Sebbie’s Story – Managing The Behaviour Of Traumatised Children

In the third guidance in her series of dealing with children with trauma related issues , Dr Margot Sunderland offers practical guidance for non-specialist teachers and school staff on how to respond to children in distress

To take challenging behaviour at face value and write disruptive children off as ‘troublemakers’ is to do them a disservice. By failing to acknowledge each child’s unique history and context, we are fundamentally letting children down.

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      string(5730) "grateful that someone is finally hearing their story, and appreciative that the questions are simply about supporting their child better.Mr Timpson was aware of the physical abuse Sam had suffered and had also been trained to recognise trauma triggers. As a result of this proficiency and knowledge, Mr Timpson stopped the bus and guided Sam out into a nearby field. Mr Timpson knew that he needed first to emotionally regulate Sam – aka, to stop the amygdala in Sam’s brain sending danger alerts out. When a hyperaroused child is calmed by a soothing adult, neuroscientists refer to this process as the amygdala “going quiet”.There are lots of ways to emotionally regulate children and teenagers: all evidence based (neuroscience and physiological studies). Mr Timpson used empathy, understanding and a soothing voice. All of these are proven to calm the amygdala (Morelli et al 2014 and Seltzer et al 2010)He said “Sam, something triggered you when that mouthguard hit your head, didn’t it? Let’s sit here for a while until you feel safe again and if you want to talk about what happened I’m right here to listen.”Eventually, Sam calmed down. They talked about the horse in the next field, before Sam rejoined the bus. The rest of the school trip went by without any problems.In his trauma informed schools training, Mr Timpson learnt the importance of calming the body down first before the teenager engages in any conversation or reflection on what happened. Later in the term, Sam asks to talk to Mr Timpson and tells him he is worried about his Mum.He also tells Mr Timpson about the terror he felt at the hands of his Mum’s partners. With Mr Timpson’s assistance, Mum receives counselling for the first time in her life. Once she discusses her traumatic childhood in a safe setting, she’s able to change her pattern of unhealthy relationships and is no longer drawn to men who are repeats of her past. For the first time Sam and Mum have a calm safe time together. Unacknowledged trauma is like a wound that never heals and may start to bleed again at any time ( Alice Miller)  Reflection‘Zero tolerance’ approaches to discipline in school – such as the use of detention, isolation rooms and permanent exclusions, entirely overlook the reality for so many troubled children of traumatic life events. 70 percent of excluded children in the UK have special education needs of disability and many of these children/teenagers will also have unresolved trauma. (BBC Parliament Accountability Jan 19 2019).Research shows that the brains of traumatised children change in the same way as soldiers returning home from war. The shocking events for both the children and soldiers can cause physical changes to the brain. And yet, through the use of permanent exclusions, we isolate thousands of traumatised children due to their challenging behaviour which manifests as a result of over-active stress response systems. (McCrory, et al 2011)Take away messagesResearch shows that two out of three teachers worry that if they have a conversation with a teenager who self-harms, they will make matters worse for that teenager (Talking Self Harm Report, 2015). This feeling of ‘narrative incompetence’ leaves far too many children and young people seeking alternative sources of help e.g. internet sites which tell them to ‘cut deeper’ or simply ‘end it now’.When teenagers come to talk to teachers about difficult things at home, suitably trained staff can often provide vital, life-changing conversations. Trauma informed training for staff includes giving accurate empathic responses and ‘finding the words to say it’. With appropriate training, school staff no longer need to be frightened of addressing mild to moderate mental health problems. They no longer need to see mental ill-health as some kind of scary brain disease (which it really isn’t) but rather painful life experience that heed to be acknowledged, talked about and made sense of.From our training in over 500 schools in regions across the UK and seeing the moving results achieved by staff we have trained, we entirely endorse the research findings of the Government Green Paper, ‘Transforming Children and Young People’s Mental Health Provision’ (December 2017), which states:‘There is evidence that appropriately-trained and supported staff such as teachers, school nurses, counsellors and teaching assistants can achieve results comparable to those achieved by trained therapists in delivering a number of interventions addressing mild to moderate mental health problems (such as anxiety, conduct disorder, substance use disorders and post-traumatic stress disorder)’.Behaviour should always be considered as a possible communication and not simply seen as a deficit or naughtiness in the child.We need to protect traumatised children/teenagers by ensuring they have a calm safe base at school at least once a day with a trusted adult, where they can emotionally regulate/emotionally refuelDr Margot Sunderland is Co-Director of Trauma Informed Schools UKwww.traumainformedschools.co.ukReferencesGeisler, F. C. M., Kubiak, T., Siewert, K., & Weber, H. (2013). Cardiac vagal tone is associated with social engagement and self-regulation. Biological Psychology, 93, 279–286.Langley-Obaugh, C. (2020). How Stress Can Lead To Emotional Trauma – Christine Langley-Obaugh. [online] NotSalmon.: https://www.notsalmon.com/2015/04/04/how-stress-can-lead-to-emotional-trauma/Miller A (1998). “Thou Shalt Not Be Aware: Society’s Betrayal of the Child”, p.226,"
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ADHD

Sam’s Story – Managing Challenging Behaviour

26 May 2020

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      string(5742) "can also be trauma triggers. Consider ‘The Suitcase Kid’ by Jacqueline Wilson, where a child is constantly on the move as divorced parents continue to argue with each other. It is vital that adopters are aware of the books their children are studying in school so that potential problems can be averted before they arise.HistoryThere are many aspects of history that might cause difficulties. The study of World War 2 with stories of children being evacuated and moved to other families resonates with children who have been moved from family to family with no control over what happens to them.The story of Anne Frank hiding in a small dark place to avoid being discovered by the Nazis and being in fear for her life is an important part of the curriculum. However, it is the same experience as some of my children have had hiding under beds and in cupboards to escape the threat of parents who have beaten them or beaten each other.Citizenship and PHSE (Personal, Health and Social Education)Topics such as relationships, drugs, alcohol use and sex education are covered in these lessons. Children who have difficulties making relationships with others, or whose lives have been adversely affected by drug and alcohol use may struggle to engage with these topics. They may well be reminded of their past life and all of its traumas. For the sexually abused child who may not have realised that what was happening to them was wrong, the sudden realisation, through learning about what is and is not appropriate, may provoke an intense shame reaction. Lessons about the roles of the emergency services and in particular the role of the police in helping and supporting within the community may well be at odds with our children’s experience. For some of our children, where the police attended the motor accident that killed their sister, they saw the police as being the reason they were removed from the care of their mum and stated to me that they’…hated the police’. Another one of our children, who witnessed that her parents had no respect for the police, has grown up with no respect for them either.One of our children, as part of her Global Citizenship Award, needed to learn about Road Safety and the programme of learning included some very graphic footage of road accidents. Fortunately, in this case school were aware of her history and agreed that rather than watching the video, she could design a poster about road safety.Another, recently, has been considering post-traumatic stress as part of her college course. She has had sufficient preparation from us to understand that she suffers PTSD, herself, as well as developmental trauma. However, this didn’t stop her having to leave the room, to the dismay of her friends and tutor. ScienceOne of our sons has always been very scared of loud noises and chaos, both trauma triggers for him. When we started visiting secondary schools to choose an appropriate one for him, we visited the science labs where teachers and students were showing off their prowess in creating chemical reactions which produced loud explosive bangs. Our son’s reaction was to cover his ears and run sobbing from the room. It has taken some time for him to be comfortable with science experiments.ArtOne of our children’s schools has a programme of cross-curricular work where they use famous paintings to explore different aspects of the curriculum. Some of the pictures they have used have been particularly inappropriate given her history. In particular the picture ‘The Scream’ by Edvard Munch was one that was used. This was so traumatic for her to look at that her teacher suggested that instead exploring the picture, she could use the computer to research the artist and the reason behind the painting. This suggested that he was reflecting the screams he could hear from the nearby lunatic asylum to which his partner had been sent. Our daughter was even further traumatised.Another problem with art lessons is that children are expected to manage using the paints and other equipment at an age-appropriate level. However, for children who have never had the chance to experiment with paints and other art materials at a younger age, this presents them with problems and often they are in trouble for making a mess and experimenting with the equipment. Religious EducationOne of the stories which caused immense problems for at least one of our children is the story of Moses from the Old Testament of the Bible. His birth mother (admittedly by force of circumstance) must deny knowing him. So Moses is abandoned by his Mum and then adopted by the Princess of Egypt. The Hebrews are abused by the Israelites and Moses, who is a Hebrew, kills an Egyptian who he saw hitting a Hebrew. Moses is later called by God to free the Hebrews from Egypt and this is achieved as God sends plague after plague against the Egyptians. Finally, God gives Moses the 10 commandments with rules such as ‘Do not steal’, ‘Do not kill’ and ‘Honour your father and mother’. The themes of rejection, adoption, abuse, murder, stealing and the expectation that you should have respect for parents even if they have abused you proved to be very traumatising for our daughter.As can be seen the curriculum is a minefield of trauma triggers which can easily dysregulate vulnerable children. It is vital then to know in advance what is to be taught in school and prepare the child as much as possible. Even seemingly innocuous subjects can cause problems so keep an open mind and think outside the box to check"
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Emotional and Behavioural Difficulties

Trauma In The Curriculum

17 Apr 2018

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      string(5737) "With 25 years of experience in child development and physical and mental health, I felt that the time was right for a step-change in how we support children’s mental health and wellbeing in schools. School days can be the best days of your life but they are certainly full of ups and downs.That’s totally normal. I firmly believe that the key to enabling children to thrive in school is helping them to see that everyone needs help sometimes and it’s ok to ask for it. Giving children the tools to know who and how to ask for help is vital and we must empower them with a common language, so they can identify what they’re feeling and how to express themselves in a way that is understood by their peers, teachers and parents.A framework for conversationsEvidence suggests that schools, teachers and children need help. All of these groups need to feel that they are being supported through the uncertainties that we are now facing, they need to understand that it’s perfectly natural to feel anxious and worried and, most importantly, they must know who and how to ask for help.Delivered through the PHSE timetable, the iSpace Wellbeing and #iWonder Curriculums enable a whole school approach to mental health and wellbeing. The evidence-based curriculums provide an age appropriate framework for mental health conversations across KS1, KS2 and KS3 and are designed to make learning about mental health a fun and engaging experience.The Wellbeing GalaxyThe curriculum starts in KS1, with stories that introduce children to characters such as Dunican (Dun ‘I can’) and Niam (N ‘I am’), who live in a Wellbeing Galaxy on the Planet Wellbeing and who learn about their own and other’s thoughts, behaviour and feelings. Their names reinforce some of the core principles of the iSpace Wellbeing curriculum, and help pupils explore topics like ‘who am I?’ and ‘who can I be?’.The curriculum helps children to understand how their brains work, how to identify and discuss their thoughts, feelings and behaviours and to reflect on important early lessons like sharing and friendship, anti-bullying, physical and emotional health, the environment and diversity in our community. In KS2 Dunican and Niam grow and ‘travel’ across the Wellbeing Galaxy, which consists of 10 wellbeing themed planets. Throughout their adventures they collect ‘backpack’ tools and other resources to support the development of healthy relationships, character, emotional intelligence, resilience, life skills and wellbeing.These engaging characters and space-based missions help schools to equip children with the tools and language to understand each other better; identify the resources that can support them to feel healthy and strong and be their best, and to know who and how to ask for help.Additional iSpace Wellbeing resources such as videos, music and Virtual Reality exercises build engagement and encourage active learning, a mindfulness approach, and are included in the curriculum tools.Advanced life skillsThe KS3 #iWonder curriculum focuses on advanced life skills such as managing thoughts, emotions and behaviour, understanding risk in a digital world, problem solving and decisionmaking. It is designed to help older children to navigate their way through life’s ups and downs, learn from failure and build resilience and character.The #iWonder curriculum is based on a compass tool that helps children to navigate their wellbeing landscape and equip and resource themselves with the knowledge and skills to live life well. There is also a journal tool that helps them to securely document their steady progress and development, as they continue through the curriculum. What resources are provided?The curriculums are continually evolving and additional lesson plans and updates are added regularly. Currently there are 20 lessons and supporting slides for KS1, 84 lessons and supporting slides for KS2 and 40 lessons and supporting slides for KS3. Lesson plans can be built around stories, challenges, activities and discussions and are purposely designed to empower children to learn about mental health and wellbeing in a way that will stay with them for the long-term.Every lesson plan contains clear Learning Objectives, an outline of the Materials and Resources that will be used and where to find them, and a helpful summary of Key Words that should be used within the lesson. The lessons themselves are divided into Teacher Knowledge (background information and suggested questions), Teacher Action (steps like introducing the lesson aim, breaking the class into small discussion groups or reading a particular story) and Active Learning (children respond to questions, work in pairs or take part in a challenge).Attention trainingThere are also optional Attention Training exercises that can be used at the start and end of the lesson to help the children relax, as well as Success Criteria, which allow pupils and teachers to reflect on what has been learned. Each lesson plan comes with a range of resources to use or print, including character and planet cards, activities, worksheets and colouring sheets.Schools and parents can also buy toolkits, which include a manual, conversation map and card deck, to provide supporting tools for conversations and group work, and an additional reference guide that can be used by teachers in the classroom or parents at home. The curriculum and supporting toolkit includes everything a teacher could need to run successful lessons on a range of mental health and wellbeing-related topics.What training is provided?"
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Inclusion

Do We Need To Move Children’s Mental Health And Wellbeing Centre Stage

14 Sep 2020

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      string(403) "... ssocial work teams, and proactivepartnerships with the fosteringservice, CAMHS and schools. Asa professional network I think wehave all been really impressed withthe outcomes for these children.These have included improvementsin behaviour, increased skills andconfidence, integration with peers,and attachments to their care givers.The savings made to date aresignificant, with ..."
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      string(5653) "laughter– and are a really good way for carersto share their experiences, skills andknowledge.Each programme will typicallyrun for 9 – 12 months, with childrengraduating before moving onto theirlong-term family home. Our FamilyTherapist will work with the familymember or long term foster carer/adopter prior to a child graduatingso that they are trained and equippedto continue implementing theprogramme on an ‘MTFC light’ scale,with the team continuing to providesupport for a 3 – 6 month period.Our experience to date has shownus the importance of  staying true tothe clinical model, and consultationis provided from the NationalImplementation Team based at theMaudsley Hospital in London.  Theyin turn have direct links to researchersand staff  at Oregon. This line ofconsultation has helped Pitstop stay ontrack clinically, and in working towardssite certification (we are on track tobecome a Certified Site early next year).Is it effective?To date, six out of seven childrenhave successfully graduated from theirprogrammes.  Three of these childrenhave returned to their birth families– something the team is very proud of,as the original care plans were for longterm foster care.  Our preventativeapproach has been made possible bythe support given by the children’ssocial work teams, and proactivepartnerships with the fosteringservice, CAMHS and schools. Asa professional network I think wehave all been really impressed withthe outcomes for these children.These have included improvementsin behaviour, increased skills andconfidence, integration with peers,and attachments to their care givers.The savings made to date aresignificant, with reduced spending onhigher cost placements and additionalservices for each of  the children,particularly for those who havereturned to the care of  their families.http://www.teachingtimes.comThis month’s FeaturesPractice exampleMary was seven years old when she came into care.  She had been brought into the UK illegally by a familymember who had been unable to understand or manage her behaviours.  This resulted in Mary beingphysically chastised, being removed from the home by social workers, and beginning her journey into thechild in care system.Mary experienced numerous foster placements, each struggling to both understand and meet her needs.At the point she joined Pitstop, professionals were expressing concerns at her continuing difficulties inschool, social interactions with adults and peers, and due to her weight and attitude to food, were of theview that she had a compulsive eating disorder.Mary joined Pitstop aged 11 years, and was matched with one of our foster carers.  As the only childin placement (a requirement of the model), the carer was able to notice and report Mary’s behaviours,strengths and difficulties in great detail and on a daily basis.  This information and that from thecomprehensive assessment undertaken by Pitstop prior to Mary being placed, guided the individualisedprogramme for her. Key behavioural targets were set within her daily routine and charts and rewardsagreed to motivate her in working hard.The first targets for Mary were ‘’Kind Hands,”  “Calm Voice” and “Good Personal Space”. The programmesupervisor worked individually with Mary  so that she could see and hear what these skills look like, practiceusing them safely, and gain confidence in order to generalise this learning into school and friendshipcircles.  Twice weekly skills coach sessions supplemented this work and used fun activities such asswimming, dance and sport to help Mary build on her skills and manage the anxieties that come with  newexperiences.In a relatively short time, Mary was confident enough to practice her “hostess with the mostest” skills.Individual team members visited the foster home after school so that Mary could practise welcomingguests to the home, navigating personal space, initiating and responding to conversation, sharing food,and helping to tidy afterwards.  The daily routine addressed hygiene issues, with her foster carer teachingMary the basics in keeping clean and tidy. This developed into “beauty regimes” that included trips to thehair dressers and clothes shopping expeditions.Staff at Mary’s school were incredibly supportive of her programme and worked closely with Pitstop’sAdvisory Teacher to identify key areas of work and the most appropriate interventions.  These includedinput from the Speech and Language Therapist, social skills group and daily input from the TeachingAssistant.  Staff also worked with us to ensure that Mary’s school card was completed every day so that wecould chart her progress in managing each lesson and her school day generally.Mary’s learning curve seemed infinite, and her confidence grew with each achievement.  At the mid waypoint in her placement, Pitstop and her social worker identified a suitable long term foster carer, who hadregular sessions with our Family Therapist.  The carer was taught and coached in using the strategies andinterventions used by Pitstop, so that she could continue implementing them to support Mary’s progress.Our Family Therapist met with Mary’s older sister Elena, and had regular sessions aimed at helping Elenacome to terms with some of the family’s previous difficulties, and to support her in re-establishing contactand rebuilding their relationship.  The Family Therapist collected life family information and photos thatcontributed to Mary’s life story. This included previously unknown information about Mary’s journey to theUK.Mary was placed with her"
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Inclusion

The Pitstop Project

6 Oct 2011

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