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BY Jolene

Post-Traumatic Stress Disorder (PTSD) is a much more common condition in children and teens than most adults want to believe. But, the facts and figures compiled at the government's National Child Traumatic Stress Network (NCTSN) show that a significant percentage of children have been exposed to trauma and later developed PTSD.

How can parents and other adults help children and teens living with undiagnosed, untreated PTSD find the help they need? An understanding of the symptoms of PTSD is a good place to start. Some of the symptoms in children and teens are the same as those for babies and toddlers. These include hypervigilance, emotional distress when reminded of the initial trauma, fear or avoidance of places that remind them of the event, nightmares, and other sleep issues.

But other symptoms are more common in children over the age of 3 and into the teen years. Today's focus is on those symptoms.

1. Flashbacks

Once they develop sophisticated language skills, children may begin to describe unexpected, intrusive thoughts about the initial trauma. This is common for the first few weeks or months after a trauma. But thoughts that continue long after that time period are a symptom of PTSD.

2. Physical Reaction

When reminded of the initial trauma, older children may complain of vague illnesses like stomachaches and headaches. The pain is very real to the child, even though no underlying cause can be diagnosed. Adults may discount the complaints as "all in the head," when in truth, the complaints are a very real symptom of PTSD.

3. Denial of Event

Sometimes, children old enough to clearly remember a traumatic event vehemently deny it ever occurred. They would rather bury their pain than recall the reality of the trauma endured. Left buried and unprocessed, these painful mental wounds fester and develop into post-traumatic stress disorder. Children displaying this symptom need treatment, the sooner the better.

4. Difficulty Concentrating

Children suffering from PTSD are often misdiagnosed with attention deficit hyperactive disorder (ADHD). What looks like ADHD is a response to trauma triggers. They respond with fear and try to move on to something that seems safer. When they encounter another trigger, they move on again.

5. Startle Easily

Depending on the type of trauma experienced, children may jump when they hear loud noises or become skittish in situations similar to the initial trauma. Children who have suffered physical abuse may flinch when an adult's hand comes near the face.

6. A Foreshortened Sense of the Future

Lenore Terr documented this symptom in her book, Too Scared to Cry. The book describes interviews with 26 California school children who were kidnapped, buried alive, and eventually escaped in 1976. In periodic interviews after the trauma, Terr asked children what they wanted to be when they grew up. Many of them consistently answered that they didn't bother thinking about that because they expected to die young.

7. Self-destructive Choices, Irritability, and Impulsiveness

These behaviors are often a direct, though unconscious, response to a child's foreshortened sense of the future. Because kids with PTSD don't think they'll live long, why should they bother making safe choices? Why should they try to get along with anyone? Why should they save their money for the future? They feel like they have no future. So they make self-destructive choices, don't try to maintain relationships, and act or spend impulsively.

8. Depression or an Overwhelming Sense of Sadness and Hopelessness

Again, this symptom has its roots in the foreshortened sense of the future mindset. The facility where my son received treatment, Intensive Trauma Therapy, Inc in West Virginia, referred to this symptom as "an impending sense of doom." That mindset is the perfect environment for depression, sadness, and hopelessness to flourish.

Of course, many children without PTSD exhibit behaviors similar to the symptoms listed above. So when should parents or other adults who observe any of these symptoms in a child seek professional treatment?

When they know the child has experienced significant trauma in the past, even the distant past.

When the symptoms persist more than three months after the initial trauma.

When adults suspect trauma occurred and have observed several symptoms.

When the child's behavior is significantly different from what is normal in other kids in the same age group.

Remember, treatment for children is highly effective. For more information about symptoms and treatment of PTSD in children, check out these resources:

Books on Post-Traumatic Stress disorder

1. Trauma Through a Child's Eyes by Peter A. Levine and Maggie Kline

2. Trauma-Proofing Your Kids by Peter A. Levine and Maggie Kline

3. The Boy Who Was Raised as a Dog: And Other Stories by Bruce Perry

4. Different Dream Parenting: A Practical Guide to Raising a Child with Special Needs by Jolene Philo

5. Wounded Children, Healing Homes: How Traumatized Children Impact Adoptive and Foster Families by Jayne Schooler

Latest Special Needs Products

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8 Symptoms of Post Traumatic Stress Disorder in Children and Teens - Friendship Circle - Special Needs Blog

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Post-Traumatic Stress Disorder (PTSD) is a much more common condition in children and teens than most adults want to believe. But, the facts and figures compiled at the government's National Child Traumatic Stress Network (NCTSN) show that a significant percentage of children have been exposed to trauma and later developed PTSD.

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As a former teacher and instructional coach, I found many of my students had experienced significant trauma during their childhood. Many of my students lived in poverty and were exposed to an extraordinary amount of community violence, substance abuse and lack of resources. I found many new teachers were ill-equipped to manage the behaviors of some of these students, not understanding the cause of many of these behaviors occurred because their students were in a constant state of survival.

These are the eight strategies I used in my teaching to embed trauma-informed practices in my classroom in order to build trust and resiliency in my students:
1. Provide a safe environment for students.
Provide a safe environment for students that enhances learning and reduces student stress. Research suggests brain plasticity (the brain's ability to grow and adapt in response to external stimuli) can be enhanced by high quality teaching. The average teacher works with students until they get it right. Expert teachers work with students until they can't get it wrong. Greet students by name before they come into the classroom and provide time to check in with each of them throughout the day.
2. Create motivational support systems.
Understand student motivation and building positive relationships are vital to the success of students. Align teaching with your students' interests and learning styles. Poll students to find out what motivates them and build on that. Positive praise goes a lot further than negative consequences. Remember, screaming and punishment do not grow dendrites!
3. Involve parents.
Parents can promote brain-based learning by providing proper nutrition, exercise and enrichment activities for their children. These are things you can review through classroom newsletters and parent engagement meetings. Remember, many parents have not had successful school experiences themselves. They may feel they are inadequate to help manage their children's behavior. Students who are stressed likely have parents who are stressed. Make sure you communicate with them regularly and reinforce they are a partner in their child's learning. Respectfully ask if you can do a home visit to learn what life is like for them at home.
4. Build a relationship with your students.
Find time to meet with each student every day. Even meeting students at the door on their way into your classroom provides the opportunity to make a connection. This may require time during lunch, recess or after school. Students don't perform for teachers they don't like. Many studies show the correlation between student/teacher relationships and a reduction in stress and disciplinary problems.
5. Incorporate movement in your classroom.
Did you know the average kid spends seven and a half hours outside of school on a screen ? Today's kids are getting less outdoor play and more screen time. Build in some mind body activities into the daily routine and provide opportunities for teaching empathy through role play. Provide opportunities for students to stand, stretch and move. We cannot expect kids to sit for unlimited hours on the rug or at their tables doing work. We do need them to feel physically and emotionally regulated so they are able to attend to the lessons we're teaching.
6. Shift your instruction.
Many schools don't offer "hands on" learning opportunities. Provide opportunities to build on student strengths and promote positive behavior outcomes in class. Make sure your instruction is differentiated according to student learning style and interest. Provide an opportunity for assignments to be chunked and student-selected. Give choices when possible.
7. Practice self-care.
Take good care of yourself. Find healthy way to manage your stress, both during the day and at home. Secondary trauma is real and must be acknowledged. If you find you are taking on your student's stress, make sure you are talking to a trained professional or mentor teacher. Include mindfulness activities such as mandala sheets, visualizations, breathing exercises, feeling wheels, etc. into your classroom instruction and daily life.
8. Understand the relationship between emotions and behavior.
Recognize you can change and influence a child's emotional state. You are the weather in your classroom. Pay attention to possible triggers that indicate emotions are escalating and engage them before a meltdown occurs. Provide opportunities for students to ask for a break. In my classroom, I provided mandala sheets, sensory activities and a "cool down" center for students to use as needed.

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8 Tips for Teaching Students With Childhood Trauma

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As a former teacher and instructional coach, I found many of my students had experienced significant trauma during their childhood. Many of my students lived in poverty and were exposed to an extraordinary amount of community violence, substance abuse and lack of resources.

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According to the Children's Defense Fund, one in three African-American boys and one in six Latino males born in 2001 will end up imprisoned sometime in his lifetime. These staggering numbers are tragic beyond words. But in order to change them, we have to change how we perceive the children behind the statistics.

One of us (Joyce) helps teachers and administrators do just this. Joyce works with the San Francisco Unified School District's Student, Family, Community Support Department and several underserved San Francisco schools through her award-winning UCSF Healthy Environments and Response to Trauma in Schools (HEARTS) program. While educators sometimes see a misbehaving child as a bad kid or a mean or oppositional kid, Joyce helps them to see that this is a scared kid. In other words, the child's behavior is the result of chronic exposure to traumatic events beyond their control.

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In addition to impacting behavior, trauma can wreak havoc on a student's ability to learn. Scientists have found that children who have been subjected repeatedly to trauma suffer from other social, psychological, cognitive, and biological issues, including difficulty regulating their emotions, paying attention, and forming good relationships-all of which make it very difficult for a child to succeed in school.

But trauma exposure does not seal one's fate. As the UCSF HEARTS program teaches, there are things that educators and other caring adults can do to mitigate the effects of trauma-and help at-risk students flourish rather than fail.
The scourge of complex trauma
Most of us have experienced some kind of traumatic event in our lives when a situation so overwhelmed us that our brain and body were unable to cope with it. Depending on our internal and external resources, most of us were probably able to recover. However, children who live in under-resourced communities-where domestic and neighborhood violence, racial discrimination, and poverty are more prevalent-can develop post-trauma difficulties after experiencing what is called complex trauma.

Complex trauma occurs through repeated and prolonged exposure to trauma-inducing situations, most of which take place in a care-giving situation. When a child can't rely on a close caregiver for comfort and safety-whether due to the caregiver's own emotional suffering or because the caregiver is the source of trauma-that young person's ability to metabolize and recover from toxic stress gets seriously hampered.

The metaphor Joyce uses in her work with schools to explain the effects of complex trauma is that of a vinyl record. When a song is played again and again, a groove is worn into the record. If, when playing a different song, someone accidentally knocks the record player, the needle will skip across the record and land in the deepest groove, playing that song yet again. Even when you reach the end of the song, sometimes the groove is so deep the needle skips back to play it once more.

Like a needle on a record player, complex trauma wears a groove in the brain. So when something non-threatening happens that reminds us of a traumatic incident, our bodies replay the traumatic reaction-mobilizing us to either run from or fight the threat, while shutting down other systems that help us think and reason. If this happens over and over, we become more easily triggered into that fear response mode, never giving our bodies time to recover. After awhile, as we adapt to this chronic triggering, our behavior can seem crazy or rude when taken out of the context of trauma.

For a child in a classroom, something as simple as the teacher raising their voice to get everyone's attention or accidentally getting bumped by another classmate can steer that child into this groove. When triggered, the child's out-of-proportion emotional and sometimes physical reaction often makes no sense whatsoever to the teacher, making it difficult for the teacher to respond appropriately.
Strategies for teachers
So what can teachers do to help students in their classrooms who have experienced complex trauma? In her work with educators, Joyce offers the following four strategies.

1) Recognize that a child is going into survival mode and respond in a kind, compassionate way. When you notice that a child might be having a difficult time, start by asking yourself, "What's happening here?" rather than "What's wrong with this child?" This simple mental switch can help you realize that the student has been triggered into a fear response, which can take many forms. For example, the student might:

Get a "deer-in-the-headlights" look

Turn red and clench their fists

Breathe more rapidly

Begin moving because their body is getting ready to run or react

Burst into tears or look as if they are about to cry

It's worth noting that not all kids will act out. However, for those who do, once you recognize the trigger, kindly and compassionately reflect back to the child: "I see that you're having trouble with this problem," or "You seem like you're getting kind of irritated," and then offer a couple choices of things the child can do, at least one of which should be appealing to them. This will help the child gain a sense of control and agency and help them to feel safe once more. Over time, if a student who is experiencing something that is frightening or harmful sees that you really care and understand, then they will be more likely to say, "I need help."

2) Create calm, predictable transitions. Transitions between activities can easily trigger a student into survival mode. That feeling of "uh oh, what's going to happen next" can be highly associated with a situation at home where a child's happy, loving daddy can, without warning, turn into a monster after he's had too much to drink.

Some teachers will play music or ring a meditation bell or blow a harmonica to signal it's time to transition. The important thing is to build a routine around transitions so that children know: a) what the transition is going to look like, b) what they're supposed to be doing, and c) what's next.

3) Praise publicly and criticize privately. For children who have experienced complex trauma, getting in trouble can sometimes mean either they or a parent will get hit. And for others, "I made a mistake" can mean "I'm entirely unlovable." Hence, teachers need to be particularly sensitive when reprimanding these students.

To use Rick Hanson's words in his presentation at the GGSC Summer Institute of Educators: "Nurture the hell out of these children." Capture those moments when the student is doing really well and point it out to build their self-worth: "Wow, I love how you sat at your desk for a whole five minutes" or, "Thank you for helping your classmate." When you need to re-direct the behavior, do so privately and in as calm a voice as possible.

4) Adapt your classroom's mindfulness practice. Mindfulness is a fabulous tool for counteracting the impact of trauma. However, it can also be threatening for children who have experienced trauma, as the practice may bring up scary and painful emotions and body sensations.

If you use mindfulness in your classroom, you might consider using the following adaptations that the UCSF HEARTS program and Mindful Schools created:

Tell students that, if they wish, they can close their eyes at the beginning of the practice. Otherwise, they should look at a spot in front of them so that no one feels stared at.

Instead of focusing on how the body feels, have students focus on a ball or other object they're holding in their hands-what it feels like and looks like in their palm.

Focus on the sounds in the room or of cars passing outside the classroom-something external to the body.

By breaking mindfulness practice down into these elemental components, the child is more likely to have a successful experience-and thus be more willing to practice in the future.

5) Take care of yourself. This actually should be number one! The metaphor of putting on your own oxygen mask first before putting it on the child is very true in this situation.
Next week's article will focus on what both teachers and administrators can do to take care of themselves and build a healthy school environment in the face of chronic trauma.
Greater Good wants to know: Do you think this article will influence your opinions or behavior?

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How to Help a Traumatized Child in the Classroom

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Exposure to chronic trauma is having tragic effects on some of our students. How can educators help?

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With grief, sadness is obvious. With trauma, the symptoms can go largely unrecognized because they mimic other problems: frustration; acting out; or difficulty concentrating, following directions, or working in a group. Students are often misdiagnosed with anxiety, behavior disorders, or attention disorders rather than understood to have trauma that drives those symptoms and reactions. However, learning can also be a big struggle for children who have experienced trauma, and trauma-informed teaching can help.

Here are 10 tips for understanding kids who have been through trauma, plus strategies to help them build resilience so they can bounce back and overcome their challenges.

1. Kids who have experienced trauma aren't trying to push your buttons

If a child is having trouble with transitions or turning in a folder at the beginning of the day, remember that children may be distracted because of a situation at home that causes them to worry. Instead of reprimanding students when they're late or forget homework, affirm and accommodate them by establishing a visual cue or verbal reminder.

"Switch your mindset and remember the kid who has experienced trauma is not trying to push your buttons," says Caelan Soma, PsyD, chief clinical officer with Starr Commonwealth, an organization that offers resources to help schools build trauma-informed, resilience-focused communities.

These positive interactions might seem small, but they can build resilience in students, rewiring areas of their brains that have been impacted by trauma. On the other hand, starting the day with a reprimand can cause a child to shut down.

2. Kids who have been through trauma worry about what's going to happen next

A daily routine in the classroom can be calming, so try to provide structure and predictability whenever possible. Since words may not sink in for children who go through trauma, they need other sensory cues, says Soma. Besides explaining how the day will unfold, have signs or a storyboard that shows which activity-math, reading, lunch, recess, etc.-the class will do and when. Knowing what to expect lets kids feel secure enough to focus on learning. With time, that can show kids that they have the resilience and power to do well in school.

3. Even if the situation doesn't seem that bad to you, it's how the child feels that matters

Trauma is highly individual. A situation that one person can easily recover from can cause trauma for another person. As caring teachers, we may unintentionally project that a situation isn't really that bad, but how the child feels about the stress is what matters most, says Soma.

For some children, it may not be a singular event but rather the culmination of chronic stress. For example, a child who lives in poverty may worry about the family paying rent on time, keeping their jobs, or having enough food.

"Anything that keeps our nervous system activated for longer than four to six weeks is defined as post-traumatic stress," says Soma.

The good news is that the opposite is true, too: small positive interactions, like greeting a student in the hall, might seem insignificant to you but can foster resiliency in your students.

4. Trauma isn't always associated with violence

Trauma is often associated with violence. Yet, kids experience trauma from a variety of situations-like divorce, a move, or being over-scheduled or bullied.

"All kids, especially in this day and age, experience extreme stress from time to time," says Soma. "It is more common than we think."

You never know which student-or how many-can benefit from trauma-informed teaching.

5. You don't need to know the cause of trauma to help

Instead of focusing on the specifics of a traumatic situation, concentrate on the support you can give children who are suffering.

"Stick with what you are seeing now-the hurt, the anger, the worry," Soma says, rather than getting every detail of the child's story.

Privacy is a big issue in working with students suffering from trauma, and schools often have a confidentiality protocol that teachers must follow. You don't have to dig deep into the trauma to be able to effectively respond with empathy and flexibility. Instead, focus on trauma-informed teaching to create a classroom community that builds connections with students and lets them know you're there to help them succeed.

6. There's a direct connection between stress and learning

When kids are stressed, it's tough for them to learn. Create a safe, accepting environment in your classroom by letting children know you understand their situation and support them.

"Kids who have experienced trauma have difficulty learning unless they feel safe and supported," says Soma. "The more the teacher can do to make the child less anxious and have the child focus on the task at hand, the better the performance you are going to see out of that child. There is a direct connection between lowering stress and academic outcomes."

7. When kids feel they're good at something and experience success, it builds their resilience

Find opportunities that allow kids to set and achieve goals, and they'll feel a sense of mastery and control, suggests Soma. Help build resilience by assigning classroom jobs students can do well or letting them help peers.

"It is very empowering," says Soma. "Set them up to succeed, and keep that bar in the zone where you know they are able to accomplish it and move forward."

Rather than saying a student is good at math, find experiences to let them feel it. Because trauma is such a sensory experience, kids need more than encouragement-they need to feel worth through concrete tasks.

8. Self-regulation can be a major challenge for students suffering from trauma

Some kids with trauma grow up with emotionally unavailable parents. The result is the inability to self-soothe. They may develop distracting behaviors and have trouble staying focused for long periods. To help them cope, you can schedule regular brain breaks and promote social-emotional learning. Tell the class at the beginning of the day when there will be breaks for free time, to play a game, or to stretch.

"If you build it in before the behavior gets out of whack, you set the child up for success," says Soma.

A child may be able to make it through a 20-minute block of work if they know there will be a break to recharge before the next task.

9. It's OK to ask kids point-blank what you can do to help them make it through the day

For all students with trauma, you can ask them directly what you can do to help. They may ask to listen to music with headphones or put their head on their desk for a few minutes. If a child isn't able to name what will help them, try offering options: having a snack, going for a walk, or taking deep breaths, for example.

"We have to step back and ask them, 'How can I help? Is there something I can do to make you feel even a little bit better?'" Soma says.

10. You can support kids with trauma even when they're outside your classroom

Loop in the larger school, creating an ecosystem of trauma-informed teaching. Share trauma-informed strategies with all staff-from bus drivers to parent volunteers to crossing guards. Tell them how small interactions, like complimenting a student or offering a smile, can help kids with trauma build resilience.

Remind everyone: "The child is not his or her behavior," says Soma. "Typically, there is something underneath that's driving that to happen, so be sensitive. Ask yourself, 'I wonder what's going on with that kid?' rather than saying, 'What's wrong with the kid?' That's a huge shift in the way we view kids."

Looking for more ways to build resilience in your students?

Transform the lens through which you view and react to student behavior. Trauma-Informed Certification for Teachers offers strategies for helping kids cope with stress while building their resilience.
LEARN MORE ABOUT TRAUMA-INFORMED CERTIFICATION

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10 Things About Childhood Trauma Every Teacher Needs To Know

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With grief, sadness is obvious. With trauma, the symptoms can go largely unrecognized because they mimic other problems: frustration; acting out; or difficulty concentrating, following directions, or working in a group. Students are often misdiagnosed with anxiety, behavior disorders, or attention disorders rather than understood to have trauma that drives those symptoms and reactions.

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http://www.kellybear.com/TeacherArticles/TeacherTip28.html

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10 Tips For Disciplining a Traumatized Child - Main NorthWest Trauma Counseling Page

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Kids with trauma (and the more trauma, the more true this is) are very vulnerable when they are disciplined, so you want to discipline very carefully. Try to be as gentle as you can while still holding reasonable and safe guidelines.

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Episode 23: Parenting Traumatized Children

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Oppositional defiant disorder (ODD) is a scary ordeal to undergo whether you are a new parent or a seasoned one. The challenges are endless, but it's possible to get through it. Develop a positive plan for behavior, discipline, and consequences and be consistent. This won't change your child's behavior overnight but will begin to grow and expand as you build your child's skills and emotional resources. Find out what ODD is and the various ways to help make life with a child who has this condition a bit easier to manage. All of this information should help parents feel quite a bit more confident moving forward.

Oppositional defiant disorder is an affliction affecting 10.2 percent of all children. All kids will act out, but what makes children with ODD different is parents will notice a pattern of behavior. These behaviors will manifest in many ways, but will largely be comprised of disobedience, anger, irritable moods, hostile and defiant actions, and argumentative conduct.

Children won't always display all of the symptoms of oppositional defiant disorder. Some afflictions may come and go, and some may be more severe than others. It's important to record what behaviors you see in your child so you can come up with the best strategy.

Some typical behaviors parents will want to be on the lookout for are challenging authority, lying, blaming others, becoming easily annoyed or annoying others, and low self-esteem. This isn't a comprehensive list of behaviors, however, but just a few of the most common examples.

Keep reading to learn the importance of paying attention to your child's behavioral signs.

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Living With A Child With Oppositional Defiant Disorder

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Oppositional defiant disorder (ODD) is a scary ordeal to undergo whether you are a new parent or a seasoned one. The challenges are endless, but it's possible to get through it. Develop a positive plan for behavior, discipline, and consequences and be consistent.

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Parenting traumatized children with Craig Peterson

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7. Give choices: If your child is oppositional, do not give them a discipline they have to cooperate with. IE: if you say you must go up to your room, this is a        set up for opposition. Be more creative. Say, "You can choose to go up to your room to calm down or you can choose another way to calm down.        What would you like to do?” You can leave the room if you need to. Do not decide on consequences, if any, until kids are calmed down. If your child is        dysregulated, getting them regulated is the first priority. Give choices as much as possible. For kiddos that feel like their life is out of control, give them        as much control as you can. The trick to giving choices is to give two choices that are okay with you. Don’t say, “you can either wear appropriate        clothes or go to school in your pajamas;” say, “I can see why you want to wear those short shorts, they are stylish (identify and empathize with         desire). However, those are too short for the dress code at school, so you can wear longer shorts or wear pants.” Or you can say, “Your choices for        your veggie is carrot sticks or cucumbers, which would you like?”

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7. Give choices: If your child is oppositional, do not give them a discipline they have to cooperate with. IE: if you say you must go up to your room, this is a        set up for opposition. Be more creative. Say, "You can choose to go up to your room to calm down or you can choose another way to calm down.        What would you like to do?” You can leave the room if you need to. Do not decide on consequences, if any, until kids are calmed down. If your child is        dysregulated, getting them regulated is the first priority. Give choices as much as possible. For kiddos that feel like their life is out of control, give them        as much control as you can. The trick to giving choices is to give two choices that are okay with you. Don’t say, “you can either wear appropriate        clothes or go to school in your pajamas;” say, “I can see why you want to wear those short shorts, they are stylish (identify and empathize with         desire). However, those are too short for the dress code at school, so you can wear longer shorts or wear pants.” Or you can say, “Your choices for        your veggie is carrot sticks or cucumbers, which would you like?”