Trauma_Informed_Care.vtt TRAUMA-INFORMED CARE: AN INTRODUCTION FOR BRIDGE RESOURCE PARENTS

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Funded through a Cooperative Agreement with the Department of Health and Human Services, 
Administration for Children and Families,
Children's Bureau,
Grant #90C01033


Female Speaker: As a Bridge Resource Parent for foster and adoption, you've opened your heart and your home to children who need your care. Many of these children have lived through traumatic experiences.

Male Speaker: Traumatizing experiences can be so terrifying or disturbing that one feels anxiety thinking about it long after it occurs.

Female Speaker: Think about an event in your life that you would call traumatizing. Most likely certain sights, sounds and scents can trigger memories of the experience. Male Speaker: You may find yourself reacting physically or psychologically when you're reminded of it. Your heart may begin to race just thinking about it.

Female Speaker: Your impulse may be to protect yourself to prevent the event happening again, even if the precautions appear to be nonsensical over-reactions to others.

Male Speaker: The children in your care may feel these very things. If you were in their shoes, would you feel even more helpless if the adults in your life failed or were otherwise unable to protect you from the experience?

Female Speaker: What if the adults who were supposed to protect you caused the traumatic experience?

Male Speaker: What if multiple adults caused you trauma?

Female Speaker: Would you be able to trust other adults to protect you or not take advantage of you in the future?

Male Speaker: All of these situations can be issues to consider when working with the children in your home. Bridge Resource Parents must assume that any child placed in their care has experienced some trauma.

Female Speaker: Children bring their traumas with them wherever they go. For some children in care, the trauma is so severe it affects nearly every aspect of their lives.

Male Speaker: Trauma can affect the child's behavior, development and relationships.Traumatic stress reactions can cause children to behave ways that are confusing, frustrating and even alarming to their caregivers.

Female Speaker: Caring for a child who has experienced trauma without the proper tools and understanding can lead to problems for the child and the caregiver.

Male Speaker: A child's responses and or the caregiver's responses to trauma can be so severe that it contributes to the child's placement disruption.

Female Speaker: Caregivers might experience compassion fatigue. Feeling numb, burned out and unable to handle one more child's sad history.

Male Speaker: Adopting a trauma-informed care approach to working with youth is critical to providing a safe and nurturing environment for a traumatized child.

Female Speaker: Our goal is to help children with sensitivity and trust without adding to their trauma.

Male Speaker: In this video, you will learn about the different types of trauma children in care may have experienced, and the physical and emotional effects of trauma on children.

Female Speaker: You will also be introduced to the principles of trauma-informed care so that you can communicate with children who've experienced trauma and help them improve their behavior and attitudes.

Male Speaker: We want to help you get children the help they need from schools, case workers and therapy.

Female Speaker: And reduce your own risk of compassion, fatigue or stress.

Male Speaker: We want to help you become a more effective and satisfied Bridge Resource Parent.

Female Speaker: By the end of this video you will be able to define Trauma, Acute Trauma, Chronic Trauma, Complex Trauma, and Trauma Reminders.

Male Speaker: List different types of events that may cause traumatic stress in children.

Female Speaker: state and describe the three different categories of traumatic stress reactions. You'll be able to discuss different practices that influence the impact of trauma and state the effect trauma has on physical and cognitive skill development.

Male Speaker: You will understand how trauma can derail children's development and impact their ability to form relationships and have a working knowledge of trauma-informed care in ways you can practice it.

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TYPES OF TRAUMA

Female Speaker: As we stated, children in the foster care system typically have experienced some kind of trauma.

Male Speaker: Often understanding the type of trauma a child has experienced can help caregivers understand the child's resulting behaviors.

Female Speaker: When trauma is associated with the failure of those who should be protecting and nurturing the child, nearly every aspect of the child's life is affected.

Male Speaker: In this segment you will learn the different kinds of events that may cause trauma to children, as well as definitions for different types of trauma.

Female Speaker: As you watch, think about a real child you know. This could be a child currently in your home or a child who was once in your home. 

Male Speaker: Consider his or her experiences and history as you learn about trauma.

Female Speaker: To start, think about what makes something traumatic as opposed to just stressful.

Male Speaker: According to mental health experts, a traumatic event is different from a simply stressful or upsetting event in three important ways.

Female Speaker: First the event threatens the life or physical integrity of the child or someone critically important to the child. Such as a parent, sibling, grandparent or friend.

Male Speaker: Second, it causes an overwhelming feeling of terror, helplessness, and horror.

Female Speaker: The third way a traumatic event is different from a merely stressful event is that the body reacts to the threat with the fight or flight response.

Male Speaker: Here are the characteristics of the fight or flight response. The person may experience an increased heart rate, shaking, dizziness or faintness.

Female Speaker: One may experience rapid breathing and the release of stress hormones such as adrenaline and cortisol and even lose bowel or bladder control.

Male Speaker: The physical response to trauma can be terrifying in and of themselves. When children have traumatic responses, their bodies feel out of control. Their sense of helplessness and panic overwhelms them and they sense danger as if it is inside and outside all at once.

Female Speaker: Physical and sexual abuse are typically the kinds of experiences that come to mind when thinking of children in traumatic experiences. 
However, there are many other ways children may experience trauma.

Male Speaker: They include neglect, psychological abuse, witnessing domestic, community or school violence and traumatic loss.

Female Speaker: Medical trauma, natural disasters, war, terrorism and refugee trauma are other forms.

Male Speaker: Most cases of trauma can be separated into two types: acute and chronic trauma. Acute trauma is trauma that is defined as brief and severe.

Female Speaker: What do you think might be an example of acute trauma? 
A. Ongoing sexual molestation. 
B. Surviving a home invasion.

Male Speaker: The answer is B. Acute trauma is a single traumatic event that is limited in time. Some examples of acute trauma are:

Female Speaker: A serious accident such as a car accident or being attacked by a dog.

Male Speaker: The sudden or violent loss of a loved one.

Female Speaker: A natural disaster such as a tornado.

Male Speaker: Being a victim or witness of community violence such as a school shooting, a crime or gang violence.

Female Speaker: And a physical or sexual assault such as being shot or raped.

Male Speaker: Even during a brief traumatic event a child can go through an amazing and bewildering number of feelings, thoughts and physical responses as he or she reacts to the danger and thinks of how to find safety.

Female Speaker: These feeling and responses add to the sense of feeling overwhelmed and powerless.

Male Speaker: A certain moment that occurred during the acute event, such as the dog bearing it's teeth or the bad guy pointing his gun, can stick in a child's mind as the worst or scariest memory and can become a trigger for the child's trauma.

Female Speaker: Children gauge the seriousness of an event by their parents and other adult's responses. When parents or other adults or protectors react in fear, the child's fear is compounded.

Male Speaker: Chronic trauma is an experience of multiple and/or varied traumatic events, often over a long period of time.

Female Speaker: Some examples of Chronic trauma are exposure to ongoing domestic violence as a victim or witness. 

Male Speaker: Ongoing sexual molestation or assault.

Female Speaker: Repeated painful or frightening medical procedures.

Male Speaker: Neglect and multiple instances of trauma.

Female Speaker: For example, a child witnesses a violent fight between his parents. Later he's hurt in a drive-by shooting, then has to spend weeks in the hospital undergoing frightening medical procedures.

Male Speaker: Like acute trauma there are moments with chronic trauma that stand out with the child as particularly terrifying. Inside the ongoing situation there are precise, troubling memories.

Female Speaker: The effects of chronic trauma build on each event. The brain and body of a child who's experienced chronic trauma for years may respond differently to a scary event than a child who has not experienced chronic trauma.

Male Speaker: Children who have experienced a series of traumas may become more overwhelmed by each succeeding event and more convinced the world is not a safe place.

Female Speaker: Sometimes the lines between acute and chronic trauma can be blurred. Think about children who survived Hurricane Katrina. Surviving the hurricane itself could be an acute trauma event.

Male Speaker: However, after the storm many children faced a series of traumatic events. Including displacement, loss of loved ones, pets, community and friends.

Female Speaker: While struggling for survival in need of water, food, clothing and shelter, they felt the anguish of their parents and families and may have seen intense suffering and even dead bodies.

Male Speaker: Although the original threat to safety was acute, the after-effects of the event created additional traumas.

Female Speaker: Next, neglect is one of the most common reasons children enter out-of-home care. Neglect is defined as the failure to provide for a child's basic needs.

Male Speaker: Imagine an infant left alone in a crib for hours. Exhausted from her unanswered crying her eyes are sore and her mouth dry. Her stomach painfully rumbles with hunger and her skin burns with a rash caused by her unchanged diaper.

Female Speaker: To a child who is completely dependent on adults for care, neglect can feel like a threat to survival.

Male Speaker: For older children not having proper care, attention, and supervision, opens the door to traumatic events such as accidents, sexual abuse and community violence.

Female Speaker: Neglect can make children feel abandoned and worthless and reduce their ability to recover from traumatic events they may experience.

Male Speaker: The impact of trauma is compounded when the trauma is caused by the people children depend on for survival and safety.

Female Speaker: Trauma experts have used the term "complex trauma" to describe trauma and its effects when children are exposed to multiple traumatic events that begin at a young age - 
typically younger than five.

Male Speaker: Complex trauma also includes traumatic events that are caused by adults who should have been caring for and protecting the child.

Female Speaker: Chronic physical and sexual abuse from caregivers are two kinds of traumatic experiences associated with complex trauma.

Male Speaker: Neglect and complex trauma often go together with negligent parents. Committing such acts such as confining the child to a closet, tying him or her up in bed, refusing the child food or water or drugging the child to keep him or her quiet.

Female Speaker: Complex trauma has profound effects on nearly every aspect of the person's emotional and cognitive development and functioning including behavior and relationships in school and at home.

Male Speaker: It echoes through the child's life. When a child is placed in your home, here is a series of questions you can ask yourself to start to evaluate the extent of the trauma.

Female Speaker: What sort of traumatic experiences has he or she endured?

Male Speaker: Would you classify the child's trauma as acute or chronic trauma?

Female Speaker: Do you think the child experienced complex trauma and then, why or why not?

Male Speaker: Finding the answers to these questions when possible will help you understand where the child has come from and help you find the best approach.

Female Speaker: In this segment you learned about the different types of traumatic eventsa child may have experienced. You also learned definitions of different types of trauma.

Male Speaker: The next segment features real stories of children in foster care who's lives and behaviors are effected by trauma. We'll explain some technics help interpret their lives.

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TRAUMA BEHAVIORS

Female Speaker: One of the most frustrating things about being a Bridge Resource Parent is having unanswered questions about children's past experiences.

Male Speaker: However, even when we don't know exactly what happened, using the trauma lens approach can help us understand children's behavior. It's a compassionate way of looking at a situation that takes into account the child's past trauma instead of the surface explanation for behavior.

Female Speaker: The trauma lens technique helps you to analyze what is within the child's control and what is not.

Male Speaker: Now we're going to share the stories of several children of different ages who have been in foster care. We will discover how their baffling, frustrating and sometimes disturbing behaviors make more sense when seen through a trauma lens. Although the details have been changed to protect their privacy, these cases are based on the experiences of real children and adolescents.

Female Speaker: First, meet Mya. An eight month old baby who's currently living with her mother's older sister, Jenna.

Male Speaker: Mya often wakes up in the middle of the night crying hysterically. When Jenna picks her up to soothe her, Mya arches her back, pushes her hands against Jenna's shoulders and screams even harder. 

Female Speaker: When Jenna holds tighter and tries to make eye contact with Mya, the baby turns her head away.

Male Speaker: Jenna has said, "This little baby makes me feel completely rejected. Sometimes I feel so helpless, I just have to put her down and let her cry."

Female Speaker: Mya was taken into care after a 17-year-old mother brought her to the emergency room. Mya was unconscious with broken arms and bruises on her body.

Male Speaker: In Mya's short life she's experienced physical abuse, separation from her mother, probable neglect and medical trauma, including time with her arms in casts.

Female Speaker: Let's view Mya's behavior through a trauma lens and see how we can connect how a responses are tied to her trauma.

Male Speaker: What has trauma taught Mya about crying. Mya has learned that when she cries, either no one responds or others hit her or yell at her. Crying is scary and no one is there to comfort her.

Female Speaker: What has trauma taught Mya about physical contact. She has learned to associate physical contact and being held with danger. She may be bracing for physical assault. Her resisting Jenna may be her way of physically defending herself.

Male Speaker: What can Jenna discern from Mya's responses. If Jenna persists in trying to physically soothe Mya, perhaps this is Mya's way of disassociating from the contact and mentally escaping from the situation if she cannot physically escape. Mya has learned that other people cause pain, not comfort, and are not safe and cannot be trusted.

Female Speaker: Next is four-year-old Tommy's story. Tommy plays repeatedly with a toy police car and ambulance, crashing them into each other while imitating the sound of sirens wailing.

Male Speaker:  When his Bridge Resource Parent, Elizabeth, tries to change Tommy's play by having the ambulance take someone to the hospital, Tommy screams and throws the toy cars.

Female Speaker: Tommy has been in Elizabeth's home for three weeks. He was taken into care after his father beat his mother so severely that she required hospitalization.

Male Speaker: In his life, Tommy has seen violence, seen his mother brutalized and has been separated from her by people in authority positions.

Female Speaker: How might Tommy's behavior be a result of his experiences? Is there a connection between how and what he plays with?

Male Speaker: Children, particularly those of Tommy's age, tend to act out or express their experiences through play. Since Tommy's recent experiences include the involvement of law enforcement and an ambulance, Tommy may be remembering and working through his trauma.

Female Speaker: Might his crashing the vehicles together be an expression of anger? Perhaps it is anger toward his father for hurting his mother, or anger toward the police and EMTs for separating him from his parents. He may be blaming the police car and ambulance for his current situation.

Male Speaker: Why might Tommy react with screaming when his play is changed? Is he angry because someone is interfering with his process of working through the situation?

Female Speaker: He may be angry or scared because the ambulance taking a person to the hospital reminds him of his mother being injured.

Male Speaker: Maybe he reacts so dramatically because the police car and ambulance represent the scariest or worst part of the trauma for him.

Female Speaker: Now, meet nine-year-old Andrea. Andrea enjoys reading with her Bridge Resource Father Daniel. One day while sitting on his lap reading her favorite story book, Andrea began to rub up and down against his crotch. 

Male Speaker: Shocked and startled, Daniel pushed her off his lap, roughly telling her to "get out of here." Andrea ran to her room sobbing, "Why does everyone hate me?" and began frantically packing her suitcase. 

Female Speaker: Andrea was placed in foster care when she was about a year old because of severe neglect. She's been in this, her third foster home, for about a month. This is her first placement apart from her brothers. 

Male Speaker: Andrea's history and her other foster homes and with her brothers is unknown. But many children who have been sexually abused act out sexually, even instigating the contact.

Female Speaker: Through the trauma lens, let's link how Andrea's behavior maybe a result of her past trauma.

Male Speaker: At some point Andrea learned to initiate sexual contact. This may have been a pattern of behavior she was taught by an abuser. This may have been the only way she learned to get attention and love. 

Female Speaker: This may also be a defense mechanism she developed to offset to prevent other types of abuse. She may be thinking that acting first will provide some protection for herself or her brothers.

Male Speaker: Andrea takes Daniel's angry reaction as a failure on herself. Perhaps she was used to a loving or gentle response and initiate sexual contact to get that response.

Female Speaker: Finally, here's 15-year-old Javier's story. At school, Javier frequently gets into trouble for being class clown and lately has been skipping classes to drink or smoke pot in a nearby park.

Male Speaker: While at a party recently, Javier saw one of his friends verbally abusing a girl. When the friend pushed the girl, Javier jumped in; beating up the other boy. When his case worker Michael asked what had happened, Javier said, "I don't know. It was like I just went into kill mode."

Female Speaker: Javier has been in foster care for a little under a year. He was removed from his parents' home after he tried to intervene in one of his parents fights and his father beat him severely. He would try to divert his parents' fights by making jokes and has begged his mother to leave his father but she won't.

Male Speaker: How might Javier's behavior be a result of his past trauma? Javier's withdrawal, lack of interest in school and hopelessness may be related to the helplessness and frustration he feels about his family.

Female Speaker: Javier used humor to defuse fights at home. Making others laugh may be the only thing Javier feels good at. He may be engaging in substance abuse as a form of self-medication.

Male Speaker: Javier's aggressive reaction to his friend may have been sparked by the memories of seeing his mother being abused.

Female Speaker: Following his father's example he may have internalized that a violent response is the way to handle conflicts.

Male Speaker: In this segment, you were introduced to viewing children's behaviors through their traumas. You've learned how experiences in the past are linked to the child's current behaviors and how confusing behavior makes more sense in light of the trauma.

Female Speaker: In the next segment you will learn how trauma affects children physically and developmentally.

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TRAUMA AND THE BRAIN

Female Speaker: Perhaps no aspect of child development is as miraculous and transformative as the development of the child's brain.

Male Speaker: Traumatic events however, can cause real, tangible, negative effects on children's brains and bodies.

Female Speaker: In this segment we will take a closer look at the physical processes children endure when they experience a traumatic event. We'll also explore how trauma can effect brain development and cause developmental challenges.

Male Speaker: To fully understand just how the brain responds to danger, it helps to take a closer look at the body's internal alarm system. When faced with a threat, the brain triggers the release of adrenaline, cortisol and other stress hormones.

Female Speaker: These chemicals activate the system the body needs to immediately respond to the threat. Either by fighting back, getting away or freezing.

Male Speaker: Imagine you are taking a walk in a park. You glance down and in front of you is a huge snake. How do you think you would react? Now imagine you have to walk through the park again a couple of days later. How do you think that would make you feel? More than likely you're going to be watching the ground a lot more closely, right? A stick on the path is more likely to startle youbefore you can even have a conscious thought about a snake.

Female Speaker: Even if you've been through the park many times before without seeing a snake, seeing a snake once changes your perception of the park and makes you expect danger there. That's because it's a lot more dangerous to mistake a snake for a stick than to see a snake in every stick. Our brains are wired this way: to generalize in the direction of looking out for danger so we can protect ourselves.

Male Speaker: The function of the brain that prompts the fight or flight response is sometimes called the primitive brain. This is the first part of the brain to develop, and it controls the most basic function and reactions we need to survive including fear, anger, sexual responses and memory.

Female Speaker: The primitive brain enables us to make the split-second decisions that protect us in dangerous situations. Other more advanced parts of the brain are responsible for thinking, reasoning and consciously processing information.

Male Speaker: These areas of the brain help to analyze the threat and signal the primitive brain to stop pumping out stress hormones so the body systems can return to normal. When you realize you were looking at the stick and not at a snake, you feel yourself relax. Those higher centers have done their job.

Female Speaker: For most people the body's emergency response shuts down shortly after danger has past. However, for children exposed to severe or chronic trauma, the emergency response system can get stuck in the on position.

Male Speaker: The stress hormones keep flowing and make it harder for the parts of the brain that think and plan to work efficiently. The stress hormones are related brain chemicals that are generated actually get in the way of rational thinking.

Female Speaker: Take a moment and think of a time that you were genuinely frightened. Were you able to think clearly, take in new information and plan for the future during that moment? Or was all of your mental energy focused on keeping yourself safe?

Male Speaker: It is no wonder why children in a regular state of this type of stress may act irrationally outside the norms of social niceties or seemingly without regard to their best future interests.

Female Speaker: Trauma during childhood effects many aspects of a child's functioning because childhood is when the brain develops and becomes organized.

Male Speaker: A child's brain grows from the bottom up. Starting with the most basic functions needed for survival. More and more complex functions develop as the child's accumulates experiences.

Female Speaker: The brain develops by forming connections. Even though a baby is born with a hundred billion brain cells, the connections between these cells form over time, mostly during infancy and early childhood. These connections, called "neural pathways", are like the wiring in a house that connects one part of the brain to another.

Male Speaker: Let's see what you know about brain development. 
True or false: The brain's development depends entirely on the genes with which a person is born. 
A. True B. False

Female Speaker: The answer is B. false. Early experience and interaction with the environment are the most critical to a child's brain development.

Male Speaker: Think of everyday moments a parent shares with a child. A mother lovingly gazing into her baby's eyes as she feeds him. A father talking gently to his daughter as he reads her a book. Those everyday moments, these simple, loving encounters provide essential nourishment to the brain. Healthy brain development is built on these small moments.

Female Speaker: Next question. True or false: A toddler's brain is less active than the brain of a college student. 
A. True B. False.

Male Speaker: The answer is B. False. A three-year-old's brain is twice as active as an adult's brain.

Female Speaker: A young child's brain is working overtime to learn all of the essential skills adults have already learned and may take for granted. Language, visual processing, mobility, cause and effect, the difference between fantasy and reality, emotional cues and responses, and many other skills. Learning these skills and making important brain connections is critical to a child becoming a functional adult.

Male Speaker: A number of factors influence early brain development including genetics, nutrition and physical activity. However, experiences both with caregivers and ones that stimulate the five senses, impact the development of the brain and influences a specific way in which the brain becomes wired.

Female Speaker: Early experiences provide the connections that form the basis of thoughts, feelings and behaviors. Early experiences have a decisive impact 
on the actual architecture of the brain. The more an experience is repeated, the stronger the resulting brain connections become. 

Male Speaker: For example, when you repeat words and phrases to a baby you are strengthening the baby's language connections. By the time a child is three years old, their brain is formed about one thousand trillion connections; about twice as many as adults have.

Female Speaker: While good experiences can have a positive effect on the brain, repeated traumatic experiences can have a negative effect.

Male Speaker: When the people who should be protecting, loving and guiding young children expose them to trauma instead of care, children's development can be derailed. A brain that is constantly reacting to threats can become wired for survival in a risky and unpredictable world.

Female Speaker: These brains may develop in a way that keeps the child on constant alert for danger. This allows the child to respond quickly to even the slightest threat. When this happens, other developmental pathways get disrupted and children may fail to accomplish other important developmental tasks.

Male Speaker: There are certain special times during the brain's development when it is most open to certain kinds of learning. For example language and speech are best learned when a person is a very young child. 

Female Speaker: When trauma occurs during one of these periods, the effect of the trauma may show itself by hampering the development of the skill the person needs to develop. 

Male Speaker: Let's discuss different skills by age group to see how trauma may effect children's development.

Female Speaker: Early childhood from birth through the pre-school years is a crucial time for the development of several important brain pathways.

Male Speaker: Here are some brain pathways that are developed between birth and pre-school age followed by how trauma negatively effects the pathway.

Female Speaker: The brain pathway develops the child's ability to process what is seen and heard. If this pathway is disrupted the child may become particularly sensitive to loud noises and have a heightened startled response.

Male Speaker: The brain pathway develops the child's ability to recognize, analyze and respond to emotional cues. If this pathway is disrupted the child may reject contact and avoid being touched.

Female Speaker: The brain pathway develops the child's ability to become attached to a primary caregiver - the person on whom the child depends on for survival. If this brain pathway is disrupted then the child may be confused about what's dangerous and who to go to for protection, particularly if the trauma was at the hands of a caregiver. The child may be clingy and resist being separated from familiar adults and places where he or she feels safe.

Male Speaker: Remember Mya, the baby being cared for by her Aunt Jenna? Mya often wakes up in the middle of the night crying hysterically. When Jenna picks her up to soothe her, Mya arches her back, pushes her hands against Jenna's shoulders and screams even harder. When Jenna holds tighter and tries to make eye contact with Mya, the baby turns her head away.

Female Speaker: The trauma Mya experienced before Jenna's care has negatively affected her brain pathways. Her night crying may be due to sound sensitivity. 
She may be easily startled. Mya's rejection of contact with Jenna is also a signal of altered brain pathways.

Male Speakers: In early childhood, trauma can be associated with a reduced size of the cortex of the brain. Which regulates complex functions such as memory, perceptual awareness, thinking and language.

Female Speaker: A reduced cortex may also affect how the two sides of the brain work together, affecting IQ and the ability to regulate emotions. Increased fearfulness and a reduced sense of safety and perception are also results.

Male Speaker: During the school age years, the brain starts building the pathways that enable children to more consciously and rationally process their experiences. 

Female Speaker: In this age range the brain pathway developed gives the child the ability to manage fears, anxieties and aggression. If the brain pathway is disrupted the child may experience mood swings. For example, shifting between being shy and withdrawn to aggressive, demand lots of attention and have specific fears such as fear of the dark.

Male Speaker: Also, the brain pathway developed gives the child the ability to focus attention on learning and solving problems. If the pathway is disrupted, the child may have difficulty in school in other learning situations.

Female Speaker: The brain pathway developed gives the child the ability to control his or her impulses and manage their physical reactions to perceived dangers. If the pathway is disrupted, the child may revert back to younger behavior such as baby talk or wanting adults to feed or dress him or her.

Male Speaker: During adolescence, trauma can interfere with the development of the pre-frontal cortex of the brain and hamper the pathways that regulate decision-making, thinking and reasoning. 

Female Speaker: Because the cortex is the least developed part of the brain at birth and keeps developing until adolescence and beyond, the cortex is more sensitive to experiences than other parts of the brain.

Male Speaker: Adolescents develop the brain pathway that gives them the ability to imagine the future and anticipate and consider the consequences of their behavior. If the brain pathway is disrupted an adolescent may engage in aggressive, disruptive or self-destructive behaviors, such as drug or alcohol abuse, cutting themselves or having unprotected sex.

Female Speaker: Adolescents develop the brain pathway that gives them the ability to make realistic appraisals of what's dangerous and what's safe. If the brain pathway is disrupted, the young person may have trouble accurately assessing risks, either over- or under-estimating the danger of the situation or activity.

Male Speaker: Also, they develop the brain pathway that gives them the ability to alter their current behaviors in order to meet their long-term goals. If the brain pathway is disrupted, adolescents may have difficulty imagining or planning any kind of future, instead living in the moment without regard to consequences.

Female Speaker: Let's review Javier's story. At his high school Javier frequently gets into trouble for being the class clown, and lately has been skipping classes to drink and smoke pot in a nearby park.

Male Speaker: While at a party recently, Javier saw one of his friend's verbally abusing a girl. When the friend pushed the girl, Javier jumped in, beating up the other boy. When his case worker what had happened, Javier said, "I don't know. It was like I just went into kill mode." Let's discuss what brain pathway disruptions could be happening to Javier.

Female Speaker: As we listed before, disruptions could include aggressive and disruptive behavior including drug and alcohol abuse. Javier may be unable to assess the risk in situations when he is in self-described "kill mode." This also shows an inclination to act without considering consequences.

Male Speaker: Since trauma can derail development children fail to learn how to identify, express or manage emotions. As a result, children who have experienced trauma may display behaviors more typical of younger children.

Female Speaker: For example, babies learn to regulate and tolerate their shifting feelings with caring adults. If this skill is not learned and the child grows older, the child may seem more like a baby emotionally.

Male Speaker: During the school age years children learn to think before acting. Adolescents who never learned this skill may be especially impulsive and prone to get into trouble.

Female Speaker: The good news is that children whose development has been derailed by trauma can learn new ways of thinking, relating and responding emotionally. In fact the cortex continues to develop through adolescence and into adulthood. This is the highest part of the brain, the part that makes us human and is associated with reason and analysis.

Male Speaker: By providing new positive experiences and examples we can help children and adolescents who have experienced trauma build new neural pathways to bypass old ones. Rational thought and self-awareness can help young people override primitive brain responses.

Female Speaker: The process of unlearning and rebuilding will take time and patience. But we should always remember there is hope and potential for change. There are techniques you can use to help stimulate a child's brain growth and development. In this segment you learned about the physical processes a child goes through when enduring a traumatic event and how trauma can effect a child's developing brain.

Male Speaker: In the next segment we will expand on how trauma effects children and discuss ways in which children may react psychologically and emotionally to trauma.

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EFFECTS OF TRAUMA

Female Speaker: Everything that children experience becomes a part of the fiber of their being. 

Male Speaker: These experiences include the very bad and confusing events we call trauma, as well as the good experiences we create in share with them.

Female Speaker: In this segment you will learn the different effects traumatic stress has on children's feelings and behaviors.

Male Speaker: Trauma can result in such intense fear, anger, shame and helplessness that the child feels overwhelmed. Even neutral experiences can unleash a flood of overwhelming emotions and panic.

Female Speaker: Trauma can have profound effects on a child's healthy physical and psychological development. Children who have survived trauma often find it difficult to trust other people and feel safe.

Male Speaker: They have difficulties understanding and managing their emotions. Past traumas can affect the way they adjust and respond to life's changes.

Female Speaker: Adapting physically and emotionally to stress can be a struggle.

Male Speaker: Over time a child who has continually felt overwhelmed may react negatively to what others see as minor everyday stresses. 

Female Speaker: The impact the trauma has on a child depends on a number of factors including the child's perception of the danger faced.

Male Speaker: And whether the child was the victim or a witness to the traumatic event.

Female Speaker: The child's temperament is also a factor. Some children are naturally more resilient against stress than others.

Male Speaker: The child's relationship to the victim or perpetrator and the child's past experience with trauma are also a contributing factor.

Female Speaker: How adults reacted to the child's traumatic experience also determines how severely the trauma impacts the child.

Male Speaker: What happened after the traumatic events and whether the child was believed and supported or rejected and/or ignored effects the level of trauma also.

Female Speaker: The child may or may not have had other adults available who could offer help or protection. Children fare better after trauma with the support of caring adults.

Male Speaker: Trauma may have continued after an initial event. Like our Hurricane Katrina example earlier. Our life may have returned to normal. The duration of trauma affects a child's ability to recover.

Female Speaker: Trauma's impact may differ according to the child's age, developmental stage and developmental level.

Male Speaker: As discussed in the previous segment, children can become so emotionally overwhelmed by the trauma that their development of age-appropriate behaviors may be delayed.

Female Speaker: Children manifest symptoms of traumatic stress through behaviors or reactions called traumatic stress reactions. These reactions are grouped into three categories: hyper-arousal, re-experiencing, and avoidance and withdrawal.

Male Speaker: The first category is hyper-arousal. If the child experiences this reaction, the child is jumpy, nervous and quick to startle. He or she is frequently on the alert or braced for more danger.

Female Speaker: The second category is re-experiencing. When the child is re-experiencing their trauma the images and sensations or memories of the event keep coming back uncontrollably to the child's mind.

Male Speaker: People commonly call this a flashback. But re-experiencing can be more subtle than being abruptly thrust back into a scene of the trauma.

Female Speaker: A trauma reminder may cause a child to re-experience trauma. Everything associated with the traumatic event; sights, sounds, smells become linked in the child's brain with the trauma. It can be as simple as a whiff of a kind of food or a loud noise.

Male Speaker: Can you remember a time when you encountered something that so reminded you of a past experience that it brought you right back into that memory?

Female Speaker: Maybe it is a song you heard on the radio that reminded you of a precise day that you were a teenager.

Male Speaker: Maybe it was the smell of a perfume your mother used to wear, or you saw someone who reminded you of your best friend in grade school.

Female Speaker: Sometimes these reminders can be so powerful we even remember details of the past even that we had forgotten.

Male Speaker: Imagine if this reminder were tied to being raped, or seeing your parent murdered.

Female Speaker: Imagine you're confronted with this reminder at the grocery store or at a birthday party or just about anywhere you went.

Male Speaker: Remember Tommy? The little boy who saw his mother taken away by an ambulance after his father beat her. Remember how he crashed his toy police car and ambulance together? How do you think Tommy might react when he sees an ambulance or a police officer or hears the sound of an emergency siren?

Female Speaker: Remember when Javier said he just went into kill mode when he saw his friend push a girl? He was reacting to a trauma reminder. Think of how a child who's been sexually molested might react if he or she were to smell the same cologne the perpetrator used on someone else.

Male Speaker: Or think of how a child who's survived a devastating tornado might react when there's stormy weather or when he or she hears a tornado siren blare.

Female Speaker: When faced with a trauma reminder the child may re-experience the trauma or react as if back inside it.

Male Speaker: The child may withdraw from ordinary activities to avoid being confronted by the reminders, or disassociate and disconnect from present surroundings and appear withdrawn internally or spaced out.

Female Speaker: We experiencing trauma through a trauma reminder isn't always a conscious process. The child may be unaware of the connections which may further add to his or her sense of alarm and bewilderment.

Male Speaker: In the space of a day, children may face so many trauma reminders that the whole world seems dangerous and no adult can be trusted.

Female Speaker: The third category of traumatic stress reaction is avoidance and withdrawal.

Male Speaker: In this state the child feels numb, frozen, shut down or separated from normal life, and may pull away from friends and activities - even those he or she used to enjoy. Sometimes children withdraw to avoid any reminders of the traumatic event.

Female Speaker: Some children dis-associate when they face trauma so that the event seems to be happening outside of themselves. It's an attempt to separate themselves from what is happening to them.

Male Speaker: A child who has learned to dis-associate to protect him or herself may dis-associate during any stressful or highly emotional event.

Female Speaker: Let's practice a little of what you just learned about the three categories of traumatic stress reactions.

Male Speaker: Alexis suffered facial scarring when she was attacked by a dog. If she walks around her neighborhood and hears a dog barking she immediately drops to her knees and covers her face. What category of traumatic stress is Alexis experiencing? 
A. Hyper-arousal 
B. Re-experiencing 
or C. Avoidance/Withdrawal.

Female Speaker: The answer is B. Even though she only hears the dog's bark she immediately associates the sound with the trauma she experienced and is thrust back into the moment of the attack. Alexis showed signs of the re-experiencing reaction.

Male Speaker: Next scenario. Rod witnessed his best friend being shot to death in a gang violence incident at a school's sports game. Now when Rod attends school sports functions, his heartbeat speeds up, he nervously watches the people in the crowd and he braces himself whenever he sees anyone take their hands out their pockets or jackets. What category of traumatic stress is Rod experiencing? 
A. Hyper-arousal 
B. Re-experiencing 
or C. Avoidance/Withdrawal.

Female Speaker: The answer is A. Rod is nervous and jumpy but not necessarily in the moment of his traumatic event. He appears to be experiencing hyper-arousal.

Male Speaker: Traumatic Stress reactions can lead to a range of troubling, confusing and sometimes alarming behaviors and responses. The child may have trouble learning, be unable to focus, concentrate or take in new information.

Female Speaker: The child may have trouble going to or staying asleep or experiencing nightmares.

Male Speaker: He or she may feel moody - tearful one minute and cheerful the next. Or suddenly become angry or aggressive.

Female Speaker: The child may not act his or her age, instead acting like a much younger child.

Male Speaker: He or she may develop physical complaints, such as headaches or stomach aches.

Female Speaker: Children's worries about traumatic events may surface in play. Young children especially tend to act out their experiences with their toys or other people.

Male Speaker: This kind of play can serve many purposes, including helping young children make sense and process traumatic events.

Female Speaker: Children may act out the whole story of the trauma, such as when Daddy hit Mommy and Daddy was taken away. Or only a piece of it, such as the moment when the ambulance came.

Male Speaker: Children may also take on the role of the abuser. Such as hitting or yelling at a doll.

Female Speaker: Some children get stuck on one moment of the event. And some children may try at different outcomes, such as a superhero flying in to the rescue.

Male Speaker: Remember when Tommy became upset when his Bridge Resource Mom, Elizabeth, tried to change the story of his play? Tommy was still stuck in the moment of the earlier traumatic event.

Female Speaker: Traumatic play can be a healthy way for children to process their fears and emotions. However, consult your Child Welfare Specialist if the child's centers most play activities around traumatic events.

Male Speaker: Or if the child becomes very upset when engaging in traumatic play.

Female Speaker: Other reasons for concern are if the child repeatedly plays the role of the abuser with dolls or stuffed animals or acts out abuse with other children or animals.

Male Speaker: Also consult your Child Welfare Specialist if the child plays in a way that seems to be interfering with his or her relationships with other children or his or her development.

Female Speaker: Although some children are willing or unable to talk about trauma others may talk about their trauma in ways that are confusing or disturbing. For example, they may constantly talk about a particular traumatic event or events.

Male Speaker: They may bring the topic up at unexpected and inexplicable times and they may be confused or mistaken about details of the event.

Female Speaker: They may remember only fragments of what happened or avoid talking about anything even remotely related to the trauma.

Male Speaker: Consult the Child Welfare Specialist if talking about the traumatic events interferes with the child's ability to focus on anything else or gets in the way of his or her relationships with other children.

Female Speaker: Also consult if the child is focused on feelings of regret, guilt, shame or an inability to accept what happened.

Male Speaker: Without help and support, children are left to their own devices to develop survival strategies in order to cope with traumatic stress. Some of these coping devices are called "reenactment behaviors."

Female Speaker: These behaviors are often triggered by trauma reminders. They may seem out of place now but were appropriate and even helpful at the time of the trauma.

Male Speaker: The behavior may not make sense to others but make clear sense to the child.

Female Speaker: Early in this segment, Alexis' response to a barking dog illustrated reenactment behavior.

Male Speaker: Although she faces no imminent danger, when she hears a dog bark she immediately takes action to cope with the situation and protects herself, although her actions might seem strange to an observer.

Female Speaker: Some coping skills may seem negative, inappropriate or bad to the outside observer, such as anger, aggression and sexualized behavior.

Male Speaker: Coping strategies might include sleeping, eating and elimination problems, high activity level, irritability and acting out.

Female Speaker: Also, emotional detachment, unresponsiveness, distancing and numbness.

Male Speaker: Hyper-vigilance to perceive danger and an increase in mental health issues, like depression and anxiety, may occur.

Female Speaker: Children may also give an unexpected and exaggerated response when they are told "no."

Male Speaker: These behaviors can become ingrained over time because they are familiar and help the child survive past relationships.

Female Speaker: The behaviors may prove the child's negative beliefs and expectations of adults. To them a world they can predict feels safer than one that cannot be anticipated.

Male Speaker: Coping techniques can help the child vent frustration, anger and anxiety.

Female Speaker: Also they can give the child a sense of control and mastery over old traumas and current fears.

Male Speaker: Because these behaviors can be negative, they can threaten new relationships and endanger Bridge Resource Placements.

Female Speaker: Remember Andrea, the nine year old girl who initiated sexual contact with her Bridge Resource Father?

Male Speaker: How must it must have felt for Andrea when her Bridge Resource Father reacted so negatively to the behavior that had been ingrained as appropriate in her?

Female Speaker: Could this incident endanger her placement? Could you see the Bridge Resource Father so disturbed by her actions and afraid of accusations that he might move to end the placement?

Male Speaker: Children who experience trauma are doing their best to make sense of the world with only their past as a guide. Your understanding of and approach to their trauma can help them begin to heal.

Female Speaker: In this segment you learned some of the ways traumatic stress affects children.

Male Speaker: In the final segment, you will be introduced to some principles or trauma-informed care. These principles teach you ways you can practice caring for a child who has survived trauma.

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"Just as despair can come to one only from other human beings, hope, too, can be given to one only by other human beings."
Elie Wiesel

Female Speaker: During World War II, Elie Wiesel was shipped to a concentration camp at the age of 16 and lost his entire family.

Male Speaker: His words about hope and despair mirror the role we play in the lives of traumatized children.

Female Speaker: We cannot fix all the hurts in children's lives but we can foster the resilience and give them the skills and the hope to heal.

Male Speaker: Sometimes caring for a child who has been traumatized may feel like an overwhelming task.

Female Speaker: Trying to make sense of the behaviors, reactions and attitudes of these children can leave Bridge Resource Parents feeling confused, frustrated, unappreciated, angry and helpless.

Male Speaker: But there is hope. There are many things that you, as a caring adult, can do to help boost children's resilience against the effects of trauma.

Female Speaker: In this segment, you will learn some of the principles of trauma-informed care. These principles will give you tools to best help children placed in your care and help you become a more effective and satisfied Bridge Resource Parent.

Male Speaker: First and foremost trauma-informed care is about understanding behavior.

Female Speaker: When we view children's behaviors through a trauma lens, the behaviors begin to make more sense. This helps caregivers, case workers and other members of the child's team to develop effective strategies to help the child together.

Male Speaker: You have already begun practicing making sense of children's behaviors as you have progressed through this video.

Female Speaker: Safety is critical for children who've experienced trauma. Many children have not consistently felt safe or protected in their own homes.

Male Speaker: While it may appear to you the child is physically safe with you, he or she may  not feel psychologically safe. As part of trauma-informed care, you must establish an environment for the child that is physically safe, and work with the child to learn what it will take to create psychological safety.

Female Speaker: Providing calm, consistent and loving care can set an example for children to teach them how to define, express and manage emotions. You can help children to understand the link between their thoughts, feelings and behaviors and to take control of their behavioral responses.

Male Speaker: Many children don't want to share their stories. Be a safe listener when they do share. Work with them to build bridges across the disruption in their lives. Help them to develop a strength-based understanding of their life stories.

Female Speaker: Children learn about themselves and the world through the connections they make, including relationships with other people. Positive, stable relationships play a vital role in helping children heal from trauma.

Male Speaker: A child will be more likely to bounce back from trauma if he or she has a strong, supportive relationship with a competent and caring adult. For any child in your home, that adult is you.

Female Speaker: Children who have been abused or neglected often have insecure attachments with other people. Regardless, they may cling to these attachments, which are disrupted or even destroyed when they come into care.

Male Speaker: You can help the child to hold on to what was good about these connections. You can help to reshape and make new meaning from their past attachments.

Female Speaker: There's several factors in a child's life that can promote resilience. Children will be more likely to recover from trauma if they feel a connection with a positive role model or mentor. This can be someone who has also gone through painful experiences and survived, or someone the child aspires to be like when they become an adult.

Male Speaker: Feeling some sense of control over their own lives promotes the ability to bounce back. Being removed from a home and placed in out-of-home care can increase feelings of having no control. 

Female Speaker: Feeling invested in and part of a larger community such as their neighborhood, a faith-based group, scout troop or charity organization can also promote resilience. Children make positive progress when they feel their talents and abilities are being recognized and nurtured and when adults play to and re-enforce children's strengths.

Male Speaker: Remember Javier's story? Let's review it and look for his strengths. At school Javier frequently gets into trouble for being class clown, and lately has been skipping classes to drink or smoke pot in a nearby park. 

Female Speaker: While at a party recently, Javier saw one of his friends verbally abusing a girl. When the friend pushed the girl Javier jumped in, beating up the other boy. When the case worker asked what had happened Javier said, "I don't know. It was like I just went into kill mode."

Male Speaker: We know he formed a strong attachment with his mother. That he is able to form friendships with his peers and that he has a strong sense of justice and morality.

Female Speaker: These traits all demonstrate that Javier has the ability to form meaningful relationships with others. The absence of this can be a great challenge.

Male Speaker: We also know that Javier has some attributes that his Bridge Resource Parents can direct and encourage in a meaningful positive way for his future.

Female Speaker: He's the class clown, an entertainer with a good sense of humor. His Bridge Resource Parents should nurture his talents and encourage him to test them in the world in appropriate ways.

Male Speaker: When he protected the young woman, he showed that he can care about people other than himself. With the proper direction he could turn his interest in social justice into some form of community service or career, making meaning out of his difficult past.

Female Speaker: Let's return to another story. Aunt Jenna has been making some strides with baby Mya. Jenna has discovered that Mya is most comfortable taking her bottle if it is propped up so that she can hold it herself.

Male Speaker: Jenna has found that playing soothing classical music when it's time for a bottle calms Mya. Every time Mya hears Brahm's Lullaby she begins to relax. 

Female Speaker: One evening, Jenna began to hum the tune as she gave Mya her bottle and Mya made eye contact with her.

Male Speaker: Based on Mya's story here are her strengths: She can express her needs through crying. She has not given up.

Female Speaker: We know she can take comfort from her bottle and respond to soothing music.

Male Speaker: Baby Mya can also connect to Jenna when her aunt hums the melody she has come to associate with comfort and safety.

Female Speaker: Here is some ways that Jenna can build on these strengths: As Jenna continues to meet Mya's needs predictably and consistently, Mya will begin to learn that the world can be safe and other people can be relied upon. Through Jenna's simple actions, Mya can begin to feel safe and capable. She can hold her own bottle.

Male Speaker: Jenna's consistent and predictable care is showing Mya that she is lovable. The love Mya feels from Aunt Jenna will help to keep the trauma from affecting her later in life.

Female Speaker: Here is a list of questions you ask when looking for ways to boost a child's resiliency:

Male Speaker: What strengths or talents can you encourage?

Female Speaker: What people have served as role models for the child?

Male Speaker: What people have served as sources of strength or comfort?

Female Speaker: What does your child see as being within his or her control?

Male Speaker: What causes or organizations larger than him or herself could you encourage your child to participate in?

Female Speaker: As a Bridge Resource Parent, you can also help children by advocating for them. You are intimately and consistently connected with the child, and play a critical part in ensuring that efforts to help the child are coordinated.

Male Speaker: It takes a team of people and agencies to facilitate a child's recovery from trauma. Advocate for trauma-informed psychological assessments and treatments by experienced child trauma professionals.

Female Speaker: Help others view your child and his or her behavior through a trauma lens. This goes a long way in helping the child find the acceptance that is so crucial to healing.

Male Speaker: Before we close there are a few ideas Bridge Resource Parents should let go of that can actually get in the way of trauma-informed parenting and make life more stressful.

Female Speaker: First, set yourself free from the idea that it's possible to be the perfect parent. If we fall into the trap in believing that we have to be perfect parents, it may keep us from being the good enough parents our children need.

Male Speaker: Second, be willing to accept your limitations and the child's limitations. Your child may appreciate you and let you know or not. The fact that the child does not express appreciation or love does not mean that you're not having an impact.

Female Speaker: Third, let go of the idea that the child will recognize the trauma and leave his or her family in the past. Even children who have suffered extreme neglect and abuse at the hands of their families will feel deeply connected and attached to them. The child is better served not by trying to sever those connections but by helping the child make sense of them and reshape them for the future.

Male Speaker: Fourth, release yourself from the thought that it's best to just forget about the trauma and move on. We may think the best way to get over traumatic experiences is to not think or talk about them. This may even work for us in our own lives but many children can't forget. They need our help to talk about and make sense of their traumatic experiences in order to keep the experiences from having negative reverberations in all aspects of their lives.

Female Speaker: Fred Rogers, the creator and gentle host of Mr. Roger's Neighborhood once said, "Parents are like shuttles on a loom. They join the threads of the past with threads of the future and leave their own bright patterns as they go."

Male Speaker: In this video you have learned about the effects of trauma on children and how you can make a difference in how the child copes with the trauma.

Female Speaker: By parenting children in a trauma-informed way, we can indeed leave new bright patterns in their lives. Thank you for your decision to help children have brighter, healthier futures. Thank you. Good-bye.

Male Speaker: Good-bye.

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