Trauma Safe Schools - Trauma safe education a neurocognitive approach to teaching and curriculum development

Trauma Safe Education: A neurocognitive approach to teaching and curriculum development Michael Changaris, Psy.D.

Abstract

In 2011 there were 3.4 million reports of child abuse made to child protective services. Child abuse as Bessel Van Der Kolk said a ‘hidden epidemic.' While not all children exposed to trauma develop a full diagnosis of PTSD many do. Symptoms of PTSD effect both brain development and neurocognitive functioning. These disruptions in development can lead to poor educational functioning, disruptive behavior and for some students lead to dropping out entirely. Understanding the neurocognitive effects of PTSD can allow educators to develop curriculum and classroom management techniques that support students to learn more effectively. This paper explores factors that lead to the development of theory of mind, emotional regulation, and attention. The author considers both cognitive and affective coping strategies to manage symptoms of trauma and principles for incorporating them into trauma sensitive education.

Trauma Safe Education: A neurocognitive approach to teaching and curriculum development.

Millions of children every year experience traumatic events. While many of these children are able to bounce back with minimal impact to their lives, there are others who will display various symptoms of post traumatic stress disorder (PTSD). Trauma for some children impacts the ability to learn, inhibits formation of social rapport with peers, and interferes with their relationship to authority figures. Data indicate that these changes also affect the trajectory of neurological development and the development of neurocognitive skills (De Bellis, Hooper, Spratt, & Woolley, 2009).

Since like education, the brain develops by building on previous abilities, if the trajectory of neurocognitive development is altered in childhood it can create profound effects later in life (Bluhm, R. 2013). In fact while children diagnosed with PTSD do not display shrinkage in their hippocampus adults who experienced childhood trauma do (Woon, & Hedges, 2008). Symptoms of trauma affect a student’s ability to function effectively in education (Theodre & Massat, 2005). However, understanding factors that increase resilience and age-appropriate neurocognitive developmental milestones can facilitate the development of educational paradigms effective for children who suffer from exposure to traumatic events. Exploring what we know about age appropriate development of neurocognitive domains, social skills and how PTSD can affect growth could facilitate the development of curriculum, classroom interventions and educational policy recommendations.

Neurotypical development. Neurotypical development is the process by which most brains under relatively normal conditions develop. Since the brain is a learning context that builds its ability in interaction with the environment there can be brains with vastly different developmental paths. While a genetic factors determine large amount of brain development , other factors critical factors include experiential process. There are key periods where the brain is primed for certain structural developments.

Most theorists assume that the driver for the developmental shifts is combination biological and environmental events. Twin studies have found that the frontal lobe (the area of the brain used predominately for higher cognition), basal ganglia (motor movement, emotional set point), and the cerebellum (movement other vital processes) are the most plastic structures. These structures are also those most influenced by experiences (Giedd, et. al. 1999). Neilson et. al. (2005) described the social processing network model. This model divides the processing of emotions into three major systems or what they called nodes. These are the detection node (intraparietal sulcus, superior temporal sulcus, fusiform gyrus, temporal and occipital regions), the affective node (amygdala, ventral striatum, hypothalamus and orbitofrontal cortex) and the cognitive regulatory node (pre-frontal cortex).

These systems develop across childhood and are directly and indirectly impacted by exposure to a traumatic event (Blakemore, 2008). Young Children (0-5) Ages 0 to 5 are important years in brain development. Brain derived neurotrophic factor (BDNF) is highly elevated in these years (Roth, Lubin, Funk, & Sweatt, D2009).

BDNFis a key neurochemical in modulating the speed of brain development and as such the expression of change that defines brain plasticity. During this time the brain can double in size or shrink by half over the course of one year. The process of myelination, which is the wrapping of nerve cells, contributes the largest amount of brain growth during this period. Myelination is correlated with increased cognitive skills. From ages 0 to 6 the frontal lobe experiences a rapid rate of growth--at a pace (Giedd, et. al. 1999). Key brain structures responsible for hand eye coordination reaches maturity by age four. Dopamine expression (a neurochemical related to learning, brain plasticity, pleasure and motivational behavior) is important in the development of the prefrontal cortex (Roberts, Robbins, & Weiskrantz, 1998).

Dopamine plays a role in the maintenance of attention. In young children there is an interaction between parenting style and genetics effecting dopamine expression (Sheese, Voelker, Rothbart & Posner, 2007). School Age Brain Development (6-12) The total brain size changes in volume significantly over the course of childhood (Giedd, et. al. 1999). There are several periods of intense growth in the brain followed by a period of pruning back the connections to the most parsimonious connections needed. There is a parabolic relationship between gray matter and development while white matter follows a linear development completing in the 24th year.

The total brain volume peeks at the ages of 10.5 for girls and 14.5 for boys (Lenroot, & Giedd, 2006). The years from six to 12 are key years of development in the gray matter (cell bodies). After the age of 14 for most areas of grey matter there is a pruning or reducing of connections. Pruning later in life is associated with academic success. It maybe an experience rich context in these years supports a later pruning period there by academic success.

Not all brain regions are developing at the same time. Some areas are blooming (creating rich webs of connections) when other areas are pruning (trimming back connections to the most useful). This implies that there are time periods that are important for development of neurocognitive skills and that if these time periods are disrupted there can be alterations in the developmental pathway of brain tissue. Along with different areas of the brain developing at different times there are gender effects in brain development (Lenroot, & Giedd, 2006). Girls tend to peek in their development of any given area 1 – 2 years earlier then boys. There is also a different pattern in the development of the emotional regulation system for boys and girls.

For boys in the Dorsal Lateral Prefrontal cortex there is a bilateral development in childhood, right dominance in adolescents, and bilateral presentation in adults. This is not seen in girls. For both girls and boys there is a similar pattern of bilateral, right dominated and bilateral development in the amygdale. Adolescent Brain Development (13-24). Adolescence is a time of large-scale changes in the neurochemistry. Dopamine expression, associated with impulsiveness, desire, addiction, and sexual behaviors, is dramatically increased in teens (Casey, Jones, & Hare, 2008). Change in dopamine function likely contributes to some of the typical adolescent impulsive behaviors (Wahlstrom, Collins, White, & Luciana, 2010). Adolescents have decreases in serotonin expression which is associated with being satiated, feeling content and enjoyment of the here and now (Spear, 2000).

The combination of reduced ability to be satiated (serotonin) and elevated appetitive behaviors (dopamine) makes them at high risk for boredom and sacrificing long-term safety for excitement. In adolescence the amygdale (a driver of emotional intensity) matures quicker then the frontal cortex (which regulates and contextualizes emotional reactions) (Lenroot, & Giedd, 2006). An implication of this finding is that the teen has a high amount of emotional impulse with minimal ability to calm it down. The prefrontal cortex is not fully developed until age 24. This implies the emotional limbic system may drive the development of the frontal lobes as the adolescent learns the capacity to regulate emotions. Emotional Processing In childhood there are increases in the ability to manage and regulate emotions. Children ages 2 – 6 display a rapid increase in emotional vocabulary (Underwood, M. K. & Rosen, 2011). They display increased ability to correctly label emotions in themselves and others.

Children at this age can discuss past emotions and anticipate emotions in the future. Children in this age group also often use emotions in pretend play. Children in the four to five age group display increased ability to reflect verbally on emotions. This is the time when most children begin to understand that different people can react with different emotions to the same event. Children in this age group also begin to understand the display rules for emotions. This coincides with the increased ability to socially regulate emotions. Children ages six to twelve display an increased ability to understand complex emotions requiring the integration of primary emotions with social cognition and perspective taking (Underwood & Rosen, 2011). There is also an increased ability to suppress emotions that are not socially acceptable. It is at this time that children begin to using self-initiated strategies for regulating emotions.

In the adolescent years the limbic structures and the detection structures are functioning at or near adult levels but the cognitive control system continues to develop (Blakemore, 2008). The gap between cognitive control and emotional responses maybe involved in the large fluctuations in adolescents reasoning abilities. Parenting styles effect emotional development (Gottman, 2011). There is a spectrum of parenting styles from emotional coaching to emotional dismissing. An emotional coaching parent supports the child’s ability to tolerate their emotions. Children with emotionally coaching parents are better at self-soothing, tolerating negative feelings, are more effective at focusing their attention and have fewer behavioral problems then children with emotionally dismissing parents. Overall children with parents who are emotionally coaching have better classroom behavior. Teachers also fall on the spectrum between emotionally coaching or dismissive styles. Some of the behaviors that emotional coaching parents display are: monitoring their children’s emotions, they view negative emotions an opportunity for teaching, assists children in labeling emotions and coaches children on how to effectively handle emotions (Gottman, 2011). Emotional Dismissing styles on the other hand: deny and ignore emotions and view their job as changing negative emotions. Social Skills and Theory of Mind (ToM) Theory of mind is the understanding of ones own mental states and attribute unique mental states to others (Lewis, 1994).

ToM is a critical neurocognitive development for effective social relationships. There are two major classes of factors that lead to development of ToM: internal factors and situational factors. Internal factors increasing the development of ToM are: language abilities and executive functions. Understanding language gives the child more ability to test a hypothesis they are making about another’s experience (Schatz, 1994). Executive functions are the cognitive abilities to think about emotions. A child needs to be able to think about their thinking and feelings in order to effectively understand their own world and the inner life of another. Situational factors that researchers find contribute increasing the development of ToM are: having siblings; participating in pretend play; reading storybooks with adults; talking about experiences with peers and adults; care providers who talk about thoughts, wishes, and feelings; adults who provide reasons when correcting a child’s behavior (Jenkins, Astington, 1996: Hughes, et. al. 2005).

Theory of mind (ToM) relates to the understanding that other humans have there own mental states, feelings, motivations and beliefs. It also has a profoundly positive effect on a child’s ability to function well. Children with high ToM: are better communicators, can resolve conflicts with peers more effectively, are rated by teachers as more socially skilled, are more popular, happier in school and their schoolwork is often more advanced. There are pitfalls that can accompany high ToM children (Bosse, Memon, Treur, 2007). A list of some of the most common pitfalls are: Being manipulative, teasing and bully children more effectively, effective lying, and gaining social control thus enabling the child to avoid learning from social mistakes. Biopsychosocial Impacts of PTSD on Development.

Experiencing a single overwhelming life event can alter the course of development. Experiencing ongoing repetitive traumatic events has profound impacts on multiple aspects of a child’s life (van der Kolk, 2006). The brain and mind co-develop in relationship with the environment. If any of these factors are vastly different then the course of development is profoundly different. Developing PTSD leads to changes in psychological, biological, social and neurocognitive functions. The three key domains of symptoms of PTSD are: 1. Re-experiencing: Upsetting thoughts, flash-bulb memories, nightmares, emotional reactions, and increased physiological stress about the event or reminders of the event. 2. Hyperarousal: a state of increased psychological and physiological arousal including anxiety, startle responses, insomnia, fatigue, and increased aggression. 3. Avoidance and Numbing: Loss of interest in life and pleasure; Feelings of “deadness” or “numbness” and distance from relationships; Difficulty having positive feelings; avoidance of stressful, challenging, or social situations; Avoidance of triggers associated with the event.

Young Children Neurocognitive Impacts

It is important to note that young children (0 to 5) display more intense symptoms oftrauma, have a greater chance of developing symptoms of trauma more incidences of hyperactivity and depression after traumatic events (Coates, & Gaensbauer, 2009; Cook- Cottone, 2004). Young children often do not display symptoms of numbing. They do display what one researcher called symptoms of “new fears and aggressions.” Young children are often misdiagnosed as oppositional defiant disorder and separation anxiety disorder.

Young children tend to display these symptoms: re-enactment play (playing in a manor that resembles the trauma), toy destruction, aggression towards peers, defiance toward parents and adults (living with domestic violence is related to more aggressive and acting- out behavior, possibly due to modeling), difficulty sleeping, night-terrors, reduced attention span, relationally, survivors of interpersonal trauma suffer from a loss of trust and a sense of betrayal. The developing brain is highly vulnerable to the effects of PTSD. Some of these effects are observable in the child some only become clear as the child matures.

Subsequent to a trauma young children display changes in the catecholamine’s (e.g. dopamine, epinephrine and norepinephrine) (Pervanidou, 2008). Studies also indicated that there is brainstem dysregulation leading to changes in impulsivity, emotion regulation, sleep problems and cardiovascular dysregulation (Perry, 1994). The main structures vulnerable in this age group are noted to be prefrontal cortex (planning, behavioral modulation, problem solving and emotional regulation), hippocampus (learning and long-term memory acquisition), and corpus callous (integration between brain hemispheres) (Giedd, et. al. 1999).

Neglect leads to the development of multiple neurocognitive impacts. One study indicates that children with high amounts of neglect had lower IQ (Glaser, 2000). The neglected children also had difficulty with reading, math, attention, memory tasks, learning and planning, problem solving and processing speed. The combination of PTSD and neglect had a stronger deleterious effect on functioning then either PTSD or neglect alone. This study indicated a negative correlation between academic achievement and PTSD symptom severity. School Age Neurocognitive Impacts Many children who have been traumatized have moderate to extreme difficulty with attention (Beers & De Bellis, 2002).

Attention is a highly complex concept. Fundamentally attention is the ability to focus one’s mind on single task. Attention increases factors associated with synaptic plasticity (Manna, et. al. 2010). Neurochemicaly dopamine enhances signal, increases rate of plastic changes, and increases on task behavior (Braver, & Cohen, 2000; Berridge & Robinson, 1998). Norepinephren increases concentration by dampening extraneous noise. Changes in norepinephren are seen when children are in high levels of stress such as those seen in children with symptoms of trauma (Pervanidou, 2008). Alertness is a key domain of attention. Alertness and arousal can be changed by PTSD in two ways. Hyperarousal (fight/flight stress) effects level of alertness. When a child is hyperaroused they appear to bounce off the walls, have a heightened startle response, increased aggression, and it is hard to maintain focus on a single task.

Dissociation or hypoarousal (freeze response) has a large impact on a child’s ability to learn. When a child becomes dissociated their mind can feel foggy, unfocused and their ability to take in new information is impaired. Adolescents Neurocognitive Impacts. Teens have significant neurocognitive impacts from symptoms of PTSD. The teen’s executive functioning is at adult levels at times, however their abilities fluctuate more then adults (Blakemore, 2008). Teens are working to develop advanced reasoning skills, abstract thinking skills, and the ability to think about thinking in a process known as meta-cognition. Elevated fight-flight activation and elevated freeze response reduce executive functioning in adults (Newcomer, et. al. 1999). Teens are capable of very complex and accurate judgments but may lack the cognitive control to perform appropriate actions (Blakemore, 2008). Adolescents are influenced by peers. Social skills and social awareness are impaired in teens with symptoms of PTSD. This can lead to significant problems even for teens who had excellent social skills prior to the trauma. Attention and concentration develops dramatically in teen years (Monk, et. al. 2003). Teens with symptoms of trauma display difficulties with attention and concentration, increased irritability, emotional outbursts, poor affect regulation & cognitive emotional integration, and poor learning and memory consolidation.

Adolescents have changes in sleep patterns (Wolfson, & Carskadon, 1998). Adolescents prefer later bedtimes and rise-times making them more likely to be sleep deprived. If a teen is exposed to a traumatic event they can have profound alterations in their sleep cycle (Perry, 1994). Sleep also plays a large role in mood regulation and learning. The disruption in sleep due to symptoms of traumatic stress can have wide ranging impacts social, emotional and academic functioning (Wolfson, & Carskadon, 1998). Curriculum Development. In schools, children learn social and emotional skills through curriculum, interaction with teachers and peers and by completing assignments (Greenberg, Kushe, & Riggs, 2004). However, these skills are not typically taught in a direct or methodical manor.

A child learning to complete math problems is learning attention, emotional regulation skills and even at times moral development (not looking at the child’s page next to them). Neurocognitive skills are like any other aspect of education. The skills build on each other and develop can be facilitated through use of a loosely sequenced pattern. No one would expect a second grader to jump from basic math to trigonometry but often the social emotional skills are not sequenced in how they are presented to children. Symptoms of PTSD make this difficulty even more profound. Using some basic principles it maybe possible to create effective and developmentally sequenced curriculum that fosters social and emotional skills along with mitigating the impact of PTSD on learning. Examining some of these principles may elucidate this.

The first principle proposed is that development has its own pace and requires helping the child who you are working with to achieve their next best developmental marker through providing the right scaffolding for the right skill. If a child is struggling in math. A teacher might notice that it is his frustration tolerance that is low (e.g. when the child gets a problem wrong there is an explosion). The teacher can then add to their math lessons that incrementally increase frustration tolerance. The direct focus on where the disruption is makes the intervention more effective (Amsel, 1994).

The next principle is that development of a skill requires that the intervention works at edges of the child’s zone of proximal development (Kozulin, Gindis, Ageyev, & Miller, 2003). Like learning math or English, learning neurocognitive skills requires identifying current abilities and providing lessons that push the edge of the child’s current abilities. Okay so explain what this looks like. How is the teacher to know what this zone is and then how to use it.

Using the challenge resolution cycle is the next principle. The challenge resolution cycle occurs when the attempts at learning a new skill creates stress (or challenge) and as the stress builds, the child increases in their ability to complete the task. This leads to a reduction of the stress as the success gives the child a small burst of positive emotions. This process helps a student learn that they can be successful in the learning process. For many children with PTSD this ability is disrupted. The child with PTSD has to contend with a heightened stress response at times making their minds race or become foggy, blank and have difficulty thinking.

The next principal is that working within optimal arousal zone creates the most effective learning (Eysenck, 1976). The optimal zone of arousal represents a balance between the intensity of fight-flight arousal and the rest response. If there is too little arousal a child will be board or disconnected. If there is too much the child is overwhelmed, stressed, panicked or dissociated. When a student is past their optimal level of arousal learning is difficult and it is more likely that the student will act-out (Bauer, Quas & Boyce, 2002). Children with symptoms of PTSD have small tolerance for arousal. It is possible to identify signs of hyperarousal and to have a repertoire of skills to reduce arousal levels.

The next principal is teaching to the arousal state to students. The whole class often also has it’s own zone of optimal arousal. A teacher can learn to monitor this cycle and adjust educational styles and activities accordingly, at times nudging the class to a higher level of arousal and at others reducing the arousal in the class. It is important that the style of teaching an educator uses helps the class oscillate around optimal arousal. It is impossible to stay in a perfectly optimal zone so allowing the change is important. The teacher can function like a thermostat helping the class regulate their arousal levels. The next principal is to stabilize attention through teaching. Another key disruption in individuals with PTSD is to attention and concentration. These disruptions can make it difficult to learn.

Children who suffered traumatic events have increased levels of negative thoughts. These negative thoughts can be highly discouraging and quite distracting. Dopamine has been associated with key aspects of maintaining attention. It helps the child sustain attention on a task. There are many interventions that can increase dopamine for students (Izuma, Saito, Sadato, 2008). These fall into two classes of interventions. The first is interventions that make the information important to the child (salience). The second is interventions that increase pleasure or positive emotions (rewards).

Teaching of emotional management and neurocognitive skills within curriculum. Individuals with PTSD have significant difficulty with emotional management. These difficulties can have profound effects such as acting out, talking back, difficulty concentrating, drug addiction, pregnancy and dropping out. Increased emotional management and higher levels of school attachment appear to be mitigating factors for these outcomes.

Individuals with PTSD have difficulty forming safe attachments with authority figures. Teaching emotional management skills within curriculum could reduce impulsivity, increase learning and positive relationships with educators and school attachment. The core domains of teaching emotional regulation skills are: cognitive skills or thought based skills and emotion based skills focused on tolerating or changing the physical response to emotions (Bush, Luu & Posner, 2000). As cognitive behavioral therapy notes changing cognitive interpretations change emotional reactions (Samoilov, & Goldfried, 2000).

Thought based skills are skills, which use cognitive control mechanisms to reduce, change or reinterpreted emotions or events. There are three basic groups of thought skills that can be applied to the educational setting. These are: a. self coaching (skills that use thinking to help tolerate difficult emotions e.g. I have made it through difficult things before, I can make it through this), b. next step thinking (thinking that helps a student stay on task and brakes the task into manageable chunks e.g. now that I finished adding the first number, I carry it over), and c. solution thinking (taking a positive approach to problem solving, e.g. what are ways that I could find out how to spell the word orange?).

The next type of thought-based skills is based on recognizing and challenging thought distortions. These skills are: recognizing thought distortions when they happen (e.g. recognizing all or nothing thinking like “I never get this one right.”), challenging distorted thinking. Educators can help students make more accurate self-statements. A comment like I don’t know anything can be met with a series of Socratic questions that help the child identify the distortion of magnification and develop a more accurate belief like, “I have had problems with spelling, I am good at math, if I work hard I can do well at spelling.”

Lastly the skill of realistic thinking helps a student to learn accurate reality based self-appraisal that is neither overly disparaging nor over blown. The third type of thought based cognitive skill set is self-reflection and metallization skills. These include: Reflective dialogs that help a student connect their inner experience with events and outcomes. Empathy building dialogs where a student reflects on another’s experience of an event and self-monitoring success.

Student’s learn to monitor the outcomes of their actions and focus on what made the attempt at a skill or learning successful. Younger children can draw pictures or tell a story that is written down by an adult. Emotion based skills are skills that are aimed at developing the limbic node or the emotional system (Gross, 1998; Neilson ET. al. 2005). These skills brake down in to three categories as well: observing emotions, tolerating emotions, and soothing emotions. Observing emotions allows the child to recognize the bodily reaction to the emotion (Linehan, 1993). This skill helps build distress tolerance. For children with trauma the bodily experience of emotions is often overwhelming so developing mastery experiences with recognizing the emotion can be very helpful. Tolerating emotions brakes down into four basic skills. These are: Distress Tolerance, Acceptance Skills, Self-Soothing of Emotions, Mindfulness of Emotions.

Distress tolerance or the ability to tolerate difficult emotions. Improving the moment skills support an individual to find constructive things to do with difficult feelings until they pass (Linehan, 1993). Taking the long-term view of emotions is a skill that helps children to learn that emotions change if they just wait. It is important for a child to learn the to watch emotions as they rise up become intense and pass away. This is difficult for many students with symptoms of PTSD.

Radical acceptance is a skill that helps children learn to accept difficulties when they occur (Linehan, 1993). This skill is just plainly accepting a difficult situation when one cannot change the situation. The third series of skills are the skills aimed at soothing emotions. These are skills that help a student shift from a stress state to a rest state. The short hand for these skills are anything that helps the student feel strong, effective, pleasure or hopeful shifts the student from a fight or flight reaction to a rest reaction.

A brief list of these skills is below: 1. Resourcing: Having the child remember or notice a positive experience. Then asking the child to attend to the bodily experience of positive emotion (Levine, & Mate, 2010). 2. Orienting: Look around the physical space and notice what the child sees (Levine, & Mate, 2010). 3. Soothing in the five senses:

Soothing in the five senses is a quick pneumonic for finding a way to create relaxation response. The teacher can help students go through finding things that make them feel good using their five senses (Linehan, 1993). 4. Vocal tone: When an individual is stressed it can be heard in the voice. The voice becomes more monotone it looses it musicality (prosody). If a teacher uses a calm voice with musical inflection it evokes a relaxation response.

Body posture: Body posture as an immediate impact on conflict and sets the tone of communication. Some children with symptoms of PTSD have triggers for a stress reaction related to body postures and positions. 6. Co-regulation: In social animals, relationships can be significant triggers for stress. Social regulation techniques combine validation, empathy, attunement and support a since of social safety. Co-regulation is the interactive regulation of emotion between people (Efklides, 2008).

There are four steps to prepare for an effective intervention and a process for implementing the interventions. Step one educators identifies specific neurocognitive skill to develop. Step two the educator identifies types of experiences that develop skill. Step three educators identify type of trauma reaction that is impacting development: A. Re-experiencing. (Intrusive thinking and images, triggers), B. avoidance numbing. (Dissociation), physiological symptoms. (Fight flight and learning, freeze and learning, startle and behavioral. correction.

Cool down time to regulation, positive emotions “undoing effect”). The forth step is to identify how to provide scaffolding for the development of the next skill level of maturity in skill development. Managing fight-flight activation in the classroom. For students with symptoms of PTSD there are multiple factors that can interrupt their ability to learn. Working with setting the initial conditions can help the student be in a mental state that allows for learning. The first step is to regulate your own reactions to the event so that your emotional reaction is not a trigger for the child’s behavior.

The second step help the student regulate their emotional state using a soothing intervention. After the student shifts from stress to rest, they are more able to learn. This is when to provide the skill or education. After the skill is provided foster another soothing event. Then allow the child to reflect on success in learning. Classroom Management. Classroom management is also profoundly effected by symptoms of PTSD. Children can act-out, be quick to react, have strong emotional reactions to body posture, and feedback about behavior. It is important for students to be able to learn from their mistakes and for teachers to provide behavioral corrections. Children’s and teens ability to use cognitive control (a.k.a. knowing better) is not fully developed. There is a limited campsite to tolerate negative emotional experiences. Behavioral correction and reflection on mistakes requires effective cognitive control.

Educators can provide scaffolding for a students cognitive control system by reducing the strain on the system through support for emotional regulation. There are several ways to do this. The first is to set the initial conditions by evoking a relaxation response or reassuring the student the stability of the relationship. Helping the student move from overwhelm to a resting state allows the cognitive control system to function more effectively by reducing the loading on the system. Use positive emotions to support mastery and distress tolerance (Positive emotions reduce stress, increase how quickly a student can reduce hyper arousal and control their behavior.) Fredrickson et. al. (2000) described the undoing effect of positive emotions. Positive emotions can undo the impact of negative emotions.

The Attitude proposed by Daniel Hughes (2000) is an effective tool for creating the foundation for effective trauma interventions. The attitude has these five features remain calm (stay calm ware the poker face), firm (stick to the rules while remaining kind and supportive), accepting (accept the child fully not the actions), empathic (Your empathy helps the child grow empathy for others), and playful and curious (Enjoyment is key for a child with trauma. Curiosity is the hallmark of safety). The last and most important aspect is that relationship are built by repairing after a rupture. The rupture creates negative emotions (e.g. giving feedback about work) the repair reaffirms that the rupture did not destroy the relationship. For individuals with PTSD often there are significant difficulties feeling safe in relationships. Following a rupture with a repair can strengthen their ability to tolerate a range of emotions and effectively tolerate feedback.

References

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Beers, S. R. & De Bellis, M. D. (2002). Neuropsychological Function in Children With Maltreatment-Related Posttraumatic Stress Disorder. Am J Psychiatry 2002;159:483- 486. 10.1176/appi.ajp.159.3.483

Bluhm, R. (2013). Childhood Trauma, Brain Connectivity, and the Self. Treating Complex Traumatic Stress Disorders in Children and Adolescents: Scientific Foundations and Therapeutic Models, 24.