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Life threatening health situations and/or painful medical procedures

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Life threatening health situations and/or painful medical procedures

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What are we talking about?

This section will cover students who have either experienced or are anticipating the following:
- a life-threatening physical injury
- a life threatening medical diagnosis
- an upcoming painful or scary medical procedure

These criteria cover a wide variety of situations and could include events such as a severe allergic reaction, a serious car accident, a serious injury on the sports field, a diabetic coma in an undiagnosed child, a severe asthma attack, an upcoming painful dental procedure for a child who is allergic to anesthetics, a cancer diagnosis, an epileptic seizure, and many more.

A students who is anticipating or experiencing one or more of these situations could exhibit the following signs/ symptoms of trauma:

Avoidance - The student may avoid discussing their experience and related thoughts and feelings, and may also avoid situations similar to the one they were in when the incident occurred, such as no longer playing sports after a serious injury or preferring to stay inside during recess after a sever allergic reaction to a bee sting.

Hyper-arousal - Students may exhibit symptoms similar to a panic attack or PTSD, and could be triggered by certain experiences they associate with the incident, such as being frightened by a car horn after a serious car accident.

Re-experiencing - The student may continue to re-live the event after it has occurred, either finding themselves thinking about it a lot or involuntarily re-experiencing it through a triggering stimulus such as a sight, sound. or smell. There is a healthy amount of re-experiencing that can help the student process the ordeal and come to terms with it, but excessively re-living the event can be traumatic.

Incidence

Around 80% of children with illnesses or serious injuries experience some trauma associated with the event(s), and around 15-25% of children and 20-30% of parents/ caregivers experience persistent traumatic symptoms associated with the event, which can affect adherence to treatment.

Strategies for Educators

Incorporate Student Interests - Encouraging the student to pursue their interests and utilizing those interests in the design of lessons can be an effective way of enabling the student to participate in their education without the threat of their trauma looming over them.

Allow room for Processing - Students with medical or injury-related trauma often need time and a safe space to process their feelings related to their experience. This can sometimes be tricky, especially in cases where the student's parents/guardians wish to shield them from the full implications of a serious diagnosis. Still, allowing them room to participate in lessons at their own pace immediately following/preceding a traumatic medical event can help students process their feelings and get back to good.

SEL Practices - Socio-emotional learning practices can help students develop communicative capacities to better indicate their trauma-related needs.

PLC Practices - It is often the case that several areas of expertise are beneficial in best addressing the needs of a student dealing with medical-related trauma. Building a professional learning community can help address not only the educational needs of the student, but also their medical, socio-emotional, and psychological needs as well.

Citations

NCTSN (n.d.) Effects of Medical Trauma. Retrieved from https://www.nctsn.org/what-is-child-trauma/trauma-types/medical-trauma/effects

Upper Grand District School Board (2018).  Students with Life-Threatening Medical Conditions Procedures Manual. Retrieved from https://www.ugdsb.ca/wp-content/uploads/2018/03/518-A-Students-with-Life-Threatening-Medical-Conditions-Procedures-Manual-June-2018.pdf

Kenardy, De Young, Le Brocque, & Ma (2011).  Childhood Trauma Reactions: Teacher Manual. Retrieved from https://schools.aidr.org.au/media/4605/conrod_childhood-trauma-reactions.pdf

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Symptoms may be physical, emotional and/or social, which include:

Crying, Chronic Fatigue, Body Aches, Headaches, Digestive Issues

Anger, Annoyance, Feelings of Anxiety, Frustration, Guilt, Longing, Emotional Numbness

Unusual and excessive desire to be alone; Refusal to talk to others; Unusual instances of “acting out” or engaging in high risk behavior;

Responding to Bereavement among Students

Let the student know that it is normal to grieve

Suggest that the student might express grief, both verbally and nonverbally.

Refrain from lecturing or making decisions for the students. Instead, help him/her
examine the available alternatives.

Be encouraging and hopeful.

Even though it is difficult, encourage students to eat properly, exercise, and get
sufficient sleep and rest.

Encourage students to take “breaks” from grieving if they feel like it.

Citations
“Students Coping with Grief & Loss at School.” Accredited Schools Online, 15 Apr. 2021, https://www.accreditedschoolsonline.org/resources/managing-grief/.

"GRIEF: RECOMMENDATIONS FOR HELPING STUDENTS WHO HAVE EXPERIENCED A SIGNIFICANT LOSS" University of Delaware Department of Education, Jan. 2013, https://www.education.udel.edu/wp-content/uploads/2013/01/Grief.pdf.

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Bullying, also known as peer victimization, is a deliberate and unsolicited action that occurs with the intent of inflicting social, emotional, physical, and/or psychological harm to someone who often is perceived as being less powerful. Bullying typically happens repeatedly and is a form of aggression and harassment that prevents someone from enjoying a safe, stress-free living, learning, or working environment.

Different manifestations of bullying:

physical, such as hitting, poking, tripping or pushing

verbal, such as name calling, insults or abuse

social (covert or hidden), such as lying about someone, spreading rumours, mimicking or deliberately excluding someone

psychological, such as threatening, manipulating or stalking behaviour

online, often referred to as cyberbullying, which means using technology such as email, mobile phones, chat rooms or networking sites to bully verbally, socially or psychologically. It can involve sharing of photos which upset or embarrass the person being bullied and taunting or malicious comments. Often people who bully online also bully in person.

Signs of a child being bullied:

Declining grades, loss of interest in schoolwork, or not wanting to go to school.

Self-destructive behaviors such as running away from home, harming themselves, or talking about suicide.

Feelings of helplessness or decreased self esteem.

Sudden loss of friends or avoidance of social situations.

Changes in sleep and eating patterns.

Anger of Frustration.

Signs of a Child Bullying Others:

Get into physical or verbal fights.

Have friends who bully others.

Are increasingly aggressive.

Get sent to the principal’s office or to detention frequently.

Have unexplained extra money or new belongings.

Blame others for their problems.

Effects of Bullying:
Children or teens who have been exposed to trauma and violence may be more likely to:

Bully others

Be more distressed by bullying or appear desensitized to bullying

Be the targets of bullying themselves

The relationship between trauma and bullying is complex. Being bullied can lead to traumatic stress reactions including Posttraumatic Stress Disorder. For example, a 2012 study (Idsoe, Dyregov, & Idsoe, 2012) found that for all students who experienced bullying, 27.6% of boys and 40.5% of girls had PTSD scores within the clinical range. Symptoms were even worse for those students who both bullied others and had been the targets of bullying themselves.

Children who have experienced trauma are more likely to be bullied and to engage in bullying behavior. In some cases, children who experience trauma may develop social or interpersonal difficulties, making them more likely to become targets of bullying. Studies of Adverse Childhood Experiences, or ACEs, have found that children who report more ACEs are also more likely to exhibit bullying behavior (Sacks, et al., 2014).

What hinders bullying victims from receiving help?

Bullying can make a child feel helpless. Kids may want to handle it on their own to feel in control again. They may fear being seen as weak or a tattletale.

Kids may fear backlash from the kid who bullied them.

Bullying can be a humiliating experience. Kids may not want adults to know what is being said about them, whether true or false. They may also fear that adults will judge them or punish them for being weak.

How to prevent bullying?
Tips for parents and school administration:

Vigilant approach by parents and school to consistently observe students to identify any change in behavior.

School administration must quickly conduct an investigation and reprimand individuals guilty of bullying to dissuade others from doing so.

Tips for students:

Avoid the bully and use the buddy system. Use a different bathroom if a bully is nearby and don't go to your locker if nobody else is around. Make sure you have someone with you so that you're not alone with the bully. Buddy up with a friend on the bus, in the hallways, or at recess — wherever the bully is. Offer to do the same for a friend.

Hold the anger. It's natural to get upset by the bully, but that's what bullies thrive on. It makes them feel more powerful. Practice not reacting by crying or looking red or upset. It takes a lot of practice, but it's a useful skill for keeping off of a bully's radar. Sometimes kids find it useful to practice "cool down" strategies such as counting to 10, writing down their angry words, taking deep breaths, or walking away. Sometimes the best thing to do is to teach kids to keep their face calm until they are clear of any danger (smiling or laughing may provoke the bully).

Act brave, walk away, and ignore the bully. Firmly and clearly tell the bully to stop, then walk away. Practice ways to ignore the hurtful remarks, like acting uninterested or texting someone on your cellphone. By ignoring the bully, you're showing that you don't care. Eventually, the bully will probably get bored with trying to bother you.

Tell an adult. Teachers, principals, parents, and lunchroom personnel at school can all help stop bullying.

References:

Bullying. (2022, June 27). Trusted Health Advice | healthdirect. https://www.healthdirect.gov.au/bullying#how-stop

Causes of PTSD: Bullying. (n.d.). PTSD UK. https://www.ptsduk.org/causes-of-ptsd-bullying

Effects. (2018, October 10). The National Child Traumatic Stress Network. https://www.nctsn.org/what-is-child-trauma/trauma-types/bullying/effects

Helping kids deal with bullies. (n.d.). Nemours KidsHealth - the Web's most visited site about children's health. https://kidshealth.org/en/parents/bullies.html

Warning signs for bullying. (2021, November 10). StopBullying.gov. https://www.stopbullying.gov/bullying/warning-signs

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What is it?

Bullying is a repeated pattern of behavior that is intended to cause harm either physically, or emotionally to a fellow student or group. This can occur both physically (in school) or online (cyberbullying) and can result in physical, emotional, and psychological trauma in the victims. Bullying can negatively affect a student's self-image, self-worth, peer-to-peer interactions, and academic performance and even result in mental health conditions such as depression and depression.

Where does it occur and who does it affect?

Most school-aged children are exposed to bullying in some form or fashion due to a perceived, or existing unequal balance of power and influence within the school environment. This is extremely common in youth relationships and peer groups and tends to become a greater problem as children move through elementary school and eventually peaks during early adolescence, Bullying mostly occurs in unstructured settings such as cafeterias or lunch halls, hallways, playgrounds and traveling to and from school. Bullying is largely a social phenomenon with 85% of bullying instances occurring in front of a group of witnesses. Anyone can be the target of bullying but in most instances, the target of bullying is someone who is perceived as weaker or different from the larger/dominant classroom demographic. Victims of bullying can be targeted due to a myriad of factors including but not limited to ethnicity, race, gender, sexual orientation, or physical differences.

Signs and symptoms (including but not limited to)

Stress

Anxiety, and depression

Anger or frustration

Loneliness and isolation

Feelings of rejection, or poor self-esteem

Changes in sleep and eating patterns

Health complaints

Poor relational skills

School avoidance, including missing or dropping out of school

Poor academic performance

Separation anxiety

Self-injury

Eating disorders

Suicidal or homicidal ideas or actions

Note this list of symptoms is taken from The National Child Traumatic Stress Network and referenced below.

Four t ypes of bullying

1. Physical bullying – this can include hitting, kicking, tripping, pinching, and pushing or damaging property.

2. Verbal bullying – this can include name-calling, insults, teasing, intimidation, homophobic or racist remarks, or verbal abuse.

3. Social bullying (Covert Bullying) - Social bullying occurs behind a person's back and is designed to harm the victim's social standing and cause humiliation. Social bullying can include:- spreading rumors, mimicking, and, playing mean-spirited pranks.

4. Cyberbullying - can be overt or covert bullying using social media and other digital platforms. Cyberbullying can include: spreading nasty rumors and gossip, account hacking, and spreading abusive or hurtful posts, images, and videos. with the intention of humiliating and hurting the victim.

Response strategies at school

1. The majority of bullying takes place in the presence of others (85%). So it is important to instill in students the confidence they will need to intervene either directly or seek intervention from an authority figure. It is important to make positive behavior a norm and reinforce it on a regular basis through things like age-appropriate stories or personal testimonies.

2. Emphasizing a sense of shared responsibility and promoting a team dynamic amongst students in the classroom. Promote a culture of ‘We not me’, ’Through tasks and activities that require cooperation and interpersonal discovery. This ideally will allow the educator to get ahead of the problem by creating empathy and greater understanding amongst students

3. Encourage students who are feeling victimized or isolated from their peers to seek help. There can be a stigma in schools that it is somehow a bad thing to ‘talk to someone’. Encourage students to speak to their parents, their peers, or teacher if they are ever feeling like they are being bullied. In other words, work at erasing the stigma surrounding looking for emotional support.

4. Creating a series of ‘checks and balances’ (norms and rules) for how we behave towards and interact with each other and school. Promote positive classroom citizenship and praise or reward positive interactions and caring behavior amongst peers.

5. Teach and promote the concept of Digital Citizenship. Make the students understand the importance of this concept and how it relates to both their online lives but also how they can also modify that thinking to fit their physical environment.

References

Effects. (2018, October 10). The National Child Traumatic Stress Network. Retrieved August 10, 2022 from https://www.nctsn.org/what-is-child-trauma/trauma-types/bullying/effects

Bullying In Schools. (n.d) Children’s Hospital of Philadelphia, Center for Violence Prevention:Retrieved August 10, 2022 from https://violence.chop.edu/bullying-schools

Types of Bullying, (n.d) National Center Against Bullying: Retrieved August 10, 2022, from https://www.ncab.org.au/bullying-advice/bullying-for-parents/types-of-bullying/

Jerry Fingal, The 5 Competencies of Digital Citizenship, (October 12, 2021), ISTE Area of Focus, Retrieved August 10, 2022 from https://www.iste.org/explore/5-competencies-digital-citizenship

Bullying prevention for educators, (n.d), Governance of Alberta, Alberta.ca, Retrieved August 10, 2022, from https://www.alberta.ca/bullying-prevention-for-educators.aspx

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Abandonment, betrayal of trust (such as abuse by a caregiver), or neglect  (Jieun)

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Abandonment, betrayal of trust (such as abuse by a caregiver), or neglect  (Jieun)

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What is a Betrayal Trauma?

Definition

Betrayal Trauma: The phrase "betrayal trauma" can be used to refer to a kind of trauma independent of the reaction to the trauma.
Betrayal trauma was first introduced as a concept by psychologist Jennifer Freyd in 1991. She described it as a specific trauma that happens in key social relationships where the betrayed person needs to maintain a relationship with the betrayer for support or protection.
From Freyd (2008): Betrayal trauma occurs when the people or institutions on which a person depends for survival significantly violate that person’ s trust or well-being: Childhood physical, emotional, or sexual abuse perpetrated by a caregiver are examples of betrayal trauma.

Signs and symptoms

The trauma of betrayal can affect physical and mental health, but the specific effects can vary depending on the type of trauma. Keep in mind that not everyone experiences trauma in the same way, either.

Childhood trauma

The effects of betrayal can show up shortly after the trauma and persist into adulthood.

Key signs include:

trouble recognizing, expressing, or managing emotions

anxiety, depression, and other mental health symptoms

nightmares

physical pain or stomach distress

panic attacks

thoughts of suicide

difficulty trusting others

Infidelity trauma

Betrayal in a romantic relationship usually takes the form of infidelity, though other types of betrayal, such as financial betrayal, can also provoke a trauma response.

The discovery of infidelity often leads to:

loss of self-esteem and self-worth

numbness

anger

guilt

difficulty controlling emotions

intrusive thoughts about affair details

Trauma in Adulthood

In adulthood, betrayal trauma is usually experienced in relationships with intimate partners, especially if a person has experienced trauma in the past. However, people may also experience betrayal trauma at the hands of others such as a close friend, colleague, or other person in their life.

Betrayal trauma in adulthood could look like:

Physical, emotional, sexual, or verbal abuse

Infidelity

Revelations of financial problems or significant debt

Ulterior motives or other secretive behaviors

Coping With Betrayal Trauma

If you have experienced betrayal trauma, Dr. Romanoff suggests some steps that can help you cope:

Acknowledge the betrayal: The first step is acknowledging how you were betrayed and hurt. Be honest with yourself and consider the impact of the betrayal on the relationship and your life.

Write your feelings in a journal: You may find relief through writing down your feelings in a journal. It can help you identify the emotions you’re experiencing and create space to reflect on them, instead of suppressing or avoiding them.

Process your emotions: Confronting the trauma you experienced in the past can bring up a lot of emotions, including grief, fear, anger, regret, loss, and anxiety. It’s important to process these emotions so you can start healing.

Seek support or treatment: It is also helpful to seek support by talking with a friend or therapist. People who have experienced betrayal trauma often feel like they can only rely on themselves and tend to isolate themselves when they are betrayed. Instead, it is important to do the opposite and reach out for support or treatment.

Set boundaries: If the person who betrayed you is still in your life in some capacity, set firm boundaries in your relationship with them to protect your physical, emotional, and mental well-being.

Recognize patterns: If you have experienced betrayal trauma in the past, it’s important to recognize whether it’s affecting your relationships in the present. Understand that you deserve to have relationships that are mutually supportive and beneficial.

A Word From Verywell

Being abused or betrayed by someone you’re close to or someone you depend on can be devastating. It can affect all your subsequent relationships and take a toll on your mental and physical health.

It’s important to address the betrayal you faced, process it, and take steps toward healing and self-care.

Reference

DePrince, A.P, Brown, L.S., Cheit, R.E., Freyd, J.J., Gold, S.N., Pezdek, K. & Quina, K (2012). Motivated forgetting and misremembering: Perspectives from Betrayal Trauma Theory.  In Belli, R. F. (Ed.), True and False Recovered Memories: Toward a Reconciliation of the Debate (Nebraska Symposium on Motivation 58) (pp 193-243). New York: Springer.

Kelley, L.P, Weathers, F.W., Mason, E.A., & Pruneau, G.M. (2012) Association of Life Threat and Betrayal With Posttraumatic Stress Disorder Symptom Severity. Journal of Traumatic Stress, 25, 408–415.

Freyd, J.J.& Birrell, P.J. (2013).  Blind to Betrayal.  John Wiley & Sons.

Freyd Lab Article

https://www.verywellmind.com/betrayal-trauma-causes-symptoms-impact-and-coping-5270361

https://www.healthline.com/health/mental-health/betrayal-trauma#recovery

https://dynamic.uoregon.edu/jjf/defineBT.html

https://www.theatlantic.com/education/archive/2014/12/how-teachers-help-kids-heal/383325/

https://greatergood.berkeley.edu/article/item/five_ways_to_support_students_affected_by_trauma

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12 signs you might be suffering from PTSD

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Life-Threatening Illness in a Caregiver (Nick)

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Life-Threatening Illness in a Caregiver (Nick)

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https://www.youtube.com/watch?v=JaOmIIF5Z-o

What does a life-threatening mean?

Life-threatening diseases are chronic, usually incurable diseases, which considerably limit a person's life expectancy. These include cancer, diabetes, neurological conditions, coronary heart disease and HIV/Aids.

What is a caregiver?

A person who gives care to people who need help taking care of themselves. Examples include children, the elderly, or patients who have chronic illnesses or are disabled. Caregivers may be health professionals, family members, friends, or social workers. Often they are referred to as Parent(s) or Guardians in the context of a school when children are involved.

What are the effects on a child?

Children and adolescents who are growing up with a chronically ill caregiver experience negative consequences from this situation in their daily lives such as mental health problems, problems in the parent-child relationship, and inadequate school results.

What are the signs to look out for?

If there is a change in behaviour in the child the following are some possible changes that may occur:

incomplete homework

poor concentration in class

a decrease in academic performance

messy schoolwork

unkempt appearance

tiredness

irritability

being withdrawn, tearful or aggressive

an increase in absences from school

an increase in somatic complaints, including stomachaches and headaches

disengagement from peers or changes in friendships

over-willingness to please

over-helpfulness

What strategies can the school use to support the family?

1. It can be helpful to identify several staff members the student or their siblings can talk to if they have any difficulties while they are in school.

2. Member(s) of staff should be identified as the key contact for the family and for health professionals.

3. It is important that any staff identified feel able to take on these roles and are appropriately supported.

4. Suggest other supports for the students that the school cannot provide (at-home counselling, at-home private tuition.) The more options provided the better.

5. Keep in regular contact with the caregiver.

What strategies can we use to support the child in your classroom?

1. Provide opportunities to meet with the assigned counsellor.

2. Encourage the development of friendships.

3. Check-in regularly with the child.

4. Ask how the child is going.

5. Listen to the child in a supportive, non-judgemental way.

6. Offer assistance

7. Acknowledge and validate the difficulties the child is facing

8. Ask the child what they can do in the short-term to help themselves feel okay.

9. Take care with your responses.

10. Know your limits.

11. Keep in regular communication with the caregiver.

12. With permission of the child, inform their peers of the situation.

References and Resources

Student with a seriously ill parent - free resource for Schools. Psych4Schools. (2021, August 17). Retrieved August 9, 2022, from https://www.psych4schools.com.au/free-resources/seriously-ill-parent/#:~:text=and%20resources%2C%20including%3A-,Provide%20social%20and%20emotional%20support,with%20accurate%20age%2Dappropriate%20information

Toolkit to help educators support children of parents with serious illness. (n.d.). Retrieved August 8, 2022, from https://www.mghpact.org/assets/media/documents/MGH-Cancer-Educator-Toolkit.pdf

NHS. (n.d.). NHS choices. Retrieved August 8, 2022, from https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/supporting-seriously-ill-student-school/

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When a parent is diagnosed with cancer | Alexandria Knipper | TEDxYouth@BeaconStreet

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Witnessing or Experiencing Community Violence (Casey)

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Witnessing or Experiencing Community Violence (Casey)

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What is it?
Students may sometimes be traumatized by witnessing violent events in their surrounding community. This concept is given the term Community Violence Exposure (CVE) and encompasses the witnessing of acts such as murder, sexual assault, burglary, etc. Although the student in question is not directly involved, just the experience of witnessing these events can have profound negative effects on their well-being and academic performance.

Where does it occur and who does it affect?
Exposure to community violence is highly correlated to an area's general crime rate. Students in countries with higher rates of crime or ongoing war are more likely to witness violent events in their community. (Koposov et al., 2021) Additionally, higher levels of crime if often associated with economically disadvantaged communities, meaning the effects of any resulting trauma can be exacerbated by additional factors. Boys generally experience more violence than girls and are more likely to externalize their trauma through agressive behaviors. Girls are more likely to develop certain disorders such as dissociation and depression. (TeachTrauma, 2022) Ultimately it's important to be aware of the effects of CVE regardless of the circumstances as increased CVE negatively impacts academic function. (Koposov et al., 2021)

Signs and Symptoms
Students who witness traumatic events in their community are more like to develop mental disorders like PTSD, anxiety, and depression. Students can also suffer from multiple disorders at the same. Furthermore, increased exposure to violence was associated with more severe symptoms.

Generally symptoms can categorized as externalized and internalized behaviors.

Externalizing behaviors- PTSD-like behaviors such as hyper-arousal, agression, high stress/anxiety.

Internalizing behaviors- depression-like symptoms such as withdrawal and dissociation.

Young children may also have issues forming a positive self-image and trusting relationships with others. (Guerra et al., 2011)

Treatment, Repsonse, Prevention
PTSD-like symptoms may be adressed through trauma-focused therapy or medication. Trauma-focused therapy would include treatments such as cognitive behavioral therpay, EDMR, exposure therapy, etc. (UpToDate, 2022)

In addition to the aforementioned treatments, students whose trauma manifests as depression or withdrawal may benefit from the emotional support of school psychologists/mental health professionals. Teachers can also be considerate of students' mental health by providing intermittent breaks or extra time to complete assignments. (Lochrie, 2022) Schools can offer programs that teach life skills and social-emotional development in order to teach students methods of coping with their trauma and the resulting thoughts/feelings. Teachers can work with students to create mental care toolboxes; a concept in which students explore various relaxation/destressing techniques and figure out which works best for their individual situations.

Ultimately, the first line of defense against CVE trauma is to create a safer community settings for students. This could be collaborative efforts from families within the community to monitor activity and report incidents of crime. Parents can also monitor their child's activity, making sure they remain in safe areas and don't have access to violent television/movies/video games (all of which may trigger past traumas).

References
Guerra et al., November 2011. The Effects of Community Violence on Child Developmen. Encyclopedia of Early Childhood Development. https://www.child-encyclopedia.com/social-violence/according-experts/effects-community-violence-child-development#:~:text=In%20addition%20to%20higher%20levels,youth%20exposed%20to%20community%20violence.

Koposov et al., July 2021. Community Violence Exposure and School Functioning in Youth: Cross-Country and Gender Perspectives. Front Public Health. https://pubmed.ncbi.nlm.nih.gov/34386472/

UpToDate. July 2022. Patient education: Post-traumatic stress disorder (The Basics). https://www.uptodate.com/contents/post-traumatic-stress-disorder-the-basics#:~:text=PTSD%20is%20treated%20with%201%20or%20both%20of%20the%20following%3A&text=Trauma%2Dfocused%20therapy%20%E2%80%93%20This%20involves,desensitization%20and%20reprocessing%20(EMDR).

Lochrie, Amanda S., April 2022. Depression Factsheet (for Schools). KidsHealth. https://kidshealth.org/en/parents/depression-factsheet.html

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Physical abuse of a child can be any intentional or unintentional form of abuse where a child’s parent or caregiver may perform an act which result in the child suffering physical injuries such as cuts, bruises, welts, muscle injuries or sprains, marks, or even broken bones. According to the experts at the Office for Victims of Crime (2013) nearly every child that is physically or emotionally abused knows their abuser as possibly a parent, caregiver, and/or family member. Physical abuse is any abuse where a child is given any form of pain by means of a weapon and can be committed by anyone, thus, should not be taken as a select group of victimizers and teachers and parents should be on the lookout for signs of abuse to help. In South Africa teachers are obliged to inform the police and child protected services in the event a case becomes evident, or they are informed of physical abuse against a minor.

Signs and symptoms may include:

·      A student that has no confidence and often act out
Physical abused students will often seek extra validation, be it from the teacher or other students, these students could act out to get attention, to try to gain confidence that you can see they are lacking as their actions won’t further their study path it might even cause them to

·      Signs of pain or marks being covered up
Students who are physically abused will often try to hide their wounds, marks and or pain from the teacher and other students. This could be in the form of always wearing longer clothes, make-up, and not participating in activities that may reveal their discomfort.

·      Withdrawal from the class or no friends, so the student is generally a loner or the opposite, being very loud, verbose, and even downright over-powering:
Physically abused students can often walk in two different ways of life, one is to become quieter while they try to hide their fears, emotions, and the abuse that they are suffering. Or they become very loud, almost over-powering every person including the teacher in a way to disguise their suffering – looking strong but fighting an inner battle that only they know all too well.

·      Student displaying constant ‘shows’ of anger
This could be in all sorts of forms like shouting at others, fighting, crying, and even tantrums in younger learners. Physically abused students will often look for an outlet to express their emotions, this could be in the form of shouting, pushing, shoving, bulling others, and even fighting with others over small issues that could be resolved by talking, however, they might not have the ability to show others kindness due to their lack of expression of their situation.

·      Emotionally unstable
Students that was at the receiving end of physical abuse can be emotionally unstable and have outbursts at any given time and for any reason. The student could be trying but being emotionally stable and keeping your emotions in check could be a challenge that the student could not even know how to deal with.

Strategies to help a child in our classroom that is being physically abused:

·      Create a safe, positive space for your students.
Students should be able to approach you without fear and with the utmost trust in your abilities to assist them. If you do not have the answer, be honest, tell students that you need time and space to return to them with an answer that is specific to their scenario rather than breaking their trust. Make your class the space where all students feel at ease, safe and comfortable to share their ideas, thoughts, and problems – within a reasonable framework – a teachers are not counselors, please do not provide counselling or give unsolicited advice. Manage what you can like speak to student behavior and attitude, do not shame students. Support the student’s decisions, with no reasoning – just acceptance. Meeting students where they are at can help you to help them figure out emotions and ideas that they cannot always explain or understand themselves.

·      Keep confidentiality as much as possible and inform the student that you cannot stay quiet about this – due to legal reasons.
Like I said you cannot keep quiet, so as the adult and teacher you must be honest with the students about the fact that you have to report this to the relevant authorities, however, there are parts that they share that you can keep to yourself. Do not share what students shared with you with your class or other teachers. Create a space where your students can approach you with trust and respect.

·      Build positive relationships with your students.
Students who are encouraged and motivated by their teacher and their peers might find it easier to navigate their way through their school life. This could also help students become more confident in asking for help or just speaking to others in class. Trusting those around them will be difficult and being positive and encouraging could help these students work through their trauma without feeling like they need to be the victim at school. Following up with these students is major in terms of being positive as it can help them experience a sense of belonging and positively impact their lives and reduce their need for displaying their anger. This can help the student experience whole brain learning which is what teachers should be encouraging.

·      Create opportunities for abused students to feel included – create inclusivity in your class.
This can help students that has been experiencing physical or any form or abuse to work through their trauma by means of creatively voicing their concerns and or just release their thoughts through art forms like painting, writing, singing, and other artistic ways.  This can help them to display their anger in a more manageable manner and in a manner that can help them feel heard.

·      Building resilience
As a teacher help students to learn to build resilience in order to help them work through their emotions and how to deal with it.

References:

Five Ways to Support Students Affected by Trauma. Greater Good. Retrieved 10 August 2022, from https://greatergood.berkeley.edu/article/item/five_ways_to_support_students_affect

Managing an Abused Learner - Childline South Africa. Childline South Africa. (2022). Retrieved 10 August 2022, from https://www.childlinesa.org.za/educators/for-educators/child-protection-at-school/managing-an-abused-learner/.

Office for Victims of Crime. (2013). Children, Violence, and Trauma—Treatments That Work [Video]. Retrieved 8 August 2022, from https://www.youtube.com/watch?v=3EyvaEk0K-k.

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Symptoms might include but are not limited to:

Children becoming extra clingy and showing anxiety about having to go to school or needing help to complete tasks they have previously mastered

Very young children may experience developmental regression (eg: crawling, baby talk) and older children may neglect personal hygiene and appearance

Older students will likely fall behind in their school work or fail classes in which that they had previously done well

Children not being able to sleep well resulting in extra fatigue at school and falling asleep in class

Students not being able to focus and having trouble making decisions or solving problems

Students will have heightened anxiety and may start worrying that other people in their life may die

Students may lose trust in others (including teachers) if they feel they have been abandoned by the person who died

They may act out in school or skip classes and engage in risky behavior

Younger children may start talking about about death in their play and older students may bring up the topic in class discussion

Response strategies include but are not limited to:

1. Helping younger students to clearly understand what has happened by being direct with them so they are not confused or feel guilt or shame about the death (see video)

2. Inviting older students to talk so they can speak with trusted adults and receive care if they are being leaned on by other younger family members

3. Allowing students to express themselves in class and in their work rather than telling them how they should feel. This can include writing letters to the deceased, creating a scrapbook of memories, building a time capsule, drawing a body map to show stress, forming group counseling sessions for students to connect with others who have had similar experiences, and reading books about dealing with death and grief.

4. Communicate with parents or caregivers to communicate how the student is coping in school and coordinate support efforts

5. Provide learning support through additional tutoring, giving extra time for work and assignments, or adjusting assessment schedules

References:

1. The National Child Traumatic Stress Network. (2013). Child Trauma Toolkit for Educators. Western Michigan University. Retrieved August 5, 2022, from https://wmich.edu/sites/default/files/attachments/u57/2013/child-trauma-toolkit.pdf

2. School Counseling Office (2020, August 24). A Guide to Supporting Grieving Students | Morgridge College of Education Online. DEN-EDU. Retrieved August 5, 2022, from https://morgridgeonline.du.edu/blog/how-to-support-grieving-students/

3. How to Recognize When Your Child Is Struggling With Grief. (2022, July 25). Verywell Family. Retrieved August 5, 2022, from https://www.verywellfamily.com/signs-of-grief-in-children-and-how-to-help-them-cope-4174245

4. How To Deal With Grief and Loss | Mental Health Advice. (2022). YoungMinds. Retrieved August 5, 2022, from https://www.youngminds.org.uk/young-person/my-feelings/grief-and-loss/

5. Park, C. (2013, May 17). 5 Tips for Supporting Grieving Students. Edutopia. Retrieved August 5, 2022, from https://www.edutopia.org/blog/tips-grief-at-school-2-chris-park