Tirs Guidebook 2020

TRAUMA-INFORMED
RESILIENCE-FOCUSED SCHOOLS
GUIDEBOOK
DRIVEN TO HEAL STARR.ORG

Trauma Informed Resilient Schools
GUIDEBOOK
Starr Commonwealth
13725 Starr Commonwealth Road, Albion, MI 49224
www.starr.org | info@starr.org
©2019
Table of Contents
Starr’s Professional Training and Coaching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

10 Steps to Trauma-Informed Schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Starr’s Core Values and Beliefs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Circle of Courage® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
What is Resilience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
What is Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Trauma Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Types of Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Activity: The Animals Inside Me . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Understand Trauma’s Impact Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Potential Signs and Symptoms that May Indicate Trauma . . . . . . . . . . . . . . . . . . . 13
Life Events Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
ACEs Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
View Trauma as an Experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Trauma and Attachment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Fostering Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Emotional Awareness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Body Scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Time In vs. Time Out . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Turning Routines into Rituals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Vulnerable Times for Feeling Unsafe at School . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Top Ten Fears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Impact of Safety at School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Activity: Brain Break . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Childhood Trauma Infographic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
10 Things About Childhood Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Childhood Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

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Children’s Mandate
“If you don’t think what I think,
feel what I feel, experience what
I experience, and see what I see
when I look at myself, others
and the world around me,
how can you possibly know
what is best for me?”
Starr Commonwealth
Starr Commonwealth’s professional training centered on the concept that changing behav-
and consultation arm emerges from the vision ior isn’t possible until you change the sensory
that: knowledge + empowerment = impact. memories that fuel that behavior. SITCAP®
provides a powerful framework for helping
Starr provides guidance and expertise to those who have been traumatized engage in
“helpers” from around the world in the form program activities to allow them to experience
of research, publications, e-learning courses,
themselves as safe and empowered. They will
in-person trainings, conferences and events,
no longer be victims but survivors and thrivers,
professional certifications, as well as school/
ready to flourish. They will experience them-
agency-wide accreditation. These products
selves differently and thereafter view their ex-
and services are offered through Starr’s three
key training programs: The National Institute perience in ways that are manageable.
for Trauma and Loss in Children (TLC), Re-
Developed and used since 1990 and field-test-
claiming Youth International (RYI), and Glass-
wing (GW). ed in schools and community agencies, SIT-
CAP® is supported by the latest scientific ad-
Starr’s proven SITCAP® (Structured Sensory vances in brain science and has been featured
Interventions for Traumatized Children, Ado- in leading journals and numerous books on
lescents and Parents) model was pioneered childhood trauma.
by internationally recognized experts and is
© 2019 Starr Commonwealth -1-

Trauma-Informed Resilient Schools Guidebook
10 Steps to Trauma-Informed Schools

1. Focus on Resilience
2. Understand Trauma as an Experience
3. Foster Connections
4. Prioritize Social and Emotional Skill Development
5. Establish Safety
6. Promote Play
7. Understand the Link between Private Logic and Behavior
8. Collaborate with Families and Communities
9. Support and Invest in Staff
10. Collect and Utilize Outcome Data
-2- © 2019 Starr Commonwealth

www.starr.org
Starr's Core Values and Beliefs
We believe...
n That there’s no such thing as a bad child.
n That badness is not a normal condition but is the result of misdirected
energy and unmet needs.
n That every child will be good if given an opportunity in an environment of
love and activity.
n In play.
n That children are resources.
n That children merit confidence and trust.
n That problems are opportunities.
n That everyone has a responsibility to help and no one has the right to hurt.

Core Values and Beliefs

What are the core values and beliefs in your professional setting?
How do these values and beliefs influence the way children are viewed and
treated?

www.starr.org
Circle of Courage©
Restore and Nurture Universal Needs
Belonging Independence
The presence of a strong sense of belong- In contrast to obedience models of disci-

ing makes young people more receptive to pline, teaching should be designed to build
guidance from other community members. respect and teach inner discipline. Children
And, even if parents/caregivers are struggling should be encouraged to make decisions,
– there are others there to help children. A solve problems, show personal responsibility,
sense of belonging helps children draw from and learn/practice emotional awareness and
a group as well as from themselves. regulation. Adults can model, nurture, and
guide but children should be given opportu-
nities to make choices without coercion.
Mastery Generosity
The goal of mastery is to achieve one’s po- Children must be given opportunities to
tential, not perfection, and then contribute develop abilities for being generous and un-
to and provide for their greater community. selfish. In helping others, we create our own
When success is met, the desire to achieve proof of worthiness, for we have the power
is strengthened. to make positive contributions to the world.
Children increase their sense of self-worth
as they become committed to the positive
value of caring for others.
“The developmental needs of children are universal.”

-Dr. Martin Brokenleg

Trauma-Informed Resilient Schools
What is Resilience?
Resilience is the ability to achieve positive outcomes – mentally, emotionally, socially, and
spiritually – despite adversity.
What does research tell us today?
Four Main Protective Factors for Resilient Children
1. Supportive adult-child relationships

2. A sense of self-efficacy and perceived control
3. Adaptive skills and self-regulatory capacities
4. Sources of faith, hope, and cultural traditions

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What is Trauma?
Trauma is any experience that leaves a person

feeling hopeless, helpless, and fearing for their
life/survival or safety. This experience can be
REAL or PERCEIVED.
We can experience trauma in many ways. The

causes of trauma are less important than how
trauma manifests in a child’s life but it is import-
ant to understand that we can experience trauma
in many ways.
www.starr.org -7-
Trauma-Informed Resilient Schools
TRAUMA
EXPOSURE
• Victim (abuse, neglect, car accident)
• W
itness (personal witness – domestic violence,
police, fire)
• R
elated to (peer, siblings – of chronically ill
siblings, sibling that completed suicide)
• L
istening to details of trauma (therapists,
media exposure, video games, etc.)

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Types of Trauma
Types of Trauma
• Type 1 – Single exposure
• T
ype 2 – One type of exposure that is repeat-
ed OR exposure to one or two different events
• T
ype 3 – Toxic Stress and Developmental
Trauma Disorder
About Developmental Trauma Disorder

• A
proposed diagnosis to help us understand
the symptoms and reactions children experi-
ence when they have grown and developed in
a constant state of stress and trauma.
• W
ould help us when there are multiple diag-
noses but we know trauma is at the core of
the symptomology.
• W
ould help us when we don’t know how to
diagnose but we know trauma is at the core.
Proposed by Robert Pynoos and Bessel van der Kolk

in 2005, 2009, 2013 – with no success for approv-
al by the APA.
www.starr.org -9-
Activity: The Animals Inside Me

Script:
Today I want to teach you about how your body responds to various experiences. The best way
I have found to teach kids about this is to have them think about three animals. I am sure you
have heard about tigers and owls, but there is another less common animal. Let’s talk about the
animals now.
Meerkat
Have you ever heard of a meerkat? They are cat-like animals
that live in Africa. Meerkats live in groups and one of them is
always watching out for the others. They take turns being the
watch guard for their pack. They keep a look out for predators
like hawks and eagles. When the meerkat sees, hears, smells,
or feels something suspicious they let out a big bark to alert the
others. When you think about a meerkat, think about them as
watch guards.
Tiger
Tigers are part of the cat family. They love to eat, sleep, and
play. They are excellent hunters and can be very ferocious when
they feel threatened. They are always ready to run or fight.
Owl
Owls are wise and able to see things from a long distance. They
are good problem solvers and decision makers.
- 10 - © 2019 Starr Commonwealth

www.starr.org
Let’s review, the meerkat is a watch guard, tiger is always ready to run or fight but really loves to
play, and the owl is a good decision maker.
Think about your body as having three animals, a meerkat, tiger, and owl living inside.
All three are present all the time. The meerkat is quiet but is always on the lookout and respon-
sible for alerting the tiger and owl if they sense danger, worry, or hurt. The meerkat will let out
a loud sound to let the tiger and owl know when something looks, smells, or sounds suspicious.
The more bad things that happen, the more the meerkat will be on the lookout. Think of the
meerkat as the watch guard.
If the meerkat is quiet and not sounding an alarm, the tiger plays with friends, enjoys a good
night of sleep and eats when he is hungry. The owl will be busy reading books, learning new
things, making good decisions, and forming plans.
What we need to remember though is if the meerkat sounds an alarm, then the owl will immedi-
ately fly away and hide because he gets scared! If the meerkat sounds an alarm, the tiger feels
threatened and gets ready to run and fight.
This example can help you understand why when you are really worried or scared or angry you
may want to run away or fight instead of paying attention in school, listening to a parent, or
spending time with friends. It is also the reason why you might have a hard time sleeping, eating,
or remembering things.
When the meerkat is not sounding an alarm and is calm, so is the tiger. When this is the case,
the tiger (just like you when you are calm) can eat, sleep, and play. When the meerkat is not
sounding an alarm, the owl ( just like you when you are calm) can think, make good decisions,
and pay attention. However, when the meerkat is worried, the tiger comes out to run and fight
and the owl flies away.
© 2019 Starr Commonwealth - 11 -

Understand Trauma’s Impact Activity

TRAUMA activates the stress thinking brain
response. When the brain stem
is activated, do the following
physical symptoms increase
sensory brain
(s) or decrease (t)? Circle the
arrow below that applies. brain stem
s Heart rate t
s Respiration t
s Muscle Tension t When this activation lasts for LESS than

four weeks it is called acute stress.
s Blood flow t
s Coritisol t When this activation lasts for MORE than four

weeks it is called postraumatic stress.
s Adrenalin t
When stressed, the Thinking Brain: When stressed, the Sensory Brain:
r WORKS WELL or r DOES NOT WORK WELL r WORKS WELL or r WORKS OVERTIME
Name or describe three symptoms of trauma as a Name or describe three symptoms of trauma as a
result of the stress impact on the Thinking Brain: result of the stress impact on the Sensory Brain:
1. ____________________________________ 1. ____________________________________
2. ____________________________________ 2. ____________________________________
3. ____________________________________ 3. ____________________________________
Students in trauma often react by engaging in fight, flight, or freeze responses.

Describe a student experience for each of the responses in the appropriate boxes below.
FIGHT FLIGHT FREEZE

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Potential Signs and Symptoms

that May Indicate Trauma
r oss of appetite
L
r Easily startled
r Difficulty concentrating or remembering
r Frequent headaches or stomachaches
r Constant state of alert
r Diminished interest in school and activ-
ities
r Inability to experience joy or pleasure
r Self-blame or shame
r Feeling of detachment from others
r Recurrent conflicts with peers
r Irritability
r Outbursts of anger
r Trouble focusing on classwork
r Acting as if the traumatic event
were recurring

Life Events Checklist

Name Date
Instructions: Check all of the following life events that your child or adolescent has experienced.
Write down any other incidents that are not on the list that might have been traumatic for your
child or adolescent.
Home School
q Death of a family member q Behavior problem
q Domestic violence q Failing grade
q Abuse q Fight/bullying
q Neglect q Victim of bullying
q Separation/divorce q Use of drugs or alcohol
q Incarceration of a parent or sibling q Skipped school or a class
q Neighborhood violence q Death of a teacher or classmate
q Robbery or theft q Illness of a teacher or classmate
q buse of drugs or alcohol by parent/
A q Conflict with a teacher
guardian/sibling q Conflict with a classmate
q Illness of family member q Other:
q Fight with parent/guardian/sibling
q Utilities turned off
q Other:
Personal Social
q Family treatment q Argument with friend
q Psychotropic medication q Use of drugs or alcohol
q Illness q Car accident
q Cutting/self abuse q Witness to fight
q Use of drugs or alcohol q Witness to violence
q Eating disordered behavior q Trouble making friends
q Suicidal ideation q Does not get along well with others
q Intense sadness q Other:
q Intense hopelessness
q Intense anger leading to harming someone
else
q Other:
Life Events Checklist is a screening tool designed to identify potentially traumatizing events that have occurred in a
child or adolescent’s lifetime. This tool does not diagnosis PTSD, however, it does identify incidents and events a child
or adolescent has experienced that may lead to PTSD. Pack of 50 checklists. Available at https://store.starr.org.

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ACEs Questionnaire
There are 10 types of childhood trauma measured in the ACE Study. Five are personal — physi-
cal abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. Five are related
to other family members: a parent who’s an alcoholic, a parent who’s a victim of domestic vio-
lence, a family member in jail, a family member diagnosed with a mental illness, and the dis-
appearance of a parent through divorce, death, or abandonment. Each type of trauma counts as
one. So a person who’s been physically abused, with one alcoholic parent, and a mother who was
beaten up has an ACE score of three.
There are, of course, many other types of childhood trauma — watching a sibling being abused,
losing a caregiver (grandmother, mother, grandfather, etc.), homelessness, surviving and recov-
ering from a severe accident, witnessing a father being abused by a mother, witnessing a grand-
mother abusing a father, etc.
The most important thing to remember is that the ACE score is meant as a guideline: If you expe-
rienced other types of toxic stress over months or years, then those would likely increase your risk
of health consequences.

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Prior to your 18th birthday:

r No r Yes Did a parent or other adult in the household often or very often… swear at
you, insult you, put you down, or humiliate you? Or act in a way that made
you afraid that you might be physically hurt?
r No r Yes Did a parent or other adult in the household often or very often… push,
grab, slap, or throw something at you? Or ever hit you so hard that you had
marks or were injured?
r No r Yes Did an adult or person at least 5 years older than you ever… touch or fondle
you or have you touch their body in a sexual way? Or attempt or actually
have oral, anal, or vaginal intercourse with you?
r No r Yes Did you often or very often feel that … no one in your family loved you or
thought you were important or special? Or your family didn’t look out for
each other, feel close to each other, or support each other?
r No r Yes Did you often or very often feel that … you didn’t have enough to eat, had
to wear dirty clothes, and had no one to protect you? Or your parents were
too drunk or high to take care of you or take you to the doctor if you need-
ed it?
r No r Yes Were your parents ever separated or divorced?
r No r Yes Was your mother or stepmother often or very often pushed, grabbed,
slapped, or had something thrown at her? Or sometimes, often, or very
often kicked, bitten, hit with a fist, or hit with something hard? Or ever re-
peatedly hit over at least a few minutes or threatened with a gun or knife?
r No r Yes Did you live with anyone who was a problem drinker or alcoholic, or who
used street drugs?
r No r Yes Was a household member depressed or mentally ill, or did a household

member attempt
suicide?
r No r Yes Did a household member go to prison?
__________ Add up your “Yes” answers. This is your ACE Score.
Now that you’ve got your ACE score, what does it mean?
The CDC’s Adverse Childhood Experiences Study (ACE Study) uncovered a stunning link be-
tween childhood trauma and the chronic diseases people develop as adults, as well as social and
emotional problems. This includes heart disease, lung cancer, diabetes and many autoimmune

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diseases, as well as depression, violence, being a victim of violence, and suicide.

The study’s researchers developed an ACE score to explain a person’s risk for chronic disease.
Think of it as a cholesterol score for childhood toxic stress. You get one point for each type of
trauma. The higher your ACE score, the higher your risk of health and social problems.
As a person’s ACE score increases, so does their risk of disease, and social and emotional prob-
lems. With an ACE score of 4 or more, things start getting serious. As the likelihood of chronic
pulmonary lung disease increases 390 percent; hepatitis, 240 percent; depression, 460 percent;
suicide, 1,220 percent.
RESILIENCE Questionnaire
This questionnaire was developed by the early childhood service providers, pediatricians, psy-
chologists, and health advocates of Southern Kennebec Healthy Start, Augusta, Maine, in 2006,
and updated in February 2013. Two psychologists in the group, Mark Rains and Kate McClinn,
developed the 14 statements by editing suggestions from the other members of the group. The
scoring system was modeled after the ACE Study questions. The content of the questions was
based on a number of research studies from the literature over the past 40 years including that
of Emmy Werner and others. Its purpose is limited to parenting education. It was not developed
for research.
Please circle the most accurate answer under each statement:
1. I believe that my mother loved me when I was little.
Definitely true Probably true Not sure Probably not true Definitely not true
2. I believe that my father loved me when I was little.
3. W
hen I was little, other people helped my mother and father take care of me and they seemed
to love me.
4. I’ve heard that when I was an infant someone in my family enjoyed playing with me, and I
enjoyed it, too.
5. W
hen I was a child, there were relatives in my family who made me feel better if I was sad or
worried.

6. When I was a child, neighbors or my friends’ parents seemed to like me. P

7. When I was a child, teachers, coaches, youth leaders, or ministers were there to help me.
8. Someone in my family cared about how I was doing in school.
9. My family, neighbors, and friends talked often about making our lives better.
10. We had rules in our house and were expected to keep them.
11. When I felt really bad, I could almost always find someone I trusted to talk to.
12. As a youth, people noticed that I was capable and could get things done.
13. I was independent and a go-getter.
14. I believed that life is what you make it.
_________ How many of these 14 protective factors did I have as a child and youth?
(How many of the 14 were circled “Definitely true” or “Probably true”?)
_________ Of these circled, how many are still true for me?
The more resilience or protective factors you had as a child or now, the better.

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Posttraumatic Stress Disorder (DSM 5)

View Trauma as an Experience
Re-experiencing (INTRUSION – 1) Avoidance Negative Cognitions Arousal (2)
(NUMBING - 1) and Mood (2)
Flashbacks Detachment Distorted sense of self Aggression
Intrusive thoughts -images Numbing Estrangement to others Reckless behavior
Traumatic dreams OCD like behavior Markedly diminished Self-destructive and

Phobic like behavior interest rule-breaking
behaviors
Sleep problems Self harm Depression Hypervigilence
Physical complaints Substance abuse Blames self or others Irritability
Eating disorders Inattention
Not wanting to talk Cognitive/learning

about it problems
ACTIVITY: Connections Assessment
• First, either list the names or place photographs of every child in your school,
grade or classroom on the walls of the school cafeteria or gymnasium.
• Then, invite all staff members (not only teachers) and consistent parent help-
ers to walk around the room and place a sticker or check mark next to every
child’s name or photograph with whom they feel they have a connection.
• Afterwards, identify kids who are without connections or have little connec-
tions and assign a few staff members to each of these children. Encourage
staff to make a point to say hello and greet these kids as often as they can
during the school year. Almost every day is ideal. The goal is to make every
child feel like an adult, or several adults, notice them and are excited to see
them in class, in the hallway, or at school events. The kids with little or no
adult connections are the ones who need connections most. The caring adults
in your school are the perfect people to help increase the overall school con-
nectedness that children experience.

Trauma and Attachment

Children who have experienced
developmental trauma have a
chronic feeling of disconnect or
“not belonging” and this leads to
masking of their symptoms be-
cause they have a desire to
fit in.
Bids for Connection

We know how much stress changes the brain...
So do acts of caring, teaching, learning, and love! Kids learn and grow when meaningful connec-
tions are made with trusted adults. Like a tennis match... serve and return...accept and make
bids to connect. Repeatedly!
4:1 Interactions Ratio

Increase the number of positive interactions with students
instead of negative interactions. The critical ratio is 4:1.
Positive interactions include:

• F riendly conversation
• N onverbal acknowledgment
• P raise vs. criticism
Negative interactions include:

• P
unishment
• N
egative or non-existent nonverbal
actions toward student
It is not about compliments but about improving the rela-

tionship.
Increasing connectedness:
• Improves positivity
• H elps student feel engaged
• Increases motivation
• P romotes academic achievement and regulated
behavior

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Fostering Connections
Name 3 kids you are solidly connected to.
What specifically makes you believe they feel the connection too?
Now, name 2 kids you know in your classroom/your school who could benefit
from a connection with you or a peer.
What are 3 ways you can make a bid to connect with these kids?

Emotional Awareness
Sensations
Feeling Sensation in Body

Sad
Anger
Worried
Tired
Excited
Calm

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Body Scan

Time In vs. Time Out

Time In Time Out
Kids act out because they Kids act out because they
NEED attention WANT attention
Time together Time apart
Give attention, connection Withdraw attention, disconnect
Opportunity to learn No opportunity to learn
Adult is there to help child regain Child is left to regain regulated state on their
a regulated state own
Growth, empowerment, acceptance Punitive, shame, rejection

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Turning Routines into Rituals

What are ways you can turn your school routines or schedule into a ritual?
Write them in the chart below.
Routine How to Make It Into a Ritual

Vulnerable Times for Feeling Unsafe at School
Riding the
Walking in the Hall
bus
Start of Day
Recess Other
Other
Lunch
Do they have a friend
Other to eat lunch with?
Point System
A stick is turned,
a color used,a point lost
Changing Class-
Other
rooms End of Day
Other Other
What are you doing today to make these times safer?
What are the things your school could do better?

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Top Ten Fears

What do you think are the top 10 fears for children ages 6-14?
1. ______________________________________________
2. ______________________________________________
3. ______________________________________________
4. ______________________________________________
5. ______________________________________________
6. ______________________________________________
7. ______________________________________________
8. ______________________________________________
9. ______________________________________________
10. _____________________________________________

Impact of Safety at School

Many children in the United States do not grow up in
homes that are fully protective, do not experience a safe
and supportive neighborhood, and do not think that
their school is a safe school.
Yet, when they do think their school is a safe school,

the positive effect is profound regardless of the
other adversities the child experiences.

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ACTIVITY: Create a Brain Break Calendar

Use the calendar template on the next page and write in at least one brain break for every day on
the calendar.
Ideas to include:
• Give your class a riddle or tell a joke
• Play Simon Says
• Doodle for 5 minutes
• Do 25 jumping jacks
• Play Rock Paper Scissors
• Dance to a top 40 hit

Brain Break Calendar

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What is childhood trauma?

Childhood trauma refers to
traumatic experiences
that happen between
the ages of 0–17.
These traumatic experiences

can be the result of intentional
violence—such as physical
or sexual abuse or domestic
violence—or the result of a
natural disaster, accident, or
war.1
When a trauma happens,

the child is overwhelmed by
terror and can experience a
prolonged heightened state
of alertness, stress, or
persistent fear for his or
her safety.
Starr Commonwealth
13725 Starr Commonwealth, Albion, Michigan 49224
info@starr.org | www.starr.org

How common is it?
Childhood trauma is more prevalent than many

people realize and often has long-lasting effects.
26 %
of children in
the U.S. witness or
60 %
of adults say
they experienced abuse
experience a traumatic or other traumatic
event before they family events in their
turn four years old.2 own childhoods.2
11 %
of girls ages 14 to 17
41 %
of youth under 18
reported experiencing reported experiencing
sexual assault or abuse a physical assault in the
during the past year.3 last year.3
14 %
of children have
70 %
of children living in
experienced abuse by a poor inner-city
caregiver.3 neighborhoods are
exposed to trauma.4

starr.org
How is learning affected?
Childhood trauma can negatively impact learning

and behavior because of the way terror and fear
create changes in the brain. Following exposure
to a traumatic experience, survivors may become
frozen in a heightened state of alertness or have
a persistent fear for their safety.
Without trauma intervention, research has shown
that these emotional states alter brain function
and the student’s ability to process information.
This leads to difficulty in:
Processing verbal information
Following teacher directions

Focusing
Recalling what was heard
Retaining information

Additionally, these cognitive

deficits may result in:
Low
self-esteem
Poor problem solving
Increased truancy
Behavior issues
Hopelessness
Increased peer conflict
Increased dropout rates

starr.org
How to recognize if a child may

have experienced trauma
Watch for these signs:
• Loss of appetite
• Easily startled
• Difficulty concentrating or remembering
• Frequent headaches or stomachaches
• Constant state of alert
• Diminished interest in school & activities
• Inability to experience pleasure or joy
• Self-blame or shame
• Feeling of detachment from others
• Recurrent conflicts with classmates
• Irritability or outbursts of anger
• Trouble focusing on classwork
• Acting as if the traumatic event were recurring 5
What happened?
Where’s the happy,
confident student
we knew?

What can you do?
Don’t assume a child showing

signs of trauma will be okay if
left alone. Being an advocate
for the child is vital. Without
treatment, the damage done
by childhood trauma can last
a lifetime—with consequences
as serious as a risk of suicide
that is 15 times higher than that found in the general
population.
The goal is to help move the children who have experienced
trauma from “victim thinking” to “survivor thinking,” which
leads to empowerment, choice, active involvement in their
own healing process, and a renewed sense of safety and hope.
Educators and school professionals are encouraged to learn
about how trauma impacts learning so that they are able
to provide trauma-specific intervention(s). This will help
minimize the learning and behavioral difficulties that can
‘‘
result when the needs of trauma victims go unrecognized or
ignored.
If you don’t think what I think ... feel what I feel ...
see what I see when I look at myself ...
‘‘
how can you help me?

starr.org
Starr can help
Starr Commonwealth was founded in 1913 and is

dedicated to creating positive experiences so all
children, families, and communities can flourish.
Utilizing positive, strength based programs, Starr
leads with courage to provide school professionals,
crisis intervention teams, medical and mental health
professionals, childcare professionals, community
leaders, and more, the training and resources needed
to help children, parents, families, and schools thrive.
Starr’s resilience-focused certification programs,
conferences, books and online courses provide
thousands of professionals annually the tools
necessary to recognize trauma and build resilience
in individuals they serve.
Books & Interventions

MORE One-Minute Interventions
FOR TRAUMATIZED CH ILDREN AND ADOLESCENTS
eLearning Courses
Professional Certification
Caelan Kuban, PsyD, LMSW, CTC-S
Sarah Slamer, MA, LLPC, CTC-S
Training at your organization
Accreditation & Consulting

Starr’s SITCAP®
Starr’s revolutionary approach leads the field in the

treatment of childhood trauma: Structured Sensory
Interventions for Traumatized Children, Adolescents,
and Parents (SITCAP®)
Our SITCAP® programs give children and adolescents the
opportunity to safely revisit and rework the primary subjective
experiences of their traumas within the sensory context in
which they are experienced, stored, and remembered. PTSD
symptoms, grief, and trauma-related mental health reactions
can be significantly reduced, the gain sustained, and
resilience developed and strengthened in ways that support
growth.
Want to know more?

Visit starr.org
Email info@starr.org
Call 800.837.5591
www.weareteachers.com

starr.org
10 Things About Childhood Trauma

Every Teacher Needs to Know
With grief, sadness is obvious. With trauma, the symptoms can go largely unrecognized because
they show up looking like other problems: frustration, acting out, difficulty concentrating, fol-
lowing directions or working in a group. Often professionals misdiagnose students with anxiety,
behavior disorders or attention disorders, rather than understanding the trauma that’s driving
those symptoms and reactions.
For children who have experienced trauma, learning can be a big struggle. But once trauma is
identified as the root of the behavior, we can adapt our approach to help kids cope when they’re
at school. Chief Clinical Officer and Senior Trainer at Starr Commonwealth, Dr. Caelan Soma of-
fers these tips for understanding kids who have been through trauma, plus strategies for helping
them.
1. Kids who have experienced trauma aren’t trying to push your buttons.
If a child is having trouble with transitions or turning in a folder at the beginning of the day,
remember that children may be distracted because of a situation at home that is causing
them to worry. Instead of reprimanding children for being late or forgetting homework, be

affirming and accommodating by establishing a visual cue or verbal reminder to help that
child. Switch your mind-set and remember the kid who has experienced trauma is not trying
to push your buttons.
2. Kids who have been through trauma worry about what’s going to happen next.
A daily routine in the classroom can be calming, so try to provide structure and predictability
whenever possible. Since words may not sink in for children who go through trauma, they
need other sensory cues. Besides explaining how the day will unfold, have signs or a story-
board that shows the sequence of activities—math, reading, lunch, recess, etc.
3. Even if the situation doesn’t seem that bad to you, it’s how the child feels that
matters.
Try not to judge the trauma. As caring teachers, we may unintentionally project that a situa-
tion isn’t really that bad, but the way the child feels about the stress is what matters most.
We have to remember it’s the perception of the child … the situation is something they have
no control over, feeling that their life or safety is at risk. It may not even be just one event,
but the culmination of chronic stress—for example, a child who lives in poverty may worry
about the family being able to pay rent on time, keep their jobs, or have enough food. Those
ongoing stressors can cause trauma. Anything that keeps our nervous system activated for
longer than four to six weeks is defined as post-traumatic stress.
4. Trauma isn’t always associated with violence.

Trauma is often associated with violence, but kids also can suffer trauma from a variety of
situations—like divorce, a move, being over scheduled, or bullied. All kids, especially in this
day and age, experience extreme stress from time to time. It is more common than we think.
5. You don’t need to know exactly what caused the trauma to be able to help.
Instead of focusing on the specifics of a traumatic situation, concentrate on the support
you can give children who are suffering. Stick with what you are seeing now—the hurt, the
anger, the worry, rather than getting every detail of the child’s story. Privacy is a big issue in
working with students suffering from trauma, and schools often have a confidentiality proto-
col that teachers follow. You don’t have to dig deep into the trauma to be able to effectively
respond with empathy and flexibility.
6. Kids who experience trauma need to feel they’re good at something and can influ-
ence the world.
ind opportunities that allow kids to set and achieve goals, and they’ll feel a sense of mas-
F
tery and control. Assign them jobs in the classroom that they can do well or let them be a
peer helper to someone else. Set them up to succeed and keep that bar in the zone where
you know they are able to accomplish it and move forward. Rather than saying a student is
good at math, find experiences to let him or her feel it. Because trauma is such a sensory

starr.org
experience, kids need more than encouragement—they need to feel their worth through con-
crete tasks.
7. There’s a direct connection between stress and learning.

When kids are stressed, it’s tough for them to learn. Create a safe and accepting environment
in your classroom by letting children know you understand their situation and support them.
Kids who have experienced trauma have difficulty learning unless they feel safe and support-
ed. The more the teacher can do to make the child less anxious and have the child focus on
the task at hand, the better the performance you are going to see out of that child. There is a
direct connection between lowering stress and academic outcomes.
8. Self-regulation can be a major challenge for students suffering from trauma.

Some kids with trauma are growing up with emotionally unavailable parents and haven’t
learned to self-soothe. These children may develop distracting behaviors and have trouble
staying focused for long periods. To help them cope, schedule regular brain breaks. Tell the
class at the beginning of the day when there will be breaks—for free time, to play a game, or
to stretch. If you build it in before the behavior gets out of balance, you set the child up for
success. A child may be able to make it through a 20-minute block of work if it’s understood
there will be a break to recharge before the next task.
9. It’s okay to ask kids point-blank what you can do to help them make it through the
day.
For all students with trauma, you can ask them directly what you can do to help. They may
ask to listen to music with headphones or put their head on their desk for a few minutes. We
have to step back and ask them, ‘How can I help? Is there something I can do to make you
feel even a little bit better?’
10. You can support kids with trauma even when they’re outside your classroom.
Loop in the larger school. Share trauma-informed strategies with all staff, from bus drivers
to parent volunteers to crossing guards. Remind everyone that the child is not their behavior.
Typically there is a wound underneath that drives the behavior to happen, so be sensitive.
Ask yourself, “I wonder what’s going on with that kid?” rather than saying, “What’s wrong
with that kid?” This will mark a huge shift in the way we view kids.

Childhood Trauma
Expert Answers
to Tough Questions
from Real Teachers
When kids in our classrooms are hurting from traumatic experiences like divorce, bullying, and
abuse, we want to help—but it can be hard to know just what to say or do. We collected real
questions from teachers in our Facebook community about these tough situations and asked
trauma expert Dr. Caelan Soma, Chief Clinical Officer and Senior Trainer at Starr Commonwealth,
to share her best advice.
Q: How can I help my first grade student thing you can do. The child will benefit most
whose family is going through a really difficult from consistency and routine in the class-
divorce? I am seeing regression in my student room. Try to give your student ways to calm
and a lot of anxiety around pickup and drop- down on a sensory level—like breathing or
stretching—to work through anxiety she may
off, and I want to approach her parents in a
be feeling from home. While it may be frus-
useful and non-confrontational way. trating that you can’t control what happens
when your student leaves your classroom, you
A: Divorce is tough on students when they’re can feel good about the fact that the strate-
at home and at school, and your student is gies you teach your student to use at school
lucky to have a teacher who recognizes this can also be used to help her deal with the
and wants to help. Let the parents know you stress she experiences at home.
are noticing changes. Don’t bring up the
divorce. Focus on the child and what you
are seeing in class. If they tell you about the Q: How can I support my sixth grader whose
divorce, you are in the know, but don’t specu- grandmother just died? They were very close,
late. This will make the parent feel defensive and he just can’t seem to focus in class and is
and view you as placing blame rather than so withdrawn that I’m worried about him. How
trying to help. Instead, ask them what behav- should I react? At what point do I contact a
ior they’re seeing at home. Ask if there is any-

www.starr.org
counselor or call a parent?

Q: We had a 14-year-old girl in our school
A: Teachers are such caring individuals, and commit suicide, and everyone is in shock. How
it’s so hard when they have constant worries can I help my students get through this? This is
about one of their students. While it may look the second suicide of a young girl this year.
like an oppositional behavior, your student
may just need time to heal and to know you
understand. You can normalize the reaction A: It can be very upsetting for both teachers
by telling your student, “I get it. It’s hard and students when a student commits sui-
to pay attention. It’s going to come out of cide. There is a lot of concern that talking
nowhere and you’re going to feel sad.” Give about suicide and how it happened will lead
your student the OK to tell you if he needs to to “contagion”—making other kids do it—but
get a drink or put his head down during the there is no research to back up that worry. For
day. Let his parents know about the chang- many kids, it’s the opposite, and for them,
es and tell them you will keep in touch to it’s better to talk about the situation. But re-
update them on whether things are improving member reactions vary. The event will be very
or not. A school counselor may be helpful, upsetting to some of your students and not to
but you don’t need to move to an intervention others. We have to respect all symptoms and
until the normal grief response period of six reactions. There is a continuum and everyone
to eight weeks has passed. Generally, with is going to be on a different page. Schools
emotional support at home and at school, a can offer an outlet for kids who are having
grieving child’s heart will heal significantly the hardest time coming together to process
during that time period. the event, but no one should be required to
talk about it. Make it optional. It’s best, too,
that memorials—for any death—take place
Q: How can I help a second grader in my class outside of school for the same reason. Stu-
who comes in from recess most days on the dents should have the choice to participate.
verge of tears because of bullying on the play- It has nothing to do with disrespecting the
ground? I’ve not seen it in my classroom, and family or not caring, but it has everything to
he hasn’t confided in me. do with respecting everybody else. When you
respect and honor each student’s individual
A: Thank you for keeping your eyes and ears reactions, you help create a supportive envi-
open to potential bullying in your school. It’s ronment that allows everyone to process and
best to address the problem head-on. Ask the heal in his or her own way.
student and others, such as the recess moni-
tor, what is happening. Link the student with Q: I have a fifth grader who has been placed
a peer buddy and an adult he feels safe going
in three different foster homes in the past
to or giving a signal to when he is not having
year. What can I do to help him stay on track?
a good day. The code can be a wink or a silly
word to alert someone he needs support. His home life is so unstable, and I can see it’s
Bullying doesn’t have to be violent. It can be affecting him at school too.
a look or a whisper. While it might not seem
traumatic to adults, peers are the center of A: It’s really hard for a teacher to see a
kids’ lives, and their non-acceptance can student bounced around from foster home to
be traumatic. Intervene before the situation foster home. The best thing you can do is to
spirals into something that’s out of control, be the constant, stable person in your stu-
and you’ll be able to help your student on the dent’s world—and sometimes that’s enough.
road to happier days at school. You don’t have control of what goes on out-

side your classroom. To have one consistent, Q: I’m in my second year teaching middle
caring adult in the life of a child—even if school, and both years I’ve had a student in
it’s not a caregiver or a parent—is one of the my class find out she’s pregnant. How can I
most beneficial characteristics of building support these girls? What do they need to hear
resilience.
from me? It’s such a sensitive situation.
Q: I’m having trouble connecting with one of A: Teen pregnancy can be an overwhelming
my third graders whose family is homeless experience for these girls, but having a teach-
and lacks support at home. What can I do? Her er like you who cares about their education
mother is so overwhelmed that she basically can be invaluable. Treat the girls who are
pregnant like the rest of the girls in the class.
told me she didn’t have energy to help her
Do acknowledge that they are pregnant, but
daughter or care how she is doing in school. I don’t make a big deal about it. Be proud of
want to engage and motivate my student, but them for coming to class. When they know
the mom’s attitude is rubbing off on my stu- their teacher thinks it’s brave for them to
dent. stay in school, they’ll be more likely to keep
coming to class.
A: When parents aren’t emotionally available
to support the positive things happening in Q: How do I make school a safe place when I
the classroom, it can be really frustrating teach in one of the most dangerous cities in
for teachers. It usually helps to shift the
the country? It seems like there’s not a week
lens away from what you think is wrong with
that goes by when the students aren’t telling
the mom to look at what’s happening in her
world. The mom is in crisis and survival me about a stabbing or drive-by shooting. How
mode. Likely, she does care, but her priority do I help my students cope with ongoing news
is finding a place to live. Find a time to talk of student deaths as the result of violence and
to her informally and briefly—no need for gang activity? What can I do to create a safe
a big meeting, which could make her feel environment for them at school?
uncomfortable and defensive. Reframe the
experience, rather than putting the blame A: It’s so tough for caring teachers to know
on the mom. Tell her you know it’s a tough they can’t control what’s happening to their
time and validate her feelings. Say to her, “I students outside the classroom. The best
know you care. You just have so much going thing you can do is be consistent inside your
on now, but your daughter needs you to tell classroom. Have routines and try to connect
her you care and school is important.” Then with students. You may hear students say,
ask how you can help. Separately, tell your “What’s the point?” Engage them in activities
student that you understand her mom is that allow them to feel some sense of hope—
working hard, and it might not seem like she even if it’s just talking about activities in the
cares, but she really does—and so do you. near future that they are looking forward to
Ask her how you can help. You may need to doing. Allow for movement and physical-ac-
modify homework expectations or set up a tivity breaks in the classroom, so they can
peer support person to help her with assign- have some fun. Encourage them to seek out
ments. The support and understanding you safe places, and become an advocate for af-
give to the parent and the student will help ter-school programs, clubs, and equipment in
everyone connect and motivate your student the parks. Your encouragement and effort will
to succeed. go a long way in helping them stay away from
situations that may put them in harm’s way.

www.starr.org
Q: How can I support a high school student may feel like a difficult conversation to have
whose mother has terminal cancer and is in with a student, it will help her—as well as the
hospice care? What is the right thing to say to rest of your class—feel safe and supported.
him? How can I accommodate him?
Q: I have a second grader who was sexually
A: Your student is lucky to have a compas- abused by her uncle, and I fear for her safety.
sionate teacher who wants to say the right What should I do? She tells me her family still
thing. You can let the student know you sees him—even at their house, and I’m worried
understand his mom is sick and you are avail- about the situation.
able to talk. Ask if there is someone to sup-
port him at home. Sometimes all the focus A: Thank you for being concerned and asking
shifts to the sick person, but others in the this important question. You should contact a
family suffer and there is some unintentional school social worker and the principal. If you
neglect. Pay attention to changes in academ- know this information, you are a mandated
ics or behavior and make an accommodation reporter. If the child is at risk of harm, you
if needed. Your caring support will be a bright need to report it to be investigated. That’s a
light for this student during a very difficult serious situation, and you can help your stu-
and sad time in his life. dent greatly if you get the appropriate people
involved as soon as possible.
Q: A tenth grade girl in my class was physi-
cally abused by her dad. How do I balance her Q: How do I handle one of my special ed stu-
need for support with the comfort level of her dents in ninth grade with behavioral difficul-
classmates? She’s been sharing a lot of details ties who had a close friend who was murdered?
with other kids in class, and I can see it’s mak- He’s sharing some pretty intense emotions in
ing them feel uncomfortable. I want to support class, and I can’t imagine how difficult it must
her, but I also want to help her understand be for him to process.
when it is appropriate to share..
A: Especially when teachers are working
A: This type of situation can leave teachers with special education students, it can
feeling torn: You want to help the student be hard to know when to draw the line.
who is suffering, but you also want to make The classroom isn’t the best place for
sure the other students are comfortable in
the student to share the details of what
your classroom. It’s best to be direct. You
happened. Sometimes we see acting-out
want to protect the girl who was abused, but
you also need to protect the other kids. Take behavior as that becomes the only way
her aside discretely and let her know it’s ap- the student is able to communicate their
propriate to share with a very close friend who anger and frustration. But if the child is
desires to listen, a teacher or counselor, but risking his safety or the safety of others,
it is not appropriate to share with everyone. he should not be in the classroom. If it’s
When other students hear the details, they to that level, it’s escalated and it’s too
may perceive it can possibly happen to them, much. In that case, the student definite-
which can cause post-traumatic stress reac- ly needs to be linked with a professional
tions in those students too. It doesn’t have and removed from the classroom if safety
to actually happen to them for it to worry
is an issue. To best help this child, you
them. If other kids are complaining, let them
should follow your school’s protocol for
know they can come to you if she shares too
much with them. They have a right not to be handling the behavior.
exposed to the discussion. Even though this

Q: What should I do to work through my fourth A: When an event such as a natural disaster
graders’ grief over a student in our school who occurs and is so widespread that it affects
was killed in a car accident recently? Many of the entire community, there can sometimes
my students have never known anyone who be a long period of transition where people
are out of sorts. Acknowledge to your class
died—let alone someone their own age.
that things are not like they were and it may
be rocky. As people rebuild or another storm
A: When tragedy strikes a community, it can
comes, memories can resurface along with
affect the children in your classroom, and it
feelings of stress. Natural disasters are so
can be tough on teachers too. People are of-
difficult because they affect so many people
ten really curious to know the details. By giv-
and they are unknown. It can lead to a chron-
ing the facts, you can reduce the rumor mill.
ic state of stress that may last up to a year as
It’s important for some brief notification to go
the family resettles, but your constant caring
out from the superintendent or principal that
and support will make this time a lot easier
tells the community what happened—only
on your students.
to the point the family approves. Some kids
will have more questions than others, and
As teachers, we want to do whatever we can
it’s best to tailor your answer to their level of
to help our students who are suffering. Many
curiosity. These events can sometimes make
times, however, the situations your students
people feel helpless, and they want to do
experience are so complicated, the best thing
something to respond. Ask students if they’d
you can do is be there to listen. Caring can
like to make cards for the family to send their
be more powerful than any academic lesson
condolences, which is a compassionate way
and may be just what a child in trauma needs
to support the family and help your students
most.
positively express their emotions.
Q: Our community just experienced a tornado.

How can I help my students get through this
rough time and feel secure again? Many of my
students are struggling in temporary housing.
Others are scared whenever the sky looks
threatening.

www.starr.org
Resources
ACEs Connection Network - Join the movement to prevent ACEs, heal trauma and build resilience
www.Acesconnection.com
Prevent Child Abuse - The Paper Tigers Project

www.preventchildabuse.org/take-action/papertigers
ACEs Too High News - Find your ACE and resilience scores
www.acestoohigh.com/got-your-ace-score
Play Resources
Maker Spaces and Fab Labs
http://www.fabfoundation.org
Makerspace Playbook
https://makered.org/wp-content/uploads/2014/09/Makerspace-Playbook-Feb-2013.pdf
Science through inquiry

https://www.exploratorium.edu
Arts Integration
http://capechicago.org/arts-integration/
Footnotes
1. National Child Traumatic Stress Network, “Early Childhood Trauma” (http://www.nctsn.org/trauma-

types/early-childhood-trauma)
2. National Center for Mental Health Promotion and Youth Violence Prevention, “Childhood Trauma
and Its Effect on HealthyDevelopment,” July 2012 (http://www.promoteprevent.org/sites/www.
promoteprevent.org/files/resources/childhood%20trauma_brief_in_final.pdf)
3. JAMA Pediatrics, “Violence, Crime, and Abuse Exposure in a National Sample of Children and
Youth,” May 2013 (http://www.unh.edu/ccrc/pdf/05-13%20PED%20childhood%20exposure%20
to%20violence.pdf)
4. Family–Informed Trauma Treatment Center, “Understanding the Impact of Trauma and Urban
Poverty on Family Systems: Risks, Resilience and Interventions” (http://www.nctsnet.org/sites/
default/files/assets/pdfs/understanding_the_impact_of_trauma.pdf)
5. Starr Commonwealth, “Common Trauma Reactions,” Oct. 2013 (https://www.starr.org/research/
common-trauma-reactions)


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TRAUMA-INFORMED

DRIVEN TO HEAL STARR.ORG

Starr’s Professional Training and Coaching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

© 2019 Starr Commonwealth -1-

10 Steps to Trauma-Informed Schools

-2- © 2019 Starr Commonwealth

Starr's Core Values and Beliefs

© 2019 Starr Commonwealth -3-

Core Values and Beliefs

-4- © 2019 Starr Commonwealth

The presence of a strong sense of belong- In contrast to obedience models of disci-

“The developmental needs of children are universal.”

© 2019 Starr Commonwealth -5-

What does research tell us today?

Four Main Protective Factors for Resilient Children

1. Supportive adult-child relationships

-6- © 2019 Starr Commonwealth

Trauma is any experience that leaves a person

We can experience trauma in many ways. The

• Victim (abuse, neglect, car accident)

-8- © 2019 Starr Commonwealth

About Developmental Trauma Disorder

Proposed by Robert Pynoos and Bessel van der Kolk

Activity: The Animals Inside Me

- 10 - © 2019 Starr Commonwealth

© 2019 Starr Commonwealth - 11 -

Understand Trauma’s Impact Activity

s Muscle Tension t When this activation lasts for LESS than

s Coritisol t When this activation lasts for MORE than four

Students in trauma often react by engaging in fight, flight, or freeze responses.

FIGHT FLIGHT FREEZE

- 12 - © 2019 Starr Commonwealth

Potential Signs and Symptoms

© 2019 Starr Commonwealth - 13 -

Life Events Checklist

- 14 - © 2019 Starr Commonwealth

© 2019 Starr Commonwealth - 15 -

Prior to your 18th birthday:

r No r Yes Were your parents ever separated or divorced?

r No r Yes Was a household member depressed or mentally ill, or did a household

r No r Yes Did a household member go to prison?

__________ Add up your “Yes” answers. This is your ACE Score.

- 16 - © 2019 Starr Commonwealth

diseases, as well as depression, violence, being a victim of violence, and suicide.

Please circle the most accurate answer under each statement:

1. I believe that my mother loved me when I was little.

2. I believe that my father loved me when I was little.

© 2019 Starr Commonwealth - 17 -

6. When I was a child, neighbors or my friends’ parents seemed to like me. P

8. Someone in my family cared about how I was doing in school.

13. I was independent and a go-getter.

14. I believed that life is what you make it.

- 18 - © 2019 Starr Commonwealth

Posttraumatic Stress Disorder (DSM 5)

Intrusive thoughts -images Numbing Estrangement to others Reckless behavior

Traumatic dreams OCD like behavior Markedly diminished Self-destructive and

Physical complaints Substance abuse Blames self or others Irritability

Eating disorders Inattention

Not wanting to talk Cognitive/learning

ACTIVITY: Connections Assessment

© 2019 Starr Commonwealth - 19 -

Trauma and Attachment

Bids for Connection

• Victim (abuse, neglect, car accident)

r No r Yes Were your parents ever separated or divorced?

r No r Yes Was a household member depressed or mentally ill, or did a household

r No r Yes Did a household member go to prison?

__________ Add up your “Yes” answers. This is your ACE Score.