Creating a Trauma Informed
Learning Environment
Presented by:
Kym Asam, LICSW, QMHP
Objectives
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Differentiate between PTSD and developmental trauma
Understand the impact of trauma on the brain utilizing
the Neuro-Sequential Model of Therapeutics (NMT)
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Impact on students’ capacity to learn
Brain regions and a tiered (PBiS) approach to intervention
Understand the students’ states of arousal and how it
impacts their functioning in school
Key skills in working with children who have experienced
developmental trauma
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ARC and its intersect with a tiered approach
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Adults
Students
Polling Question #1

How many audience participants have had
some training on developmental or
complex trauma?
Grounding Principles
Trauma-Sensitive Schools benefit all
children – those whose trauma history is
known, those whose trauma will never
be clearly identified and those who may
be impacted by their traumatized
classmates.
Schools are the Central Community for
most children.
Definitions
What is trauma?
Trauma is not an event itself, but rather a
response to a stressful experience in
which a person’s ability to cope is
dramatically undermined.
What is Developmental Trauma?
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•
•
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•
A psychological and neurobiological injury that
results from protracted exposure to stressful
events
Derails typical development across all domains
(neurological, psychological, cognitive, social,
self/identity)
Experiences often occur in the caregiving
system.
Impact is immediate and long term
Effects will require all tiers of intervention
Sources of Trauma
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Sexual abuse
Physical abuse
Emotional abuse
Neglect
Domestic Violence
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Neighborhood violence
Torture
Bullying
Prolonged exposure to traumatic stress
Intrauterine stress
Epigenetics
Toxic Stress Pyramid
Pervasiveness in children
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Overall substantiated child maltreatment in 2011 =
approximately 681,000 (705 in Vermont)
9.1% experienced sexual abuse (67% in Vermont)
17.6% experienced physical abuse (37.1% in Vermont)
78.5% experienced neglect (2.6% in Vermont)
48.6% were males
51.1% were females
Source = National Children’s Alliance and US Department of Health and Human Services, 2011 report
Child Welfare League of America
The brain
develops from
the
bottom up
Cortex
Limbic
Diencephalon
Brainstem
and the
inside out
Early childhood synaptic growth
Brain Function
Encourage Abstract
Thought
Facilitate Socioemotional Growth
Introduce SomatoSensory Integration
Establish State
Regulation
Perry, B. 2006
Cortex
Limbic
Diencephalon
Brainstem
Abstract Thought
Concrete Thought
Affiliation/Reward
Attachment
Sexual Behavior
Emotional Reactivity
Motor Regulation
Arousal
Appetite /Satiety
Sleep
Blood Pressure
Heart Rate
Body Temperature
The still face experiment
http://www.youtube.com/watch?v=apzXGEb
Zht0
Neuronal Connections
http://www.youtube.com/watch?v=8NA_o1j
OjsQ
Impact of Neglect on the Brain
Stages of Sleep
Polling question #2

How many of you have students who
frequently go to the nurse?
Negative Interactions
Social experiences with caregivers become biologically embedded
.
Caregiver’s
indicate
displeasure: yell
at or ignore baby
Early experiences shape
the developing nervous
system and determine
how stress is interpreted
and responded to in the
future
Baby’s brain
releases stress
hormones ,
primarily cortisol
Too much cortisol
compromises the
immune system
and decreases
dopamine and
serotonin
The toddlers set
point for cortisol is
established.
The number of
receptors in the
brain is reduced by
repeated early
exposure to stress
Effects of Trauma on Brain
Functioning
Thalamus
Prefrontal Cortex
(Integration and Planning)
Visual, auditory, olfactory,
kinesthetic, gustatory
Amygdala
Hippocampus
(cognitive map)
(Intensity/significance)
Normative Danger Responses
Autonomic Nervous Response
System
Fight
 Flight
 Freeze
 Flock

Emotional Identification
Facial Expression Recognition
Arousal Continuum
State
Calm
Arousal,
Attention
Alarm
Fear
Terror
Adaptive Response
Rest
Vigilance
Freeze
Fight
Flight
Regulation
Brain Region
Neocortex
Cortex
Cortex
Limbic
Limbic
Midbrain
Midbrain
Brainstem
Brainstem
Autonomic
Deesecalating Adult
Responses
Talking, adult
presence,
rocking
Eye contact,
simple
directives,
quiet voice
Quiet words,
invited
physical touch
Disengagement,
quiet adult
presence
Wait, leave group, allow
child to calm, no words
Escalating Adult
Responses
Noise,
confrontation
Complex
directives,
anger,
ultimatums
Raised voice,
shaking finger
Chaos,
frustration,
yelling
grabbing, shaking
screaming
Cognition
Abstract
Concrete
Emotional
Reactive
Reflexive.
Perry, B. (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatized children. New York, NY:
Guilford Press
Typical path to reactions
Express Route to Reactions!
Arousal and Cognitions
As arousal increases cognitive
ability decreases. Hyperaroused children may be
defiant, resistant and/or
aggressive.
They are stuck in survival
mode and may freeze, fight,
or flee.
A child in a hyper-aroused state can not be reasoned with,
she needs you to help her reduce her arousal level.
How to Intervene
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Somatosensory interventions
Targeting the part of the brain that was
impacted by developmental insults
 EVERY DAY
 EVERY GRADE
 EVERY BODY
Targeting the Tiers, PBiS
approaches
Intensive
targeted
universal
Brain
stem/diencephalon
limbic
cortex
Building up from the base
Establish State Regulation -Intensive
School staff can be thinking about short, predictable, repetitive,
patterned interactions throughout the day which would include:
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Touch
Rhythmic activities (rocking)
Eye contact
drumming
Brainstem
Bruce Perry (2006)
Respond to physiological cues. A child’s heart rate is a great
indicator of levels of arousal (low end 80, high end 120). When
interacting become an affective co-regulator for the child.
Building up from the base
Introduce Somato-Sensory
Integration – targeted, intensive
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Diencephalon
Large motor and fine motor
Music and movement
Bruce Perry (2006)
Sensory stimulation
Predictable routines (eating, transitions, sleeping)
Consider beginning the day with predictable, structured, patterned,
rhythmic music and movement activities. Studies have indicated that
children have increased self-regulation throughout the day when sensory
integration occurs early.
Remember that the brain fatigues after 7 minutes.
Polling Question #3

How many of you work with students who
receive targeted or intensive level of
supports who struggle with playing games
or taking turns?
Building up from the base
Facilitate Socio-emotional Growth
– targeted
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Turn-taking
Team play
Win & lose
Sharing
Limbic
Bruce Perry (2006)
Consider that social development is a progression and the ability to
form satisfying reciprocal interactions may depend on backing up
and purposefully creating opportunities for parallel play or learning
opportunities in a dyad with an adult and then a dyad with a peer
before group play or group learning will be successful.
Building up from the base
Encourage Abstract Thought –
Universal
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Humor
Language
Art
Games
Conflict resolution, problem solving
Self-development and identity
Self-esteem
Cortex
Bruce Perry (2006)
Children who have foundational skills will be able to utilize their
prefrontal cortex successfully. However, for children with disrupted or
traumatic early experiences, adults will need to emphasize the earlier
skills. Remember, stage not age.
Polling Question #4

Who in webinar land is familiar with the
ARC model?
ARC Model - 10 Building Blocks
Trauma
Experience
Integration
Executive
Functions
Self Dev’t
& Identity
Dev’tal Tasks
Affect
Identification
Caregiver
Affect
Mgmt.
Modulation
Attunement
Affect
Expression
Consistent
Response
Blaustein & Kinniburgh, 2010;
Kinniburgh & Blaustein, 2005
Routines
and
Rituals
attachment
intensive
Caregiver
Affect
Mgmt
Attunement
Affect
Identification
targeted
Modulation
Dev’tal Tasks
Executive
Functioning
Affect
Expression
Selfregulation
Self Dev’t
& Identity
universal
competency
Trauma
Experience
Integration
Blaustein & Kinniburgh,
2010; Kinniburgh &
Blaustein, 2005
Routines
and Rituals
Consistent
Response
4 Key Principles of Attachment
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Build school staff capacity
to manage affect
Build school staff-child
attunement
Build consistency in
school staff response to
child behavior
Build routines and
rituals into classroom
and school
Healthy Attachment Sequence
Physical or psychological need
Relaxation
(parasympathetic
ANS)
Security, trust,
attachment, selfregulation, object
constancy
Attunement/satisfaction of
need
Beverly James
State of high
arousal
Unhealthy Attachment Sequence
Physical or psychological need
Anxiety, rage,
numbing
Shame, mistrust,
disregulation, disturbed
mental blueprint
Needs are
disregarded/attunement
disrupted
Beverly James
State of high
arousal
Affect Management
When caregivers modulate their own affect
and emotional responses, they can create
an emotionally safe environment in which
children a can learn
Attunement
Caregivers accurately read cues to respond
to underlying emotion rather than overt
behavior. Behavior is usually a front for
feeling that a child has difficulty expressing
in a more effective way.
Attunement
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Communicating unmet needs
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What is the function of the behavior?
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Being a feelings detective!
Consistent Response
Caregivers respond in a consistent way to
both positive (desired) and negative/unsafe
behaviors. Predictability reduces the child’s
need for control.
Routines and Rituals
Routines increases predictability and the
child’s ability to anticipate next steps.
Establishing classroom and school-wide
routines helps reduce trouble spots
(transitions, substitute teachers,
unstructured activities/days).
SELF REGULATION
Self-Regulation
A Stepped Approach
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Affect Identification
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Affect Modulation
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Affect Expression
Islands of Competence
“When the student is allowed to be successful in his or her
area of competence, the learning process can begin to take
hold and develop. Focusing on an island of competence
should not be misunderstood as “dumbing-down” an
activity or lesson; rather, it is tailoring learning to a child’s
interests in order to achieve academic success. Not only
does success bolster learning, but it is also central to
developing a positive, trusting relationship with the
student.”
(From, “Helping the Traumatized Child Learn”)
Competency
3 Key Principles
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Build student executive functioning skills
Target self-development and identity
Target additional key developmental tasks
The child develops an ability to evaluate situations,
inhibit impulsive responses and actively make
choices.
Jessica
http://www.youtube.com/watch?v=qR3rK0k
ZFkg
Possible Collision Points at School
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Schools focus on preparing children for and
information related to the external world
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Much of school is motivated by connection and
participation with others
Schools often use delayed gratification
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Students with DT focus on the present and internally to stay safe.
Students with DT are focused on the present to stay safe. Delaying
gratification is dangerous and unpredictable.
Teachers often set limits/goals for the common good
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Youth with DT don’t operate with a template that understands the
common good.
Competing Demands
 Survival

vs. learning
It is nearly impossible to dedicate your full
attention and energy to survival and learning
at the same time.
The Healthy Mind Platter
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Physical time
Sleep time
Focus time
Time in (flossing your brain)
Down time
Plan time
Connecting time
The Whole Brain Child, Dan Siegal
Keys to Successful Intervention
The 6 R’s
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Relevant (developmentally matched)
Repetitive (patterned)
Rewarding (pleasurable)
Relational (safe)
Rhythmic (resonant with neural patterns)
Respectful (child, family, culture)
Relevent Links
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http:/studentsfirst.org
http:/howardcenter.org
http://www.nctsn.org/
http://mentalhealth.vermont.gov/
http://healthvermont.gov/
http://www.ptophelp.org/
Questions?????