hello my name is Carrie Johnson I am a licensed clinical social worker I have been with family Menders since 2016 I began my tbri journey in 2018 become a full practitioner in September of 2023 today I will be doing an overview of trust based relational intervention referred to as TBR and I am just beyond excited to present this presentation to you uh like everyone can utilize it any capacity that they communicate with anyone honestly we will jump right in today you will learn what TBR is how trauma affects the brain and we'll specifically go over the handb brain model and the 5bs of TBR the three TBR principles first one being the connecting principles which focuses on the value of relationships to promote healing mindfulness of self and mindfulness of others then the empowering principles which focuses on the value of hydration maintaining optimal glucose levels and sensory processing as well as the importance of routine and helping children prepare for Transitions and lastly we'll go over the correcting principles which focuses on appropriate discipline versus punishment and the value of sharing power and the importance of balancing structure in nature and we will also go over how to use the TBR principles within each principle and we get tools handouts and resources to utilize what is TBR it is an evidencebased practice that meets the needs of the whole child now this intervention was designed to meet the needs of vulnerable children or children who come from hard places and have experienced trauma so this first video puts all the basic principles of TBR together to explain the need and reason for this intervention TBR trust-based relational intervention has at its core building a trusting relationship it has three sets of principles and they look at the child as a whole and you think about development the baby cries and I say yes I will comfort you so this child learns that they have a voice they learn trust which is the lesson of the first year of life I can trust there are so many children from hard places and for those children their capacity to trust has been fiercely damaged the brain chemistry of a child who cries and no one comes is dramatically altered the child with a history of trauma or loss or abuse has no hope of healing without a nurturing relationship in every way that I make time and space that I give touch eye contact and I give words I am going to empower this child to go back to the beginning of what he or she should have experienced in the arms of a loving parent that said when you cry I will come the phenomenal thing about a trust-based intervention is as we connect to this child as we build safety we actually change the brain chemistry we change the wiring of the brain this is really the heart and soul of all that we are and all that we do do I look into the child's eyes do I touch their arm when I talk to them when they talk to me do I stop what I'm doing and talk to them this is the essence of mindfulness the excitatory chemicals about I'm afraid I'm hungry I'm cold those are balanced when the caregiver comes and gives warmth all regulation occurs first with an external regulator so in the beginning I regulate all they're cold I bring warmth they're crying I bring myself and out of my regulation their brain develops capacity for self-regulation if this child didn't have this experience that child doesn't feel safe this chemistry can be altered first by knowing they're safe second by nutrient-rich Foods Third by my environmental regulation of that child's emotion and fourth by appropriate exercise so we can balance brain chemistry by creating a holistic environment we clearly have to deal with behavior correcting means showing a child the right Behavior pray prising him when he gets it and showing it to him until he can get it right and showing him with no fear and no shame so that he builds success not a greater sense of failure so the message of Hope for our families is that we can help our children to dramatic levels of healing we simply have to be devoted to it and be willing to invest what it's going to take I hope you found that video very informative I love the little anime care and purose Institute has developed I feel like there brings everything together who uses TBR principles of TBR have been used in homes schools residential facilities orphanages within the court system detention facilities child welfare therapeutic interventions really anywhere where you can imagine that there's going to be any interaction with a child who has experienced any type of trauma when I did the practitioner training there were people from Georgia from all areas judges group homes providers residential providers foster care workers School socier workers churches anybody and everybody they are really trying to make this like they said a holistic approach so that anybody who has any sort of interaction with children can utilize the TBR okay so the second video it is also very very good but it is an hour and 15 minutes so we will not watch it for this presentation but I wanted to put this link in here so that you could view it later if you have time it is it is a really great video and I highly encourage you to watch it [Music] [Music] TBR is an attachment based trauma inform intervention so it's important to understand how the first year of Life can have a profound impact on a child especially how they do relationships so Research indicates that how one is shown attachment in the first 12 months of their life is the attachment style that they will have as adults you know we also are aware that these attachment Styles can change with different types of intervention and education but ideally what you're exposed to the first 12 months of life is what you're likely going the attachment style that you're going to have as an adult so just kind of want to draw your attention here so as you saw in the video when an infant is distressed right here and they Express that they have a need you know usually sometimes by crying if it's an infant they're wet they're hungry they just want to be held then a loving caregiver comes and responds and provides Comfort this repetition of you know the baby is in distress the needs are met they're comforted this repetition here teaches the infant that they are safe they have a voice obviously if they cry that somebody's going to come so they can trust others to meet their needs it also gives the child feelings of selfworth because through this repetition they realize that they are seen and valued this helps develop the capacity to one day self-regulate on their own over here I just want to draw your attention to when the needs are not met for an infant so they express the needs nothing is happening they are not met nobody comes to meet the need these children live in chronic distress they do not learn the capacity to self-regulate and these are the kids that you see that can just you know be triggered by the smallest thing they couldn't get a candy bar in a store even they throw this huge tantrum they're not trying to be bad it's that they just did not learn the skill when they were younger to self-regulate and simply just don't have the capacity to self-regulate they still have to be taught how to self-regulate by caring adults [Music] TBR identifies six early risk factors that influence the way children from difficult backgrounds think trust and connect with others could be just a you know a difficult pregnancy now this could be medically related or you know maybe the mother used drugs or alcohol while pregnant or could be any other type of trauma while the Mom is pregnant you maybe they were in a car accident any sort of trauma uh but it could also be good stress they have stress because they are just pregnant and they're excited and you know getting the room ready all the good stress so how you know any sort of high levels of stress throughout the pregnancy the baby feels it the same way whether it's good stress or bad stress it affects it affects the the baby the exact same way it could be a difficult birth you know maybe there's a traumatic birth or some sort of trauma happened at Birth could be many reasons you know maybe the baby was out without oxygen for a brief amount of time you know maybe there was something wrong with the umbilical cord you know there could be a lot of things that happen that could go into the category of difficult birth early hospitalization so children who experience early hospitalization often experience painful touch rather than nurturing comforting touch in the first days of their life you're thinking of those that might have to go to the niku might have some sort of surgery you know they're getting the the painful Touch of you know maybe needles or medical procedures or whatever is needed obviously it's needed to save their life but that baby's first sense of touch is a painful touch as opposed to if there were no issues usually it's a comforting loving touch now obviously we've come a long way with understanding the need for care and attachment because now usually when the baby is born the the baby is immediately given to the mom to get that kind of like skin on skin care um or they call sometimes kangaroo care so you know they've really learned that that is extremely important to have that healthy touch that good touch as soon as the the baby is born very you know first few minutes and days of their life abuse so children from abusive backgrounds know to always be on guard their brains have been trained to be hypervigilant to their environment neglect the message sent to the child from a neglectable background is you don't really matter children from neglectful backgrounds often suffer from the most severe behavioral problems and developmental deficits and Trauma any number of trauma in a child's life can cause the child's developmental trajectory to change uh this you know any sort of trauma maybe they were in a car accident maybe there was some sort of natural disaster maybe they were separated from their family for whatever reason you know just any sort of traumatic [Music] event there are five major stages of brain development in childhood in addition to the age of five which is when most children enter school so that is a pretty significant deel brain developmental stage uh but there are like I said five other major stages and at each stage there's an increase in the child's behaviors has been noted as well as an increase in the need for support now Dan seagull worked very closely with Karen peris at the Karen per Institute to develop TBR and he came up with a handb brain model to teach us how the brain works kind of regarding thinking feelings and behaviors but I also found this video that really kind of summarizes how the brain works and I think this would be great for you to be able to show anybody that you work with that they can kind of help understand it too ever felt a big reaction to something and not known why here's a way to help you understand your brain and manage your behavior the hand model of the brain the bottom of your hand represents the brain stem and is involved with the automatic physical processes that Keep Us Alive like breathing and our heart rate your thumb is your limbic system and with your brain stem forms part of your emotional brain this helps you to manage and understand your feelings and stress responses the outside of your hand and fingers are are your cortex or your thinking brain when the thinking and emotional brain work together it's easier to manage your emotions talk with others and problem solve but if you feel surprised unsafe or scared your emotional brain takes immediate action it can act much faster without working with your thinking brain so you flip your lip if you're in real danger acting fast can help keep you safe and that's really important and then when the danger has passed your lead comes back on your thinking brain is back in control but sometimes we flip our Lids when we don't need to how we think and behave isn't helpful you can practice putting your lid back on by breathing slowly or by spending time with someone you trust this tells your emotional brain you are safe and it can work with your thinking brain again now your whole brain can help you manage your behavior and your [Music] feelings I just really felt that that video just was so very informative and I thought it was a great video that we could show even kids or adults and just kind of give them a little understanding of what's going on so from this model I just want to kind of see that you can see right here that they refer to it as you know the thinking brain refer to it as the upstairs brain that's you know responsible for the thinking and while your downstairs brain or your emotional brain is responsible for feelings so if one has flipped their lid their downstairs brain is in control basically their upstairs brain is offline so for children who've experienced trauma their brains are operating at a level of survival so their primary concern is getting their needs met any way possible so they are in their emotional brain most of the time if not all of the time so it's very hard to use their thinking brain because they're they live in their emotional [Music] brain the TBR is all about helping people understand the why so we can respond with deeper compassion so knowing that adverse childhood experiences or Aces can lead to toxic stress helps us better understand what may be happening on the inside which is why it's important to understand how the brain works which is why I wanted to utilize um the handb brain model but from this infographic you can see what goes on in the brain of a child who's experienced chronic stress remember those who you know were distressed expressing they needed a need and nothing was ever met for those kids there's an increase in difficulty in making friends and maintaining relationships lowers the tolerance for stress which can result in behaviors such as fighting checking out or Defiance increases stress hormones which affect the body's ability to fight infection may cause lasting health problems increases problems with learning in memory reduces the ability to respond learn or figure things out which can result in problems in school but also just kind of want to draw your attention to this little bubble where it says I can't hear you I can't respond to you I'm just trying to be safe because that just really shows that they are in their downstairs brain so their thinking brain is offline they really can't hear you they can't hear what you're saying they can't comprehend what you're saying and you know utilize anything that you're trying to tell them to do when they're in their downstairs brain what you see here on the left is a pet scan of a healthy brain and and on the right is one that has experienced abuse in infancy because of the reduced brain activity in the temporal loes which is the one obviously that are circled here this child will suffer emotional and cognitive problems without supportive intervention so I just want to draw your attention to the bottom of the photo which is the downstairs brain and the emotional brain if you will see that the child who's experienced abuse has more activity here as you can see there's more red there's more activity here and so this is just a great way to show that a child who has experienced trauma does not have the capacity to self-regulate yet so remember the brain is like plastic so as it changes in response to what happens to it it which means it can adapt to new situations so that's where you know if we remember the video at the very beginning you know your brain chemistry can change over time depending on what kind of interactions it is exposed to when there are disruptions in the attachment attachment cycle and a child has experienced trauma they have not developed a skill set to self-regulate basically they don't know how to calm themselves by themselves so what we see here basically is the chronical age of a kid who is 14 but he is more developmentally like a child half their age so more like a seven eight-year-old maybe even six these kids you know although they're 14 they're going to display behaviors that you were probably going to see more out of a six or seveny old because the child didn't learn how to use their voice to get their needs met they move to maladaptive strategies manipulation lying stealing to get what they want so what you see is that these 14y olds now have the street smarts or survival skills of someone twice their age so while these negative strategies may be necessary now or may not be necessary now because they are in a safe space these children don't necessarily feel safe and they have been taught through repetition remember the repeated cycle that they have to use these maladaptive strategies to get what they need because their body and their brain has learned that nobody is going to meet their need except for them and they're going to meet their need however however they can whether it's you know stealing lying aggression whatever the case may be you know a lot of times we get people and they're like well if they're smart enough to manipulate to get what they want or they're smart enough to know to steal and try to get away with it and have that thought process to think it through they should be you know smart enough to know right from wrong or smart enough to know that they to put the dishes in the dishwasher or to take the trash out what you know whatever the situation is because they think if they have this level of Street smarts they show that level of smarts on any other level or that they're capable of having it when really they're not their brains were not trained that way their brains were trained to be in survival mode at all times so they're not having that rational thinking they don't they don't have that part of their brain [Music] activated the five bees of TBR developmental trauma produces widespread changes in our brain body biology beliefs and Behavior now while I like this little picture because it shows you that behaviors are just the tip of the iceberg however we tend to mostly focus on the behavior but that the behavior is just providing Clues to the history of the child the pain they experienced fear the needs that they have or had that were never met and they had to meet them meet themselves instead of focusing solely on the behavior we need to let the behavior point us to the needs below the surface just want to touch a little on these so the brain we know from the earlier slides and the videos that trauma impacts the brain it causes a person to have a more developed survival brain or downstairs brain you know which is responsible for keeping us safe through our fight flight freeze response so while this becomes overdeveloped the upstairs brain becomes underdeveloped because it's so preoccupied with surviving it hasn't been able to develop remember the attachment cycle when a different cries and no one comes to meet their need they are stuck in dist stress with basically cortisol flooding their system they don't get the relief from an attentive caregiver meeting their need and you know helping calm them down so this could cause several issues such as immune issues immune system suppression which mean you know the kids that are chronically sick you there's a lot of kids that we work with you know that often often are sick always get strap always get flu you know the cold or whatever whatever's going around you know they're usually going to get it um and the On's insulin receptors and Metabolism are act are impacted so it makes it extra important to address like nutrition and hydration uh the body which is the sensory systems especially the internal senses that help us with body perception you know such as where we are in Space the belief system so what are some of the beliefs that you see in children or adults from traumatic backgrounds you know they believe that they can't trust people they have no voice they have no control over their life no value it's all their fault they are bad they're always going to be bad they have to look out for themselves because nobody's going to look out for them no one loves them you know they have to be the boss because nobody was ever the boss of them so in TBR changed behavior is the result but it's not the goal we're when we focus on helping repair all of the these the behaviors will [Music] change with the Mind shift to being trauma responsive this is where we're trying to basically change the belief or the thought of you know the caregiver the adults you know whoever interacts that child interacts with that child from believing that however they're acting is just being willful disobedient instead of seeing it as a survival strategy so you have the the ones you know when you're have the willful Disobedience thought as a caregiver an adult it's you know what's wrong with you why can't you do this right why do you always mess this up you know we went over this a hundred times why can't you just do it correctly the first time what's wrong with you as opposed to when you shipped it to the trauma responsive and the survival strategy thought whereas you know what happened to you you know obviously he he or she can't do whatever it is but it's not just because they're being willfully disobedient and just don't want to be don't want to do it or being defiant it's they really have not developed the capacity to do whatever it is so instead of being like you know why can't you do this right why can't you fix this or you know if the kids late every morning getting ready for school you know why can't you get up on time why can't you maybe shift to being like okay so obviously what what we're doing this system that we have in place isn't working so let's figure out what maybe we can do differently that will work let's try something different let's think about some things that we can try different do we need to get up earlier do we need to do more stuff than night before to prepare for the next morning you know what are some things that we can do to make it better instead of just continuously making that child feel like they're bad now when children feel safe in their environment they feel secure enough to explore learn try new things play and connect with others even though the child is now in a safe home or environment away from the abuse the trauma or whatever the you know negative situation was the child may not feel safe physically Al they are safe but you know emotionally they're still in their emotional brain they don't feel safe you know it could have taken however long to get that child to a safe place weeks months years however long so just having that child in a safe place for a short amount of time is not going to change their brain chemistry to make them feel safe when it could have taken years of their Sur their survival brain being developed and overdeveloped so just you know having a short amount of time is not going to even out the development in their brain so now we're going to go into the TBR principles so the first one is the connecting principle which is basically designed to help build trust by Deep connection between the child and adult and we'll go over mindfulness strategies and engagement strategies the empowering principles helps children learn self- skills like self-regulation so we'll do that with the physiological strategies which is their internal needs and E olical strategies which is their external needs and the correcting principles which are proactive strategies and responsive strategies now the correcting is the last principle people who focus on just the behavior and not everything else they usually want to correct first instead of trying to connect with the child correcting principle it is designed to help build social and behavioral competence so the child's more successful in navigating the social World social world so we'll dive into the connecting principles the connecting principles are the heart and soul of TBR as they help children build trust in meaningful relationships healthy attachment involves both the caregiver and the child the mindfulness strategies are designed to help caregivers become aware of their personal thoughts beliefs and behaviors that they bring to interactions with children in their care and how they influence the relationship a caregivers own attachment history or anybody who's working with that child could be you know a teacher a therapist a provider somebody transporting that child supervising the visits in any way capacity you know that you're having any sort of interaction with that child you know your own attachment history influences you know the care that you give to a child so for most people like I said the attachment style at 12 months of age is the one that you're going to carry throughout your life so someone who grows up secure in his or her attachment is able to give loving caring response and be consistent while someone who grows up insecure and their attachment may not have the same capacity for consistent responsiveness to a child for many reasons so a caregiver's understanding of their own history but how it influences their behavior and how they interpret the behavior of others as part of being mindfully aw mindfully aware so you know this is taken into consideration if you have some sort of trigger maybe it's the kid doing something simple like rolling their eyes I'm not excusing the behavior or justifying it but maybe you know your reaction to it is Extreme when it really doesn't need to be extreme for what is kind of considered a small Behavior so you know maybe looking look been to yourself and like why is this such a big deal for me like what maybe maybe it was however your perod natur caregivers dealt with that when you were a kid you know you just never know there could be something going on to why you're you know maybe overreacting or being a little less understanding than probably you should so being mindfully aware that just means like I said act with awareness be aware of what's going on be less reactive you have to be able to come back to you know a place of emotional stability you have to be the one who is the stable adult be non-judgmental again not why can't you do this right why are you always doing this wrong what is wrong with you more of okay what can we do to make this situation better encode it that basically means you need to figure out the words to be able to you know figure out what's going on or to identify and say what's going on Define what's going on maybe the kid doesn't have the capacity to do so so this more of like really looking in to see what's going on why are are they you know stealing whatever what's what's really going on and you know be self- observant observe yourself and how you are responding to situations whether you're being over responsive under responsive what the situation is this is very hard for some adults because a lot of adults want to see that it's just the child's Behavior that's the problem it's the child that's the problem it's who whoever did whatever to the child whatever the case may be or whatever happened it's not their problem they're not I'm not doing anything wrong there's nothing wrong with my parenting this is how I was raised and I'm fine and that might be all well and good but this child had a very different experience than probably what you had when you were a child or that person had when they were a child which is why their interactions and relationships with others and behaviors are wildly different there's just a lot of having to be very Mindful and this is very very hard um like I said for a lot of caregivers and a lot of times caregivers need to to look a little more Inward and do a little more work on themselves to learn what's going on and not just see it as it's just the child or I'll just take this parent in class and it'll be fine without really trying to understand what's going on with their reactions and their interactions with other people people if you have been at Family MERS for a while we have done many many seminars and trainings and provided many resources on self-care and that also goes hand inand with mindfulness you know being able to take the time out that you need to be mindful of others not get overwhelmed not you know just be so exhausted all the time from being a parent or being a caregiver or working with children or working in this capacity and all the other responsibilities that comes along with self-care is extremely important and I hope that if you have done those trainings you've taken something from it and that you're practicing self-care if you are not please please reach out for any sort of guidance and resources on how to do so for the connecting principles the engagement strategies are the second part and they teach how to connect with children through non-verbal interaction so I just just want to make sure that everybody is aware that when I'm saying caregiver this could be anybody who has any interaction with these children the engagement strategies are designed to help caregivers better understand how to relate to the relationship from a child's point of view so they involve specific techniques that make it easier to relate to children and the ways they communicate best non-verbally and through playful interaction so we have here you can see the Healthy Touch you know I know for a lot of providers including family Menders we have a hands-off policy you know for various reasons but you know that doesn't mean if a child comes running up to you to give you a hug you immediately say no get away that's that's not going to help their connection they like oh hey Hey listen I'm you know unfortunately we can't do that but hey let's figure out something else we can do maybe a secret handshake maybe hi FES a symbolic handshake whatever the case may be there's things there's other things that you can do you know just like little chin prompt things of that nature that doesn't mean like I said solely hands off and completely be like nope get away there's other things that you can do to kind of have that Healthy Touch symbolic touch connection eye contact eye contact changes the brain chemistry we all know that if somebody's giving you eye contact you think they're paying attention as opposed to when someone is not so you want to get eye contact from a child when you can but never force it there are some kids you know maybe they're on the autism spectrum they have difficulty looking you in the eye or maybe they just have difficulty looking you in the eye for other reasons maybe it makes them scared you know who knows what the case may be so never force a child to look you in the eye but remember as as the adult to always use kind gentle eyes to communicate to your child that they are precious even if the child may not be having precious behaviors at the time you as the adult still need to let them know that they are still loved and important you know let them know with you know your kind eyes that you still love them and they can make mistakes and we can learn from it but you definitely need to make sure that you are aware of how you're looking at kids my kids will tell me sometimes I give them the mom eyes which you know means either they're doing something that I don't approve of or that's going to get them in trouble you know sometimes have to be a little mindful of that you know voice quality I when I'm a loud person and I have to be mindful of that especially when I am working with some kids who that might trigger them or that might you know really throw them in some sort of Whirlwind that they can't get out of because they're used to people being loud all the time and yelling and that's just too much with him so really have to be mindful of your tone your volume your Cadence how you say things when you're saying things there's ways that you can say things that come across as mean and derogatory but you can say the same thing in a completely different tone and it come off nice and understanding so just be very mindful of how you're speaking okay Behavior matching this can be anything sitting the same way as a kid or a teenager you know I think a lot of times times they have the thought and some professionals have the thought you know they need to be in a position to show that they are a professional you may be sitting behind a desk or sitting very professional you know not you know having any sort of leadway or anything of that nature to let them know that you can just be relaxed and get down on their level you know whether that's getting down on the floor and you know sitting just like they are right beside them just talking about things going for a walk whatever it is you don't have to you know have this like division between you guys for them to know that you know you're an adult I mean it could even with your little kids it could be something as choosing the same color saying you have the same book you love the same things whatever it is like just you know don't be afraid to get down on their level and playful interaction I I know this is hard uh for some people because I have heard more than once well my parents didn't play with me when I was little I had to figure it out on my own or you know play with my friends or play outside my parents never played with me and I'm fine again your childhood is very different from what they experienced think back to when you were a baby well you probably don't remember in the first you know 12 months of your life but your parents probably did get down on the floor play with you show you colors teach you colors letters alphabet you know play with the little toys with you all those kinds of things you probably had that which helped you learn the capacity once again to self-regulate and do things on your own these kids did not have that and they need it so again if it's you crawling around on the floor acting like lions and tigers and bears then crawl out on the floor and act like lines and ERS and bears we've got to get back to understanding that these kids did not get that and they need it as opposed to just well they can just figure it out on their own or they have friends or they can go outside they might have friends and they might can go outside but they also need the playful interaction from an adult you don't have to do all these at once you know you can't say oh too loud and now all of it's gone or you know maybe I said the wrong thing or maybe I gave them the mean mom you know once or whatever you don't have to do them all at once maybe start with just one thing and try to gradually induce the introduce the others just keep trying the empowering principles so the empowering principles will provide you with many tools to help children feel safe starting with simple things like making sure they stay hydrated to eating nutritious foods but remember because their biology was significantly altered by their beginning children who come from hard places are physically more fra fragile you know like I said they're designed to facilitate change in children by supporting their physical needs and teaching them self-regulation skills also meeting their internal and external needs which these strategies help children learn to self-regulate their behavior and emotions want to kind of look at senses and the sensory processing of the body the external senses which are s smell touch taste and hearing serve four primary function FS for your body it is to alert the body and brain protect the body and brain from becoming overwhelmed select what is important to pay attention to and organize the brain automatically the internal senses help the brain understand sensory input so the vestibular sense is controlled by the fluid in the inner ear and it tells the body where it is in relation to Earth it helps the body balance if the vestibular sense is off so is everything else um think of you know if you ever think of children or maybe even adults when you have ear infections you you feel off balance I know a lot of times when kids have ear infections they they're wobbly and that's why their whole body is off balance or if you think of um if you have ever experienced vertigo that's another thing you're off balance and when you're all you you can't really do anything it's hard to stand up it's it's hard to walk it's hard to move it's hard to really do anything so that's why it's important to know if that sense is off everything is off your proprioceptive sense registers the amount of pressure when the body is being touched so we know from science that firm G muscle pressure is calming and organizing for the brain and body obviously we're hands off we don't want to be giving massages to children but you know think of teaching their caregiver their parent whoever it may be maybe some pressure points are things that they can do to help you know give them that pressure that their body needs to kind of reset itself the vestibular sense has connections all over the brain which is why when it's off everything is off the tactile sense that is the first sense to develop in utero and it is fully functioning at Birth so touch is the way infants connect with others from the very beginning of Life which is why we went over that you know sometimes if you have a difficult birth or early hospitalization that is why the touch is very very important because when you have maybe a harmful touch how that affects the brain versus when you have the nice comforting soothing Touches at the beginning of Life soothing touch um often calms fussy babies and even very very young infants can distinguish the touch of their mothers from the touch of others so that's why it's just very important for you know babies to have that nice loving comforting soothing touch the physiological strategies or internal strategies for sensory processing it is common for children who have experienced trauma to have deficits in their sensory processing capacities sensor processing disorder disorder is defined as the failure of one or more of the senses to develop appropriately causing a person to have confused sensory interactions with the environment so when children from hard places feel overwhelmed or out of control their brains move to a primitive response system which is the downstairs brain with few options you know basically fight flight or freeze so in situations where sensory input is involved children react this way when they get too much input maybe they're overstimulated or not enough input maybe they're under stimulated you know you want to think of the children that might have issues with going into anywhere that's really loud maybe the lunchroom is too loud for them maybe any sort of anything they might be having at school like in an auditorium or something where they're having speakers and the whole school is in there that might be too much that just might be too much going on for them they're way over stimulated whatever whatever the sense is that's overstimulated is affecting their whole body or maybe there's not enough and you know their brain is overreacting because it's being under stimulated so there's just a lot of things that go with the senses and how it affects people in general but also how it really affects those who have experienced trauma the physiological strategies or internal needs so these strategies focus on the internal physical needs the the biology of a child who experiences trauma was significantly altered by their stressful Beginnings children from hard places are easily disregulated by dehydration and low blood sugar so when children are dehydrated or hungry they which means they don't have enough glucose in their blood their brain function is compromised even at the lowest levels dehydration causes changes in children's thinking learning and behavior so keeping children hydrated is extremely important most schools either encourage or require kids to bring a water bottle every day my kid School basically requires them to have their own water bottle every day so I just want to make sure that if that is not that not required that you know you are providing that with that child every day so that they can have access to water to make sure they are hydrated blood glucose so especially for children from hard places minor fluctuations in blood glucose are associated with negative side effects so planning and maintaining regular healthy snacks is important I know sometimes this is um a little harder for others you know depending on the situation but a lot of times your blood glucose which is basically just sugar sometimes they just need you know maybe gum maybe you know a sucker maybe they just need a little bit of sugar the gum and stuff really helps that um the proprioceptive sense because it gives you that that feeling that they need so a lot of times just because you know it's gum or a sucker or something it's not just giving them what they want or giving them candy to you know make them quit fussing about whatever it is or whatever the case may be um a lot of times their body really just needs it of course they don't know it and that's not an excuse for their behavior but I just don't want you to always see it as a negative thing nutrition obviously a balanced diet helps stabilize blood sugar mood and learning you know we always want to try to have a balanced diet maybe the the family or the caregiver cannot provide fresh fruits and vegetables daily so this is just doing the you know do the best you can with what you have or what you have available or what you can access a lot of schools and churches you know do you know the snack program where they can send home you know healthy snacks with kids over the weekends or after school or over the summer a lot of churches and stuff have food pantries so really helps some of your families reach out and utilize these resources if they need them it is extremely important to try to keep the kid as healthy as possible allowing and encouraging children to get plenty of physical activity is associated with increased endorphins increased depression anxiety and stress so you know always want to try to have a kid get a little exercise do what they can to try to stay um you know healthy and regulated I mean maybe this is something that you guys could do together remember we talked about playful interaction and kind of getting down on their level so maybe this is something you know yall could do together find a little yoga video on YouTube something that you guys can do together I know um a lot of schools maybe only have PE once a week or twice a week so you know they're not really getting that at school as much as when might think so it is also very important to try to keep that in mind along with nutrition we all know the importance of getting good sleep I for one you know don't function great when I don't get a lot of sleep especially if I don't get a lot of sleep or as much sleep as I might need several days in a row I really do not function well I might be cranky I am tired I have no energy I'm not motivated kids are the same kids are the same way while us as adults can usually say I'm just tired I did not sleep good kids usually don't no I'm not tired no I don't want to take a nap I'm not sleepy can I please just stay up later I'm fine they're going to try to avoid sleep if they can that's a normal kid Behavior but it is very important as the caregiver for you to try to help make sure they get enough good sleep and that you also get enough good sleep there are several several ways to establish a good sleep pattern certain kinds of music maybe you have a routine whatever the case may be but not allowing screens an hour before bed is extremely important there's really been an increase in just screen time in general that when you know a child is on a screen and they're they're constantly being stimulated by whatever show they're watching or game they're playing the lights the colors the over stimulation it's going to take them longer to fall asleep because it's going to take their brain longer to calm down the things y'all can do read Journal draw there's tons of other things to [Music] do ecological strategies these are the strategies that focus on the external environment like transitions so transitions can be tough and we know children who have experienced trauma need a little longer to process transitions by practicing them and creating a routine and giving transition reminders in advance allows the child to feel more in control and gives them time to get ready there's two different types of transitions there's the life transitions which are big things you know maybe they're moving homes that could just be the family is moving together it could be they're moving from the family's home to another relative's home it could be they're moving from the family to a foster home you know people they don't know whatever that moving homes might look like moving to a new town having to change schools you know any kind of big life transitions so life transitions prove more difficult and necessitate even more support from those around them I know that if it is a kid and care and they are going to have to be moved that a lot of times defax or whoever else not involved do not want to tell the child that they're going to be moved in some cases that might be the best route for you know maybe they might run or sabotage something or or do something aggressive or harmful so sometimes it might be necessary but if at all possible that child needs to be told in advance not minutes before or just an hour so that they can help prepare for what's going to happen we also have daily transitions just getting ready for school leaving for school getting ready for bed changing task maybe at school or at home you know maybe something came up and instead of having the family dinner like you always do on Thursday something else happened and now we've got to go here to do this you know any sort of transition can be very difficult and it requires preparation thinking concentration and mental flexibility many times atrisk children are often able to hold it together while they're at school but then fall apart emotionally and behaviorally once they get home and a lot of adults or other people like well they're fine at school it's just at home it's just because you know they think they can get what they want or they think they can act this way or get away with it here or whatever the case may be they're fine at school they can be fine here but really that kid possibly was overloaded and over stimulated all day with thinking and trying to regulate their behavior and the transitions that came with it and trying to just maintain their stability through it all and so when they come home it's just basically like a let down of all their systems they just kind of shut down everything falls apart it's almost where they can finally let their guard down and just let it all out and just they're kind of saying I'm I am emotionally and mentally exhausted and unfortunately know that comes out negative behaviors but really that just might be what it is transition Solutions so for life's transitions obviously I mention please try to give these kids heads up if at all possible if you know they're going to be moving for Life transitions they do life or memory books If the child is going to be adopted the adoptive case manager will usually do like a like a life or memory book explaining what happened here give them the history they needed and kind of help them with that but I also feel like sometimes it might be if they're going back to their biological family or you know maybe just doing some other transition other than being adopted it would be a good time to do a live or memory book then as well for your daily transitions there's all kinds of things that people can do Transition note cards which kind of lets you know almost like a schedule lets people know what's going to happen let them know what comes next frequent reminders hey 30 minutes we've got to leave to go hey 15 minutes we've got to leave to go hey five minutes we've got to leave to go and start you know getting ready put your shoes on but giving them frequent reminders of being instead of being like Oh gosh totally lost track of time it's time to go it's time to go and then that kid have a complete meltdown and you as the adult get all upset and frustrated too because they're having a meltdown you're already late I mean sometimes it happens but the point is to try to very hard to have frequent reminders be prare be prepared know when the transition is coming prepare for the transition at the best way that you can so regulate as we noticed they haven't learned the the ability to regulate on their own they can't Cal themselves by themselves you need to help them co-regulate which also means that you have to stay regulated in that moment children feel more prepared when caregivers explain an upcoming transition steps they can take to get ready what it might be like and this could be for anything minor or major ones prepare these kiddos for the transitions as much as we can external needs with scaffolding self-regulation I think of scaffolding like steps or scaffolding on a building the goal is for them to be able to regulate by themselves but maybe they can't so maybe they need an external regulator you as ult have to do it for them because they can't and it's kind of co-regulation helping them do it giving them the skills to do it and then them kind of learning to do it on their own when adults scaffold or appropriately assess and provide the level of help that children need learning and implementing skills like self-regulation is smoother easier and also Ely just more successful there are lots of ways to help provide self-regulation visually there are engine [Music] plates regulation posters zones of Regulation is also very very good if you haven't done that training I think it ties a lot into this training and you can use a lot of the TBR principles with the zones of Regulation teaches about the zones and their emotions what to do in each one what you can do to help calm yourself when you're in each one the engine plate kind of does the same thing through sound calming music through tactile and proprioceptive senses this could be fidgets a sensory bucket stretching yoga wall pushes weighted blankets there's things that they can also do when they are you know maybe in class or somewhere where maybe getting up and doing stretching or yoga or wall just may not be the most appropriate thing to do in that environment but there's things they could do chairs like you can um you know push push and pull kind of will help with the senses weighted blankets through the nose and mouth deep breathing calming smells I know some classrooms will diffusing like the lavender or calming smells to kind of help calm the calm the classroom all right this is an example of an engine plate you know you think of you know red is where running we're running hot probably need a lot of co-regulation um green we kind of in the middle we're fine blue is probably where you're a a little sad or down something's going on favorite calming activities this is where you would list what to do how to kind of get you out of a a Zone that's probably not where you want to be if you utilize these whether you do it as someone who's working with the family and show them how to do it or the family just does it on their own that there be one for either all the kids or every member of the family anybody who's in the house not just the one kid that might have problems regulating it'd be great for everybody to have one one to kind of Le by example but two you know so that everybody knows that everybody has different emotions and some emotions we might need a little more help with here is the zones of Regulation I was talking about the zones of Regulation is a great way to teach kids about regulation how to regulate their feelings and and sensory needs so as you can see this poster uses the characters from inside out side note if you haven't seen that movie it is great very in educational for kids to kind of help with their emotions and I love how the zones of Regulation utilized little characters in this poster it helps to explain the different emotional Zone there's also another one similar to this included at the end that kind of gives options of what to do at each Zone this one the lines at the bottom is what you were supposed to come up with to help that person when they're in each zone or work with that person together to help come up with it external needs daily rituals it is helpful to understand the difference between routines and rituals routines are practices set in place so that families and children can be prepared and know what to expect morning routine weekday routine nighttime routine eat breakfast brush our teeth brush our hair get dressed e whatever routine might be what you need to do in what order and how what to expect rituals though have a completely different function in entirely daily rituals allow people to strengthen their relationships with one another through small daily practices so you want to think between a an adult a caregiver and the child this could be something they do that is that is special just between them two so they could be making them they have their own special song they have their own special handshake they have a special daily greeting you know they do they have their own special thing they do at night for part of their bedtime think no maybe they have their own little special saying that they say or whatever it's just something that is just between that adult and that child that is unique to them that helps develop and feel connected to that adult correcting principles correcting is our last principle it helps to build social and behavioral competence um so here proactive strategies teach social skills during calm times and the responsive strategies teach tools to respond during challenging behaviors of your proactive strategies calm times when we're playing with our kids and teens having fun you know we're going to use like playful interaction to teach them skills that they might be struggling with or they need to learn the responsive strategies are more in in the moment of of of a challenging Behavior but the correcting principles are designed to balance between connecting and correcting it's the same is between a nurture and structure you really can't have one without the other or if you do the balance is way off they might be behaving and correcting and compliant all the time but they have no connection with anyone you really need to kind of have that that balance for it to really work active strategies which is like we said teaching while calm this is what you do while you're hanging out having fun whatever the case may be one of the proactive strategies is the life value terms ask children to use respectful words and actions and in turn the adult or caregiver also models this for them maybe the kid just playing and says something a little disrespectful like hey were you using respect hey do you feel like that was kind of respectful don't forget we try to use F words in this in this house or whatever the case may be it's not getting them in trouble or making them feel bad teach children to use their words not their behaviors to get their needs met so instead of going you know maybe the snack cabinet or the refrigerator and pointing at it and saying you know not using your words or just saying snack snack you know you want to teach them say can I have a snack please just helping them learn that they do have a voice and when they use their voice someone will listen and can meet their needs gentle and kind coach children to be gentle and kind to other people and animals hey don't forget to be gentle and kind don't forget to make sure we use nice hands with the animals you know whatever the case may be Listen and Obey who's the boss with permission and supervision this is a good one for a kind of your older kids so a lot of times your older kids maybe they get mad and they want to just storm off and walk away walk around the block the caregiver can't do that for you know various reasons so like okay sure hey go ahead I know you need to take a walk and calm down I'm going to stay a couple of steps behind you give you your time and space but also need to sure that you stay safe but you know you can have your time and space as you need if you want to talk that's fine I'm here if not I totally understand that too there's lots of different things are you asking or telling you know like I said you just want to do it while you're [Music] playing do maybe the puppet game or hey let's role play I'm going to be you you be the mom you know whatever the case may be so that's something to do really good when play and kind of teach them these things behavioral scripts are another proactive strategy we have redus redus is a do over to replace a negative behavior with a positive behavior let say you told them to go put their shoes up and they threw them across the room you could say how about how about let's let's redo that let's try that again behavior is not okay but it's also really something that you don't need to be too reactive and too judgmental overage like hey let's let's just redo that redo are one of the most important correcting strategies because it teaches three truths one we all make mistakes and it gives us a way to repair the mistake the child has the opportunity to practice appropriate behavior and a child can learn more from repairing the mistake than if they never made the mistake in the first place also this is something that adults can do okay I'm sorry let me redo that let me let me me say that differently because it came out wrong or it didn't come I it didn't mean what I wanted it to mean it's also very important as an adult to do this as well choices this offers children an appropriate amount of control with two acceptable options so many behaviors are attempts to gain control or felt safety and this allows the child to have some control adults sometimes have a hard time with this because you feel like you are letting the the child have all the power or the child make the decisions or the child be in charge and that's not it at all choices is where you or the child can give this child two options and they can have the choice so let's say you know hey go ahead and clean your room no I'm not cleaning my room okay you have the choice you can clean your room now or you can clean your room after dinner either way the room gets clean either way either way so it's not giving them control the goal is still met it's just letting them decide when it's going to get met it's letting them have some sort of control remember they had no control whatsoever so they are constantly fighting for it or they constantly don't want to give any of it up because they feel like if they give anybody else control they're just going to let them down so it's very important to let kids feel like they do have a little bit of control over their lives compromises so this allows the children to offer a different choice so let's say if the choices are not going to work you want to encourage the child to ask for a comfort maybe they don't want to clean the room right now they don't want to clean the room after dinner they're like hey how about will you help me clean my room before we go to bed or will you help me clean my room after dinner sure I can do that or hey how about I clean half of my room now and half of it before I go to or half of it after dinner okay fine sure it's great compromise Great Compromise good job again the goal is still being met we do not you don't have to get in this this tug-of-war this fight over control over something so little as maybe cleaning their room or putting their shoes up or whatever you know whatever it is it doesn't always have to be you know this control thing and you as the adult think that you always have to be in control or you always have to be the one in charge this isn't really giving them the ability to be in charge it's just kind of giving them a little control over when they do what they have to do responsive strategy while proactive strategies teach social skills during calm times your responsive strategies teach tools to respond during the challenging behaviors so TBR has this ideal response so you know you're looking at an immediate response respon which means it's within a few seconds of the behavior the adult or caregiver must be present and mindful you cannot be on your phone you can't be distracted you can't not know what's going on and then kind of jump to a response or consequence when when you you didn't know what was going on you weren't paying attention you weren't there you know whatever the case may be you you need to be present and it needs to be immediate you don't need to say okay we'll take care of this when we get home in 5 hours that one the kids either probably forgot about it by then and now you're just bringing it right back up and making them feel bad all over again or that is all that child is going to think about for five hours how bad they are how horrible they are how they can't do anything right and that's neither one of those are appropriate options so it needs to be immediate direct you need to be fully engaged with the child this also goes along with you know you don't need to be distracted or doing something else you need to be fully engaged with that child when you're being responsive efficient that means to use the minimum intervention necessary again this means you know you don't want to be overreactive let's just you know whatever it is is whatever we need to address it with we don't need to be overreactive action-based so the child should be an active participate participant in their own learning so kind of you know they need to know what's going on they need to know what's what happened what was it that they did that they shouldn't have done how could they have done it correctly leveled at the behavior this is focus on the behavior not the child focus on the behavior not the child so if a youth or a kid is chronically you like I said chronically late getting ready in the morning what can we do to change this not what's wrong with you not what is wrong with you as a person as an individual it is more of let's focus on this Behavior what's not working and what can we do to change it TBR um website has this little poster so I just like to reiterate it you know immediate within a couple of seconds if possible engage directly with eye contact touch proximity efficient use the measured response and e that's equal to the to the challenging Behavior actuas that's another great way give the opportunity for a redo practicing the right way leveled at the behavior not the child remember you're wanting to help this child overcome the behavior and whatever was Jobing the behavior we also have levels of response so first up we have playful engagement this promotes connections and disarm ARS fear because play disarms fear so this will look different depending on the age and situation but this can be anything from just a smile or you know playing basketball doing whatever to just be completely silly you know acting like zoo animals you know playing having a tea party whatever the case may be and that's where you're kind of teaching some of those Behavior scripts and practicing some situations in play next you have the structured engagement now this is where you what you use when there is a bit of a challenge but the child can still self-regulate so this is where the adult or caregiver is a little more authoritative and and firm in in their responses to the child behavior scripts are most useful here so this is where if the child is having some sort of a challenge or is having a challenging Behavior this is where you'd be like are you asking or telling let's let's redo that let's see if we can try that again um so you want to be a little more authoritative but not you know so much to scare the child or to escalate the situation even more the goal is to deescalate the situation next up we have the calming engagement so this is where there is some sort of pre this is to prevent potentially dangerous situations so this is where the child is not quite in the Red Zone but is pretty close and you're trying to prevent that child from getting into the red zone so the child is probably on a verge of a meltdown you can see it coming usually because you know the child so a common strategy in TBR is time in as opposed to time out time in is where the child is kept close to the adult or caregiver either next to you know right next to them or as close as possible or as close to that child's Comfort level and you want to have them close to that adult or caregiver so the child still feels connected they don't feel oscillated you know they are connected they have a person a safe person they feel safe and they know that that person can help them calm down may need some co-regulation but that adult or caregiver can help them calm down and this is obviously opposed to timeout where when a child is sent away from the caregiver or adult and is isolated whether you know be in their room or the corner whatever designated area some people use for a time out but that leaves the child to feel not safe and build a lot of fear the child is probably you know worried about what's going to happen the next time they see that adult whether walks in the room or they walk out of the room how is that adult going to respond that just tends to build a lot of fear and that's not helping calm the child down that's really just making things escalate next up and lastly we have protective engagement and this is where the situation is dangerous uh Crisis Intervention might be needed this is where the child is either a threat to themselves or others or has threatened to hurt themselves or others and you know that the threat is serious this is not taught as part part of TBR because most organizations have their own policies and procedures that has to be followed so for us at Family MERS this is when we utilize our CR crisis plans with the client or call 911 the main goal here is to keep everyone safe including the child and anyone around the child we have one last video that kind of ties in together the ideal response and the levels of response when a child from a hard place doesn't feel safe the result is often behaviors that appear willful baffling and infuriating to caregivers how we respond in these moments is critical and TBR has developed a guideline to help the ideal response looks at the levels of behavior with the goal of moving the child to a calmer State immediate means dealing with misbehavior within 3 seconds meltdowns are a Runway train a gentle word and often just the question I see you're upset what do you need need is enough to put on the brakes hunger dehydration and a need for sleep are often triggers direct isn't glancing up from your phone and yelling across the room it's responding with direct eye contact proximity and reassuring touch when possible efficient stresses levels of a response using a kind voice and the fewest words caregivers should ask what is this Behavior saying what does this child need and how can I teach them to to get these needs met action-based can offer a child a doover instead of punishment a calming smiling voice saying let's try that again followed by Praise can create an instructional pass and a positive body memory leveled at Behavior addresses the behavior not the child allowing the caregiver to be an advocate not an adversary when you're reactive instead of proactive you put your energy in the wrong place and miss the opportunity for a teaching moment playful engagement works best when the behavior is at a low level a redo can diffuse the situation quickly a cheerful can you try that again with respect can turn the tide when followed by Praise structured engagement is needed when the situation has escalated and playful engagement has failed if a meltdown ensues by offering the child a choice they learn they have a voice can I have a compromise said in a firm calm voice voice followed by good compromise can introduce recognizable scripts a child can understand when aggressive behavior looms nothing is gained by responding in anger or isolation calming engagement says here come sit beside me you seem to be having a hard time you let me know when you're ready to talk remaining calm and keeping the child close changes the dynamic when there's a potential for violence protective engagement means first remove in the child or others from the situation and letting them know that they're safe and not defined by their behavior helping the child to breathe and asking what they need can help restore calm the foundation of TBR is that behaviors are driven by fear and unmet needs and when we avoid angry punitive Behavior ourselves we open the door to better outcomes for our children I hope you found that video very useful just like the way it hases every together lastly last um part of the presentation is just the resources the TCU website has a lot of resources obviously that's where TBR was developed so they have a lot of resources YouTube as you noticed that's where all of my videos came from they also have several several more videos there are tons of books that you can see listed here and I'm sure as well as others podcast and parent coaching there are also going to be some additional trainings and if you guys want additional trainings in any of these areas you can always reach out to me and I can see when there will be one that is the closest to you or one that you maybe you could do virtually and lastly of course you can always reach out to me if you have any questions or if you want any more information or resources or you know anything that you might be able to use with the kids or utilize so you can always reach out to me if I don't have it I can definitely try to find it for you just a few more little things that I threw in here that I like from the resources this one is why does my child's Behavior trigger me just like that because it's really informative for the parents and or caregivers uh this brain is just a different one that kind of shows upstairs and downstairs brains little routine chart of course there's several more that you can find online or Pinterest or anywhere and this little zones of Regulation poster this is another additional one um I like this one because it already has some options of what the child can do to get out of each zone so a lot of times when you're having a child do this and may they may have difficulty coming up with things that they can do or what they think will help them maybe they don't know so this can go ahead and give them a couple of options to start and then of course you know as you can see at the end of each one it says I can also so they can also add anything else additionally that they think might help later on all right thank you so much and I hope you guys really enjoyed this and can really utilize this information