Building Bright Futures Council March 16th, 2012 Nicole Mondejar, MHAAdministrator of Early Childhood Programs WCMHS, Inc.
Brain Development & Trauma/Stress What to Look For Best Practices & Local Resources What You Can Do
Positive Stress All managed by brain circuits and hormones in the body . Tolerable Stress Prolonged exposure Toxic Stress to stress hormones = impaired brain development and functioning.
Trauma is defined as a physical or psychological threat or assault to a child’s physical integrity, sense of self, safety orsurvival or to the physical safety of another person significant to the child. (VT CUPS Handbook)
Children may experience trauma as aresult of a number of differentcircumstances, such as: Abuse, including sexual, physical, emotional Abandonment or neglect Witness to domestic violence Death or loss of a loved one Severe natural disasters War, terrorism, military or police actions (including media images) Witness to community violence Personal attack by another person or an animal Kidnapping Severe bullying Medical procedure, surgery, accident or serious illness Living in chronically chaotic environments
“High levels of stress during pregnancy should be categorized as potentially “toxic”, indicating that they might have long-term consequences for human development that are similar to the adverse impacts of significant neglect or abuse in early childhood”.Study Title and Authors: Richardson, HN, Zorrilla, EP, Mandyam, CD, Rivier, CL (2006). Exposure torepetitive versus varied stress during prenatal development generates two distinct anxiogenicand neuroendocrine profiles in adulthood. Endocrinology 147:2506-2517.
In one study, children aged 2–5, 52.5% had experienced a severe stressor in their lifetime. Young children have the highest rate of abuse and neglect, and are more likely to die because of their injuries. Children younger than 3 years of age constituted 31.9% of all maltreatment victims reported to authorities in 2007. Infants are the fastest growing category of children entering foster care in the US. Infants removed from their homes and placed in foster care are more likely than older children to experience further maltreatment.
Children aged 0-2 exposed to traumatic stress may: Act withdrawn Demand attention through both positive and negative behaviors Demonstrate poor verbal skills Display excessive temper tantrums Exhibit aggressive behaviors Exhibit memory problems Exhibit regressive behaviors Experience nightmares or sleep difficulties Fear adults who remind them of the traumatic event Have a poor appetite, low weight and/or digestive problems Have poor sleep habits Scream or cry excessively Show irritability, sadness and anxiety Startle easily
Children aged 3-6 exposed to traumatic stress may also: Act out in social situations Be anxious and fearful and avoidant Be unable to trust others or make friends Be verbally abusive Believe they are to blame for the traumatic experience Develop learning disabilities Experience stomachaches and headaches Fear being separated from parent/caregiver Have difficulties focusing or learning in school Imitate the abusive/traumatic event Lack self-confidence Show poor skill development Wet the bed or self after being toilet trained or exhibit other regressive behaviors
Contrary to popular belief,young children living in highly disadvantaged environmentscan be protected from serious emotional or behavioral consequences.
VT Child Trauma Collaborative (VCTC) 12 community-based mental health treatment centers serving all regions under the DMH. 6 clinicians at each site to form local ARC community treatment & service teams Services target children ages 3-18 and their families, who have experienced complex trauma Train-the-trainers series for mental health providers and community partners to provide trauma trainings across the system of care
Attachment, Self-Regulation andCompetencies (ARC) Framework for intervention with youth and families who have experienced multiple and/or prolonged traumatic stress.
Four standardized assessments administered at intake,quarterly, and at discharge: Parenting Stress Index (PSI) for ages 0 to 12 or the Stress Index for Parents of Adolescents (SIPA) for ages 11 to 19. Trauma Symptom Checklist for Children (TSCC) for ages 8 to 16 or the Trauma Symptom Checklist for Young Children (TSCYC) for ages 3 to 12. The UCLA PTSD Reaction Index (UCLA PTSDRI) to assess post- traumatic stress reactions among children and adolescents aged 7 to 12 years old. The Achenbach System of Empirically Based Assessment Child Behavior Checklist (ASEBA CBCL) for ages 1 ½ to 5 or 6 to 18.
Neurosequential Model of Therapeutics(NMT) Developmental & Relational History Estimate which neural networks & functions likely impacted by trauma Current Assessment of Functioning Brain Mapping Recommendation for interventions Addressed in developmental sequence
Early Childhood & Family Mental Health (ECFMH): Accessed through referrals to CIS Home Visiting Parent Training & Education Therapeutic Case Management Individual Therapy for parent and/or child Marital/Couples Therapy Coordination with Substance Abuse Services Linking Community Supports (LINCS) Outpatient Therapy Individualized Play Therapy
“Participation in pre-kindergartendramatically reduced participation in juvenile and adult crime, and increased high school graduation, employment and earnings, with a total benefit-cost ratio of 16 to 1.26”.
1. Healthy Adult Relationships2. Promote Protective Factors Nurturing and attachment Knowledge of parenting and of child and youth development Parental resilience Social connections Concrete supports for parentss Early Identification & Access to Supportsr Increase Awarenesss Call your legislators