Dealing with the Impact of Early Childhood PTSD
In the previous Newsletters we discussed stress and early childhood trauma, in this essay we will link these issues to help teachers cope with these students in class. To do this it is important to appreciate that teachers have to deal with the results of the disabilities generate in their classroom. Even if only one student is suffering from the effects of early childhood Post-Traumatic Stress Disorder (PTSD) the potential impact their behaviour can generate on the other students is significant.
Over the years there have been a succession of intervention programs that have been designed to help teachers deal with the dysfunctional behaviours experienced when these damaged students attend the classroom. All of these have some value and experienced teachers learn to take a pragmatic approach when applying the tactics described. The latest of these types of approaches come under a methodology described as ‘trauma informed’. The Department of Education, NSW has an excellent publication called ‘Trauma-informed practice in schools: An explainer’ which provides a thorough description of both the causes and approaches teachers can take to deal with the resulting disordered behaviours. However, and this is where our approach differs significantly from other programs, the cognitive damage that drives these dysfunctional behaviours resides within the student’s brain, ingrained in their cerebral belief systems. To change these structures requires a significant intervention over a substantial period of time by a highly trained mental health worker. This is not practical nor ethically acceptable for teachers who have to deal with these students for relatively short periods of time in a setting that has to cater for the needs of up to twenty-nine other students.
[A Note: Our approach is to help teachers control what they can, the external environment of the classroom in a way that minimises the impact of excessive stress on the behaviour of students and the teacher. This philosophy will lie behind all our future work.]
Add to this is the geographical disproportionate rates of lost learning this disability afflicts on our society. It is generally estimated that between 1% and 11% of the population will suffer PTSD resulting from childhood trauma and in some low socio-economic areas, the proportion can be up to 26%. This means that in a class of thirty students a teacher may have between zero students with these behaviour problems or up to eight who are suffering from PTSD. Not only will these disabled students’ behaviour impede their classmates’ learning but they will also have a cumulative effect on each other. This distribution becomes more concentrated when you consider the number of students who attend private schools that do not enrol students with disrupting behaviours so the ratios would be higher than those estimated above in certain areas.
Another issue is predominantly these behaviours are carried out by boys, approximately 80% of referrals to special settings and suspension data along with proportion of adults in incarceration supports this tendency; males act out and females internalise.
There is a real difference of expression between the genders which appears when the students begin to be emotionally aroused. The boys resist the threatening characteristics of the environment while the girls become compliant. The simple answer to conclude that these behaviours are cultural and historical, females have learned to stay quiet about how they feel and suffer in silence while the boys fight back. However, there is an alternative explanation of these disproportionate numbers. This is based on the work of the anthropologist Louis Leakey who concluded that once humans became the apex species the main threat to survival was attacks from another tribe. In the event of such battles, males had a greater chance of survival if they act-out, fought the invaders or ran to safety; that is they took action. Such a response was not as effective for females and children. They were more likely to survive if they surrendered or dissociated; they would be taken as trophies, it was a preferred action to survive (for a more detailed discussion about Dissociation see Newsletter 67 – Dissociation - 29 October 2018).
The graph below illustrates the impact that increased levels of stress has on the behaviour of students.
This particular graph is based on the work of Bruce Perry well known psychiatrist who has been at the forefront of research into the impact of abuse on the cognitive development of children. It can be seen that as the level of stress increases (the ‘X’ axis) the mental state (the ‘Y’ axis) ‘escalates’ from being able to think in an abstract manner, the style of engagement we want in our classroom up until the boys are ‘out of control’ and the girls are suffering a mini psychotic episode, a condition where nothing is learned.
If you examine this graph you can see how the stress controls the area of the brain we access to survive. This represents a fear response, the fight/flight/freeze explains the protective behaviours likely to be observed. There is a similar impact on behaviour when students’ stress levels are elevated because they can’t get their needs met. Of course, this model reflects the propensity of genders, there are plenty of students who will react contrary to this portrayal, the girls will act out and the boys internalise.
In the illustration below it can be seen that at any given level the teacher believes they are ‘engaging’, that is they are influencing their level of arousal, the student reaction will vary. This is another version of the importance of the inverted ‘U’ curve discussed in a previous Newsletter (The Importance of Stress - Tuesday March 1 2022). The difference is that in what appears to be an unacceptable level of classroom arousal will terrify Student 1 while hardly disturbing Student 3 who finds the chaotic lesson reflects their childhood environment. In a sense they are happier when things appear to be out of control.
Another extremely important consideration is the impact increased stress has on decision making. Many of the behaviour management programs offered to schools are based on the use of some type of cognitive intervention. The classic is the once popular ‘Stop -Think – Do’ program created by Lindy Petersen an Australian clinical psychologist specialising in behaviour management of students. The approach is to teach the students to stop before they react to a situation and then think about the consequences of their automatic behaviour and compare this to a more functioning response and then do what is best! This makes sense to everyone and when it is discussed in the school counsellor’s office the projected long-term outcomes will be appear to be excellent. But, back in the classroom, when the student is confronted and they become highly aroused this idea of delaying any attempt to protect themselves is ineffectual. The table below illustrates the impact stress has on our cognitive functions including our consideration of long-term outcomes.
It can be seen that as the level of threat increases the reference to future consequences becomes increasingly less considered.
It is obvious that the levels of stress initiate descending levels of our cognitive functions and in the case of the students with extreme disordered behaviours we work with, any elevated stressful environmental conditions will access entrenched belief systems that drive their reactions. The most effective and attractive approach would be to change these belief systems however this process is extraordinarily difficult for a practicing mental health worker dealing with the student in a one-to-one environment over an extended period of time. Such an approach is not available to a teacher who is not a trained mental health worker, does not have the luxury of dealing with the student individually over a period of time. Our only chance to improve the learning outcomes of all our students is to focus on the other side of the ‘equation’ and that is to control the level of stress in the classroom.