Reducing Risk, Supporting Resilience

Adolescent Development

prefrontal connive control networks still requires fine tuning, therefore teenager’s executive functioning not fully mature

changes in social emotional network still outpace growth of cognitive control network, leading to challenges managing emotions and reward seeking behavior

cognitive changes lead to focus on identity development, engaging in occupation to explore identity

Child Welfare System

intended to promote the well being of children by ensuring safety, achieving permanency and strengthening families

receives and investigates reports of possible child abuse and neglect

process services to families that need assistance in the protection of care of their children

arranges for children to live with kin or with foster/resource families when they are not safe at home

arranges for reunification, adoption or other permanent family connections for children leaving foster care

youth: physical, psychological, social, behavioral proems; absent from school; testing below grade level; dropping out of school; involvement in the juvenile justice system

children and youth involved in these systems are more likely to have been exposed to trauma

Juvenile Justice System

intention is to provide education and treatment to youthful offenders up to age 5

focus on rehabilitation, not punishment

children and youth involved in these systems are more likely to have been exposed to trauma

Informal Probationers (654)

committed a minor offense

often diverted into substance abuse, mental health, crisis shelters or other services

probation offices have a great deal of flexibility and can place a juvenile on informal probation if the officer decides the juvenile is under the jurisdiction of the juvenile court or is likely to be under its jurisdiction in the future

Status Offenders (601)

committed offenses unique to a juvenile such as truancy, a curfew violation

can be placed on formal probation but cannot be detained or incarcerated with criminal offenders

Criminal Offenders (602)

committed a misdemeanor or felony

can be placed on formal probation, detained before adjudication in a jubilee hall, and/or incarcerated after adjudication in a county or state faculty

they are treated differently from adults; they are not tried but adjudication; they are not convinced but their position is sustained

Juveniles Remanded to Superior Court (707)

juvenile age 14 or older who commits specified felonies and is determined not fit for adjudication in juvenile court

tried as an adult

if convicted is sentences to state prison and held in a DJJ facility for all or part of sentence

Developmental Trauma

exposure to chronic interpersonal trauma results in complex trauma

adversely affects all aspects of development

higher levels of dysregulation, functional impairments and psychiatric hospitalizations compared to children with other types of trauma impacts occupational performance: social participation, ADL, education, work, play/leisure, sleep/rest

Impact of Trauma

hypervigilance

irritable behavior, angry outburst

dissociation/numbing

problems with concentration

negative emotional state

feelings of detachment

re-experiencing of the trauma

Trauma, Sensory Responses and the Brain

brainstem: first area of brain to service as response to threat

traumatic stress → increase reactivity of brainstem = more sensitive, more reactive

sensory input: all sensory input form body and brain first goes through brainstem

if brainstem is more reactive/more sensitivity to threat → and all sensory input will be filtered through this highly reactive brain → increased responsiveness to sensation from the inner and outer world

Impact of Trauma: Sensory Processing

individual with post traumatic stress symptoms may have exaggerated responses in sensory patterns related to how threshold and lower responses in sensory patterns related to high threshold

hay help explain their motional response and disrupted participation

common responses: over responsivity to tactile, auditory, vestibular; seeking proprioception for regulation

Patterns of Trauma Response

hyperarousal: increased sympathetic activation; increased muscle tone and heart rate; general activation and externalization; hyper vigilance; more common with older children

dissociative: decreased heart rate and peripheral circulation; disengagement and internalization; numb; more common with younger children

over-responsivity/sensory sensitivity

underresponsivity/low registration

Trauma Informed Care

understanding trauma and its impact

safety

trustworthiness and transparency

peer support

collaboration and mutuality

empowerment, voice and choice

cultural, historical and gender issues

ex: ask permission for everything; acknowledge that there may be aspects of the environment you cannot change to support well being; recognize that trauma manifests in many different ways; be cognizant of the type of information you are trying to gather; foster growth and positivity

Trauma Sensitive Assessment and Evaluation

conduct assessments in a private space

inform youth and families about what to expect

give choices about the conduct of the assessment

consider potential safety issues and triggers

consider cultural norms and expectations hen greeting, engaging, and questioning students and families

give options for stopping assessment and continuing at a later time if they begin to feel uncomfortable or overwhelmed

assess in a way that is relationship oriented

maintain a strengths based focus

Resilience

able to succeed and thrive in toxic and/or traumatic environments by inheriting/acquiring certain individual strengths and befitting from various environmental protective factors

good outcomes in spite of serious threats to adaptations or development

common phenomena arising from ordinary human adaption process

a dynamic and interactive process between the individual and the environment

Resilience Themes

rising above to overcome adversity

adaptation and adjustment

ordinary magic

good mental health after crisis or trauma

ability to bounce back

Resilience Internal Factors

social attachment/interaction

cognitive skills

emotional regulation

self concept

Resilience External Factors

family support

parent support

supportive community

Interconnections

resilience factors are interrelated

complex interactions between resilience factors are important

contextual, nonlinear process

Adaptation Based Approach to Resilience

what are the attention, learning, memory, problem solving and decision making strategies that are promoted by exposures to childhood adversity?

how can we recognize those strengths?

how can we help youth capitalize on their adaptive skills?

how can we help youth see and believe in their own strengths?

Resilience Based Interventions

identify and develop internal and external resources and assets

preliminary evidence for fostering positive development

interventions improving resilience factors can reduce psychopathy after adversity