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NOWHERE TO HIDE * * * “THE ELEPHANT IN THE [CLASS]ROOM”

2/4/2017

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Trauma during development or, childhood trauma, changes the architecture of the physical brain and the ability to learn and social behavior. 

It impacts 2 out of 3 children at some level, but I didn’t even know what it was…

Childhood Trauma, or adverse childhood experiences (ACEs)can be defined as a response of overwhelming, helpless fear to a shocking or stressful event.

ACEs include physical, emotional and sexual abuse, physical and emotional neglect, a missing parent (due to separation, divorce, incarceration, death), witnessing household substance abuse, violence, or mental illness and more.

Trauma-impacted children are not sick or “bad”.  
​
Developmental trauma is an injury.  It happens TO the child.  In turn, when they become adults, many re-enact their unaddressed trauma, injuring the next generation in a merciless cycle of pain and fear.

When the injuries fester unaddressed, they set off a chain of events leading ultimately to early death, according to the CDC..


Developmental trauma changes the architecture of a developing child’s physical brain. ​

Part 1:  The changes to the  physical structure of the brain impair academic efforts.  They damage children’s memory systems, their ability to think, to organize multiple priorities (“executive function”), and hence to learn, particularly literacy skills

Part 2: The changes to the child’s  neuro-biology predispose hyper-vigilance, leading trauma-impacted children to often misread social cues.  Their fears and distorted perceptions generate surprising, aggressive, defensive behaviors.  The ‘hair trigger’ defenses are often set off by deep memories outside of explicit consciousness of the child.

Adults’ view, from the ‘outside’, of the seemingly illogical, or worse, oppositional behavior, is often one of shock, confusion, frustration and maybe anger.

If we act on our uninformed views, we risk re-triggering more of the child’s trauma, and even more aggression. I confess, as a less experienced classroom teacher, I often did exactly that.


The outward behaviors are easy to recount.

The inner pain and fear are often intentionally camouflaged and nearly impossible to perceive from the outside.

The trauma history, which connects the inside fear to the outside behavior, is often buried so deeply that even the injured can be unconscious of the connection.

ACE-impacted kids are more common than seasonal allergy sufferers

Childhood trauma is not a “color” issue.  It’s not a geography issue.  It’s not an income issue.  Experts including Surgeon Generals and the Attorney General have used the specific terms ‘national crisis’, and ‘epidemic’.  The CDC says trauma impacts are critical to understand.

CDC scientists  found that even in beautiful, suburban San Diego about one-fourth of middle class, mostly white, college educated, working folks with medical insurance had THREE or more ACEs!

Three or more ACEs is significant because three+ ACEs correlate, over a lifetime, with doubled risk of depression, adolescent pregnancy, lung disease, and liver disease. It triples the risk of alcoholism and STDs.  There is a 5X increase in attempted suicide.

Children can not address their trauma alone. They need our help.

Nevertheless, presently many adults ignore childhood trauma. It’s rarely spoken about.

Some adults normalize the pain and fear of the injured child, thinking “they’ll get over it.”  It’s actually the opposite.  Young children have fewer coping mechanisms and their immature brains are still developing.  The impacts of trauma are actually  greater on the still-developing brain.
                 
 Schools are not trauma-informed organizations 
I am embarrassed to admit my own ignorance.
I did know about the inner pain and fear of my students more intimately than most.

I began, and still begin, every school year by visiting my families, sitting in their living rooms to discuss school, life and their hopes and concerns about their child.  In the classroom, I quickly experience the child’s outward behaviors which can  seem random, nonsensical at times, and often angry.

Yet, I still do not easily connect the outward behavior in class to the fear or pain.

As an adult, the classroom seems “safe.” There isn’t an obvious or logical connection to continuing fears, in our safe context.  It seems contradictory.

What I forget is that the pain and fear are not in the environment.

The pain and fear are hidden inside the child: they bring intense fear memories with them like they bring their backpack (wherever they go).

Making the connection, intellectually, is even more difficult ‘in the moment’, in the midst of emotional, intentionally distracting, sometimes screamed, personal insults or abusive attacks from the  triggered child.
.
Even when I was able to stay calm myself, and then connect the (seeming) anger to the (hidden) fear, that was only the beginning.  I still did not understand.
There’s more.

The group context, or the social complexity in the classroom may be the most difficult aspect of all.

​If I did maintain composure, then I realized quickly that the other 30 children in the room did not all wait calmly or politely for me so I could focus solely on de-escalating one of their peers.

I also learned the hard way that when I maintained composure in the midst of the barrage, it seemed like “unfair” leniency to other children. 

Those peers see only the aggressive outward behavior and they expect “punishment”.
Even more learning:  the aggression of one student and the related commotion will likely trigger a second student’s fear, maybe others too.


Keeping the academic context in mind: all above is about a single instance only.  Several instances can happen every day.  Meanwhile, each minute ‘lost’ to de-escalating a single student is a minute lost to academic endeavors for all thirty other students.

It’s complex.

Now, imagine NOT being trauma-informed and facing 20 to 30 students, and NOT knowing that 25% to 50% are trauma-impacted…

“Success” would require becoming expert at detecting multiple, virtually undetectable triggers, within multiple students. It is not quick or simple or instinctive.

There’s more.

That same teacher must become expert at de-fusing all those students’ fear triggers, and all in advance of any “fight or flight” response.
All day today.
All week this week.
All month this month.

More context:  A teacher is not permitted to consider adjusting the scope or pace of lessons:  the “Common Core”, or academic “national standards” which are connected, lesson-by-lesson, and which lead to “standardized” testing.

The recurring, “standardized” tests and the resulting stresses are rightfully controversial for many reasons, by themselves. 

Trauma-impacts add more controversy.  First, the stress of the high stakes of the tests  can re-trigger past traumas during testing.  Second, the higher concentration of violence and stress in urban settings, with higher concentrations of students of color, and higher concentrations of trauma, impairing cognition, keeps academic achievement gaps alive and well.

Let’s pile on top:  budget cuts for public schools each year translate to fewer adults with fewer resources to accomplish trauma-informed education, year after year.

“Teaching” in this context becomes nearly impossible at many points.

We are trying to scoop water out of a boat which has  gaping trauma-holes in the bottom.

Trauma-impacted children are losing their right to equally access their education, while adults stand by, while school districts stand by, while states stand by.


That leads, of course, back to the central aspect of the context:

Schools are not trauma-informed organizations

Just as children can not address their own trauma alone, teachers can not create trauma-informed school organizations all alone.

“Success” with trauma-impacted students comes slowly, over time.  It is crucial to maintain a predictable, calm, “safe” environment, and “safe” relationships, school-wide, with all adults responding calmly, hour by hour, day by day, month after month.  And that’s only the beginning.

Training and supporting school-wide staff (on-going) is essential. At the school level, we should also be identifying, or in some way screening for, students’ trauma histories.

It’s too easy to miss camouflaged trauma, in particular those who are quietly dissociating.  We should also be re-evaluating ‘zero-tolerance’ discipline stances.

We should also be adjusting efforts against the “achievement gap” to areas with greater violence, stress and trauma.

We should also be “understanding” the impotence of “standardized” test-and-punish model for academics in a much clearer light.

In spite of all the above impacts and implications  Developmental Trauma remains “the elephant in the [class]room” for many adults !

Picture
flickr -- Public Domain
Picture
Centers for Disease Control
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    Author

    Daun Kauffman, public school teacher from Philadelphia and passionate about helping children with TRAUMA and bringing awareness to the rest of us.
    ​https://lucidwitness.com

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    • Brain Injury, the Immune System & Mental Health
    • Celiac Disease & Sensitivities, the Immune System & Mental Illness
    • Mental Illness & The Immune System
    • Racial Discrimination & the Immune System & Mental Health
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  • University of Chicago: Institute of Translational Medicine
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    • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
    • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
  • Executive Functioning & "Prison Brain" >
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    • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
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    • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
    • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
  • Medicaid Mental Health & Substance Use Disorder Parity >
    • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
    • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
  • Olmstead Disability Rights >
    • Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans with Disabilities Act and Olmstead v. L.C. (2011)
    • Comprehensive Olmstead Planning
    • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
    • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?