In October 2020, we started a series on becoming a trauma-informed educator with a list of tips. One take-away message was that being trauma-informed requires change in the educator’s mindset. However, our list is by no means a set of instructions. Adverse Childhood Experiences (ACEs) and toxic levels of stress can affect normal child development and compromise the child’s cognitive functions and emotional regulation. Positive experiences in education settings and a caring caregiver or educator can have a buffering effect on the amount of stress a child experiences, potentially preventing and even healing trauma.
This week, we will explore some frequent myths about trauma-informed education.

1. “Trauma-informed education is about fixing children.”

That’s a common misconception. Trauma-informed approaches in healthcare or education (and in general, actually) are not about fixing. They are about being aware that you are in contact with someone who might have faced or might still be facing toxic stress and trauma. We do not necessarily have to know the student’s background in order to set up interventions. Children do not need to be fixed. Children can become resilient; they can learn strategies and techniques to cope with trauma. Our job as adults is to teach them the strategies needed to build resilience and to instill in them hope, not to fix them.

2. “Trauma-informed education means that there will be no boundaries in the classroom. The students will experience no consequences for their inappropriate behaviours.”

Quite the opposite actually! Traditional discipline techniques using punishment, rewards, forced compliance, and consequences imply that children misbehave and do so intentionally. The idea is that the behaviour stands on its own and children need to be either coaxed or coerced into showing appropriate behaviours. Trauma-informed practices aim to foster relationships and connection. Children then become socially competent, joyfully creative, and then constructively cooperative for individual and shared goals when they feel safe and secure with the adults around them. This will tremendously help you as an educator in establishing group dynamics that allow all children in your class to feel motivated to try and reach their learning goals.
This does not mean that you will never intervene when students show inappropriate behaviours. Responding in a trauma-informed way would mean that you would first observe the incident (what is happening?). Then you would ask yourself what happened before the inappropriate behaviour took place (what triggered it?). Next, you would think of the consequences it should have (how can I correct this?).

3. “Becoming trauma-informed means that I need to invest a lot of time to learn new theories and approaches and re-evaluate my whole teaching style. I don’t have time for that!”

The heart of trauma-informed approaches is responding with compassion and kindness. For trauma-informed education this means that you respond to all students from a place of understanding and empathy. Many trauma-informed professionals mention that once they got exposed to this approach, they started seeing everything through a trauma lens. Many of the behaviours they were observing, which sometimes seemed out of place or inexplicable, were now understandable. They learned to see that behaviour comes from an emotion and that the emotion is a representation of an underlying (mostly unmet) need. Reading books and articles and exposing yourself to trauma-informed theory and practices is encouraged for your professional development. However, remembering the core elements of this approach and looking through your trauma lens are tools that do not need much reading, as they mostly need practice.

4. “I cannot be trauma-informed on my own! We need an approach that involves the whole school. Change comes from above.”

All of this information may sound overwhelming, especially if you work in educational settings that do not yet follow trauma-informed approaches. Support of your colleagues and even the school leaders would of course be ideal. Trauma-informed schools offer training to their personnel (from the teacher to the school bus driver or the janitor). They have appointed areas where students can go for self-regulation and stress decompression and they have furniture and decorations or plants that aid in calming the nervous system. In such a setting, the whole school’s culture aims at regularly checking in with each other. Teachers regularly discuss incidents they experienced and how they reacted; they give one another feedback on what they did well and what they could change in the future. If you happen to be the only teacher who has been exposed to this knowledge, it is good to remember that you can still make a huge, life-saving difference for individual students. To increase your own and the school’s impact of trauma-informed approaches, you might want to raise awareness among your colleagues, have a trusted and eager or trauma-informed colleague to help you and check on you, or think of ways you might present this to your school’s management. One way could be getting them in contact with ACE Aware NL.

5. “I am not a therapist. I am just a teacher!”

You are right! You are not a therapist, nor will you be asked to diagnose or treat mental diseases. However, your role can be just as important to a child’s life. You can reach so many children, before any therapist ever does! As they say sometimes: ‘You don’t need to be a therapist to have a therapeutic effect!’ You could be the adult that offers the buffering protection on a child’s toxic stress levels. This does not mean that you will have your student lay on a couch and narrate his life’s problems. It might mean that you will include this child in school and classroom activities and that you will introduce them to subjects that can be therapeutic for a person facing adversity (like art, drama or roleplay). It could mean that you choose materials for all students that instill hope and resilience and that when you see a need to ‘discipline’ them, you will use your trauma-informed lens. (We will get back to the aspect of discipline next week.) As you can see, your work as a trauma-informed educator is not significantly different from the work you might be doing now. It’s the approach and the basic assumptions you make that will have shifted.

6. “We need to know each student’s individual ACE score in order to react appropriately and work one-on-one with that particular student.”

You don’t need to know a student’s individual ACE-score in order to adapt your teaching methods to that particular child. Robert Anda, one of the researchers of the original ACE-study, as well as other scholars, have often discussed whether the ACEs-questionnaire is useful as a diagnostic tool. While the questionnaire looks very attractive because of its simplicity, it leaves out contextual information, including but not limited to the positive experiences that the child might be experiencing alongside the negative ones. These are called Positive Childhood Experiences (PCEs). This is a topic we will dive into next week.

There are many areas where your work can truly make a difference in a child’s life. Hopefully, this blog was helpful in shedding some light on how your trauma-informed educational approach can mean the world for a child!

In 1994, two physicians called Vincent Felitti and Robert Anda, set out to study the relationship between abuse, neglect, and household dysfunction on the one hand and adult chronic diseases and leading causes of death on the other. They used a questionnaire from which they later distilled the ten most prominent adverse experiences. Years later, it was acknowledged that, for example, poverty and racism can also be considered ACEs. The image below mentions the original ten items.

What was astonishing then – and still is today – is the prevalence of ACEs. ACEs appear to be very common in the countries where dedicated research has been conducted, both in rich and in underprivileged communities.

We now have hundreds of studies on ACEs and their impact on adult life, as well as many countries and communities around the world taking action to widely publicise information about ACEs. Studies steadily show that the more ACEs a person experiences, the higher their risk for common adult chronic diseases like heart disease, diabetes, obesity, anxiety, depression, as well as negative outcomes regarding substance abuse, smoking, academic achievement, time out of work, and early death. Therefore, some countries see the prevention of ACEs as a crucial public health issue, as it can help avoid the loss of overall health and wellbeing while also preventing healthcare costs.

How are ACEs correlated to chronic disease?

The evolution of our brains and nervous systems has made us the intelligent beings we are. Some parts of our brain, however, still serve the very basic functions we share with all other animals: detecting threats to our safety, in order to take action that safeguards survival. To demonstrate this, we use the triune (three-part) brain model in neuroscience. The brain is divided in three parts:

1. The reptilian brain: comprises the instinctive parts of the brain. This part of the brain is developed at birth and highly attuned to activating survival responses: fight, flight, freeze, or fawn. Continuous activation, especially in the early years, leads to toxic stress. This makes proper social, cognitive, and immune functioning difficult.
2. The mammalian brain (or limbic system): regulates emotions, memory and social interactions. This part of the brain is developed in the first years of a child’s life (roughly from 0 to 5 years old).
3. The primate “thinking” brain (neocortex): is involved in executive functions, language, consciousness, and rational, analytic competence. This part of the brain develops well into the adult years (mid-20s).

As mentioned above, in the face of a threat, the reptilian brain will be in charge of releasing hormones that will help the body go into the fight-flight-freeze-fawn responses, a clever way to escape real danger. How else to survive an encounter with a grizzly bear, for example?

We usually don’t have to worry anymore about grizzly bears or sabre tooth tigers in our daily lives, but the reptilian brain can be activated every time we experience stressors that make us feel like our existence is under threat. This starts when early in life (‘first 1000 days’), we have social experiences that our brains perceive as life-threatening. If these are too frequent or lasting too long, we get an overactive reptilian brain. Stress that is adaptive and useful under short-term serious physical threat, can in the long term become maladaptive and toxic under constant social threat.

Moreover, toxic stress can alter normal brain development and lead to lifelong problems in behaviour, social interaction, learning, and mental health and well-being. It’s as if you are always on the lookout for threats from your environment. The toxic stress from ACEs suppresses the immune system and can lead to chronic inflammation in the body, which can manifest in depression, anxiety, substance use or chronic diseases such as obesity, cancer, cardiovascular diseases, etcetera.

How can I prevent ACEs in my child’s life?

If we know how moldable the young brain is, it makes sense to strive for positive or beneficial experiences. Cultivating safe, stable, and nurturing relationships and thus fostering resilience, can help not only to raise healthy children, but also possibly mitigate negative effects of ACEs.

Many parents’ initial reaction after learning about ACEs and toxic stress is to ask: “Why didn’t anyone tell me about this stuff?” The mere realisation that we were parented and are parenting in ways that might not promote secure attachment, or, even worse, in ways that expose us or our children to toxic stress, can be frightening and can trigger both deeply buried pain and confusing denial or defense mechanisms. That is why we feel everyone deserves to know about these insights.

It is important that you are kind to yourself when you want to dive into this. Do not harshly judge yourself for harmful behaviours: you tried to cope with your difficult situation and that coping brought you here. You survived!

As you are reading this and you start this journey of (self-)discovery, you could ask yourself questions such as:

• What does this new knowledge reveal to me about my own health and wellbeing and about the way I parent?
• What difference does this knowledge make in my life right now?
• Can I think of ways to gain a better insight into my own childhood and where my own pain and needs stem from?

In the following months, we are going to discuss common parenting aspects through an ACE-aware lens, which may help you understand how this important piece of information might affect your parenting journey. Make sure to follow our social media accounts to share your thoughts and ideas and be notified when a new blog post is published. We look forward to your feedback!

Every now and then, you may come across a news site or a parenting blog publishing a piece with an eye-catching headline like “babies who don’t sleep through the night, are more likely to have behavioural problems at age 5″ or “Should you let babies ‘cry it out’?”  The articles move on to explain how a new research has shown that.
A recent example is this article, discussing an academic study in which the researchers followed 1679 families in Finland. They concluded that in their study population shorter sleep and poorer sleep quality in infancy seemed to be related to emotional and behavioural symptoms in toddlers, and these associations were strongest for internalising and dysregulation symptoms.

Your children’s sleep… for you as parents this can feel like a pretty ‘hot topic’. On the one hand, you are getting the cultural message that sleep can be taught, that you need to micromanage it to get it right (with early bedtimes and uninterrupted sleep). On the other hand, you feel the intuitive need to respond to your child’s crying and soothe them when they are upset. You can easily feel overwhelmed with these mixed messages. Is it helpful for you when infant sleep is being discussed without a definition of what are biologically normal sleeping patterns? Would it not be much more helpful for you if you could compare your baby to the biological norm?

How do we define biologically normal sleep?

Cultural practices and the interpretation of baby’s behaviours change more quickly than human biology and physiology. Fields like evolutionary biology, sociology and anthropology try to define what can be considered ‘normal’ in the sleep behaviours infants show. According to these fields, breastfeeding and sleeping in close proximity (cosleeping) are biologically normal. Just like other animals, humans have evolved to thrive when being close to each other and when forming social bonds with other members of their family and their tribe. Adult (parental) closeness is the primal way for babies and infants to feel secure and to prevent toxic stress. The experience of having a sense of secure belonging is very important for babies. They are in a stage in their development when they are laying the foundations for biopsychosocial health. Everything the adults around them can do to prevent toxic stress, has huge relevance for their later health and wellbeing and helps to prevent ACEs and trauma.

Other fields, like medicine, pediatrics, psychology and sleep science, have also tried to define what sleep behaviour “should” look like in an effort to define normality and seek out pathologies (sleep disorders or suboptimal sleep habits and routines). Until the 20th century, sleep was not considered to be a concerning issue. Families would either not consider night wakings to be problematic, or they would seek advice from the previous generations or their peers. With the shift towards science and technology at the end of the 19th century, ‘parenting experts’ (pediatricians and nurses) started publishing parenting manuals that would advise parents to follow strict feeding and sleeping schedules. By the 1930s, the rise of behaviourism in psychology, as well as the introduction of formula and cribs, shifted the norms of what infant behaviours looked like.

Taking formula fed infants, who were sleeping in their own crib or in another room, as the norm, scientists started to describe their sleep habits as the ideal. That data was replicated by other studies that confirmed the first ones. This means that for decades, infant sleep has been studied not with the biological norm in mind (cosleeping and breastfeeding), but with the culturally defined ideas (solitarily sleeping and not breastfeeding) as the frame of reference.

Reprinted with permission from ‘Safe Infant Sleep’ by James McKenna

Another difficulty in defining and measuring what is normal in sleep is the reliability of the questionnaires that parents fill in research where a sleep diary is asked. The problems with this method are twofold.
On the one hand, mothers who are breastfeeding, are more likely to rate their sleep as worse, while mothers that are formula feeding tend to overestimate the sleep (quality and quantity) they are getting. Mothers who are cosleeping, have also been shown to be more aware of their infants’ waking and to follow a similar pattern.
On the other hand, the culture the mothers are born, raised and live in, plays a pivotal role on how they view infant sleep. For example, mothers living in the US and other western nations might view solitary sleep as a way to instill independence in their children, while non-western cultures might consider solitary sleep abnormal, or even cruel. The differences, therefore, between what varying groups of people consider normal in terms of childrens’ sleep, can be considerable.

Going back to the study from Finland, we see a question arise: did the researchers take the anthropological perspective into account and did they consider the cosleeping and breastfeeding norm as “biologically normal sleep”… or did they use the westernised expectation patterns as the norm?

Adding ACEs into the discussion

Adverse Childhood Experiences (ACEs) can impact sleep in two ways:

1. In adults, the more ACEs someone experiences, the more sleep problems they might face (shorter sleep duration, poorer sleep quality), even decades later. For example, this study showed that these sleep difficulties might persist even 50 years later. In this review of the literature, ACEs were associated with the onset of sleep disorders such as sleep apnea, insomnia, narcolepsy and more. Women who were survivors of sexual abuse were shown to be more likely to have sleep disorders later in their lives.
   Many of these sleep disorders shorten sleep duration and the quality of sleep. When these people become parents and they experience fragmented sleep because they have to care for their baby, their sleep can often be even more fragmented. Facing sleep problems themselves, they are also more likely to assume that their baby’s sleep is problematic.
   However, this is a very under-researched area; although we know that ACEs seem to be strongly correlated to sleep problems in adulthood, we don’t have research on ACEs and sleep disorders in infants in particular. It is very likely that epigenetics play an important role much like genetics and a few researchers have tried to find the link between sleep disorders like insomnia and the stress-response genes that can be affected by adversity in childhood.
2. Children who experience ACEs can have disruptions in emotional processing which later on in life can lead to anxiety and depression. This article by the American Psychological Association explores these links in more depth.

Going back to the study we mentioned earlier, parental sleep disorders, ACEs or any form of adversity, stress and anxiety were not taken into account in the study design. Could it be that these parents whose children had more sleep problems were parents who were already facing sleep problems themselves? Were they themselves survivors of any form of abuse, neglect or trauma? Was it difficult for them to maintain a stable atmosphere in caring for their children during the day and did this aspect continue during the night? These are some questions worth asking when we want to draw any conclusions on child-parent sleep. The biopsychosocial component may play a bigger role than often assumed.

What does this mean for you?

It is important to remember that sleep is influenced by many biopsychosocial factors and one professional field on its own cannot “explain” or “define” infant sleep. Diverging substantially from how we evolved as humans makes any definition of infant sleep debatable. Some key points to look for next time you see a piece on baby or infant sleep appearing on a news site, a blog, or a magazine are the following:

• It is important to define what we consider “normal” when we discuss infant sleep. What are we comparing and to what?
• It is important to see whether subjective parental reports were used or whether there was another, more objective way of measuring data.
• ACEs and their effects either on the parent or epigenetically from one generation to the other are often not studied in relation to infants’ sleep. This makes it hard to find out whether later behavioural or other health issues are related to the person’s sleep patterns as a child, or whether those early sleep patterns were in themselves already influenced by stressors in the parent-infant-relationship.

Looking for answers when your baby has woken up once again at 2am in the morning can be very hard. Trying to explain to others that your baby’s behaviour is normal, in a culture that views this as clingy or a “sleep problem” can be physically and mentally daunting. And of course it can also be hard for you as parents to feel exhausted because of regular sleep disturbed nights, especially when your baby cries and when it takes a lot of time to all fall back into sleep. Rest assured, however, that your instinct of wanting to stay close to your baby, is still, to this very day, a wonderful way to respond to your baby and is perfectly aligned with our human mammalian heritage. Try to have compassion not only for your baby, but also towards yourself if you happen to be in the group of parents/caregivers that are healing from their history.