Solano Safe From the Start Project: Reducing Children’s Exposure to Violence WORKSHOP PRESENTATION

1. Solano Safe From the Start Project: Reducing Children’s Exposure to Violence WORKSHOP PRESENTATION Revised May 2003 Solano County Office of Family Violence Prevention Fairfield, California 94533 (707) 435-2702

2. The Impact of Violence on Children Based on research by Bruce Perry, M.D., Ph.D., Child Trauma, Houston, TX and Alberta, Canada, and the Safe From the Start presentation by Linda Chamberlain, PhD MPH

3. 50% of infants who have witnessed violence have eating and sleeping problems, decreased responsiveness to adults, and increased crying.

4. The child’s brain is NOT a smaller version of an adult brain. Babies are born with 1000 billion neurons: the brain’s building blocks. The greatest neuron growth occurs between 2 to 4 months of age! Neuron growth peaks at 8 months of age. These brand new neurons are not yet fully insulated.

5. Brain Development depends upon experiences of the developing child. A lack of sensory experiences or trauma can result in malorganization and diminished functional capabilities. The brain is the “ultimate use-it or lose-it” machine!

6. The brain is similar to a ladder. Each step represents a developmental phase in the brain’s development.

7. The Brain Ladder Cortex Limbic System Midbrain Brainstem

8. The first rung of the ladder represents the development of the brainstem. Brainstem damage is less reversible than damage to other parts of the brain during development. Development of the brainstem affects: BODY TEMPERATURE HEART RATE BLOOD PRESSURE SLEEP Constant stress affects early brain development

9. The impact of trauma during the development of the brainstem: Hypervigilance - defensive, always “scanning” Hyperarousal Hyperactivity, increased: hormonal response muscle tone, body temperature startle response Profound sleep disturbances Children who are chronically exposed to violence are often diagnosed as ADD & ADHD

10. Introducing the Limbic System of the Brain (No, not LIMBO) Limbic system forms an emotional blueprint for later use. The limbic system development: Regulates emotional responses Formed in early life -between 8 to 18 months Infants at this age know when they are not safe and when loved ones (mom, dad, siblings) are not safe.

11. UPPER BRAIN DEVELOPMENT (Cortical) The “upper brain” is the moderator. Children under stress cannot verbalize easily. Upper brain development affects: Empathy Sympathy Emotional Attachment Cognitive Thought (ability to learn)

12. Effect of Extreme Deprivation Healthy Child Neglected Child

13. Factors Influencing Children’s Response to Violence •  Relationship of victim and perpetrator to the child • Proximity of child to the violence • Isolated event or chronic exposure • Age of child • Developmental level of child • History of prior victimization of child • Support from the child’s family • Source: Child Witness to Violence Project, Boston, MA • One healthy adult can make a huge difference in a child’s life!

14. SHORT-TERM IMPACT OF TRAUMA IN CHILDREN Hysteria Disorganized in thoughts and actions Temporarily consumed with thoughts & feelings about the trauma LONG-TERM IMPACT OF TRAUMA IN CHILDREN: PTSD

15. The Invisible Injury: POST TRAUMATIC STRESS DISORDER (PTSD) IN CHILDREN Indicators of PTSD in Children  Repeated distressing memories - such as a repetitive play in which themes of the trauma are expressed  Recurrent distressing dreams  Sudden feeling of reliving the experience or flashbacks  Intense distress at events which are reminders of the trauma  Persistent avoidance of stimuli associated with the trauma  Loss of interest in significant activities - learning toilet training, etc., . . . Source: Knapp JF & Spense LS, Psychological First Aid Program: Helping Kids Traumatized by What They’ve Seen

16. Post Traumatic Stress Disorder Risks to the child: In a recent study, researchers: — interviewed children ages 6-12 who had witnessed domestic violence — used a control group who had not been exposed to domestic violence — Found that 85% of child witnesses had moderate to severe PTSD symptoms — Further found that 0% of the control group had symptoms Kilpatrick, Litt, and Williams et. al.

17. Children’s Reaction to Trauma Children 5 years old and younger may: •Experience extreme separation anxiety •Experience loss of feeling of safety •Have persistent crying, whimpering, or screaming • Have problems sleeping, nightmares • Have regressive behavior, developmental delays

18. Children’s Reaction to Trauma Along with the previous reactions, children 6-11 years old may also: • Withdraw from everyday activities and people •Act out with disruptive behaviors that are not typical •Have difficulty concentrating •Have irrational fears for this age group • Become irritable, depressed, suffer chronic anxiety • Feel guilty for the abuse and for not stopping it • Exhibit aggressive behavior and difficulty controlling anger • Be emotionally numb, detached, and disoriented • Get lower grades in school or become the “hero child” Source: JAMA, August 2000, Vol. 284, No. 5

19. Children’s Reaction to Trauma Along with the previous reactions, adolescents ages 12 to 17 years old may also: • Have flashbacks •Avoid any reminders of the trauma •Abuse drugs and alcohol •Have suicidal and/or homicidal ideation Source: JAMA, August 2000, Vol. 284, No. 5  70% of runaways are leaving violent homes!

20. Adolescent Risk Behaviors of Girls Adolescent Girls who witnessed violence were 2-3 times more likely to report: • Using tobacco and marijuana • Drinking alcohol or using drugs before sex • Having intercourse with a partner who had multiple partners Berenson et al, 2001 In addition, adolescent girls experienced: • Memory lapses about specific episodes of violence • Helplessness, sense of loss, “living day-to-day” • Need to escape or end violence • Attempts to understand the violence and place responsibility Bennett, 1991

21. Violence and Learning Children who do not feel safe live in a state of emergency. Their energy is consumed by crisis, making it impossible for them to focus on learning to read. From “Too Scared to Learn” by Jenny Horsman, 2000

22. Implications for Learning Traumatized children often spend so much time in the lower level brain in a state of fear that they consistently focus on non-verbal vs. verbal cues. Many of these children are very intelligent but can’t learn easily and must do verbal learning when calm. Learning needs to be more experienced-based. When traumatized children are stressed, they are reactive and reflective vs. having the ability to assess cognitive solutions.

23. Childhood exposure to violence increases the likelihood of: More school nurse visits Referral to school speech pathologist Suspension from school Frequent non-suspension related absences Lower grade point averages Huirt et al, 2001, Kernic et al, 2002

24. Trauma leaves a permanent imprint on the brain • A nurturing, supportive environment can smooth the wrinkles. Adverse development remains but is minimized

25. GUIDELINES FOR INTERVENTION WITH CHILDREN WHO HAVE WITNESSED VIOLENCE • Healing begins with relationships • 2. Help children to know what to expect • 3. Children need to tell their stories • 4. Acknowledge a child’s right not to speak • 5. Help victimized parent and perpetrator to understand • the impact of (domestic) violence on kids

26. 6. Use available resources 7. Build children’s self esteem 8. Provide positive roles and choices 9. Teach alternatives to violence early 10. Be consistent with your messages 11. Don’t make promises you can’t keep 12. Communicate your concern about safety

27. And. . . . • LISTEN and create a safe space for kids to tell their stories. • If a child discloses family violence to you, let him/her know • that it is not their fault. • Recognize that certain behaviors may reflect how a child • responds to trauma. • Teach children that family violence is not OK and while they • can not stop it, they are responsible for only their own behavior. • Help others to understand the impact of violence on children. • Learn about local resources for adult victims, perpetrators and • child witnesses.

28. Resources Solano County Office of Family Violence Prevention (707) 435-2702 www.solanocounty.com click on “Family Violence” California Attorney General’s Safe From the Start Project www.safefromthestart.org Dr. Bruce Perry’s “Vortex of Violence” report www.childtrauma.org