If a child has persistent hypervigilance, irritability, or dissociative behaviors following an instance of or prolonged trauma, then he or she may be experiencing symptoms of Post-Traumatic Stress Disorder (PTSD). We have worked with several students struggling with PTSD. There is hope. In the following articles, we want to explore:
What PTSD is
How the brain influences PTSD
Specific challenges we see with students struggling with PTSD
What is PTSD?
Many children experience instances of stress in life. Typically, this stress is recoverable. However, if a child witnesses or experiences more severe stress, such as a real or perceived threat of death, a serious car accident, invasive medical procedures (especially for children younger than age 6), animal attacks, natural or manmade disasters, physical abuse, sexual assault or abuse, emotional abuse or bullying, or neglect, then post-traumatic stress disorder may be diagnosed if resulting symptoms affect the child long-term. Many times, additional considerations for if a child will develop PTSD as a result of these events include how bad the event was, length of the event, frequency of the event, the child’s personal resiliency, and previous adaptive coping mechanisms
Though the previous mentioned behavioral symptoms may be indicative of PTSD, additional symptoms include: reliving the event in thought or play, nightmares and sleep problems, dysregulation as a result of triggered memories or sensations, lack of positive emotions, acting helpless, avoiding places or people associated with the event, and physiological symptoms like stomachaches or headaches.
What happens when a child’s PTSD is triggered?
Many students within our school that have a diagnosis of PTSD have it due to trauma from elevated behavioral incidences that occurred in educational or other social settings. As a student then struggles to process the experience, a fear based response sets in and often generalizes to other settings. Often, they have a previous history of self-regulation challenges, wherein they were met with inconsistent or overly forceful interventions and often an inadequate opportunity to debrief the event. The child may even become more dependent on their parents and refuse to be separated in order to go to school out of a feeling of dread and extreme fear over imminent threat. Over time, the idea of school in general brings about a heightened response, leading the child to need to be pulled from a school setting and home schooled as a result.
Trauma Informed Care
One central facet to assisting any child with PTSD is centered around providing trauma informed care. Armed with the understanding that these children have encountered significant life events during their developmental years, it is integral to provide these children with a safe environment, collaboration, trustworthiness, and choice. The disruption to normal development in the brain can result in developmental regression and can create an incongruence between biological age and developmental age, so part of a holistic trauma informed plan of care, especially within a school setting, is to place students in small groups based on developmental levels, such as academic readiness, needed emotional/behavioral support, independence within activities of daily living, and inter-personal communication skills. Each group should incorporate pre-teaching to both change the way a student sees the world and how they process events, situations, and their own emotions.
Interested in learning how the brain influences PTSD? Click here for Part 2.