Early Childhood Trauma and its Effect on Education and Trauma-Informed Care

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This research and professional development tool will focus on the following research questions:

RQ1:  What is early childhood trauma and how does it affect education?

RQ2:  What is trauma-informed care and how can it be integrated into early childhood education?

These questions are valuable because children with unaddressed trauma often fail to flourish in school and have additional life maladies that impair their development and well-being (De Young, Kenardy & Cobham, 2011).  The education field presents numerous research investigations and determinations on the impact of trauma on children and their ability to learn (Plumb, Bush & Kersevich, 2016).  Whether from abuse, loss, illness, or some other traumatizing event, children who suffer from such distress and disturbance have difficulty concentrating in the classroom environment or focusing on the content and skills being presented, causing them to perform below their potential (Bartlett, Smith & Bringewatt, 2017; Osofsky, Kronenberg, Bocknek & Cross Hansel, 2015).  As a result, the traumatized child not only must deal with his or her ordeal but also often becomes burdened with learning barriers caused by not acquiring needed skills or information at common developmental and academic levels.  As these children progress through school, if their trauma is not recognized and dealt with, they may end up failing or dropping out, compounding their pain and suffering (Wright, 2014).  The compounding effect of unrecognized or treated trauma is particularly detrimental for those in early childhood, as their learning and development may be impacted for longer periods of time and many foundational skills have not yet been acquired (Roberts, Ferguson & Crusto, 2013).  

It is therefore vital that early childhood educators learn to recognize trauma, as well as to support and provide modified instruction and assessment for traumatized children as part of differentiated instruction, potentially even entering into the ESSA program.  The researcher was first made aware of this situation when working in an early childhood environment where several children either experienced trauma during their enrollment or had experienced trauma earlier in their lives.  The differences between these children and those not suffering from trauma was substantial, but had the researcher not been informed of the situations and impact by other early childhood educators, the symptoms presented by these children could have been dismissed or attributed to other factors, leaving the children without the care and support they need to thrive in academics and in life.  Early childhood educators need a thorough introduction and overview of trauma in young children, the impact of trauma on education in the early childhood years, best practices for working with the traumatized child, and how educators can support trauma-informed care.

Although trauma in early childhood is often underreported as such incidences occur as part of greater family functioning and the child is often unable to articulate his or her experiences or is afraid of telling and subsequently getting in trouble, 26 percent of children in American will experience at least one severe trauma by the age of four (NCMHP, 2012).  Exposure to a single incidence of trauma, if left unaddressed, can result in disruptive behavior, difficulty concentrating, aggressing and/or withdraw in interpersonal interactions, and reduced ability to learn (NCMHP, 2012).  When trauma is repetitive the impact is more severe; those with five or greater traumatic experiences prior to turning four are 76% more likely to experience language delays, emotional development delays, or impaired cognitive development (NCMHP, 2012).  

According to De Young, Kenardy and Cobham (2011), untreated childhood trauma results in substantial burdens to both the child and to society, as traumatized children who are not assisted in trauma recovery are three times as likely to be depressed, misuse alcohol or drugs, become unemployed, or contract preventable chronic conditions such as COPD or sexually transmitted diseases.  Their risk of a suicide attempt increases fifteen times over.  In addition, they are less productive in the workplace and more likely to receive some form of public assistance (De Young et al., 2011).  

The significance of early childhood trauma is therefore substantial for both the child and for the rest of his or her community, and an issue of which many early childhood educators may be misinformed or even unaware (Wright, 2014).  Children who are traumatized but do not receive help for their trauma are less likely to succeed in school and are less likely to become productive, healthy adults, jeopardizing their future well-being (NCMHP, 2012).  In addition, they are therefore more likely to require government support, becoming a burden to the rest of their communities (NCMHP, 2012).  Consequently, it is vital that early childhood educators learn to recognize and assist children who have experienced adverse life events.

Literature Review

This review of literature provided a general overview of many of the aspects involved in the effects of trauma on early childhood education and trauma-informed care, but less focus on the specific role of early childhood educators and how they can assist and/or support traumatized children in recovery and academic success.  Many studies in early childhood trauma focus on the prevalence of trauma, which is often unreported or under-reported, on the epistemology of trauma, or on the comparative impact of one type of trauma event versus another (Fusco & Cahalane, 2013; Lieberman, Chu, Van Horn & Harris, 2011; Saunders & Adams, 2014).  A broader body of literature also investigates how children become traumatized; these studies tend to focus on a particular type of traumatic event such as natural disasters, being from conflict zones, or a parent being deployed for military service, and then evaluate children’s experience of trauma from that specific event (Osofsky et al., 2015; Slone & Mann, 2016).  A number of research investigations examine trauma-informed care, and how trauma in young children can be approached from a psychological or counseling perspective (Bartlett, Smith & Bringewatt, 2017; Buss, Warren & Horton, 2015; Roberts, Ferguson & Crusto, 2013).  

However, De Young, Kenardy and Cobham (2011) report that a gap in literature existed at the time of their investigation regarding the manifestation of trauma reactions in early childhood aged children, as well as evidence of frequency, comorbidity, and results of these trauma reactions within the classroom environment.  The authors speculate that some of these unexamined aspects of early childhood trauma, although centered in a location in which many young children spend considerable time, stems from a lack of knowledge and awareness among early childhood educators of the symptoms of trauma and how they can and should deal with traumatized children (De Young et al., 2011).  Wright (2014) similarly reports a lack of study into the role of early childhood education environments in strengthening the young child’s perception of safety and how this increased feeling of safety can play a vital role in a child’s ability to process and overcome adverse experiences.  The early childhood environment and educators have substantial opportunity to support traumatized children, provided they are trained in recognizing trauma reactions and have the tools to assist these children in healing from their traumatizing events (Wright, 2014).  Literature, therefore, supports a potential gap in the literature, supporting this research.  

General findings from such research indicate that childhood trauma is prevalent and can be debilitating (Buss et al., 2015; De Young et al., 2011; NCMHP, 2012; Roberts et al., 2013).  If left untreated, these traumatic experiences can result in lasting negative impacts on the child, even into adulthood (De Young et al., 2011; NCMHP, 2012;).  Further, early childhood can be one of the most difficult periods for a child to experience trauma (Buss et al., 2015; Fusco & Cahalane, 2013; Wright, 2014).  After analyzing more than fifty studies, Bartlett, Smith, and Bringewatt (2017) conclude that “research demonstrates that the first few years of life constitute a period during which driller are highly sensitive to trauma and more vulnerable to its negative effects than during any other period in life” (p. 4).  Researchers agree that the child’s lack of verbal skills and understanding of events happening around and to them at this time make it difficult for the child to handle the strong emotions trauma events cause (Bartlett et al., 2017; Buss et al. 2015; Fusco & Cahalane, 2013; Wright, 2014).  

Scholars also indicate that many venues for assistance do not actually provide support for the traumatized child (Bartlett et al., 2017; De Young et al., 2011).  Parents and caregivers are often experiencing these traumatic events at the same time as the child, leaving them unable to fully support the child in his or her distress (Fusco & Cahalane, 2013; Van der Kolk, 2014).  In this case, parenting communication plans may not be effective. A number of researchers also indicate that common fallacies such as that the child is too young to understand or be impacted by adverse events, or that he or she will forget and grow out of traumatic experiences, compound decisions leading to lack of care for the traumatized child (Cummings, Addante, Swindell & Meadan, 2017; Lieberman et al., 2015; Plumb, Bush & Kersevich, 2016).  

One consistent theme in literature is the role of adults outside the immediate family in providing trauma support to young children.  As Fusco and Cahalane (2013) report, a child is rarely traumatized alone; typically his or her family members are involved in some manner, whether as those enacting the trauma or as co-participants in viewing or experiencing the adverse events.  This can leave family members unable to assist the child effectively, or even protect themselves from negative and damaging treatment (Bartlett et al., 2017; Fusco & Cahalane, 2013; Van der Kolk, 2014).  Similarly, Shapiro (2014) notes that in many traumatic homes, family members lack the ability to perceive trauma or abuse for what it is, and instead internalize events or reframe them as normal.  In such situations, researchers agree that those outside the family must intervene on behalf of the child and provide the safe environment and supportive relationships he or she needs to deal with overwhelming emotions and insecurities (Buss et al., 2015; Cummings et al., 2015; Nicholson, Perez & Kurtz, 2019; Plumb, Bush & Kersevich, 2016). 

Another consistent theme in literature is the importance of trauma-informed care, whether called by that name or simple promotion of one or more of its components.  Trauma-informed care provides assistance and support to the young child by first creating an environment where the child feels safe and is empowered to express emotions he or she may be experiencing (Bartlett et al., 2017; Nicholson et al., 2019). Through this emotional expression, the child is provided support, promoting processing and healing (Cummings et al., 2017; Nicholson et al., 2019; Plumb et al., 2016).  Young children’s perception of the power differentials between them and adults such as parents, teachers, and doctors is real and can be frightening if safety and trust are not also part of the child’s perception; therefore, when such safety and trust is not present, the child can experience intense emotions, flashbacks to adverse events, or generalized fear (Buss et al., 2015; Lieberman et al., 2015; Wright, 2014).  Trauma-informed care focuses on creating safety and trust between the child and others in the environment to ensure anxiety is lessened, emotions are processed, and positive environment is maintained (Bartlett et al., 2017; Cummings et al., 2017; Nicholson et al., 2019; Wright, 2014).  

Finally, literature is consistent regarding the need for additional education and guidance for early childhood educators in trauma-related areas (De Young et al., 2011; Nicholson et al. 2019).  Trauma has only recently been emphasized in early childhood educator training, and many early childhood educators did not undertake formal education or credentialing, having begun in the field during a period when formal education and training was not considered necessary (Bartlett et al., 2017; Wright, 2014).  Fusco and Cahalane (2011) report that children in the foster care system, who frequently have high levels of trauma exposure, benefit substantially from continued attendance at the same preschools with the same teachers, providing both stability and safety that support the child in overcoming trauma. If educators are unaware of the signs of trauma or its impact on children’s functioning, they are unable to provide assistance to the traumatized child (Bartlett et al., 2017; Nicholson et al., 2019).  

Methods

This research employed a qualitative meta-synthesis design to draw information from multiple sources and present this information in an organized, thematic manner.  As Creswell and Creswell (2018) explain, meta-synthesis is a means to analyze both quantitative and qualitative data in a coherent and purposeful way.  This design can be used to identify potential research questions to investigate as well as to select scholarly articles and research for inclusion in the study, appraise these publications for their benefit in addressing the research question, summarize the important and relevant information each presents, and then combine the resulting evidence so as to construct a meaningful response to the research question.  Meta-synthesis, therefore, combines some of the elements of the traditional literature review with additional practices typical of qualitative investigation, where qualitative data sets are coded, sorted, and described, allowing the synthesis of large groups of data to identify commonalities and themes (Creswell & Creswell, 2018).

The meta-synthesis of existing research was selected for this project as the researcher did not have access to enough credible, expert sources to interview regarding the effect of trauma on early childhood education and trauma-informed care for the mentally ill in the student population, nor was access to a viable population or the resources needed to conduct experimental research available. Further, meta-synthesis allows integration of multiple types of studies and scholarly publications related to a particular topic, enabling broader and more comprehensive findings (Creswell & Creswell, 2018).  Not only can empirical research be considered, but other reviews of literature and studies of multiple primary sources combined to construct a supported picture of an issue or event (Creswell & Creswell, 2018).  

The strengths of the meta-analysis methodology include the ability to combine multiple studies and researcher contentions, resulting in broad and strongly supported findings and conclusions (Creswell & Creswell, 2018).  While a single researcher or group of researchers may be influenced by bias or skew data to reach a foregone conclusion, the likelihood of numerous researchers behaving similarly is unlikely (Creswell & Creswell, 2018).  In addition, meta-synthesis provides a vehicle to incorporate studies from multiple locations, populations, and time periods, resulting in more transferable findings and conclusions as potentially influential variables are eliminated through the combination of so many studies and investigations (Creswell & Creswell, 2018).  

One limitation of this design in this particular research is the availability of information to which the researcher had access.  Given the time constraints of the project and the researcher’s status as a student, even a graduate student, information was limited to published sources.  Limitations also potentially existed in the identification and choice of sources to include (Creswell & Creswell, 2018).  While there were arguably other sources, the researcher selected articles and studies that aligned with the research question and were available through databases that did not require a monetary purchase, limiting the number of data sources included.  Further, inherent in meta-synthesis is the heterogeneity of results (Creswell & Creswell, 2018).  When studies come to divergent results, as may occur in meta-synthesis, it may not be clear to the researcher conducting the meta-synthesis why these dissimilarities have occurred.  This can make it difficult to identify commonalities and themes across the body of research included in the study.  

In terms of the project deliverable selected, a PowerPoint presentation suitable for an early childhood education in-service was selected as the most beneficial way to communicate study findings to an early childhood educator population.  Most of the information on the research topic fell into one of two categories:  scholarly studies that included pieces of beneficial information or skills, and general websites that covered trauma at the surface level only.  The latter were not used in this project, but the researcher realized the need to create a vehicle for quickly informing early childhood professionals about trauma and the impact of trauma on education.  

There are notably a few strong and comprehensive sources available regarding trauma-informed care in the early childhood classroom.  For example, Trauma-Informed Practices for Early Childhood Educators by Nicholson et al. (2019) thoroughly explains trauma and how trauma-informed care can be integrated into the early childhood education environment and professional practice.  Bartlett et al. (2017) provide a similar but briefer overview.  However, many of those working in early childhood education may not be likely to spend the time and energy required to negotiate the amount of information presented in the book and then apply this information in their educational practice (De Young et al., 2011).  Wright (2014) notes that while early childhood education is becoming increasingly recognized as a professional field, a number of teachers and early childhood educators entered the field without formal education and have persisted due to years of experience rather than educating themselves to attain current credentials.  In addition, credentialing requirements vary greatly from state to state and based on the level of credential required.  An additional group of early childhood educators has been out of the classroom for a number of years and while credentialed, may not be current on issues drawing additional focus today such as early childhood trauma (Wright, 2014). 

Creation of an instructional PowerPoint presentation can serve to inform early childhood educators through a brief but focused in-service on the effect of trauma on early childhood education and how trauma-informed care can be supported in the early childhood education environment.  As this in-service is focused, it provides for an increased likelihood of transfer of training, where participants apply what they have learned in their work and/or use it foundationally to learn more about an area of instruction (Noe, 2017).  The lack of transfer of training, including self-training through books, videos, and similar, is the most influential factor in workers not applying new knowledge or skills to their everyday tasks (Noe, 2017).  The in-service can be followed by others that present additional, more specific best practices and skills to both create classrooms where children feel safe and can trust those with whom they interact, and to integrate trauma response and treatment appropriately as an early childhood educator.

Findings and Analysis

Findings of this research identified a number of effects of trauma on early childhood education, as well as a comprehensive overview of trauma-informed care and its usefulness in the early childhood classroom.  A review of the literature was conducted to determine answers to the two study proposed research questions, broken down into five sub-questions.  The questions “What is early childhood trauma?” was included to provide a foundation for those early childhood educators not familiar with trauma.  “How does trauma effect education?” explains the direct and indirect results of untreated trauma in young children, focusing on the preschool years.  “What is Trauma-Informed Care?” explains the trauma-informed care components and methods, while “Creating School-Wide Trauma-Informed Culture” and “The Role of the Early Childhood Educator in Trauma-Informed Care” provides an overview of how schools and early childhood educators can create a trauma-sensitive learning environment.  Data was organized and explained so as to create a foundation for the PowerPoint planned as an instructional tool for early childhood educators.  

What is Early Childhood Trauma?

In order to understand the effect of early childhood trauma, one must first understand what it entails.  A traumatic event is defined (much like the criteria for PTSD) as any violent, dangerous, or frightening occurrence that the child perceives as a threat to his or her body or life; these events may cause either emotional or physical harm, or a combination of the two. Trauma differs from other stressors experienced in life in its intensity and severity, causing extreme emotions unlike a normal range of emotional response (Bartlett et al., 2017).  

Traumatic events can include acts committed against the child, such as physical or sexual abuse; loss of a parent, significant caregiver, sibling, or other people in close relationship to the child, even temporarily, can also cause adverse impact (Lieberman et al., 2011).  Severe injury or illness are often traumatic, as are other types of abrupt changes in the child’s environment, such as suddenly moving to another location without time to properly close existing relationships and prepare for the new location, or experiencing a fire or other natural disaster (Saunders & Adams, 2014).  Even witnessing violent or traumatic events can cause trauma in young children (Lieberman et al., 2011).  Trauma events are often repetitive or complicated by multiple types of trauma, such as in cases of abuse.  According to Bartlett et al. (2017), 77 percent of young children who have experienced trauma experience three or more adverse incidents in a given year.  

Importantly, the amount of trauma a child experiences in any of these events is complex and influenced by the other stable or supportive factors in his or her life, as well as how the trauma is addressed by adults and caregivers (Cummings et al., 2017).  Events are most impacting when children view themselves without support or assistance available (Osofsky et al., 2015).  At the time of the event, the child may experience physical reactions to these emotions such as elevated heart rate, loss of bladder or bowel control, trembling, or vomiting.  These reactions may continue to occur after the event has passed if the child is unable to process the emotions caused by the trauma.  

The mechanism for trauma-influenced behavior is rooted in emotional processing skills, abilities often lacking in most young children (Bartlett et al., 2017).  Traumatic events typically result in emotions so strong that the child cannot adequately process them; in response, the child develops reactions to environmental stimuli that are associated with the trauma or have recurrent thoughts about the trauma that persist to the point daily life is negatively affected (Buss et al., 2015).  These reactions persist long after the traumatic event, even if additional or ongoing adverse events occur (De Young et al., 2011).  Until the child is helped to deal with these strong emotions and the recurring reactions they cause, the child may continue to suffer from his or her trauma (Cummings et al., 2017).  

This suffering manifests in different ways; emotional upset or response not appropriate to situations, symptoms of anxiety or depression, difficulties with self-control, behavioral changes, barriers to forming normative attachments with others, and loss of previous abilities or skills are all manifestations of unprocessed trauma (Buss et al., 2015).  The child’s sleep patterns are often disrupted by insomnia and/or nightmares, and appetite may also be affected (Saunders & Adams, 2014).  Unexplained physical pain, particularly in the form of undefined achiness, sometimes occurs (Buss et al., 2015).  

How Does Trauma Effect Education?

Children who have experienced trauma may face educational impacts in the attachment, physical, affect regulation, behavior, cognitive, or self-concept domains of development (Bartlett et al., 2017).  Holmes et al. (2015) explain that many young children form healthy attachments to their teachers and other adults in the school setting, as well as to one or more peers.  These attachments provide the child with a safe place to ask for assistance as needed and try new things, even if they may potentially fail.  When a child is unable to form healthy attachments, learning is impaired, as the child may not allow himself or herself to risk possible failure, or may consider failure a foregone conclusion and not try.  Hyper-vigilance, whether in perfectionist work habits and extreme emotional responses when he or she cannot perform a task to his or her expectations may occur in children with attachment difficulties (Holmes et al., 2015).  Such assertions and findings are echoed by many researchers and experts in early childhood trauma (Bartlett et al., 2017; Cummings et al., 2017; De Young et al., 2011; Plumb et al., 2016; Wright, 2014).  Alternatively, attachment may be extreme in the opposite direction, with children clinging to a parent, caregiver, or even sibling, and expressing extreme distress when separated from that person (Plumb et al., 2016).  This can lead to extended periods of emotional distress that both tire the child and prevent him or her from learning and participating in classroom activities during the initial separation period (Cummings et al., 2017).

Physically, traumatized children may experience more frequent medical issues, whether due to actual physical issues resulting from abuse or lowered immune systems due to chronic stress; they may also exhibit psychosomatic physical problems, whose primary cause stems from mental issues (Buss et al., 2015; Lieberman et al., 2011; Roberts et al., 2013; Saunders & Adams, 2014).  In either case, the traumatized child is more likely to miss substantial amounts of school and engage less when in attendance, putting him or her at risk of falling behind other similarly aged students (Wright, 2014).  The child is also unwilling or unable to participate in many physical activities, which over time can lead to delays in coordination and fine or gross motor skills that impact academic success, such as difficulty with handwriting or sitting still (Roberts et al., 2013).

Affect regulation, or the ability to regulate stressful feelings and minimize defensive emotional states is another domain impaired by trauma (Saunders & Adams, 2014).  Affect regulation difficulties may present as difficulty in producing appropriate emotional responses to events or circumstances, such as children who laugh when a friend is injured during play (Fusco & Cahalane, 2013).  Such children may have difficulty calming down after emotional experiences and struggle to identify or describe their emotions or internal needs.  As a result, they have difficulty communicating their needs, often impairing their ability to ask for assistance when needed in the classroom (Slone & Mann, 2016).  This may result in the child sitting through lessons he or she does not understand without providing cues to that effect, and subsequently falling behind his or her peers (Cummings et al., 2017).

Struggles in the behavior domain are often the most prominent issue with traumatized children (Saunders & Adams, 2014).  Bartlett et al. (2018) report that children who have experienced trauma often exhibit poor impulse control, unusually aggressive behavior, or self-destructive behavior.  As such, they have difficulty making friends and functioning during group activities.  They may also demonstrate either strong oppositional and defiant behavior or excessively compliant behavior, causing them to be difficult to manage in the classroom or motivate to take initiative and do independent work, respectively.  Traumatized children may also reenact their traumas, frightening other children in the classroom.  In all, this can make them difficult to handle as they do not comply with classroom norms and expectations.  The untrained or unaware teacher may then punish the child, which exacerbates the behavior, creating a spiral of worsening conduct that can disrupt learning opportunities for the entire class (Bartlett et al., 2018).  

Cognitively, thought patterns and neurological development may also be disrupted by extreme adverse events (Lieberman et al., 2011).  In the early childhood academic environment, the child may demonstrate regression in areas of previous academic mastery (Roberts, Ferguson & Crusto, 2013).  For example, a four-year-old who was previously able to recite the alphabet may now mix up or leave out letters or may refuse to demonstrate her alphabet knowledge due to “forgetting” that skill.  The child may also struggle to pay attention in class or complete assigned tasks, whether due to what appears o be daydreaming or due to overwhelming emotions such as anger or sadness (Wright, 2014).  Further, the pace of the child’s learning can be impacted, with children taking longer and having more difficulty remembering information or mastering new skills (Bartlett et al., 2017).  

In addition to difficulties paying attention and/or focusing on tasks previously mentioned, traumatized children may have difficulty processing information due to ongoing anxious thoughts that overwhelm brain activity (Saunders & Adams, 2014).  These same anxious thoughts can negatively impact the child’s ability to plan or appropriately forecast consequences, complicating certain academic tasks as well as the child’s overall decision making (Cummings et a., 2017).  Lieberman et al. (2014) report that children who have experienced very severe trauma or multiple traumas are more likely to have developmental delays and learning difficulties, particularly in regards to language development.  In the classroom, teachers may attempt to address these difficulties or delays as coming from a different cognitive cause, resulting in interventions that are ineffective and reinforce children’s feelings of failure (Wright, 2014).  In contrast, recognizing the learning or developmental issue’s trauma root can provide an opportunity for the child to deal with severe adverse life events, and by doing so, also reduce or eliminate learning difficulties or delays (Wright, 2014).

Self-concept may also suffer, although several researchers contend that it is not clear whether these negative feelings and perceptions result from the traumas experienced by the child or as a secondary result from other educational deficiencies caused by trauma responses, as discussed above (De Young et al., 2017).  However, traumatized children often believe they are in some way bad or insufficient and that these failures are a root cause of their trauma, even in adverse effects that do not involve abuse, such as the loss of a parent due to death or divorce (Lieberman et al., 2011).  The child then perceives negatively what others might view as neutral (Cummings et al., 2017).  For example, when a teacher instructs the child to sit down, the child may interpret this as being yelled at even if the teacher is not yelling.  Similarly, the traumatized child may question why putting forth effort is worth doing so, as if he or she is already bad, there is no amount of good behavior that will cause him or her to become good (Cummings et al., 2017).  This negative self-concept can, therefore, lead to children who are apathetic about tasks or learning opportunities, or who misinterpret others actions and respond with exaggerated reactions to them (Bartlett et al., 2017).  

Overall, children who experience an inability to protect themselves or who lacked protection from others to avoid the consequences of the traumatic experience may also feel continually overwhelmed by the intensity of physical and emotional responses, creating a cycle of trauma reactions that do not align with the child’s current circumstances (Bartlett et al. 2017).  For this reason, the child may react mentally, physically, or emotionally in the classroom even when stimuli that would warrant such reaction is not present (Bartlett et al., 2017).  When viewed without trauma awareness, the child may appear to be lazy, selfish, spoiled, or purposefully misbehaving, yet in reality, he or she is experiencing a traumatic reaction (Cummings et al., 2017).  It is vital, therefore, that early childhood teachers and school leaders be aware of the effect of trauma on education and its symptoms in the classroom environment.

What is Trauma-Informed Care? 

Trauma-Informed Care is a method of interacting with potentially traumatized individuals, both as individually and systemically, in a manner that alleviates their trauma symptoms, helps them succeed in their current endeavors, and facilitates long-term healing from the trauma event(s) they have experienced (Plumb et al., 2016).  Trauma-Informed Care begins systemically through the construction of a culture that promotes safety, equity, and inclusion regardless of behavior or academic ability; the goal of this culture is a focus on positive student outcomes and the means required to achieve those outcomes (Holmes, et al., 2015).  This includes positive rather than punitive response to student learning difficulties, lack of self-control, and behavioral struggles, and an emphasis on attendance with engagement (Bartlett et al., 2017).  Systems that promote student and family self-care, as well as teacher and school leader support, are emphasized (Plumb et al., 2016).  

Trauma-Informed Care involves awareness for the signs of trauma, and training for educators in how to respond (Cummings et al., 2017).  This may include different means of discipline or direction for students than the educator practiced previously, such as changing from requiring students to remain in their chairs until an activity is completed to differentiating such requests based on the pace that a student typically learns or completes similar work (Wright, 2014).  On a school-wide basis, policies and procedures should be evaluated to ensure they support traumatized children (Holmes, et al., 2015).  For example, provided the safety of other students is maintained, immediate suspension or expulsion policies may be adapted to provide supportive instruction for children with behavioral issues rather than simply counting the number of behavioral events and moving to suspend or expel (Holmes, et al., 2015). 

Thus, the school and/or classroom integrating Trauma-Informed Care both addresses symptoms of trauma when they present in a specific child, but also fosters policies and practices that create a general learning environment that is positive for any trauma-affected child, even if dramatic symptoms do not present (Wright, 2014).  Holmes et al. (2015), when explaining the Trauma-Informed Head Start program they analyzed and evaluated, note that many traumatized children do not present symptoms of significance to the point they are obviously from trauma, and as a result many of these children may not receive the care they need if the school or classroom overall does not integrate Trauma-Informed practices.  In fact, it is through the presence of Trauma-Informed practices in the classroom that some children are able to first communicate their adverse effects, providing the opportunity for intervention and protection for them (Holmes, et al., 2015).

Creating School-Wide Trauma-Informed Culture

First and foremost, the school and classroom environments must promote safety and trust for all students (Bartlett et al., 2017).  For example, school administrators and classroom teachers act in consistent, predictable ways based on clear and equitable policies (Plumb et al., 2016).  If a child is rewarded or corrected for a behavior one day, a similar response occurs the next day, and this response is largely regulated throughout the school to ensure consistency, ensuring that any school staff that interacts with the child will treat the child in a similar manner (Plumb et al., 2016).  Administratively, having consistent teachers and explanations when a teacher is absent, including letting children know when that teacher will return, provides the child with feelings of stability and increases his or her ability to trust the school as a whole, increasing safety throughout the school environment and not only in one classroom (Cummings et al., 2017).  

This systemically trauma-aware culture also includes channels for collaborative communication, through which members of the school staff can partner with families and community stakeholders such as physicians, social workers, afterschool care providers, and others to better serve the child (Wright, 2014).  Within the school setting, it is important for teachers or staff with concerns that a child may be exhibiting trauma responses to have other trained adults available for second opinions, as it is not always clear whether learning, behavioral, or emotional issues stem from trauma or some other cause (Plumb et al., 2016).  Teachers should have other educators, administrators, or counselors they can contact if questions about an individual student arise, and similarly, other school staff who notice a potential issue should have a mechanism to address their concerns with the child’s classroom teacher(s) (Bartlett et al., 2017).  

Further, teachers and other school staff should be provided a means for communicating with children’s families as well as build personal rapport with them when possible, allowing for greater family trust and therefore more likely provision of information or direction requiring events that have happened to the child and/or his needs (Bartlett et al., 2017).  Policies and standard practices at the school must also include mechanisms for separating trauma that is not caused by abuse from trauma which is abuse-based (De Young et al., 2017).  Fusco and Cahalane (2013) explain that while most children in the child welfare system have been placed there due to abusive homes and protection of the child should be paramount in decisions to report potential abuse, there also exist situations where such reports have actually caused this trauma, as children have been removed from their families for questionable reasons and/or without thorough investigation.  For example, if the child states, “Mommy hit me with the ball,” this is not necessarily an abuse situation, and additional questions should be asked prior to assuming abuse has occurred.  While the authors note that these situations are rare and actually can undermine the ability of child protective services personnel to safeguard children, they caution that situations be properly investigated before removal decisions are made (Fusco & Cahalane, 2013).  Schools must, therefore, have vetted procedures by which teachers or other staff can report potential trauma situations or responses in children, and ways that these issues can be evaluated by the school staff to ensure a child traumatized by a non-abuse event is not further impacted by unnecessary removal (De Young et al., 2017).  

The Role of the Early Childhood Educator in Trauma-Informed Care

The teacher in the early childhood classroom has a vital role both in creating and maintaining a trauma-informed culture in the classroom and school and in supporting and assisting children who have experienced trauma.  This role begins with the classroom culture, but in particular establishing relationships with students where they perceive the teacher to be fair, like them, and be interested in their success (Plumb et al., 2016).  While teachers will have different personalities and it is nearly impossible to click with every student, the teacher can integrate several general practices into his or her interaction with students to create a trauma-informed classroom (Plumb et al., 2016).  

First, the teacher must feel confident in his or her ability to deal with traumatized or potentially traumatized young children (Holmes, et al., 2015).  The early childhood educator may be reluctant to consider trauma-informed care as part of his or her role; after all, educators are not counselors and are not typically equipped to assist children in psychological maladies (Holmes, et al., 2015).  However, many of the basic tenets of Trauma-Informed Care are good principles for any teacher-student relationship, and skills it would benefit both educator and pupil if the teacher develops (Plumb et al., 2016). The teacher who does not feel confident in these practices has a variety of means to increase self-efficacy and skill set, including formal education, in-service training, reading, being mentored, and reflection-based professional development, just to name a few (Wright, 2014).      

The educator must also develop positive relationships with students.  This includes teacher expression of encouragement, supportive instruction, and positive response to discipline and other issues (Wright, 2014).  Importantly, positive relationships also involved providing opportunities for the child to express his or her feelings and responding to those feelings empathetically, a practice that can be difficult in the early childhood environment where students have limited verbal skills and may have difficulty identifying how they feel (De Young et al., 2017).  Role modeling is extremely important, as when the child hears the teacher express, “that makes me sad,” or “I feel worried when this occurs,” it gives the child not only words to potentially use to communicate emotions but labels for the emotion he or she may be feeling (Bartlett et al., 2017).  When the teacher notices a child appears upset and asks, “Are you upset?” it not only assists the child in identifying the emotion but reinforces that it is okay to discuss feelings, which is particularly important for the traumatized child but beneficial for all children (Plumb et al., 2016).  The teacher should not tell the child not to feel a certain way, even if done so from a motivation of encouragement, such as “Don’t be sad” (Plumb et al., 2016).  

The teacher also can facilitate student learning by providing adequate time and assistance with pacing; particularly with young children, the child may not be sure how quickly he or she is expected to complete a task or may easily become distracted and therefore not accomplish learning activities in the classroom (Cummings et al., 2017).  When the teacher can positively assist the child in staying focused and working at a comfortable pace, the child feels safe and confident in his or her ability to learn (Cummings et al., 2017).  Holmes et al (2015) note that pacing is particularly important in the early childhood classroom, where children the same age may be at significantly different developmental levels, and that expectations of students should, therefore, be individualized.   

As Wright (2014) explains, the foundation for all these practices is a student-centered classroom, where instruction can be differentiated as needed but inclusive components, such as play-based activities, are incorporated regularly throughout the school day.  In such an environment, the teacher focuses on the student and his or her learning outcomes, not an agenda for the class or a series of needed results.  This allows traumatized children the ability to feel safe and supported, to deal with their trauma experiences, and to work to their full current potential (Wright, 2014).

Discussion, Implications and Next Steps 

Trauma is, therefore, an important consideration for early childhood educators.  Not only can trauma influence their students’ ability to interact and learn, but not effectively dealing with trauma can create life-long barriers to academic success and quality of life (Bartlett et al., 2017).  Unfortunately, many working in early childhood environments are not aware of trauma and its impact on young children, nor are they trained in how to effectively create a trauma-supportive school or classroom deal with a child who has experienced severe adverse life events (Wright, 2014).  In many states, no education or preparation is required at all to operate a daycare with a small number of students or to teach in a larger school provided some certified personnel are on staff (Wright, 2014).  Other staff may not be aware of recent discoveries regarding trauma and the importance or process of trauma awareness and trauma-informed care within their classrooms (Bartlett et al., 2017).  Parents also are likely to be uninformed about trauma, requiring the educator to instruct, refer, or otherwise provide support to the family as well as the child when traumatic experiences have occurred (De Young et al., 2011).  As a result, many traumatized children are not helped in overcoming their traumatic experiences and may even have such experiences compounded by their treatment in the early childhood environment and possibly at home (Plumb et al., 2016).  

The implication of not adopting Trauma-Informed Care is not only negative for the child, but can increase educator stress and burn-out, and can undermine school-wide culture and achievement of learning outcomes (Bartlett et al., 2017).  This can both lead to the loss of otherwise capable early childhood workers and reduced stability for all children at the school (Bartlett et al., 2017).  Further, as the child grows and his or her unaddressed trauma continues to undermine functioning and learning, and derail future life success (Lieberman et al., 2011).  

From a training perspective, this research underscores the need for increased resources regarding trauma in young children and early childhood trauma-informed care (Plumb et al., 2016).  Increasing trauma-awareness in early childhood educator training programs and requiring additional knowledge of trauma for those seeking certifications, non-credentialed positions working in early childhood environments, or among persons seeking to provide small-scale early childhood supervision should be adopted by state and local governments and educational institutions (Plumb et al., 2016).  Those already practicing in the field should seek to increase their knowledge and skill in Trauma-Informed Care, as well as more specific instruction than presented in this research regarding detailed classroom and policy practices found beneficial in other similar environments that are actively and successfully supporting traumatized children (Wright, 2014). 

Next steps not only include such individual educator and systemic attention to trauma in young children, but greater education of the general public regarding positive interaction with young children who have experienced trauma (Bartlett et al., 2017).  This may come in the form of additional research, increased training such as this in-service but provided to a broader audience or use of various multimedia channels to improve trauma awareness and sensitivity to working with traumatized young children.

References

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