Children who experience chronic, complex trauma are vulnerable to a host of behavioral and educational problems, yet educators often feel frustrated with their attempts to respond.
Frequently those problems are treated—ineffectively—as disciplinary issues, but a more helpful way of dealing with them might involve some eye-opening training for teachers, said Natalie Turner, M.S., L.M.H.C., program director at the Area Health Education Center for Eastern Washington at Washington State University in Spokane.
“Too often educators focus on punishing these children, when what is needed is accountability balanced with empathy,” said Turner at the National Association for Rural Mental Health annual meeting in Albuquerque in June.
Complex trauma is pervasive, episodic trauma that persists over time and often co-occurs with poverty, family violence, substance abuse, or community violence, said Turner. “These children grow up in an unsafe, chaotic, unpredictable world where they see things as threatening even when they are not, because that is what their experience has taught them.”
Constant stress induced by complex trauma appears to cause changes in the brain, leading to difficulties with motor skills, language, social behavior, and self-control.
“It's hard for them to stay in their seats, to listen, and to process and retain information,” she said. It also takes time and perhaps some teacher retraining so that the children can be helped to overcome those neuropsychiatric effects.
Although many of these children will not develop problems, the ones who do are often punished in the expectation that it will change their behavior.
The child may respond to a teacher's request for quiet or control by looking away, putting his or her head down on the desk, or simply ignoring the teacher. This may result in the child's being sent to the principal's office for punishment for acting “disrespectful,” the leading reason for such referrals.
The behavior can resemble symptoms for ADHD, anxiety, or bipolar disorder, and children are eventually so diagnosed, often because it is the only way they can get treatment, said Turner.
“Teachers personalize this behavior, although 99 percent of the time it has nothing to do with them,” said Turner. This behavior is a response to the trauma laying unseen by the teacher in a child's home or neighborhood environment.
The teacher's reaction makes things only worse. It publicly shames the students, removes them from the learning setting in class, and doesn't change their behavior. Even though the process rarely works, educators continue to do what they've always done because they haven't developed alternatives.
Counseling or medications may help many of these children, but more might be done to lessen the apparent conflict in the classroom before it escalates.
Changing both students' and educators' behavior isn't easy.
“Teachers may need more child-development training,” she said.“ They don't need to know if a child is traumatized; they just need to be trauma sensitive.”
It can take a long time to create a sense of safety in the classroom and rebuild lost attachment. Teachers have to play a consistent, safe, and predictable role over a long period, building relationships that may not exist elsewhere in the children's lives. Students need help with skills to regulate their emotional responses and cope in healthy ways with threatening environments.
“All children have the potential to overcome adversity,” she said.
Parents need support, too. Many have grown up in households where they were traumatized and so may need help breaking the cycle that is harming their children.
Turner and her colleagues have begun pilot programs in Washington state using a model that calls for restructuring the classroom and professional environments and helping teachers recognize, understand, and control their own responses to children's behavior without having to send them to the principal's office. They also have commitments from four school superintendents to try out the program in a clinical trial randomized on the building level. ▪