This document summarizes Nicole Mondejar's presentation on building bright futures for children through early childhood programs. The presentation covered: 1) How stress and trauma impact brain development in young children 2) Common signs of stress and trauma in children aged 0-6 3) Best practices for intervention including the Neurosequential Model of Therapeutics and Attachment, Self-Regulation and Competencies framework 4) Local resources in Vermont for young children experiencing stress/trauma and their families

1. Building Bright Futures Council
March 16th, 2012
Nicole Mondejar, MHA
Administrator of Early Childhood Programs
WCMHS, Inc.

2.  Brain
Development &
Trauma/Stress
 What to Look For
 Best Practices &
Local Resources
 What You Can Do

3.  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.

4. Trauma is defined as a physical or
psychological threat or assault to a child’s
physical integrity, sense of self, safety or
survival or to the physical safety of another
person significant to the child.
(VT CUPS Handbook)

5. Children may experience trauma as a
result of a number of different
circumstances, 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

12. “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
to
repetitive versus varied stress during prenatal development generates two distinct anxiogenic
and neuroendocrine profiles in adulthood. Endocrinology 147:2506-2517.

13.  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.

14. 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

15. 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

16. Contrary to popular belief,
young children living in highly
disadvantaged environments
can be protected from serious
emotional or behavioral
consequences.

17. 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

18. Attachment, Self-Regulation and
Competencies (ARC)
 Framework for intervention with youth and
families who have experienced multiple and/or
prolonged traumatic stress.

19. 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.

20. 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

23.  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

25. “Participation in pre-kindergarten
dramatically 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”.

26. 1. Healthy Adult Relationships
2. Promote Protective Factors
 Nurturing and attachment
 Knowledge of parenting and of child and youth
development
 Parental resilience
 Social connections
 Concrete supports for parents
s Early Identification & Access to Supports
r Increase Awareness
s Call your legislators