Structural Frameworks: Daily schedules, routines, organization, rules, limits, cognitive framework, teacher- child relationship

Materials: are inviting children to represent their experiences

Object Permanence: Everything has a place in the classroom. 

Physical Environment: is cared for.

Free Play: Open ended, but teachers can organize and help children elaborate

Rules: Safe and orderly environment. Offer strategies to mediate feelings and behavior which will eventually be internalized.

Object Constancy: Can be supported with a transitional object.

Instruction: Provide children with developmentally appropriate learning tools to discover concepts, acquire new skills and organize experiences.

Caregiving: Some children need help establishing trust and need check-in’s, so the adult must be consistently available.

Therapy: Talk over incidents with students to help them express feelings. 

Therapeutic techniques should be used by teachers and others who are working on developmental and socialization issues in a group setting. Ways a teacher can use therapeutic language is to ask fewer questions as initiators of conversation and use more observational comments. This allows for emotional and conceptual connections. Reflective language can consist of literal repetition to clarify situations or selective reflections. Bibliotherapy is the use of books that reflect a range of cultural issues, developmental concerns, life experiences, and emotional dilemmas. Some examples are pregnancy, loss/ death, covid, making friends, etc. Teachers can make a book with their students to add visual representation of this situations. Visual therapy is highly effective in clarifying complex issues. After reading the book, allow time for the children to work on and develop feelings about the subject. Teachers should also provide tools for self-expression and invite elaboration to further develop feelings and thoughts with opportunities for symbolic play through drawing, painting, play doh, etc. The children’s environment must be strong enough to contain their feelings. During a tantrum, a teacher must be calming and supportive. External rewards and reinforcers might intervene with the children’s ability to develop instrinsic motivation.  A behavior modification program can support a child who hurts others. The goal of this program is to increase a child’s awareness of hurtful behavior and increase awareness of their own socially appropriate behavior. The process of recalling the behaviors and acknowledging the aggressive actions is the essence of the intervention. The teacher and child should also review patterns and other alternatives. Interpretation is useful when children are anxious about an event or activity, but cannot explain the source of the anxiety , for example: a teacher is out sick and children are acting silly upon her return. She can say “I wonder if you got worried, maybe you thought I wasn’t going to return”. This can lead to a conversation where children feel connected to the teacher rather than being reprimanded which would reinforce their feelings of rejection. Teacher’s drawings of actual events could help the child reflect on their emotions. Behavior is meaningful and children can rely on adults to help them find meaning through interactions and activities.

 

Posttraumatic stress disorder: a traumatic event when a person experiences, witnesses or is confronted with that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. 

Psychiatric trauma: an experience that is emotionally painful, stressful, or shocking which often results in lasting mental and physical effects.

Children and families who experience on going trauma, have traumatic histories, or have poor psychosocial support are more vulnerable to long term mental health problems such as depression and PTSD.  If a child’s has a history of trauma and is not properly supported, they can remain in a constant physiologic state of high alert.  This can cause abnormal levels of chemicals that negatively impact learning, behavior and memory. It is important to understand that children of the same experience may not manifest trauma in identical ways.  Children under 28 months of age have no verbal memories of a traumatic event. Children of all ages have behavioral memories of trauma. These can be expressed in fearfulness, play, reenactment, and dreams. Single traumatic events tend to be remembered in detail for a lifetime, while repeated trauma tends to cause disassociation from the experiences and reduced memories of that trauma. Traumatized children can be hypervigilant causing them to be anxious and on guard. They constantly monitor the environment for potential sources of injury or loss. Traumatized children can also appear preoccupied (inattentive, worried, dazed).  These children are unlikely to remember their learning. Traumatized children can be hypersensitive to auditory stimuli and are easily frightened by loud noises.  Traumatized children may experience flashbacks of a traumatic event as if it is happening in the present moment. Traumatized children can have panic attacks causing them to cry, scream, tremble, hyperventilate, urinate, vomit, or sweat.  Trauma can alter the quality of a child’s play. These children can show restrictions, or the inability to play symbolically. Community trauma comes from recent tragedies that effect a population.  Specifically, the attacks of September 11th have caused trauma symptoms in children such as nightmares, fears, and separation anxiety for years after the attack.  Statistics show at the younger the child, the more likely he is to develop PTSD in response to trauma. Adults can experience countertransference, which is an emotional reaction caused by the child’s affects, behaviors, and issues. As we have discussed, this chapter stresses the importance of creating a classroom environment that is safe, predictable, nurturing, secure, and reliable to support these traumatized children with disorganized and unpredictable home environments. Teachers really need to understand and anticipate specific child’s anxiety and trauma in order to provide reassurance and support. Times of day where traumatized children may be more likely to become anxious are toileting, mealtime, and naptime. Offering a child a transitional object can support them during naptime, ensuring they will have enough food can support them during mealtime, and reassuring their safety during toileting can help them to feel safe. Being aware of these fears and empathizing with them is crucial to supporting children with trauma. A preschool classroom should have a curriculum that is inclusive of children’s specific experiences, support systems, and be a place where experiences are validated, emotional needs are met and students can begin to heal. 

In order to identify PDD NOS in preschool children, typical manifestations include the following:

·      Lack of relatedness

·      Oblivious to peers or overidentifies with peers

·      Atypical language

·      Lack of symbolic play skills

·      Preoccupation with fantasy characters

·      Need for sameness

·      Focused on meaningless details

·      Lacks a full range of affect

·      Atypical posture (floppy or rigid) (self stimulation)

Teachers must provide intervention strategies to support children displaying these manifestations. Some examples are helping children identify familiar and unfamiliar people, provide visual supports, social stories, and provide short 2-3 word phrases.