Key Treatment Principles

Question 1

attuned, safe relationships with caregivers

Answer 1

• trauma significantly impacts development
• 1 in 7 children in the US experience maltreatment, abuse, or neglect

Question 2

trauma significantly impacts development

Answer 2

• pervasive effects on the brain
• toxic stress derails healthy development
• (severe) neglect impacts language development more than abuse

Question 3

statistics

Answer 3

• 1 in 100 children have had a TBI
• 1 in 44 children are autistic
• 1 in 13 children have developmental language disorder
• 1 in 11 children have ADHD
• 1 in 7 children have experience maltreatment

Question 4

trauma-informed therapist

Answer 4

• have greater awareness and understandinng of the potential signs of traumatic stress in the people around them
• have a deeper understanding of their own past adverse experiences, and how they have impacted their thoughts and interpersonal interactions in life
• gain skills that allow them to thoughtfully respond to trauma in others

Question 5

what we can do

Answer 5

1. mandated reporters
2. strengthen child/caregiver interactions and attachment

Question 6

attachment styles

Answer 6

• secure
• ambivalent-anxious
• avoidant
• disorganized

Question 7

secure attachment style: positive model of others with low avoidance, positive model of self with low anxiety

Answer 7

• healthy communication and emotional awareness
• asks for help when needed
• able to self-regulate
• may have a history of caregivers who are responsive, but allow for exploration

Question 8

ambivalent-anxious attachment style: positive model of others with low avoidance, negative model of self, high anxiety

Answer 8

• needs frequent reassurance and close relationships
• has fears of abandonment
• asks for help indirectly or not at all
• struggles with anxiety or jealousy
• may have a history of caregivers who were inconsistently responsive

Question 9

avoidant attachment style: negative model of others with high avoidance, positive model of self with low anxiety

Answer 9

• difficulty expressing feelings
• withdraws emotionally to regulate
• struggles to ask for help
• very self-reliant
• may have a history of absent or emotionally neglectful caregivers

Question 10

disorganized attachment style: negative model of others with high avoidance, negative model of self with high anxiety

Answer 10

• has qualifies of both the avoidant and the ambivalent-anxious styles
• afraid of rejection, but doesn’t trust easily
• unpredictable behavior, alternating between acting out, and pulling people in
• may have a history of abuse or childhood trauma

Question 11

responsiveness, engaging interactions

Answer 11

• kids learn best when they’re actively engaged in activities that they enjoy
• “serve and return” interaction aka: communication catch
• reduces cognitive and processing demands by not asking them to switch their attention to align with ours
• follow child’s lead

Question 12

reduces cognitive and processing demands by not asking them to switch their attention to align with ours

Answer 12

allows them to better absorb information, like new vocab!

Question 13

follow child’s lead: notice what a child is interested in, and use that to provide opportunities for communication

Answer 13

• if you child likes to skip pages, that is okay; follow your child’s lead and enjoy your time together
• allow babies to play with board books, bang them, and chew on them
• rather than expecting your child to listen quietly, talk about the story, pictures, characters, and whatever your child is interested in

Question 14

5 steps

Answer 14

1. notice the serve and share the child’s focus attention
2. return the serve by supporting and encouraging
3. give it a name
4. take turns and wait
5. practice endings and beginnings

Question 15

contextual variety

Answer 15

• variety of words
• variety of sentences and settings
• components of a routine
• family guided routines
• first steps in building routines and outcomes

Question 16

variety of sentences and settings

Answer 16

• daily activities/routines: things we do often that can happen over and over again the same way
• functional: get dressed, brush teeth
• social: peek-a-boo, singing songs

Question 17

components of a routine

Answer 17

• beginning and ending
• outcome oriented
• meaningful
• predictable
• sequential or systematic
• repetitious

Question 18

family guided routines

Answer 18

• match the child and family interests
• promote positive interactions
• embed functional targets into meaningful outcomes
• are flexible and adaptable
• change with the child and family

Question 19

first steps in building routines and outcomes

Answer 19

• identify and explain the value of preferred activities and routines
• learn about child’s preferences and family expectations
• observe caregivers in routines with child
• identify outcomes appropriate for routine
• specify strategies and sequence
• gather feedback, monitor progress

Question 20

routine: getting dressed

Answer 20

• repetition
• beginning and ending
• logical sequence
• meaningful use of family objects, child’s toys, family words
• functional outcomes

Question 21

getting dressed: repetition

Answer 21

• turns within routine: different clothing items (underwear, shirt, pants, socks, coat, etc.)
• multiple times each day: dressed for school/play at home, dressed for bed

Question 22

getting dressed: beginning and ending

Answer 22

• “it’s time to get dressed for ___.”
• choosing clothing -> get dressed “all done. you ready for ___.”
• put dirty clothes away

Question 23

getting dressed: logical sequence

Answer 23

choose clothes, undress, put on clothes (shirt first, pants, socks, shoes), and put away dirty clothes

Question 24

getting dressed: meaningful use of family objects, child’s toys, family words

Answer 24

child’s clothing, “Sponge Bob” shirt, “squeaky” shoes

Question 25

getting dressed: functional outcomes

Answer 25

child is dressed, match goals to IFSP (labeling, following directions, expressing needs, etc.)

Question 26

story time: repetition

Answer 26

- turns within routine: turning pages, labeling pictures - multiple times each day: same or different stories throughout the day, bedtime, quiet time

Question 27

story time: beginning and ending

Answer 27

- choose a book or ask, "do you want to read a story?" - finish book "the end!"

Question 28

story time: logical sequence

Answer 28

choose the book, name it, turn pages, label picture, and put it away

Question 29

story time: meaningful use of family objects, child's toys, family words

Answer 29

child's favorite books, catalogs, magazines, photo albums

Question 30

story time: functional outcomes

Answer 30

points at pictures, labels words, sounds, looks at pictures, turns pages

Question 31

play

Answer 31

- how to use play expansions - when your child is playing, join in, imitate and describe - then expand your play and describe like this

Question 32

then expand your play and describe like this

Answer 32

- add objects - use the toy in a different way - do something to the toy - make toys interact with each other

Question 33

before book reading

Answer 33

- say the title and author: "this book is called ___ and is written by ___." - ask a question to build interest: "what do you think this book is about?"

Question 34

during book reading

Answer 34

- make encouraging statements: "I like how you're sitting so nicely with me!" "good job turning the page." - use nonverbal and verbal means to focus the child's attention: point to a picture and say, "look! it's a gorilla!"