Core Child Welfare Pre-Service Curriculum | Participant Guide Module 1

January 2015 Module 4: Trauma and the Child Core Child Welfare Pre-Service Curriculum | Module 4-PG 1 Table of Contents Unit 4.1: Trauma and its impact on the Child What is Trauma? Types of Childhood Trauma What is Child Traumatic Stress (CTS)? Child Development Stages Matrix Impact of Trauma on the Child’s Brain The Impact of Trauma on Very Young Children Compact Trauma and How it Impacts Children Impact of Traumatic Stress on Visible Behavior Trauma-Related Behavior in Children of Various Ages Adverse Childhood Experiences (ACE) Study Long Term Impact of Trauma Culture and Trauma Historical Trauma Unit 4.2: Approaching Children and Families in a Trauma-Informed Manner Henry’s Story Worksheet: Rewriting Henry’s Experience with Us Using a Trauma-Informed Approach in Child Welfare Practice My Rules of Thumb – How I will behave in a Trauma-Informed Manner Parents Must Truly Address the Roots of Their Trauma How People Exposed to Trauma React to Authority Unit 4.3: Referring and Advocating for the Child and Family in a Trauma- Informed Manner Screening, Assessments and Evaluation Other Referrals and Advocacy Pharmacology and the Child or Adult What Medication Does NOT Help Evidence-Based Trauma-Informed Treatment Practices Ways to Better Ensure a Trauma-Informed Approach When Culture and Historical Trauma are Considerations Cultural Scenarios Cultural Scenarios Worksheet Core Child Welfare Pre-Service Curriculum | Module 4-PG 2 Unit 4.1: Trauma and its Impact on the Child What is Trauma? • Definition of Trauma: Trauma is an emotional response to an event. The emotional response is intense, distressing and/or painful, and can overwhelm your ability to cope. There can be direct involvement in the event or indirect through witnessing the event. • Trauma also results from the persistent absence of responsive care during infancy and early brain development. The child experiences a lack of protection from his or her parent/caregiver and, as a result, can be severely traumatized. • The stress that is caused by the trauma is called traumatic stress. • The National Child Traumatic Stress Network has identified 13 types of trauma: o Community violence o Early childhood trauma o Domestic violence o Medical trauma o Natural disasters o Physical abuse o Neglect o Refugee and war zone trauma o School violence o Sexual abuse o Terrorism o Traumatic grief o Complex trauma • The seven types of trauma that you will typically see in your work as a child welfare professional include: o Early childhood trauma o Domestic violence o Physical abuse o Neglect o Sexual abuse o Traumatic grief o Complex trauma or toxic stress Core Child Welfare Pre-Service Curriculum | Module 4-PG 3 Types of Childhood Trauma • Early childhood trauma: Generally refers to the traumatic experiences that occur to children aged 0-6. These traumas can be the result of intentional violence, such as child physical or sexual abuse and/or domestic violence, the persistent absence of responsive care or as the result of a natural disaster, accidents, or war. • Domestic violence (intimate partner violence, domestic abuse, or battering): Actual or threatened physical or sexual violence, or emotional abuse between adults in an intimate relationship. o Three to 10 million children are exposed to domestic violence in the United States every year – most are under the age of eight. • Physical abuse: Causing or attempting to cause physical pain or injury. It can result from punching, beating, kicking, burning or harming a child in other ways. • Child sexual abuse: Takes place between a child and an older person or alternatively between a child and another child/adolescent. o Bodily contact: Such as sexual kissing, touching, fondling of genitals, and intercourse. o No bodily contact: Genital exposure (‘flashing’), verbal pressure for sex, and sexual exploitation for purposes of prostitution or pornography. • Child neglect: o When a parent or caregiver does not give a child the care he or she needs according to his/her age, even though that adult can afford to give that care or is offered help to give that care. o When a parent/caregiver is not providing a child with medical or mental health treatment or not giving prescribed medicines the child needs. o Neglect also includes exposing a child to dangerous environments or having poor supervision for a child (such as putting the child in the care of someone incapable of caring for children). • Child traumatic grief: When someone important to the child dies - suddenly and unexpectedly, or even anticipated. The distinguishing feature of child traumatic grief is that the trauma symptoms interfere with the child's ability to go through the typical process of bereavement. o The child experiences a combination of trauma and grief symptoms so severe that any thoughts or reminders, even happy ones, about the person who died can lead to frightening thoughts, images, and/or memories of how the person died. • Complex trauma: A child’s exposure to multiple or prolonged traumatic events and the impact of this exposure on their development. o Involves simultaneous or sequential occurrences of child maltreatment - including psychological maltreatment, neglect, physical and sexual abuse, and domestic violence - that is chronic, begins in early childhood, and occurs within the primary caregiving system. o Often sets off a chain of events leading to subsequent or repeated trauma exposure in adolescence and adulthood. Core Child Welfare Pre-Service Curriculum | Module 4-PG 4 What is Child Traumatic Stress (CTS) • Child Traumatic Stress (CTS): A psychological reaction that some children have to a traumatic experience. • These reactions can linger and affect their daily lives long after the traumatic event has ended. • Untreated, CTS can interfere with a child’s healthy development and lead to long- term difficulties with school, relationships, jobs and the ability to participate fully in a healthy life. • Psychological trauma in childhood can be just as damaging as trauma that has caused physical injuries. • Three levels of CTS: o Acute traumatic stress refers to exposure to a single event, such as a car accident. o Chronic traumatic stress refers to repeated events, such as physical or sexual abuse or exposure to ongoing domestic violence. o Complex traumatic stress refers to exposure to chronic, multiple types of trauma. Core Child Welfare Pre-Service Curriculum | Module 4-PG 5 Child Development Stages Matrix Indicators or Positive Physical Socio-Emotional Cognitive Developmental Parenting Concern Characteristics Rapid height & Concerned with From birth, infant • Sucks poorly and feeds Makes eye contact weight gain satisfaction of begins to “learn” slowly with infant Reflexes: sucking, needs with eyes, ears, • Doesn’t follow objects Interact with infant grasping Smiles in response hands, etc. with eyes by talking, smiling, Lifts head to caregiver’s voice Vocalizes sounds • singing, etc. Doesn’t respond to loud Responds to Prefers primary (coos) sounds Gently sounds by blinking, caregiver to Smiles when faces • Doesn’t grasp and hold rocks/bounces startling, crying stranger evoke memories of objects infant Shows growing pleasure Picks infant up 3 Months • Doesn’t smile at the - 0 ability to follow sound of the primary when distressed objects and to caregiver’s voice Allows for self- focus soothing (infant sucks fingers/pacifier, etc.) Rolls over Smiles and laughs Has recognition • Doesn’t hold head up Helps infant Holds head up socially memory for • Doesn’t coo, make “practice” sitting when held in Responds to people, places, and sounds, or smile Encourages floor sitting position tickling objects • Doesn’t respond to time on a blanket Lifts knees, makes Begins to Uses both hands to sounds or turn head to for rolling and crawling motions distinguish own grasp objects locate sounds reaching Reaches for image in mirror Exhibits visual • Doesn’t roll over in Responds to fears, objects from others’ interests either direction cries by holding, 6 Months - images Joins with • Not gaining weight talking, and 3 caregiver in paying reassuring attention to Talks and plays labeling objects with infant and events (4-6 months) Sits alone Indicates Finds objects • Doesn’t smile or Discipline consists Feeds self finger preference for hidden repeatedly demonstrate joy of redirecting to foods; holds own primary caregivers in one place, but • Unable to sit without different activity. bottle (6-9 May cry when not when moved support Sharp discipline, months) strangers approach Plays peek-a-boo • Does not follow objects scolding, and Crawls, pulls up, (stranger anxiety) Has recall memory with both eyes verbal persuasion and walks with Shows signs of for people, places, • Does not actively reach are not helpful support (9-12 separation anxiety and objects (9-12 for objects Holds and cuddles months) Repeats months) • Doesn’t look or react to baby Baby teeth begin performances for Imitates speech familiar caregivers Reads to baby to emerge attention (9-12 sounds • Names objects 12 Months Does not babble - months) Says da-da and ma- when baby points 6 • Shows no interest in Drops objects on ma and knows who playing peek-a-boo (by to something purpose for others these people are 8 months) Maintains to pick up (10-12 (10-12 months) consistent bed time months) Uses preverbal routine of cuddling, gestures to rocking, and communicate (by soothing 12 months) Core Child Welfare Pre-Service Curriculum | Module 4-PG 6 Walks alone Extends

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