Elementary Students with PTSD

1. Elementary Students with PTSD Krista Klein

2. Ice Breaker • Write down three “facts” about yourself. • Make two true and one false. • Choose a partner that you do not know very well. • One person will read their three statements. • Their partner will try to guess which of the statements is false. • Then, switch turns. • Try and trick your partner!

3. What is PTSD? • A traumatic event occurs • Life-threatening • Feelings of helplessness • Severe injury • Who develops PTSD? • It depends on how your body and mind respond to the stress. • Many recover without further problems. • Some develop ongoing difficulties (PTSD). • What do you think some of the common causes are?

4. Common Causes • Being victimized or witnessing • An assault • Physical abuse • Sexual abuse • Natural disaster • Terrorism • Death • Serious illness

5. Objectives • Teachers will be able to apply information learned today in order to figure out the best possible answers to 3 situational questions.

6. Current Issues • In the past, PTSD was commonly known as a disorder that affects many veterans. • Many children would remain unidentified. • Terrorist attacks on 9-11 triggered more cases and awareness of this disorder in children. • More and more children are now being identified as having PTSD.

7. Statistic • An estimated 25% of children witness or experience a traumatic event by the time they reach the age 16. • What does this mean for elementary education? • Is it important for teachers to be knowledgeable about PTSD? Why or why not? • Think, Pair, Share

8. Suspect PTSD in a Student? • Has the student been exposed to an incident that causes extreme horror, fear, or helplessness? • Keep in mind that some individuals have a delayed onset. • Refer them for screening.

9. Identifying • Individuals must be assessed by trauma-specific measures. • Most commonly used test: DSM-IV-TR • It is recommended that interviews also be administered as part of the assessing process. • In order to be identified as having PTSD, students need to display a certain number of symptoms in each of three categories. • Reexperiencing the Trauma (1 Symptom) • Avoidance Behaviors (3 Symptoms) • Increased Arousal (2 Symptoms)

10. Symptoms (See Handout) Click picture for symptom examples!

11. Symptoms can affect classroom performance • Younger elementary students are most likely to display these behaviors: • Acting out • Developmental regression • Clinging behavior • Threats to themselves or others • Traumatic play

12. Symptoms can affect classroom performance • School-age students are most likely to display these behaviors: • Developmental Regression • Fighting with peers • Withdrawal from friends • Poor attention and concentration • Declining academic performance • Anxiety-like symptoms • May describe these as stomach aches or headaches • Inappropriate concept of relationships with peers and teachers • Trouble making friends

13. Symptoms can affect classroom performance • Older elementary students may display these behaviors: • Skewed perceptions of • Identity • Future • Safety • Connection • For example, a student may have a sense of foreshortened future and lose expectations of getting married and having a career.

14. How do they get better? • A traumatic event shatters an individual’s belief that the world they live in is safe and bad things only happen to others. • In order to cope and recover, they must make sense of the event and integrate it into their thoughts about the world. • This involves confronting the memories, which can bring about fear, anxiety, and depression.

15. Therapies proven successful • Group Therapy • Communicating their experiences • Form trusting relationships • Sharing common fears and avoidant behaviors • Finding normality in their reactions to the event • Family Therapy • Facilitates open communication • Maintains or strengthens connections

16. Cognitive Behavior Therapy (CBT) • Most effective • Visual memories are expressed by • Play • Art • Narrative therapies • Journaling • Children’s literature • Memory or trauma scrapbook creation

17. Other Interventions • Teaching the student how to be safe and avoid traumatic events. • Teaching them what they should do if they find themselves in a dangerous situation in the future. • Medication • When individual is not responding to psychological interventions alone • Exposure to the traumatic event (Not at school!) • Discussing memories • Looking at pictures • Teaching the student relaxation techniques

18. What Teachers Can Do in the Classroom • Establish a safe, trusting atmosphere • Model appropriate interactions • Teacher/student relationships • Peer relationships • Generate opportunities for the student to build relationships with others • School reintegration plan

19. School Reintegration Plan • May be necessary if the student is hospitalized for the traumatic event or their reaction to that event. • Goals carefully planned with the student in mind • Collaborate with the school psychologist, student, family, and any other professionals working with the child • Educate all involved about the recovery process • Teach the student self-monitoring skills • What to do when symptoms arise • Work towards the student’s independence and ability to attend for an entire school day. • Relapse prevention

20. Polleverywhere.com • Grab your cell phone • If you don’t have one, partner up with someone who does. • Polleverywhere.com allows you to answer questions anonymously via text message • Polleverywhere.com will never send you promotional texts or share your phone number with any other company • Polleverywhere.com will not charge you for the texts that you send • Your own rates do apply • If your cell phone plan charges you per text, feel free to partner up with someone who has unlimited texting.

21. Situation 1: Stephanie • Stephanie is a 5th grade student. Her mother died of cancer when she was in 2nd grade. Her father was diagnosed with cancer last month. She often falls asleep in class and has displayed an exaggerated startle response when woken up. She has stopped engaging with peers during recess and, instead, stares blankly into the distance. • Live Poll

22. Situation 2: Anthony • Anthony is a 3nd grade student who recently witnessed a man being shot down the street from where he lives. He has been hospitalized for his displays of constant fear, anxiety, and panic around others. He is planning on coming back to school next week. • Live Poll

23. Situation 3: Brandi • Brandi is a new student in your 2nd grade classroom. She recently moved to PA from TX with her mother. She often talks in short utterances in a baby-like voice and sucks her thumb. While you are at your desk, she is often somewhere close by, asking you questions and telling you stories. She constantly asks for assistance claiming that she doesn’t know how to do things. When the rest of the students are lining up to go to art, music, or gym, Brandi is hugging you around the waist tightly saying things like, “But, Mommy, I’ll miss you!” • Live Poll

24. In Conclusion • If a teacher suspects a student may have PTSD, they should refer them to be assessed as soon as possible. • Professional-to-professional collaboration should be used as often as possible to discuss what measures teachers should take to accommodate this student. • Implement, assess, and change it if it is unsuccessful • Continue to learn about PTSD and new therapies and techniques you can use with students in your classroom.

25. Go to http://ptsded.wikispaces.com/ • This wikispace was created specifically for this in-service presentation. • Navigate by clicking the different pages on the left. • Find materials from this in-service, as well as additional information about PTSD in children.