Understanding and Promoting Resilience Against The

Understanding and Promoting Resilience Against the

Effects of Adverse Childhood Experiences

Vignettes

The following vignettes are designed to encourage conversations amongst Early Childhood professionals. These are examples of children’s reactions to adversity early in life. Early Childhood professionals should keep in mind that every child will uniquely respond to adversity and these vignettes are not a typical response for all children. It is encouraged to use these vignettes to determine the policies and procedures within the Early Childhood program where you work. For example, here are a few questions to discuss with the administrator and colleagues within your program:

·  What should specifically be documented and when?

·  Who do we talk to if we are concerned about the child?

·  How do we decide when to seek outside help?

·  What is my role as a mandated reporter?

·  When is it appropriate to make a referral to a mental health consultant?

·  What is my role and responsibility when working with a mental health consultant?

Vignette 1
Kayla
Kayla is a 9 month old who lives with her biological mother and father. Kayla does not attend the Early Childhood program on a regular schedule. Kayla’s mother has been diagnosed with bipolar disorder, but this is unknown to Kayla’s teachers. Upon arrival, Kayla appears withdrawn and does not cry when her mother leaves the classroom. The teacher’s find this unusual, especially since Kayla does not regularly attend and is developmentally at an age where stranger anxiety is present. Teachers have noticed that sometimes Kayla’s mother is very talkative and other times she barely speaks to them.
Teachers have noted Kayla will… / Strategies
·  not cry when she hears a sudden or loud noise
·  not express comfort and discomfort in different ways
·  not smile in response to social stimulation
·  wiggle and try to get out of the teacher’s arms when being held
·  not appear to be comforted by familiar adult when distressed
·  not show displeasure at loss of toy
·  not laugh aloud when playing peek-a-boo
·  not look to a familiar adult when a stranger approaches
·  not respond to the teacher’s who are clapping to celebrate her accomplishments
·  watch teachers very intently / ·  Establish a primary caregiving system so that you are better able to interpret and respond to Kayla’s needs.
·  Allow only a small number of people to be regularly involved in the care to allow Kayla to form relationships and build intimate relationships.
·  Provide warm, responsive, and predictable care to Kayla.
·  Understand that your role in helping Kayla manage her stress is one of balance, of rescuing the Kayla from distress and of letting her work things out. Obviously, you will want to change her wet or soiled diaper, feed her when she is hungry, pick her up when she cries, alleviate her discomfort and try to ease her pain.
·  Remain nearby and checking in with a glance or call Kayla’s name to help her know you are available.
·  Recognize Kayla’s signs of stress and respond with calmer interaction or surroundings (use softer voice, move away from source of stimulation).
·  Give Kayla familiar calming objects/soothing materials (soft blanket/materials, pacifier). Consult with parents to find out what object works best for Kayla.
·  Talk to Kayla when she looks to you for approval or disapproval (“You may get the toy duck from the basket”).
Vignette 2
Jorge
Jorge is a 16 month old who attends the Early Childhood program on a full-time basis. Jorge appears to enjoy school. Jorge has a hard time with engaging in activities and with peers. His parents are addicted to drugs. Jorge’s father has been incarcerated several times. Jorge and his older siblings have visited his father in jail. Jorge’s mother sometimes leaves Jorge and his older siblings alone for days. Often, Jorge is not brought to the program or picked up by the same person. He is dropped off at the program very early and is usually the last child to leave. Usually, the administrator has to call several people on the “pick up” list before reaching someone who is willing to pick up Jorge.
Teachers have noted Jorge will… / Strategies
·  stay with an activity for less than 5 minutes.
·  leave an area when other children are in it
·  use a comfort object for security, such as blanket or toy
·  spend time alone in the “quiet space”
·  run from the teacher when she tries to give him a hug
·  explore familiar areas, but will not go into areas with new items
·  will run to the “quiet space” if an unfamiliar adult comes into the classroom
·  walk away if a child takes his toy / ·  Continue to be a primary caregiver for a small group of toddlers, especially if their language is not yet easily understood.
·  To help Jorge feel secure, provide a predictable sequence in the day while maintaining a flexible time schedule. A predictable sequence will help Jorge to know what to expect next and makes transitions somewhat easier. A predictable routine is essential to Jorge because he has a chaotic home life that is unpredictable. Prepare Jorge for changes even though they may be a normal part of the daily routine.
·  Allow Jorge to use his comfort object for security
·  Comfort Jorge and let him know he is cared for and appreciated. Give pats on back, instead of hugs and ask him to sit close to you instead of in your lap where he is not comfortable. Be sensitive to ensuring that your touches are welcomed by him. If touches are not welcome, simply use words.
·  Include opportunities for Jorge to know he is a valued member of the total group in your care. For example, sing songs and play games that include each child's name. To the tune of "Where Is Thumbkin?" sing "Where is Jorge? Where is Jorge?"
·  Provide opportunities for cooperative play like a rocking boat or a wheeled toy that accommodates two children.
·  Talk about feelings. Specifically comment on the Jorge’s feelings as well as the feelings of others. “You are dancing as if you are very happy, but I don’t think Matthew feels like dancing now. He is still very sad that his Mommy went to work.”
·  Focus on Jorge’s positive qualities; his accomplishments and things he can do well. For example, "You buttoned those buttons on your coat all by yourself,” or, "That's a tall tower you built."
·  Respect Jorge’s right to have feelings and to express them. Avoid gushing sympathy such as "Oh, poor Jorge. Don't be afraid. I'll make it alright." Avoid trying to distract away from these emotions with a toy or an activity. For example, "Here's your favorite bear. I know you like to play with this bear." Avoid denying that the child's feelings are real by saying things like "Jorge, there's nothing to be afraid of." Instead, accept Jorge's feelings as real to him. Comfort him in a way that will lead him to comfort himself and know when to signal for help. For example, say, "I know you're afraid right now." Reassure Jorge that you are nearby if he needs you.
·  Stay close to or hold Jorge if he reacts negatively to the presence of a stranger. Let the stranger know about Jorge’s concern. Be careful not to be overly protective of Jorge because he is distressed by a stranger, for example by rushing over to hold Jorge each time a stranger comes into the room. Your action may send the message to Jorge that new people are to be feared.
Vignette 3
Ka’nai
Ka’nai is a 3 ½ year old who cries and is difficult to console when her aunt drops her off at the Early Childhood program. Ka’nai clings to her aunt and runs after her when she walks away to leave the classroom. Ka’nai has just been placed in her aunt’s care by Child Protective Services. Her mother often left Ka’nai at other people’s houses for several weeks, until she moved in with her boyfriend. In this new living arrangement, Ka’nai’s mother and her boyfriend physically abused Ka’nai. Finally, Ka’nai’s aunt was able to obtain temporary custody. Ka’nai is allowed supervised visits with her mother, but they rarely happen.
Teachers have noted Ka’nai will… / Strategies
·  kick and scream when the teachers try to console her after her aunt leaves the classroom.
·  be aggressive with the other children when they do not want to play with her.
·  grab items from other children’s hands. When the teachers remove the items, she climbs on the shelves to obtain the items the teachers have removed.
·  hoard toys and not allow others to play with them. If they try, she will hit or kick the person.
·  cry and cling to her favorite teacher, when the teacher tries to leave the classroom. / ·  To help Ka’nai feel secure, provide a predictable sequence in the day while maintaining a flexible time schedule. A predictable sequence will help Ka’nai to know what to expect next and makes transitions somewhat easier. A predictable routine is essential to Ka’nai because she has a chaotic home life that is unpredictable. Prepare Ka’nai for changes even though they may be a normal part of the daily routine.
·  Develop specific rituals with Ka’nai for arrival and departure times for smoother transitions.
·  Comment on and encourage positive social interactions.
·  Talk about feelings. Specifically comment on Ka’nai’s feelings as well as the feelings of others. “You are dancing as if you are very happy.”
·  Focus on Ka’nai ‘s positive qualities – her accomplishments and things she can do well.
·  Model the type of interactions with others you want Ka’nai to develop: affection, empathy and gentleness.
·  Include plenty of materials in the environment to allow Ka’nai to express and share feelings and to role-play (e.g., dramatic play props -dolls, dress-up clothes, small people/figures-, sand/water play; art, music and songs, puppets, books, etc).
·  Create a picture album with photos of Ka’nai’s aunt and Ka’nai’s favorite teacher for Ka’nai to have when these individuals are gone.
·  Celebrate Ka’nai’s accomplishments with specific observation and feedback.
·  Clearly state behavior expectations and provide specific feedback when Ka’nai behaves well.
·  Model self-control by using self-talk (e.g., ”Oh, I can’t get this lid off. I am feeling frustrated [take a deep breath]. That’s better. I’ll try again.”).
·  Coach Ka’nai to express her feelings verbally. For example say, “I see you are very upset that your aunt left. Let’s go write a story about this.”
·  Provide toolkit of solutions to support Ka’nai in working through feelings or solving conflicts (e.g., pictures of options).
·  Models appropriate behaviors across settings with the use of pictures, photographs, or other symbols.
·  Help Ka’nai use words to describe actions and feelings (e.g., “I feel ______”).
·  Encourage Ka’nai to draw or identify pictures of self that reflects emotions or how one’s feeling.
·  Teach Ka’nai how to make and be a friend through role-play.
·  Read books that include conflicts or problems requiring cooperation. Ask Ka’nai to predict what will happen next, or after reading, ask her to provide alternative solutions. You may need to brainstorm solutions with her.
Vignette 4
Lucas
Lucas is a 7 year old who loves school. He enjoys talking to teachers and engaging in his work, even though he struggles with learning. However, Lucas has a difficult time interacting with peers. He yells at his classmates and takes items from their hands. Lucas and his mother have lived in and out of domestic violence shelters. For his whole life, Lucas has witnessed his mother being abused by his father. Lucas and his father have a good relationship, so it is difficult when his mother takes Lucas and leaves his father. Lucas’ father will often say things like, “It’s your mother’s fault that we are not together, Lucas.”
Teachers have noted Lucas will… / Strategies
·  yell things like, “You are so stupid!” to other children.
·  have a difficult time focusing on his tasks
·  not appear to understand the directions on an assignment
·  hit another child to obtain items he wants
·  want to spend time talking to the adults
·  not be able to control his emotions (whether positive or negative)
·  hide under the table if there is a sudden loud noise
·  cover his ears if an adult talks to her in a stern voice
·  curse when the teacher mentions the word “mother” / ·  To help Lucas feel secure, provide a predictable sequence in the day while maintaining a flexible time schedule. A predictable sequence will help Lucas to know what to expect next and makes transitions somewhat easier. A predictable routine is essential to Lucas because he has a chaotic home life that is unpredictable. Prepare Lucas for changes even though they may be a normal part of the daily routine.
·  Comment on and encourage positive social interactions.
·  Model positive and respectful communication between adults.
·  Talk about feelings. Specifically comment on Lucas’ feelings as well as the feelings of others. “You are dancing as if you are very happy.”
·  Focus on Lucas’ positive qualities – his accomplishments and things he can do well.
·  Model the type of interactions with others you want Lucas to develop: affection, empathy and gentleness.
·  Clearly state behavior expectations and provide specific feedback when Lucas behaves well.
·  Model self-control by using self-talk (e.g., ”Oh, I can’t get this lid off. I am feeling frustrated [take a deep breath]. That’s better. I’ll try again.”).