1. Module I Orientation to Child Trauma Assessment

5. DHS CMH SCHOOLS COURTS Resource Parents

6. The Team

9. Cultural & Linguistic Competence Yvette D. Hyter, Ph.D., CCC-SLP Speech-Language Pathologist Western Michigan University Children's Trauma Assessment Center

14. Pathway to Cultural & Linguistic Competence Awareness Sensitivity Reciprocity Competence Open to others; learning about cultural histories, values, beliefs (Adams, 1995) Aware of differences & similarities that have an effect on values and behavior; no value judgments (Stafford et al., 1997) Coordinated behaviors, attitudes, and policies that allow effect service across multiple cultural & linguistic groups (Cross et al., 1989 Recognition underlying taken-for-granted assumptions, how they guide behaviors and affect those that do not hold them (Kalyanpur & Harry, 1999)

15. Reflect, Revise, Retry Know Your Self and your group Understand History Learn from others Ten Principle Practices Eliminate ethnocentrism Cultural Competence Learn from mistakes made Tear down barriers Be accountable Honor Uniqueness Center other experiences Hyter, 2009

17. The Brain-Behavior Connection Neurobiological & Neurodevelopmental Impact of Traumatic Stress & Prenatal Alcohol Exposure in Children & Adolescents: Understanding Difficult Behaviors Mark A. Sloane, DO, FACOP, FAAP Kalamazoo, MI 18 February 2009

19. Building the brain From simple to complex: Hierarchy of brain function Brain- stem Diencephalon Limbic Neocortex Abstract Thought Concrete Thought Executive Function Attachment Sexual Behavior Emotional Regulation Motor Regulation Motivation Arousal Sleep BP / Heart Rate Respiratory Drive Body Temperature Perry 2006 All sensory input enters here

20. The Delicate Balance: Brain control of emotion / behavior Top-Down “ Brakes ” (Prefrontal Cortex) Bottom-Up “Accelerator” (Brainstem/Limbic System)

21. So… now let’s talk about the accelerator

22. Wake up!!! Let’s talk about arousal …

23. No energy / tired & sleepy (Eeyore) Optimal “Goldilocks” Arousal Way too wound-up / “wild” (“Tigger - on crack”) Arousal Genesis / Regulation Too wound-up (Tigger)

25. Next, let’s talk about the… BRAKES

28. Building (& Rebuilding) the Brain Neural systems can be changed / treated but some systems are easier to change Brain- stem Diencephalon Limbic Neocortex Complexity Plasticity & Ease of change

29. Child Traumatic Stress & the Developing Brain

32. So…what about neglect???

33. But…this case only involves neglect !

34. Impact of Severe Neglect

36. Complex Trauma And Developmental Trauma Disorder Connie Black-Pond MA, LMSW, LPC

38. Domains Impacted by Complex Trauma Behavioral Control Cognition Attachment Dissociation Affect Regulation Biology Self Concept

48. Traumatic Expectations of the World

51. Sensory Processing Disorder Ben J. Atchison, PhD, OTR, FAOTA Department of Occupational Therapy Western Michigan University

54. Sensory Processing Disorder (SPD) Sensory Modulation Disorder Sensory-Based Motor Disorder Sensory Discrimination Disorder SOR SUR SS SOR=Sensory Over-reactivity-Low threshold SUR=Sensory Under-reactivity-High Threshold SS=Sensory Seeking/Craving-High Threshold Miller, et al, (2007) , Mar.April AJOT Dsypraxia Postural Disorders Visual Auditory Tactile Position/Mvt Taste Smell

59. Social Communication Yvette D. Hyter, Ph.D., CCC-SLP Speech-Language Pathologist Western Michigan University Children’s Trauma Assessment Center [email_address] , 269-387-8025

63. Social Communication Framework Higher Order Executive Functions Decision making and strategic planning processes Social Communicative Behaviors Social Communicative Competence Using language in interpersonally appropriate ways to successfully influence people and interpret events Coggins, T. E., Timler,G. R. & Olswang, L.. B. (2007). Social Cognition Understanding why people act in certain ways and what they are likely to do next. Language Sentence Structure Word meanings/relationships Language use

65. Hey!.....Here’s a good idea!... Let’s finish with a group… stress test!!!

68. Are You Ready…For the Next Step? Are You Ready for the Next Step?

70. This presentation is part of a comprehensive professional education and training project created by the SW Michigan Children’s Trauma Assessment Center funded by a grant from the Substance Abuse and Mental Health Services, Department of Health and Human Services which funds the National Children’s Trauma Stress Network