the dis-regulated child: children who lose control of their emotions, behaviors and bodies
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Children’s Relief Nursery www.crn4kids.org
The Dis-regulated Child:children who lose control of their emotions, behaviors
and bodies
Leslie Brown, LCSW
March 9th, 2010
Children’s Relief Nursery www.crn4kids.org
Introduction
Agenda
Introductions
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Course GoalsParticipants will be able to
1. Understand the needs of overwhelmed children and be able to identify evidence based therapeutic prevention strategies.
2. Recognize children who are in the peak phase of being out of control and be able to identify therapeutic intervention strategies including how to positively re-engage the child back into the classroom.
3. Identify the importance of building positive relationships with children and their families to construct positive behavior supports.
Children’s Relief Nursery www.crn4kids.org
Definition of the ‘Traumatized Child’
Has experienced a traumatic eventShows signs of being overwhelmedShows distress through their words, behavior and playShows behaviors that seem out of control, fearful, disruptive, excessively aggressive.Child becomes “flooded” with feelings of fear and anxiety.Child cannot control these behaviors without help
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Traumatic stress as a cause of dis-regulation
Definition of a traumatized child
Early childhood trauma types
Rationale for prevention and early response to trauma
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The impact of trauma
• Body’s trauma response & the brain
• Impact of early childhood development
• Attachment & trauma
• Culture & trauma
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Effects of trauma
Trauma reminders
Reenactment
Traumatic expectations
Projections
Difficulty differentiating past/present
Long term effects of untreated trauma
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Behaviors associated with trauma
How trauma impacts relationships
How it manifests in peer group settings
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What you might observe in young traumatized children
Signs & symptoms in children 0-3 years
Signs & symptoms in children 3-5 years
Behaviors that warrant concern
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Behaviors that Warrant Concern (Infants and Toddlers 0-3 yrs.)
Chronic feeding or sleeping difficultiesInconsolable “fussiness” or irritabilityIncessant crying with little ability to be consoledExtreme upset when left with another adultInability to adapt to new situationsEasily startled or alarmed by routine eventsInability to establish relationships with other
children or adultsExcessive hitting, biting and pushing of other
children or very withdrawn behaviorFlat affect
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Behaviors that Warrant Concern (Preschoolers ages 3-5 yrs.)
Engages in compulsive activities (e.g. head banging)
Throws wild, despairing tantrumsWithdrawn; shows little interest in social
interactionDisplays repeated aggressive or impulsive
behaviorDifficulty playing with othersLittle or no communication; lack of languageLoss of earlier developmental achievements
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Understanding what traumatized children need
Sensory body based prevention strategies
Feelings identification
Affect regulation/Tucker the Turtle
Safety planning
Therapeutic environment
Relaxation skill building
Building a narrative or story
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Setting up a therapeutic environment
Planning ahead
Being proactive
Sound reduction
Reducing stimulation
Limiting transitions
Dividing children & sections in the room
Predictable classroom rules & routines
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Therapeutic environmentIncreasing levels of support: designating adults anticipating difficult times: trauma remindersHelping reduce or explain other children’s reactions
to the childRole playingGiving words to useEstablishing teacher's as safe baseCoachingChoicesCommunication between teachers/emotional tone
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Prevention strategiesFind helping jobsUse 3 minute warning & pre-warn children when
doing something out of the ordinaryDescribe when you see the child doing what you
wantScheduled one on one timeFeeding the meterAvoiding problem situations
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Prevention strategies:teaching emotional skills
Feelings identification
Regulation activities
Relaxation games
Calming activities
Expressing feelings in words
Understanding triggers: child & caregivers
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Prevention strategies: teaching social skills
Role playing
Conflict resolution: use of humor
Story telling games
Boundary setting games
Teaching helping behaviors
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7 phases of escalating behavior in children
Calm Prevention strategies
Trigger Prevention strategies
Agitation Prevention strategies
Acceleration Prevention strategies
Peak Intervention strategies
De-escalation Intervention strategies
Recovery Intervention strategies
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Work Sheet Prevention Strategies
Please follow along on activity sheet
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Responding: when child is out of controlSelf check in/emotional environmentCycles of a melt downResisting child’s efforts to draw you into
“reenactments” Containment: moving child or others out of harms wayOffering choices, reflecting child’s choice, choosing a
choice for the childDescribing child’s need & intentionEmpathic mirroring & body matching
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When Child is out of control
Use of the “skying down” area
Distraction: washing a table, chairs, scrub brush
Using sensory materials: soft & rough fabrics, tornado, egg timer, blowing a pretend candle, sensory tables
Soft Voice, slow body movements
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Positively re-engaging the child back into the group
Resolve unresolved issues
Provide ways for atonement
Make a plan for next time
Follow up with teaching team
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Coming full circle
How to resolve the problemInvolving parentsLong term prevention planning
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The Magic Box
What do have in your box now?
What would you like in your box?
Suggestions
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Question and Answer
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