Hello.

My name is Jeff Shih, and I'm an associate dean from the College of Education at UNLV.

Welcome to this four-part video series about building trauma-informed schools.

This program is the result of a partnership between UNLV and the Clark County School District and is funded by UNLV President Keith Whitfield through the Coronavirus Response and Relief Supplemental Appropriations Act.

These videos offer information to help educators support students with a history of traumatic experiences.

Since trauma can impact a student's emotions, behavior and ability to learn, it is an important topic to address.

We hope this series is helpful to educators who are working so diligently to support student mental health and learning.

-Hello.

My name is Bob Weires, and I'm the director of psychological services, Clark County School District.

We all recognize the need to address the all-around development of our students, not just their academic achievement but also their social, emotional and behavioral functioning as well as their basic mental health.

The first video focuses on introducing signs and symptoms of potential trauma in students and how a multi-tiered system of supports framework can help adjust student needs.

Subsequent videos will provide strategies and other guidance for working with all students, or tier 1, targeted groups of at-risk students, or tier 2, and intensive interventions and supports for specific students, or tier 3.

Each video in the series will include a variety of panelists from UNLV and CCSD.

They will begin by providing information about trauma exposure and the varied reactions children may experience.

They will address multi-tiered systems of support, mental health, social-emotional learning and supports available within CCSD.

As working with traumatized students can be challenging, the series will conclude with a focus on educator wellness.

We trust that you will find these professional learning sessions both informative and helpful, so please enjoy them.

Thank you.

Welcome, hello.

I'm Joe Roberts, director for the Clark County School District Crisis Response Team.

Thank you for joining us today for Building Trauma-Informed Schools to Support Student Mental Health and Learning, a partnership between the University of Nevada Las Vegas and the Clark County School District.

Joining me today are Anne Marie Abruscato, a visiting lecturer with the University of Nevada School of Social Work.

As a licensed clinical social worker, she has provided trauma-based therapy for children and adults in the Las Vegas valley for 21 years.

Dr. Dambow, the founder of Genuine Intelligent Respectful Ladies Soaring, a holistic organization that advocates for 6th to 12th grade youth.

She's a licensed school counselor, principal and teacher.

She also serves as an assistant professor for the University of Nevada Las Vegas.

Dr. Dambo has five years in higher education as counselor-educator, six years as a high school counselor, and 18 years of experience with organizations serving children from underrepresented groups.

Dr. Patrice Leverett, an assistant professor of school psychology with the University of Nevada Las Vegas.

She has served in the field of education for over 15 years as an elementary educator, school psychologist and training supervisor.

Her work examines the implicit bias of learning outcomes for students.

We also have Nikki Maloff, a licensed master social worker with 15 years' experience in the Clark County School District.

She serves currently as a school social worker liaison, and she helps to support our school social workers and safe schools professionals in the field.

We also have Kristin Barnson.

She has 25 years of school counseling experience in the Clark County School District.

Kristin is currently in her ninth year as a counselor specialist with the Clark County School District School Counseling Department.

Myself, Joe Roberts, with over 20 years of experience in public education having served as a teacher, school administrator, school psychologist and the director of the Clark County School District Crisis Response Team.

I'm looking forward to a thoughtful discussion on trauma-informed instruction, especially in these difficult times, where a variety of traumas have become apparent.

Today we will be covering trauma foundations, multi-tiered systems of support, social-emotional learning and the supports available within the Clark County School District.

Our first session will cover trauma foundations.

Anne Marie, what is trauma?

(Anne Marie Abruscato) Trauma is an experience that threatens someone's life or threatens their physical or emotional well-being.

It's often a shocking situation that is out of someone's control.

It usually evokes fear and helplessness, and it overwhelms a person's ability to cope.

-What are the types of trauma?

-There's acute trauma, which is a single event that lasts for a limited period of time like a car accident or a natural disaster.

Chronic trauma is multiple events over a long period of time.

Complex trauma is a term that's used to describe chronic trauma that begins in childhood and often involves a caregiver.

So this amplifies the effects of trauma because it can disrupt a child's attachment capabilities which can impact their ability to form connections with others and actually also their cognitive development.

Traumatic grief is a severe or prolonged reaction to a loss.

This can occur with a loss that is sudden or violent or unexpected, or even an expected loss such as the death of a loved one due to terminal illness.

It's also important to include adverse childhood experiences, or ACEs.

These are life stressors such as lack of early positive relationships or experiencing persistent conflict in the home.

Research has shown that ACEs can have a significant impact on mental and physical health.

-Would you give some examples of traumatic events?

-Sure.

Physical/emotional neglect; sexual, physical or emotional abuse; witnessing violence, whether that's violence in a child's home like domestic violence or violence in the neighborhood like witnessing a shooting; racial trauma from systemic racism and microaggressions, and those ACEs, like I mentioned before, which could be incarceration of a parent or long-term parental substance abuse.

-But what if the trauma happened a long time ago, would that still affect the child?

-It certainly could.

It's important to remember that trauma affects each individual differently, and the severity of a person's reaction is influenced by many factors.

So let's talk about trauma exposure that happens to infants such as domestic violence.

Some may think that since the older child has no cognitive memory of the yelling or the hitting that they saw and heard that it won't affect them.

However, infants are highly susceptible to trauma.

A child does not have to cognitively remember the trauma in order for it to have detrimental effects on the brain, especially if traumas happened repeatedly because this is also going to get in the way of optimal brain development which can only happen in the context of a safe, stable attachment to a nurturing caregiver.

-What are the factors that can influence the severity of a child's reaction to trauma?

-We want to look at what the situation was before the trauma even occurred.

So did the child have any pre-existing mental health issues?

Did the child have any previous trauma exposure?

We want to think about what was the nature of the trauma that happened.

Was it interpersonal, meaning somebody intended to harm the child?

Was it intentional?

Was it unpredictable or uncontrollable?

All of these will worsen a child's reaction to a traumatic experience.

And lastly, we want to think about what happened after the trauma.

Were there any trauma-related losses like the loss of a home after a natural disaster?

Was there any social support or family support after the trauma?

What was the caregivers' response?

Children that don't have secure relationships are going to have more trouble decreasing activation of their stress response system; therefore, they're more likely to have more severe and ongoing traumatic stress reactions.

-And what impact has the pandemic had on children who already have a history of traumatic experiences?

-So the increased stress on families, the financial struggles, housing insecurity, worries if the family experienced any COVID-related deaths or health problems, all of this higher stress on parents is going to impact children, and also children that have past trauma are going to have particular difficulty with all of the changes to the routine that the pandemic caused.

Ultimately, the pandemic put children at additional risk for more trauma and loss.

-Anne Marie, let's discuss traumatic stress and the four clusters of PTSD.

-So first is intrusion, where somebody re-experiences the trauma that happened in the past now in the present.

So this could be through intrusive thoughts, nightmares or being distressed at anything that reminds them of the trauma.

The second cluster is avoidance.

This is when children avoid stimuli associated with the trauma-- people, places, feelings.

The third cluster is changes in mood or thinking, and this could be anxiety, fear, negative beliefs like I'm bad or no one can be trusted.

And the fourth cluster is hyperarousal and reactivity.

This is irritability, being easily startled, concentration problems, sleep difficulties and being on the lookout for danger.

Dissociation is when somebody psychologically disconnects from the present moment, and although this is not a required symptom for PTSD, it is often present as part of the stress response.

So it may appear like a child is just not paying attention, but what's happening is they're actually dissociating as part of their traumatic stress response.

And I just want to mention that just because a child has not been diagnosed with PTSD does not mean that they're not traumatized.

First of all, many children are not being assessed for trauma exposure, and secondly, we know that PTSD is actually under-diagnosed.

-And the impact of trauma.

-Physically, children may show symptoms of traumatic stress such as aches and pains or having accidents.

Behaviorally, like impulsivity or fighting with peers.

Emotionally, like irritability or numbing out their emotions altogether.

Cognitively, with inattentiveness or problems with memory or information processing.

Overall, children who have been traumatized are often described as being dysregulated, and this means they have difficulty controlling their emotions and their behavior.

It's important to note that not all children who have experienced trauma will show obvious symptoms like the ones I mentioned, and this does not mean they aren't in distress.

-Is there a difference in how the symptoms would be expressed if the child had experienced only one traumatic event versus many traumas?

-There's often a difference.

If a child has a number of protective factors like a healthy attachment to a caregiver and being raised in a safe, stable and nurturing environment and they're exposed to an acute, one-incident trauma, they're going to have more resilience that will buffer the effects of that traumatic experience, and they may have few symptoms and those symptoms may resolve quite quickly.

Conversely, ongoing traumas that start early in life, that complex trauma I mentioned earlier, has the potential to really alter the trajectory of a child's development.

If a child has a number of risk factors combined with pervasive interpersonal trauma, there will likely be more symptoms expressed at greater frequency and intensity.

Again, it's really important to remember that every individual will respond to trauma differently.

We don't want to make any assumptions about how a child should react.

There are some children who will experience one traumatic event but still have long-lasting and debilitating symptoms that require intervention.

-And what does trauma look like in preschool children?

-In preschool children, it can come across as a helplessness, an uncertainty, fear, being unusually clingy with a parent or other adult, being moody, angry or having a hard time describing their thoughts and feelings.

They can have regressive behaviors like forgetting how to talk or being unable to talk or wetting the bed.

They can engage in traumatic play, which is acting out the scary event that happened during playtime.

They can react to trauma reminders.

Those are those cues that prompt a memory of the past experience.

It could be something that they see, something that they hear, it could be a place, all of these things can cause a child to have a negative response.

-And what does trauma look like in school-aged children?

-They can have a lot of concerns about their own safety, an overwhelming fear and sadness.

They can talk repetitively about the trauma that happened.

They can have sleep difficulties, physical complaints.

They can be increasingly active but have a decreased attention span.

They can have withdrawal and numbing.

They also can react to those trauma reminders.

They can have reckless or aggressive behavior, and they can have a really poor response to authority, redirection or anything that they perceive as criticism.

-And adolescents?

-Older children and teens usually show symptoms more like adults, but they may also develop disruptive or disrespectful behaviors.

They may feel guilty for not preventing injury or deaths during the trauma.

They may have revenge fantasies against the perpetrator of the trauma.

They may be even more self-conscious.

They may have concerns about being abnormal.

They may withdraw from peers or activities that they used to enjoy.

They may have feelings of fear, vulnerability, shame and guilt.

They may have a lot of physical complaints like headaches or stomachaches.

They may have self- destructive behaviors.

They may have reactions to anything that reminds them of the trauma which can trigger a lot of fear and stress that leads to irrational thinking and even possibly out-of-control behavior.

And lastly, they may have changes in how they think about the world.

-Anne Marie, would you like to address trauma and the brain.

-So children are more vulnerable to trauma's effects because their brains are still developing.

We are all wired for survival with a stress response system.

When faced with danger, this system provides energy to fight or to flee so we're more likely to survive.

But when children are repeatedly exposed to trauma, their stress response system is on high alert.

It's like it's stuck in the "on" position, and this is a survival mechanism that happens in the brain, and it causes them to constantly be on the lookout for danger.

When they're in this survival mode, their ability to be calm and listen and learn is affected because higher cognitive functioning shuts down when the stress response system is activated.

But the good news is this concept of neuroplasticity which means that the brain can change in the context of new experiences, especially those that involve psychologically safe relationships such as with supportive teachers.

Teachers who project cues of acceptance and compassion and safety actually will calm the child's stress response system, which is going to help children become more regulated and therefore listen, comply with directions and process information.

So this is helping them get from the survival brain to the learning brain, and when this happens repeatedly, the teacher actually helps the student build their capacity to self-regulate.

-That makes sense, but how do I know if a child's being aggressive as part of a trauma response versus being just willfully disobedient?

-So you'd want to consider what might be triggering these behaviors: Is it possible the child has been a victim of trauma?

Because of the impact of trauma on child's brain, they can perceive benign situations as threatening.

This can cause them to overreact to peers and teachers.

In addition many traumatized children have developed unhealthful thought patterns such as negatively interpreting events and overestimating danger.

So what looks like intentional misbehavior may actually be part of their stress response, and when adults recognize this, they're more apt to respond to the child in a way that's helpful, rather than react in a way that's going to exacerbate the child's stress.

And from a preventative standpoint, structure and consistency help to prevent behavioral issues.

Also, just being aware of what might instigate a negative stress response like any statement or action or inaction that makes a traumatized child feel degraded, not heard or marginalized can actually activate their stress response system.

On the positive side, supportive adults such as caregivers, teachers and other school staff can actually help children become more resilient through their repeated positive interactions.

Using a trauma-informed approach to prevent and respond to student behaviors can be extremely impactful.

-Thank you.

Dr. Leverett, let's discuss multi-tiered systems of support and mental health.

(Dr. Patrice Leverett) As you know, MTSS stands for multi-tiered systems of support.

The framework focuses on implementing evidence-based practices to support all learners.

It does this by breaking interventions into three tiers to make sure that students receive the support they need based on a level of responsiveness to instruction and intervention.

Within CCSD this framework includes academic response to instruction and intervention, RTI2, and Positive Behavior Interventions and Supports.

But it can also include mental health support for a more trauma-informed school.

In this system high-quality instruction, strategic use of data and collaboration interacts with a continuum of supports to facilitate student success.

So today we're going to focus on tier 1, or universal interventions, but in the future, we'll discuss tier 2 interventions with a focus on small groups, and tier 3 interventions which focus on individual students who benefit from more intensive levels of support.

-Would you discuss tier 1 and what should we do-- or do when returning back to school?

-Yes.

Tier 1 interventions focus on strategies that are effective across the school environment.

So in addition to high-quality instruction, which is essential, it also focuses on making sure that instruction is culturally responsive, that we're building a sense of community and ensuring that students have a clear understanding of day-to-day expectations.

In fact, establishing norms and routines can be extremely helpful for students who have experienced trauma.

It reduces cognitive load, what they have to worry about on a day-to-day basis, and it helps them feel safer in the environment.

Some examples of what that can look like is establishing a shared set of rules or expectations, making time to practice those rules and expectations, being consistent about them.

It's also good to give a tour of the space.

Where are the bathrooms, the supplies, cafeteria, especially for new students who may not know where things are located.

You want to post your schedule so they know what to expect.

You want to post the rules as regular reminders, and then you want to practice transitions.

As you move around from place to place, what's the best way to do that?

You should expect to repeat yourself.

People need to hear things multiple times just in day-to-day practice, but if you're thinking about experiences, negative experiences, then you may need more repetition.

We also want to focus on complimenting positive behaviors and interactions-- catch them doing the right thing.

-Absolutely.

And how does relationship building fit into tier 1?

-So I'm glad you asked.

The more connected students feel to the environment, the more we can increase sense of belonging and then the better their educational outcomes overall.

Research shows that a higher sense of belonging is correlated with higher academic achievement, more prosocial behavior and yes, even a reduction in traumatic symptoms.

Whereas removing students from the classroom through exclusionary practices has been primarily ineffective.

Creating meaningful relationships with students has one of the greatest impacts on student belonging.

-And what suggested interventions?

-Yes.

You want to take time to learn the names of your students, pronounce them correctly, discuss with them their preferred pronouns.

You want to engage in introduction activities such as icebreakers to help the students learn each other's names.

Maybe allow time for students to share something special about them; write something that's unique to them so you can get to know them better.

Establish ways that students can connect with you one-on-one.

And then again you want to focus on the strengths of each student, so keep note of the things that they feel really positive about.

-And what about social-emotional learning, or SEL?

This comes up a lot; is this something that students can benefit from?

-Absolutely.

I think everyone, despite our age, can learn better ways to communicate with others, and social-emotional learning is something we can and should teach across school environments.

Part of it is it allows us to have a shared understanding of some ways that we want to be treated.

It's also a good way to learn about cultural differences and the way we understand words like respect or care and inclusion.

School social workers, psychologists and counselors can offer ideas on how to teach social skills.

Maybe they are doing social skills activities within the classroom, some team-building activities.

You can have explicit classroom lessons on social-emotional learning, and again, your school-based professionals can help support you in that.

And then you can utilize social-emotional learning curriculum that's provided by the school district.

There are several examples out there, which the Second Step for example is one of those.

-Thank you.

Dr. Dambo, how can educators promote student resilience?

(Dr. Neffisatu Dambo) Let's take a moment to ponder on the word "resilience."

When many of us think of resilience, we think of overcomers, individuals who never give up on trying to thrive even in the face of adversity and have the confidence to persist forth throughout life's journey.

Many of us work with studens who are resilient, students who have excellent emotional and adaptability intelligence.

While there are a number of individuals who experience trauma, approximately 64% of individuals who experienced extreme childhood challenges have become successful adults.

Educators have the opportunity to support student success and healthy development.

We play a significant role in helping children build resilience.

Educators can provide resiliency-building activities, encouragement and positive school climates where students feel welcome and safe.

It is important for educators to utilize culturally responsive practices, recognize students' strengths and maintain a student-centered approach.

Educators can support students' resiliency skills by providing opportunities for student contributions, maintaining high expectations for all students, implementing just practices, providing equitable supports, including the voice of students in decision-making processes, integrating activities that support students' cultural identity development as well as by viewing students as at-promise rather than at-risk.

Educators can also promote student resilience by using hands-on activities, problem-based learning, goal-setting and collaborative group activities.

Educators support students by building positive relationships, establishing clear expectations, providing opportunities for critical thinking, teaching coping skills, engaging students in reflective and meaningful dialogue as well as by providing events that encourage parent-community-family engagement.

-What interventions can help children build their self-regulation skills?

-Educators can help build self-regulation skills by implementing culturally responsive interventions.

This requires educators to create a culture of respect, empathy and unconditional positive regard.

Establishing a positive relationship with students is key to helping students through social-emotional learning and building upon their self-regulation skills.

It is important for educators to listen, learn about students' diverse cultures, recognize students' interests, identify students' gifts and model desired behaviors.

Students can benefit from educators who teach and model self-regulation skills like self-awareness, problem-solving, goal-setting, decision-making, coping, boundary-setting and assertive communication.

Interventions that can be used to help strengthen students' self-regulation skills include CBT techniques-- cognitive behavioral therapy-- emotional gauging, reframing, positive self-talk, journaling, calming spaces, relaxation activities, breathing techniques, imagery, prayer, self-care activities, role-play as well as creating successful routines and strategies.

Successful strategies that can be used are organization and time management activities.

-Thank you.

Kristin, what supports are offered for students at tier 1, tier 2, and tier 3 in the Clark County School District?

(Kristin Barnson) So specifically speaking to the role of the school counselor and the social worker in our tiered support of students, let's say for example, school counselors in tier 1 will provide classroom lessons, and let's say it's on coping skills.

That way the students can learn the best strategies and skills when they are feeling anxious or overwhelmed.

And in tier 2, maybe some of those students need additional help, so it will be a small group led by the counselor or the social worker and with their peers and learning those skills.

And then in tier 3, it's more a one-on-one with the counselor or the social worker and/or maybe even be referred to an outside agency.

-Who are the school-based intervention team members?

-School-based intervention team members may differ at every school site, but they do include the school counselor, the school psychologist, the school nurse, social worker, and the safe school professional.

But again, check with your school because it could look different with the professionals on-site.

-Thank you.

Niki, what do I do when a student is experiencing a crisis?

I mean, for example, suicidal behavior, cutting.

(Niki Maloff) Well, first thing you want to make sure that the student is safe, and let them know that you are there to get them the help that they need.

As a schoolteacher or a support staff member, contact your school counselor or school social worker for immediate assistance.

You want to remember never to leave the student unattended or alone, and of course if it is a medical emergency to notify 911, and also let your school administration and school nurse know as soon as possible.

-Thank you.

What is Care Solace, and how will Care Solace help my students?

-CCSD is excited for their partnership with Care Solace to help meet the mental health needs of our students, their families and our staff.

Care Solace calms the chaos of navigating the mental health services within our community.

They will help match our students, the families and our staff to local verified mental health providers and secure appointments within days, not weeks.

And so we say if anybody wants more information on Care Solace to reach out to their school counselor or school social worker and they can help them.

-Fantastic, fantastic support for our students.

Ms. Barnson, where can I find more information or obtain more information on trauma-informed schools and trauma-informed practices in the Clark County School District?

-As a CCSD employee, luckily we have more trainings that are listed on our Enterprise Learning Management System, or "ELMS."

So if they just go to ELMS and search in the search box for "trauma," those courses would come up.

Employees would also want to lean in on the expertise of their school counselor and their school social worker for additional resources.

And then also we have some listed on the screen now for other resources.

-Thank you, panelists, for those insightful points and strategies to help us as educators assist our students living with trauma.

We discussed today the importance of trauma foundations, multi-tiered systems of support, mental health, social-emotional learning and supports available within the Clark County School District.

On behalf of University of Nevada Las Vegas, Clark County School District, and Vegas PBS, I'd like to thank our panelists for joining us today.

We had Anne Marie Abruscato, Dr. Dambo, Dr. Patrice Leverett, Niki Maloff and Kristin Barnson.

We appreciate your insight in this extremely critical issue, and I hope we were able to provide you with a clearer understanding of the foundations of trauma and the challenges facing our educational system and provide tangible solutions and steps and support.

Thank you to the Coronavirus Response and Relief Supplemental Appropriations Act for funding this project, exemplifying their commitment to the welfare of Nevada's children.