This class explores neurocognitive development in early childhood as the impact of PTSD on development. The course offers tools for educators to develop and adapt class room skills to effectively support learning, behavioral management and social skills in children ages 0 to 5.

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Creating
Trauma
Safe
Schools
Image
by
Vlado
Section
Two
Zero
to
5
Trauma
In
Toddlers

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Table of Contents
1. The story of Billy
2. Trauma in the Toddler Years
3. PTSD Symptoms Yong Children (0 to 3)
4. Hyperarousal in Toddlers
5. Acting In vs. Acting Out
6. Seven Domains Effected by Trauma
7. Building Resiliency: Creating Islands of Safety
8. Moving With Building, “I Can!”
Creating Safety Building Mastery
9. Exercise: Seven Domain Assessment
10. Key Points: Trauma in Young Children

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Zero to 5: Trauma in Toddlers Section Two
They Story of Billy..
When Billy was two years old and just learning to potty train he had a
terrible fall. His parents were grateful he survived. At that time Billy’s
parents said that he became more clingy and angry but that was
understandable. Since then Billy has been slow to hit his developmental
markers. At the age of five he could talk but became frustrated when people
did not understand him.
When a teacher or parent asked him to do something he often would become
angry, or just sit and refuse. He had a difficult time solving problems with
peers. If there was a conflict over a toy Billy quickly pushed the kid or bit
the kid he was fighting with.
A very astute teacher noticed that Billy did not always understand what he
was told. The teacher noticed that using certain tones of voice, and speaking
slowly helped.
Billy was popular but also socially awkward. He was strong an tuff so the
other boys liked him but he often blurted things out in class, interrupted
people, and seemed not to notice when other kids were getting angry. Billy
has a very hard time when his parents leave in the morning.
When the teacher is absent and there is a substitute teacher, Billy will be
more hyper, aggressive and brake toys. When ever there is a loud noise Billy

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jumps. Billy will often play in dangerous ways nearly falling or getting other
kids to fall off of the top of the play structures at school.
Billy’s teacher notices that when things are stressful, chaotic or there are
changes Billy’s attention span goes down and it is hard for him to learn.
When it is difficult for Billy to learn he sometimes gets in trouble so that the
other kids do not notice. Billy’s parents report that he does not sleep well
and that he often has night terrors.
Trauma in the Toddler Years
Yong Children (0 to 5) display more intense symptoms of trauma then
adults. Because PTSD is fundamentally a disorder of emotional regulation
and children have less ability to regulate their emotions they display highly
intense symptoms of PTSD. Another factor that make young children more
likely to display intense symptoms of PTSD is that children are highly
dependent on their parents. They have less ability to stand up for themselves.
Being able to stand up and protect one self or others is has been associated
with less intense symptoms of trauma and less chance of developing PTSD.
Toddlers, preschoolers and kindergartners also have a grater chance of
developing symptoms of trauma then adults or even older children. To add
to this difficulty Young children often have more symptoms of hyperactivity
and depression after traumatic events.
Yong Children (0 to 3) display higher differences in cognitive development,
emotional development due to it being a time of large scale Neuroplasticity,
and younger children having less language abilities. Often young children

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display their anger, fear and anxiety and they cannot make sense of it. They
don’t have the verbal skills to say, “Mommy I am scared or mad now.” They
tend to just express these feelings. When they express the feelings it is often
in behaviors that make it difficult for parents, teachers and peers. They can
isolate, fly off the handle quickly, throw or brake toys, have difficulty
managing conflict with peers and poor ability to tolerate frustration. All of
these factors can be frustrating or parents and teachers and leave the child
socially isolated.
On of the key differences in between young children with PTSD and older
children or adults is that young children often do not display symptoms of
numbing. Numbing are the symptoms of feeling emotionally disconnected,
flat or disinterested. This can be a good thing because these children are
more likely to seek social support from parents, teachers and peers when
they are not in a “trigger” or highly activated states. Highly activated states
are emotional and biological states where the child feels scared, angry or
defensive. This can also be challenging. Adults can sometimes get by in
everyday conflicts despite extreme levels of activation due to the ability to
numb their feelings. So this can leave children more raw and susceptible to
acting out on their impulses.
Children 0-5 are often misdiagnosed as having oppositional defiant disorder
and separation anxiety disorder in children with trauma. Children often use
their primary support group or family to help them regulate emotions. This
makes good sense because their brains are not ready to regulate their
emotions on their own. But this also means that since their emotions are
highly intense they may feel more worried about leaving a safe parent. Thus

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increasing separation anxiety. Also, children with PTSD have experienced
the fact that this world can be a dangerous place. Because of this fact they
often worry about the safety of loved ones. They can wonder if they will see
their parents when they leave. Many children who have family members
with cancer or who work in dangerous jobs get highly anxious that they
might not see their parents again. Anxious children can be highly defiant
refusing to leave, get in the car or follow the directions of an adult. It is an
important skill to be able to differentiate between these factors. Due to
defiance, poor ability to tolerate anger, and acting out behaviors it is no
surprise that children who have experienced trauma are often given
diagnosis of oppositional defiant disorder.
Yong Children (0 to 3) Often Display These Symptoms:
Re-enactment play – Re-enactment play is play that incorporates aspects of
the trauma. Children who have had falls may pretend that they are falling.
Children who have seen violence may incorporate it into their play.
Toy destruction – Children often are not carful with their toys. Children with
PTSD however have two difficulties that make it more difficult for them.
The first is frustration tolerance. Sometimes toys are broken because the
child is frustrated. They may throw the toy or smash it when angry. The
other factor is poor attention and concentration. This is the child that seems
to not know their own strength or that seems careless in how they treat the
toy. This can be a difficulty in focus and attention due to feeling anxious,
triggered or having lots of negative feelings inside.

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Aggression towards peers – As discussed above children with PTSD in
general have difficulty regulating their aggression in an appropriate manor.
Children 0 – 5 have particular problems due to their underdeveloped
emotional regulation systems in their brains and less social skills to manage
conflict. Children learn social skills through solving problems. Children with
PTSD struggle to learn when they are angry or anxious more then most
children. This can make it more difficult for them to learn the complicated
skills of conflict resolution.
Defiance toward parents and adults – Poor emotion regulation, feelings of
anxiety or anger that appear without a clear reason can all increase the
defiance that a child displays. These children may also have times when they
are very sweet but when they get angry they “turn on a dime” and talk back
with a high level of intensity. Learning to speak the language of fight flight
and how to help the relaxation response to come back on after a triggering
event, can help a child learn to shift from defiant and angry to engaged and
thoughtful.
Living with domestic violence is related to more aggressive and acting- out
behavior, possibly due to modeling. Many children with PTSD have poor
modeling for how to manage conflict. There is no life without conflict. But
we can manage it well or poorly. Children who have seen violence are more
likely to act violent towards others. We learn many of our emotional and
social habits by watching not by being told. The good news is that educators
can be a powerful force for a more effective model for how to tolerate
emotions.

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Difficulty sleeping – We all know how much fun it is to not sleep well. It can
make us more defensive, less effective in learning and as adults our work
can suffer. Children are no different. Trauma can overwhelm the attention
system in the brain such that it is no longer effective at doing its job. This
same hyperactive attention system has been found to not allow an individual
with PTSD to rest fully. This attention system wakes up the child at small
sounds. Nighttime is also a key time for learning. It is the time when the
brain has the most acetylcholine. This is the neurochemical that produces
attention states and is involved in rates of Neuroplasticity (how the brain
changes with learning). This means if a child does not sleep well they don’t
learn well.
Night terrors – These are events where a child wakes up screaming in the
middle of the night with intense emotions of anger or fear. They typically
don’t know why they are afraid. These events can sometimes cause kids to
not want to sleep (understandably). Some kids will avoid sleep through
arguments, talking back, reading or even laying awake in their beds to stop
the intense dreams.
Reduced attention span – Children with PTSD often have difficulty
concentrating. They struggle with the ability to focus. Some of this difficulty
is due to too much fight flight arousal. We have an optimal level of arousal.
If we are not aroused enough we are board and cannot learn. If we are too
aroused our learning mind shuts off and the defensive mind takes over and
no learning is possible. To learn a child needs to be in the optimal zone.
Children with trauma have difficulty-shifting gears from stress to rest or out

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of fight (anger) or flight
(fear) and back into a good
range of arousal. We can help
children stay in the optimal
zone through providing ways
for them to calm down,
offering tools in lessons,
regulating our own emotions
and structuring curriculum to keep kids in the optimal arousal zone.
Interpersonal/Social Difficulties - Relationally, survivors of interpersonal
trauma suffer from a loss of trust and a sense of betrayal from a person who
is loved. This can be difficult for teachers. Many teachers and even parents
of children who have symptoms of PTSD feel like they are doing what they
do with other kids and that what they are doing is not working. They feel
like the child is not letting them “in.” Or that the child is acting in ways that
“push them away.” This is likely true. The child does not trust and their trust
at times has been damaged by people who were supposed to protect them.
Similarly, many children have been hurt by parents or other loved ones. This
can make it difficult for them to reach out.
Attachement behaviors help the child know you are a safe adult. Learning
the attachment behaviors which, help show the child with your body
language that you are safe, can be a valuable tool in beginning to build the
ability to trust again. Long before our thinking self knows some one is safe
our limbic brain or our emotional mind as already assessed them. This
happens at about 500 milliseconds. Our thinking mind (the front brain or

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prefrontal cortex) gets the message at about 700 - 1200 milliseconds. There
is a system in the brain that functions when we are safe. It is called the
“social engagement system.” The hallmark of the social engagement system
is curiosity, learning, focus and flexibility. The social engagement system is
off when we are afraid and on when we trust the people we are with. There
are ways to help the child move from fear to trust by showing the “body
language of safety.” How to trigger safety with body language and vocal
tone will be explored further. One researcher coined the term
“neruoception.” This is the term he uses to explain how before a child event
is consciously aware of your behaviors they are assessing how safe you are.
Personality changes - A common theme for children with PTSD is that after
the event, “they were different” or they “changed.” The child who was
relaxed and playful can become anxious and angry. This can be difficult for
parents as they struggle to make sense of the changes and feel at times like
they lost their child. It can also impact parent teacher relationships. A parent
may wish that the teacher knew the child before the event or may see a
different child at home because the child feels safe at home and does not get
triggered as easily.
Increased separation anxiety – This is very common and often relates to two
factors these are worry that about their loved ones and the need for emotion
regulation. Children more then teens and much more then adults rely on
others to help them regulate their emotions. Children with intense emotions
may feel terrified going to school with all the peer and performance stress
and also not feel like they can find a safe adult to help them tolerate the
intensity of their emotions.

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Hyperarousal in Toddlers
Hyper arousal symptoms in preschool children were associated with
increased threats of violence, mild violence, and sexual violence. Lets look a
little deeper. What is hyperarousal? Hyperarousal is the intense feelings of
fear or anger that often occur in people who have symptoms of trauma.
Our brains can be thought of as having three systems. The first is the cortex.
The cortex is where we have the higher system or the front brain that does
thinking, planning, higher levels of emotional processing and social
cognition. The second is the limbic system. This is the raw feelings of anger,
sadness, anxiety or worry. The third is the brain stem. The brainstem mostly
deals with automatic functions. All animals including reptiles have a
brainstem. The brainstem also deals with protective responses and helping
the body mobilize the tremendous levels of fight flight necessary to defend
itself from a traumatic event.
When we get very upset our front brains shutdown and our emotional brains
along with the lizard brain start to act. The truth is that between ages 0 and 5
the front brain only has a very limited ability to regulate emotions. So, when
children are hyperaroused instead of discussing it they often make threats.
Re-experiencing symptoms in preschool children were associated with
increased violence of all types. In adults who have re-experiencing
symptoms there is increased acting out of aggression. Children have less
capacity then adults to tolerate these feelings. So this finding is hardly
surprising. What is re-experiencing? Let’s look a little deeper. In a traumatic

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event the brain is set on high alert. This makes an intuitive sense because if
the child ever faces this type of threat later, if the brain remembers the threat
the child will have a better way to deal with it. That is the good side of the
traumatic reaction. The down side is extremely challenging form many
children. Because the brain is in a “high-learning state” memories are
encoded in what is called a “flash-bulb” memory. Think of it like taking a
bright snapshot of the whole event, sights smells and feelings. All of the
sensory experience at that time can be coupled or associated with the intense
feelings of arousal in the body. Like Pavlov’s dogs who salivated at the
sound of foot steps of the man who is bringing food, children with trauma
can have intense emotional reactions triggered by sounds, smells, tones of
voice, facial expressions etc. This can be highly confusing to say the least.
Say a child had a very large fall as they were looking at a red play structure.
When they fell, it felt like their stomach was falling out and they became
terrified. Now much later they may have a queasy body feeling and terror
when they see the color red. Red does not trigger these feelings for most of
us. So this does not seem to make sense to adults or the child. It is
confusing. Red is not by its nature scary! So, the child can be confused by
these emotions and act them out blaming the feelings on a friend, a teacher,
a parent or a seemingly not important event.
Many studies find that toddlers do not display symptoms of Numbing and
avoidance as frequently as adults or older children. One group of researchers
found that young children also have three symptom categories but replace
numbing with a category called “new fears and aggression.”

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Acting In vs. Acting Out
There are two main patterns that researchers have discussed in how children
and teens deal with difficult emotions. These are called externalizing and
internalizing. Both of these types of behaviors are difficult and have
negative impact on a child’s life and education. While some children “act
out” their emotional pain on others, some children “act in” inflicting their
emotional pain on themselves. Both of these patterns are difficult or both the
child, their friends and the adults in the their lives.
Acting In: Internalizing Behaviors
Internalizing behaviors are: Problems that tend to affect the child’s “inner
world.” Children who internalize their responses often display these
symptoms:
1. Withdrawing into their own world. Acting and feeling anxious. Being
inhibited in normal exploration. Feeling unsafe.
2. Depressed mood, behaviors, emotions and beliefs. Children can
appear “over controlled."
Internalizing behaviors can lead a child to isolate, not talk about their
feelings, avoid adult support and can make children defensive when people
offer help. Internalizing behaviors can be hard to spot. It is possible for a
child to be quite in class but be “imploding” on the inside unable to speak up
for themselves. In education these symptoms can be insidious. Children can
be easily distracted by their inner feelings and will fail to learn or complete

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tasks. They often can make mistakes on work and may refuse to attempt
difficult assignments.
Acting Out: Externalizing Behaviors
Externalizing behaviors manifest in children's outward behavior. The child
acts out their hurt on the external world. Children who display this pattern of
behaviors often display these symptoms.
1. Disruptive behavior Hyperactivity Impulsivity Aggressive behaviors
Delinquency.
2. Often referred to as having: Conduct problems, Antisocial behaviors
They can appear: Under-controlled
Seven Domains of a Child’s Life Effected by Trauma
Trauma is not just a psychological event. It effects the whole child, their
family and their ability to learn. The symptoms of PTSD are only one aspect
of the impact of trauma on a child. Trauma affects a child’s thoughts; the
meaning they try to create about their life and it can disrupt cognitive and
emotional development through out a lifetime.
As the brain develops more complex skills often rely on skills developed in
previous years. Because trauma effects learning, attention and a fundamental
since of safety it can dramatically alter how well a child performs in school
and even the development of brain structures. In adults PTSD has been
shown to be correlated with shrinking the hippocampus. The hippocampus is

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the main part of the brain that stores
long-term declarative (information based)
memory. This has profound effects on the
life trajectory of a child. But if these
difficulties are attended to there are
implications that these difficulties can be
reduced.
Resiliency studies show it does not take many positive relationships to help
the child reach a good adult life. In brain research reducing cortisol (a
chemical indicator of fight/flight activation) has been associated with re-
growth of the hippocampus. In other words better learning. The good news
is that reducing cortisol is very, very possible and with tools you already
know.
These are the seven key areas that are
effected by PTSD for children and teens.
1. Symptoms of PTSD: Re-experiencing, avoidance/numbing,
hyperarousal, and in young children: new fears and angers.
2. Psychological Meaning Created: Traumatic guilt, responsibility,
shame, life is dangerous, mom hates me, daddy left because I am
bad, strangers hurt people, I can’t trust any one.
3. Developmental disruptions: Each age holds a developmental
task and there are key social, emotional, neurological, cognitive

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and intellectual tasks to achieve. Trauma can create disruptions in
these tasks.
4. Effects on later development: Some developmental stages build
on capacities from previous stages thus disrupting the
development of later capacities.
5. Impact on support systems: Often times traumatic events
happen to the whole family or other important figures in the
child’s life. These traumas can effect the parent’ ability to engage
with the child. Many negative interaction patterns can develop.
6. Impact of child’s symptoms on others: The child’s symptoms
often impact others and make peer, teaching, care providing,
siblings and parenting relationships difficult.
7. Cumulative Trauma:
a. Higher exposure to trauma increases severity of symptoms and
number of symptoms.
b. One traumatic event if similar can trigger other events (trauma
stacking).
Building Resiliency: Creating Islands of Safety
Resiliency is the ability to bounce back after a stressor. Each child has their
own innate resiliency. As an educator helping a child access their resiliency
can be transformative. Because educators do this naturally there are many

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stories of teachers who changed the entire direction of a child’s life.
Teachers can give their students tools and help the child access her own
innate ability to bounce back from stress.
While all children can “bounce back.” Some children appear better at this
then others. However, social relationships, feeling competent (aka Matery
Experiences), positive adult relationships and setting goals have all been
found to help children bounce back more effectively.
There are many things that a teacher can do to help promote mastery.
Mastery is the experience of being able to accomplish what one sets out to
accomplish. This can be difficult for all kids, even adults. Children and
adults with trauma struggle with mastery due to feeling overwhelmed and
like their emotions are out of control. At times individuals with PTSD can
even feel that their whole life is out of their control.
Children with PTSD often have lost their innate ability to find safety.
Finding safety is a powerful way for a child with trauma to return to a
strong, positive and healthy life. One of the key ways for them to find this is
to build islands of safety. These are places where the child feels understood
cared for and like the adults will stick up for their needs.
In the PTSD overview section the impact of positive emotions on reduction
of the stress response was discussed. We also discussed how individuals
who had more positive emotions were less likely to develop PTSD after 911.
This is good news. Increased positive emotions and ability to calm down or
sooth after a trigger creates a feeling of safety and helps the child learn

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better. This means that teachers have a number of powerful tools in their tool
belt that can help a child who is struggling become more successful.
Children’s bodies and nervous systems have a drive to develop. This is good
news because while trauma can be a boulder in the stream of their life
children will find a way to heal or to get around the boulder. However,
trauma can make it more difficult for their brains and bodies to develop.
Reducing the trauma can help and teachers can provide many experiences
that help support increased emotion regulation, safety and foster the
development of a healthy brain and body. With young children the
relationship of safety, containment, consistency and understanding helps
them develop.
Psychologically Young Children are Establishing: Basic trust in themselves
and others; the ability to act independently; the ability to self-regulate
emotions; the trust in their ability to master their environment. For children
who have been traumatized they can be very sensitive to small changes in
the relationship. Reassurance of the fact that the relationship is still there
after a conflict or feedback can go a long to helping these children be more
effective in the classroom.
Children who have been traumatized also often feel powerless over the
events in their lives. Children who have been traumatized often feel an “I
can’t...” where other children feel an “I can!” A classroom can be an island
of safety where the child can build mastery experiences and learn to trust
again.

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Moving With Building, “I Can!” Creating Safety Building Mastery
Overview: Children with PTSD often feel a deep inner feeling of “I can’t.”
Hypervigilence can interrupt the learning process. Children with trauma
have experienced “overwhelming events.” They often feel as if life events
are unsafe, unpredictable and they cannot affect them positively. In the life
of a child with trauma it is important to build “Islands of Safety.” These are
place and times when then the child feels safe.
One of the big ways to create safety is to build mastery. Mastery is the
experience we all have when we feel capable strong and effective.
Exercise Creating Safety Building Mastery
Steps to Build Mastery…
1. Identify an aspect of the class that you teach which a child is likely to
be successful but may at times struggle.
2. Prior to the attempt give clear supportive instruction on the skill.
3. Ask the child to set their goal for what success looks like.
4. Use your verbal support and validation to help the child stay focused
and tolerate the negative emotions that often impede a child with
trauma from being successful.
5. Allow for pride (pronking – the animal reaction to success) and

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support the child to reflect on what made them successful. Asking
them to see the behaviors and action that helped them reach their goals.
6. Help the child notice that they struggled with the learning but was
successful. A good question is, “when you were first learning it looked
hard. What helped you figure the problem out?”
Exercise: Seven Domain Assessment
Overview: This skill looks to identify which areas of a child’s life is affected
by the PTSD. Through that assessment it is possible to create educational
interventions that will make them more successful. It will also help teachers
identify what referrals would best help the families.
Identify which symptoms of PTSD you see:
1. Re-experiencing: Do they have thoughts that keep playing in their
minds? Do they worry about their parents? Have separation issues, or
seemed “spaced out” like they are not listening to you?
2. Avoidance/numbing, hyperarousal: Do they have trouble staying in
their seats? Difficulty concentrating? If there are load noises do they
jump?
3. Young children: new fears and angers: Are they set off easily and get
angry quickly? Are the afraid of things thy used to enjoy?

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Psychological Meaning:
1. Are they highly sensitive to shame? Embarrassment? Do they feel
guilty and responsible for things they did not do?
2. Do they make comments that seem like the think that life is
dangerous, (e.g. mom hates me, strangers hurt people, I can’t trust any
one)?
3. Do they seem to think that the difficulty is their fault (e.g. daddy left
because I am bad)?
Developmental disruptions:
1. Are they meeting the developmental tasks for their age?
2. Assess their social skills, emotional skills, and cognitive skills. Are
they age appropriate? If not was there a recent stressor?
3. When do their developmental abilities fluctuate wildly when they are
under stress, angry, embarrassed?
Effects of developmental delay on later development:
1. When did they last meet their developmental abilities in cognitive,
emotional or social domains?

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2. Is there a current cognitive, emotional or social ability that seems to
be affected by previous disruptions in development? (E.g. In order to
develop complex moral reasoning they would need the ability to
understand their own experience and anticipate the experience of
others).
Impact on support systems:
1. Were family members also traumatized by the event? If so how
many? Did the event or events effect other important people in the
child’s life?
2. Is the trauma impacting the ability of the adults in a child’s life to
effectively support the child?
3. Are their many negative parent child, teacher parent interactions or
teacher child interactions?
Impact of child’s symptoms on others:
1. Are the child’s symptoms impacting others? How? How often?
2. Are their symptoms impacting peer, teaching, care providing, siblings
or parenting relationships? If so how?

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Cumulative Trauma:
1. Is there cumulative trauma (e.g. leaving a war zone, alcoholism or
addiction, ongoing abuse)?
2. Identify the triggers related to the events.
Key Points Trauma in Young Children
1. Young Children Display: More intense symptoms of trauma,
Increased risk of developing PTSD, More incidence of hyperactivity
and depression then older children.
2. Young Children: Act out the trauma in play more often the older
children, Tend to have a higher incidence of destructive behavior and
violence, Can display higher levels of oppositional behaviors then
older children.
3. Young children often do not display “numbing/ avoidance
symptoms.” They often display what one researcher called, “New
fears and aggressions.”
4. Young children display an increase of externalizing (acting out) and
internalizing (acting in) behaviors.
5. Trauma effects Seven Domains of a Child’s Functioning...
a. Symptoms of PTSD, b. Psychological meaning c. Developmental

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disruptions d. The effects of developmental disruptions on later
development e. Direct Impact of the traumatic event on social support
systems. (Other’s symptoms of trauma). f. Impact of child’s
symptoms on others. g. Cumulative Effects of Trauma. (Trauma
Stacking).
6. Educators can create islands of safety. Children who have been
traumatized often feel an “I can’t...” where other children feel an “I
can!” A class room can be an island of safety where the child can
build mastery experiences and learn to trust again.
A word of caution!
Learning anything new takes work! Some people may try these skills once,
feel frustrated that they did not work and give up. As you practice you get
stronger! As always if practicing this skill brings up a lot of emotion, contact
your therapist or seek out a therapist who can work with you!
Well, that about covers it for the Ebook “Trauma Safe Schools Series:
Trauma in young children (Ages 0 – 5)” I hope you enjoyed it.
We always love to hear people’s thoughts about how this has helped you in
your life. Please feel free to send us questions, feed back and thoughts!