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Advancing Social and Emotional Learning - CASEL

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CASEL is helping make evidence-based social and emotional learning an integral part of education, preschool through high school.

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Mindfulness in Schools: Mindfulness and the Brain for Children

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Betsy Andersen

"I could see him trailing off and then he started crying," says Andersen, who lives in Mundelein, Illinois. But before she swooped in, she heard Miss Eileen talking to him: "She was saying 'Hey, I see you're having some big emotions." Speaking through the puppet, Miss Eileen then led Ezra through some breathing exercises that helped him calm down and focus.

Andersen, like parents all over the country during the pandemic, has been looking for ways to fill the void left for her son and his sister while they're shuttered inside, isolated and dealing with all kinds of feelings they don't understand.

"I'm not taking my kids to the store or anywhere. They're really lonely," says Andersen, who is trying to keep them active and engaged while doing contract work as a graphic designer. The lack of a fixed schedule is also tough for her son, who gets additional help online for various emotional and developmental issues, though not as much as he received in person at school.

In fact, the facilitators on the Zoom call are particularly adept at working with children and families around times of profound traumatic stress. They're trained in a specialty known as Child Life, which works with families on the grief, fear, and anxiety that children often experience while receiving medical care for serious illnesses or injuries. While Child Life specialists typically work in hospitals, some are pivoting into other areas and are now applying their skills to the fallout from the pandemic. Some have also been coming up with suggestions for ways to help children process feelings about frightful events captured in the news, such as the killing of George Floyd.

Among those who have branched out is Miss Eileen, aka Eileen Esposito, a Child Life specialist in Tampa, Florida, who helped develop the group sessions that Andersen's children attended, called Coping through Connection. Esposito and her colleagues are part of an organization that had already stepped outside traditional medical settings, the Child Life Disaster Relief organization (CLDR), which operates virtually and includes 18 contract Child life specialists around the country.

The group was formed in 2016 to help mitigate trauma in children who have experienced disasters and crises. It also partners with organizations who are deployed to disasters, such as Children's Disaster Services. It worked with children who lived through the devastating massacre at a country-and-western concert in Las Vegas in 2017, and with children and families who survived Hurricane Dorian in the Bahamas in 2019 and Hurricane Maria in Puerto Rico in 2017.

Much of their work involves child-led play, says Katie Nees, one of CLDR's founders who lives in Cincinnati, Ohio. She recalls an experience working with children in a homeless shelter in Moore, Oklahoma, in 2013, which predates CLDR, but is instructive. Using cardboard boxes, magic markers, crayons and tape, the kids in Oklahoma built their own houses and networked with each other.

Katie Nees

"They'd say things like, 'You're my neighbor, you're my neighbor, if anything happens, we'll stick together,'" says Nees. "After a couple days, they had a moment of high energy and ran around making lots of noise. They ended up ripping the houses to shreds," she says, adding that the scene mirrored the reality of what was visible just outside.

After the demolition, the kids asked for time to sit and be calm, and Nees brought them snacks and drinks.

"We all sat together and [absorbed this feeling] of safety of the moment," she recalls. "Watching them play out that entire situation the way they did it as a collaborative effort and then at the end just making time for safety and calm, was incredible. I've never seen anything like it." (Here are some resources from CLDR.)

A turning point for Nees, who has worked in hospitals as a Child Life specialist since 2010, was when she came to understand how clearly the work of Child Life specialists was grounded in ACEs science.

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"I could see him trailing off and then he started crying," says Andersen, who lives in Mundelein, Illinois. But before she swooped in, she heard Miss Eileen talking to him: "She was saying 'Hey, I see you're having some big emotions."

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An ACE score is a tally of different types of abuse, neglect, and other hallmarks of a rough childhood. According to the Adverse Childhood Experiences study, the rougher your childhood, the higher your score is likely to be and the higher your risk for later health problems. You can take the test below:

So, you've got your score. Now what?

First, remember that the ACE score isn't a crystal ball; it's just meant as guidance. It tells you about one type of risk factor among many. It doesn't directly take into account your diet or genes, or whether you smoke or drink excessively - to name just a few of the other major influences on health.

To learn more, check the CDC's ACE Study website. You'll find, among other things, a list of studies that explore the ways adverse childhood experiences have been linked to a variety of adult conditions, ranging from increased headaches to depression to heart disease.

Remember this, too: ACE scores don't tally the positive experiences in early life that can help build resilience and protect a child from the effects of trauma. Having a grandparent who loves you, a teacher who understands and believes in you, or a trusted friend you can confide in may mitigate the long-term effects of early trauma, psychologists say.

"There are people with high ACE scores who do remarkably well," says Jack Shonkoff, a pediatrician and director of the Center on the Developing Child at Harvard University.

Resilience, he says, builds throughout life, and close relationships are key. Recent research also suggests that for adults, "trauma informed" therapy - which can center on art, yoga or mindfulness training - can help.

How best to find and help kids who are experiencing abuse and neglect right now?

Child psychologist Hilit Kletter, of Stanford University's School of Medicine, says that to spot these children, she looks for visible signs of stress to understand what might have happened to them and how best to intervene. Some kids have nightmares or recurring thoughts of a stressful event, she says, or may re-enact the trauma through play. Or the child may seem distracted or withdrawn.

"This will come out at school," Kletter says. "Teachers will tell parents [their child] seems to be in a daze in the classroom, not paying attention."

Kletter says reactions to trauma are sometimes misdiagnosed as symptoms of attention deficit hyperactivity disorder, because kids dealing with adverse experiences may be impulsive - acting out with anger or other strong emotions.

"It's something that's very common in trauma: difficulty in regulating emotions and behavior," she explains. "That's why a lot of these kids get in trouble with the classroom."

Shonkoff's research center at Harvard tests interventions that can build resilience in kids who are growing up with adverse experiences - not just problems in the family, such as those the ACE study investigated, but also trauma stemming from poverty, for example, or from the chronic stress of racial or gender discrimination.

To bolster parents, the Harvard team is testing interventions right now that use video coaching to show moms and dads how to engage their babbling infants, using sounds and facial expressions in a style Shonkoff calls serve and return.

Shonkoff says these early interactions - a kind of conversation - have been shown to help children with later learning and literacy. Even more important, they boost kids' resilience, by helping them build secure attachments with caring adults. Research suggests that just one caring, safe relationship early in life gives any child a much better shot at growing up healthy.

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Take The ACE Quiz - And Learn What It Does And Doesn't Mean

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First developed in the 1990s, the 10 questions of the Adverse Childhood Experiences test are designed to take a rough measure of a difficult childhood. Finding out your score is easy. Now what?

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12.6% or 1 out of every 8 students had 4 or more ACES.
The higher your ACE score, the worse your health outcome is.
4 or more of your students will be 12 times more likely to attempt suicide.
Higher ACE scores mean fear. Fear affects emotional and brain function over time. This changes students hormonal and immune systems over time.

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What if a child does not understand the context of some of the questions being asked? How can you explain these in a way they can understand on their level? Example: What if a child doesn't understand what drunk means but their parent often comes home drunk, could you ask them if their parent stumbles or slurs words?

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How childhood trauma affects health across a lifetime | Nadine Burke Harris | TED