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Creating a Trauma- Informed
Culture
Who am I? Misti Dorsey, LISW-S
Clinical Lead Supervisor for
Elementary School Based Team
Past experience in Community Based Mental Health working with young children, adolescents and their families
How do I regulate? Running, yoga or walking my dog.
Who am I? Kady Lacy, LISW-S
Clinical Lead Supervisor for
Elementary School Based Team
Past experience as a clinician in School Based program for both NCH and Cleveland Public Schools. Along with private practice
working with children, adolescents, adults, and families
How do I regulate? Yoga
Housekeeping
• Take care of your own needs for regulation & self
care
• Ask questions! You’re responsible for your own
learning
• Who do we have in the crowd?
Toxic Stress & The Brain
How do ACEs effect you and me?
Toxic Stress: when a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support. *also known as Adverse
Childhood Experiences
The largest study of its kind ever done to examine the health and social effects of adverse childhood experiences over the lifespan (18,000 participants). The study was conducted between 1995 and 1997.
Vincent J. Felitti, M.D.
Robert F. Anda, M.D.
The Adverse Childhood Experiences (ACE) Study
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Regular smoking by age 14 COPD
ACE score vs. Smoking & COPD
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Ace Score vs. Adult Alcoholism
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Ace score vs. chronic depression
Ace score vs. Serious Job Problems
Ace score vs. underlie suicide attempts
What does Trauma look like? • can “look like” mental health conditions and can
increase the likelihood of developing other mental health conditions • ADHD
• Oppositional Defiant Disorder
• Depression
• Symptoms might include: o disorganized, agitated, or disruptive.
o Zoning out, difficulty concentrating
o Avoidance of reminders, hypervigilance
o Reduced interest in activities
o Worried, sad, or angry
Neurons and Networks
Trauma doesn’t make it OK for kids to behave poorly but
understanding its effects can help us respond to challenging
behaviors in more effective ways.
The 6 “R”s of Healing Trauma
o Relational
o Relevant (developmentally appropriate)
o Repetitive
o Rewarding
o Rhythmic
o Respectful (of the child, family, and culture)
*as identified by Dr. Bruce Perry
• 8 years old, male • Lives with Mom, Dad and 2
siblings • Family members incarcerated
for drug related charges • Has witnessed DV between
Mom & Dad • Hears gun shots in the
neighborhood at night • School problems include: no
friends, doesn’t follow teacher directions, leaves class without permission
Case Study: Allen
PAX- GBG • classroom based interventions that teach students
self-regulation, self-control, and self-management in
context of collaborating with others for peace,
productivity, health and happiness. o not a classroom management program, but it makes managing
classrooms a breeze.
o combined science from PeaceBuilders, Good Behavior Game & other
studies.
• PBIS is the framework for promoting prosocial
behaviors; PAX is the “how-to” promote those
behaviors
What is a kernel? A kernel is the smallest unit of scientifically proven
behavioral influence.
PAX GBG is comprised of 5 evidence-based kernels
Tootles
Beat the timer
PAX Quiet
Granny’s Wacky Prizes
PAX sticks
Tootle Notes A “Tootle” is the opposite of tattling and bullying.
A way for kids to praise one another.
Why use tootles?
Help students recognize the good in others
Build friendships Reduce
picking/bullying behaviors
How do we use Tootles? Be specific
Read it aloud
Post in a visible place
Send home regularly
Peer-to-Peer
Most important
kind of tootle
Practice writing and social skills
Adult-to-Kid
Beat the Timer
Why use Beat the Timer?
• Provides reduced allocation time which in turn increases attention and focus.
• Ex: Video games
• Helps students practice for standardized tests.
• Students achieve success more frequently and feel motivated to do more.
How do we use Beat the Timer?
Beat the Timer
At transition times (i.e. lining up, walking to a
special)
During quizzes or other seat
work
Alert them at various times of how much time is left (ie, for a 5 min timer, alert
them when there is 3 min, 1 min, 10 sec left)
Challenge them to beat their previous time and identify how long it usually takes.
•Important to use a playful voice
Don’t make timer too long
in the beginning
Reward and praise their
efforts (even if they don’t beat their time) and
be non emotional
PAX Quiet (Focus): harmonica and hand signal
Why do we use these:
• Both offer non-verbal forms of telling students to be quiet and eyes on you
• 2 cues instead of 1 (appeals to visual & auditory learners)
• Decreases resistance and verbal power struggles
• Decreases students’ perception of “mean” or “loud” teachers
How do we use PAX Quiet cues? Anytime you want students’ attention, blow the harmonica and put up the PAX
signal
Avoiding saying “Be quiet” or making
other loud noises to get their attention
Hang PAX Quiet posters as a reminder to
students
Verbally praise individual students
Reward the class
Granny’s Wacky Prizes Named after the
Premack Principal, also known as
“Grandmother’s Law”
Why do we use GWPs?
• When you have done ______ (less desirable task) then you may do ____ (more desired task).
• Teach kids to delay gratification
• Reinforces effort, not innate “skills”
• Vested in success as a group, not just individually
How do we use GWPs?
Rewards:
•on-task behaviors
•quiet transitions
•winning a PAX-GBG game
•100% attendance
•Behave in assembly
•Friendly to peers
Should be a behavior they
are usually prohibited from
doing
Intermittently, for short period (30 secs-2mins)
• This increases motivation
Kids can come up with ideas too
Examples of GWPs
“Bark” or “Meow” the
Happy Birthday song
Fart noises with arm pits
“Snowball” fight with
paper
Air guitar to a favorite song
PAX sticks
Why the sticks?
• Learn skills such as taking turns and patience
• Improves focus with random calling
• Human biology says we are hardwired to pay attention if the stimuli is random (i.e. video games)
• Students learn to manage feelings of anxiety related to unpredictability
Write one student’s name on every stick
Return it to the cup each time
Don’t decorate the sticks in order to keep
the element of surprise
This prevents students’ feeling like they can be “off the hook” which causes them to lose focus
Try to use sticks for all teacher-directed
instruction
Allow students to ask for help if their name is called and
they don’t know the answer
This encourages teamwork rather than
giving up
How do we use PAX stix? PAX stix
Create Predictability and Structure
o Agenda/schedule setting
(verbal and written)
• Warn of changes in
schedule numerous days in
advance (i.e. substitute
teachers, days off school, no
music class)
o Use timers for transitions and
give warnings that transition is
coming
o Support student choice and
control (to the extent that you
are able to do so)
Set Clear Expectations o Engage students in
these expectations (i.e. make a classroom vision)
o Write the rules down and post them
• Keep the rules consistent between adults and settings
• Repeat/review daily
Relationships are key!
o Every child needs at least one person who has committed to
them in the building
• use co-regulation
o Validate student responses and emotions (even if they don’t
make sense to you!)
• Believe abuse or trauma allegations and suicidal ideations
o Be an active listener
o Engage the mental health therapist or other agencies involved
for better continuity of care
o Give positive attention to wanted behaviors
• 4:1 ratio of positive to negative
The Marshmallow Test • Original study conducted by Stanford University in
late 1960’s o Ability to delay gratification strongly correlated with success later in life
(i.e. higher SAT score, less substance abuse, parent reports of better social
skills)
• University of Rochester “revisited” this test in 2012
proving that environment also influences ability to
delay gratification o Reliable v. unreliable groups
o “wait time” was almost 9 minutes longer in the reliable group
Marshmallow Test Revisited
WEVAS for Anxiety • Ask questions “How can I help?”
o Don’t insert your own solutions without permission
• Validate “You feel left out.”
• Use soft tone of voice; even keeled
• Mirror the student’s body image & get on his/her
level (i.e. sit down if student is sitting)
• Your relationship with the student will impact
outcome o Consider allowing student to go visit another adult if relationship is not
strong/positive
WEVAS for Aggression • Don’t take anything personally; avoid those power
struggles
• Give physical space between you and student
• Don’t problem solve; use reflective/validating
statements instead
• Don’t make direct eye contact
• Use L shaped stance
• Save consequences and debriefing for later time
• Model calming strategies such as deep breaths or
walking
REMEMBER…
You have a brain, too!
“If a child doesn’t
know how to read,
we teach.
If a child doesn’t
know how to swim,
we teach.
If a child doesn’t
know how to
multiply,
we teach.
If a child doesn’t
know how to drive,
we teach.
If a child doesn’t
know how to
behave,
we...punish?
Why can’t we
finish the last
sentence as
automatically as
we do the
others?”
Counterpoint Tom Herner (NASDE President ) 1998, p.2)
Questions? Thoughts? Kady Lacy (614) 578-9278 [email protected] Misti Dorsey (614)202-7027 [email protected]
References • https://goodbehaviorgame.org/ • “The prevalence of adverse childhood experiences, nationally, by state, and by
race/ethnicity” Vanessa Sacks, MPP, and David Murphey, PhD • Georgetown University Center for Child and Human Development • Center on the Developing Child at Harvard University • https://www.cdc.gov/violenceprevention/acestudy/ • https://www.wevas.ca/ • Tom Herner (NASDE President ) Counterpoint 1998, p.2
• https://vimeo.com/109042767 • https://www.youtube.com/watch?v=rVwFkcOZHJw • https://www.youtube.com/watch?v=JsQMdECFnUQ • https://vimeo.com/195377139 • https://vimeo.com/195360620 • O’Connell, M. E., Boat, T., & Warner, K. E.. (2009). Preventing mental,
emotional, and behavioral disorders among young people: Progress and possibilities.
