify strategies and interventions to address the affects of early trauma, and Address attachment-related, regulatory and developmental challenges. Elements of A Trauma Informed E.I. System : Trauma Training for all E.I Staff: Trauma Training for all E.I Staff 20 Have you considered whether trauma has played a role in…? Elements of A Trauma Informed E.I. System : Transdisciplinary early childhood mental health and Part C team with trauma expertise: Transdisciplinary early childhood mental health and Part C team with trauma expertise Elements of A Trauma Informed E.I. System : Reflective Supervision & Consultation Focused on Trauma: Elements of A Trauma Informed E.I. System : Reflective Supervision & Consultation Focused on Trauma Priority on emotional safety and presence of co-regulating caregivers: Priority on emotional safety and presence of co-regulating caregivers 23 Elements of A Trauma Informed E.I. System : 3. What It Looks Like In Practice to Have Trauma-Informed Early Intervention : 3. What It Looks Like In Practice to Have Trauma -Informed Early Intervention 24 New Mexico Infant Team Integrated team of trauma specialists and EI providers, closely coordinated with child welfare and court system Baltimore Part C Infant and Toddlers Program Trauma screening triggers referral to collaborating infant mental health agency for consultation or service provision Have I considered?: Have I considered? 25 …whether trauma has played a role in…? Ask trauma informed questions Use trauma lens to understand behavior Screen as part of services Ensure emotional safety Avoid re-traumatization Consider trauma in all decisions (placement, childcare, visitation, etc.) . Pyramid for Promoting Social Emotional Competence in Infants & Young Children: The Center on the Social and Emotional Foundations for Early Learning Universal Promotion Prevention Treatment 80% 15% 5% Pyramid for Promoting Social Emotional Competence in Infants & Young Children Nurturing & Responsive Relationships : Nurturing & Responsive Relationships A powerful buffer against adversity and the damage it inflicts on a child’s stress-response system. Nurturing & Responsive Relationships: Supports for New Parents: Nurturing & Responsive Relationships: Supports for New Parents PowerPoint Presentation: Fussy Baby Network ® Approach Translating Research to Practice Simple Ways to Reduce Stress & Trauma: Translating Research to Practice Simple Ways to Reduce Stress & Trauma 30 Time: 0:49 E.I. Trauma Training: E.I. Trauma Training High Quality Environments Can Improve Development & Reduce Trauma: High Quality Environments Can Improve Development & Reduce Trauma 32 IHDP (Abecedarian 8-City Replication ) Cognitive Development to Age 18 McCormick, et a., 2006, Pediatrics Targeted Social Emotional Supports: Targeted Social Emotional Supports Early Childhood Mental Health Consultation: Raver , et al, 2008 and Gilliam, 2007 Early Childhood Mental Health Consultation Reduced Behavior problems in target children Expulsions Stress & depression for teachers Improved Classroom environments Teacher -child positive interactions Teacher beliefs & practices regarding developmentally appropriate & child centered practices Teacher sense of job control & satisfaction Sensitivity & classroom management Classroom climate Skills to handle difficult behavior Circle of Security: Circle of Security Step-by-step approach for promoting secure attachment Promoting Emotional Security to Explore : Promoting Emotional Security to Explore Intensive Intervention: Intensive Intervention Evidence Based Trauma Treatments: Evidence Based Trauma Treatments Expand IMH Treatments for Early Intervention: Attachment & Biobehavioral Catch Up Intervention (ABC): Expand IMH Treatments for Early Intervention: Attachment & Biobehavioral Catch Up Intervention (ABC) 39 Problem Target Outcome Children push caregiver away Provide nurturance even when children cue otherwise Secure, organized attachment Children dysregulated behaviorally and biologically Provide responsive care Enhanced self regulation capacity ABC: 10 in-home intervention sessions Parent coach provides “ in the moment ” comments to reinforce every opportunity for nurturing. Parent feels supported. Brings parent ’ s attention to specific behavior (child did x, you did x). Follows child ’ s lead. Links behavior with outcomes (e.g., that will help child feel xxx) Mary Dozier, Ph.D., University of Delaware 4. Recommendations for Trauma-Informed Early Intervention : 4. Recommendations for Trauma-Informed Early Intervention 40 Need for Trauma Informed Tool Kit Specific for Early Intervention: National Child Traumatic Stress Network at www.nctsn.org / Need for Trauma Informed Tool Kit Specific for Early Intervention Need for A New Professional: An amalgamation of a trauma informed developmental specialist with IMH expertise: Need for A New Professional: An amalgamation of a trauma informed developmental specialist with IMH expertise 42 “It’s the most important opportunity for the prevention of health and social problems and disease and disability that has ever been seen.” Dr. Vince Fellitti, Author, ACE Study: “ It’s the most important opportunity for the prevention of health and social problems and disease and disability that has ever been seen. ” Dr. Vince Fellitti , Author, ACE Study Time: 0:52

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