By Martha Staeheli, Ph.D. Yale University Program for Recovery and Community Health
Trauma and Children
Joanna’s experience is not unusual; one of every four children have experienced a trauma before the age of four, and by the time children are 18, almost 60% will have experienced at least one traumatic event that may include sexual assault, physical and emotional violence, or bullying (CDC, 2014). Significant trauma exposure can interfere with cognitive development (Perry, 2001; Perry, 2009), undermining normal development and leading to a 76% higher likelihood of delay in cognitive, emotional, and behavioral development (SAMHSA, 2018; Perry, 2001). As a result, children exposed to trauma experience significant educational obstacles (Yu & Canter, 2014) with difficulties in early learning and achievement gaps that tend to widen and persist throughout elementary school and beyond (McClelland, Acock, & Morrison 2006).
As children move into middle and high school, trauma exposure increases the risk of behavioral health disorders, risk taking behaviors, educational failure, and violence (Felliti et al., 1998; SAMHSA, 2018; Shonkoff et al., 2012). Without intervention, the consequences of trauma persist into adulthood and are amplified and often passed on to subsequent generations: risk of depression, substance use disorders, suicidality, chronic medical problems, complications in pregnancy, and interpersonal, employment and financial problems (SAMHSA, 2018; Shonkoff et al., 2012.)
Protective Factors
Schools are ideal settings to provide support to children to ameliorate the effects of trauma and amplify protective factors—factors that help protect students from both the short-term and long-term damage of stress and trauma. One of the most important of these factors is the availability of nurturing adults, such as teachers, who can help meet this need. A compassionate and healthy classroom and school culture, educated in mental health and trauma, is essential to establish a sense of security and trust that enables children impacted by trauma to heal, grow, and learn (Ford & Courtois, 2013; Shapiro et al., 2014; Zelazo & Cunningham, 2007).
Supporting Mental Health in Schools
Many teachers and school staff are similar to those in Joanna’s school, however, in that they are unsure how to identify children who may have experienced significant trauma, how to recognize symptoms of mental health disorders, and how to connect children to healing and compassionate school and community-based supports. Recognizing the opportunities within schools to support children’s mental health, the Substance Abuse and Mental Health Services Administration, has expanded the funding of regional Mental Health Technology Transfer Centers (MHTTCs), charged with regional mental health technical assistance, to support youth who have experienced school and other violence and trauma by providing technical assistance on school-based mental health service provision.
Within the Northeast Region center (MHTTC-NE), the Yale Program for Recovery and Community Health (Yale-PRCH) has partnered with the Center for Educational Improvement to create the Childhood – Trauma Learning Collaborative (C-TLC). The purpose of the C-TLC is to build state and regional capacity to advance comprehensive school mental health policies and practices, tailored to local strengths and needs, based on shared learning and technical assistance.
The New England Childhood – Trauma Learning Collaborative (C-TLC)
Fellows will identify five schools, each within their communities, to complete the S-CCATE, a 40-item assessment tool to aggregate teachers’ reports on perceptions of classroom and school culture (Mason et al., 2018a), which has been validated in early childhood, elementary, and secondary school populations.
After the initial S-CCATE completion, fellows will meet in Boston for a meeting in April, where they will discuss the purpose and structure of the collaborative and be oriented to trauma-informed practices in schools, with sessions to discuss S-CCATE results (identified needs and strengths) and protocol.
Fellows will have opportunities for: networking, sharing specific issues and concerns, and providing input into the strategic plans, protocols and operations of the C-TLC. Fellows will participate in at least one webinar a month, beginning with age-specific, in-depth knowledge of mental health disorders in children and youth, the role and strategies of schools in addressing mental health concerns, and trauma and its life-long impact.
As the C-TLC Fellows continue to work in their home communities to support building school-based mental health capacity, the C-TLC staff and faculty will be available to answer questions and provide additional support to the Fellows and their communities on an as-needed basis and using established strategies to determine the most appropriate and relevant methods and resources.
The kinds of issues that Joanna faced in school, and the risks she will continue to face as she begins to recover from a traumatic early childhood are exactly the types of challenges the C-TLC is designed to address. To give kids like Joanna the best chance for healing, teachers, administrators, and other school personnel need the tools to address trauma and promote resiliency in a way that fosters the intellectual and emotional development of students, while increasing the competence and confidence of school staff. Addressing school based mental health issues through initiatives like the C-TLC not only benefits children like Joanna who are survivors, but also fosters a school culture where all children can thrive, and all educators have the awareness and knowledge to support them as they grow and flourish.
References
Centers for Disease Control and Prevention. (2016). About the CDC-Kaiser ACE study.
Felliti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245–258.
Ford, J. D., & Courtois, C. A. (Eds.). (2013). Treating complex traumatic stress disorders in children and adolescents: Scientific foundations and therapeutic models. New York, NY: Guilford Press.
Mason, C., Rivers Murphy, M., Bergey, M., Mullane, S., Sawilowsky, S., & Asby, D. (2018). Validation of the School Compassionate Culture Analytic Tool for Educators (S-CCATE) Supplement. Vienna, VA: Center for Educational Improvement.
Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56(3), 227.
McClelland, M. M., Acock, A. C., & Morrison, F. J. (2006). The impact of kindergarten learning-related skills on academic trajectories at the end of elementary school. Early Childhood Research Quarterly, 21(4), 471-490.
Perry, B. D. (2001). The neurodevelopmental impact of violence in childhood. In Textbook of Child and adolescent forensic psychiatry (221-238). Washington, D.C.: American Psychiatric Press, Inc.
Perry, B. D. (2009). Examining child maltreatment through a neurodevelopmental lens: Clinical applications of the neurosequential model of therapeutics. Journal of Loss and Trauma, 14(4), 240-255.
Sapienza, J. K., & Masten, A. S. (2011). Understanding and promoting resilience in children and youth. Current Opinion in Psychiatry, 24(4), 267-273.
SAMSHA.(2018). National registry of evidence-based programs and practices: Cognitive behavioral intervention for trauma in schools. Shapiro, S., Lyons, K., Miller, R. Butler,B., Vieten, C. & Zelazo, P.( 2015). Contemplation in the classroom: a new direction for improving childhood education. Education and Psychology Review, 27, 1-30.
Shonkoff, J. P., Garner, A. S., Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, Siegel, B. S., Dobbins, M. I., Earls, M. F. Section on Developmental and Behavioral Pediatrics. (2012). Early childhood adversity, toxic stress, and the role of the pediatrician: Translating developmental science into lifelong health. Pediatrics, 129(1), e224–e231.
Yu, E. & Cantor, P. (2014). Turnaround for children, poverty, stress, and schools: Implications for research, practice, and assessment. Turnaround for Children.
Zelazo, P.D. & Cunningham, W.A. (2007). Executive function: Mechanisms underlying emotion regulation. In J. J. Gross (Ed.), Handbook of emotion regulation (135-158). New York, NY: Guilford Press.
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