Dr Chris Moore
Managing Change: Trauma-informed Transitions
Many children who have experienced trauma are sensitive to change. Their past relationships with adults may have been characterised by inconsistent and unpredictable responses to their needs, periods of emotional unavailability, separations and loss. Those children within the care system may have been faced with multiple changes in environment; some at very short notice. When a child’s stress-response system is compromised by these persistent experiences of fear and uncertainty, they will need more support with managing the various transitions within the school day.
Providing warm and consistent routines
It’s important that we help the child settle upon arrival to school in the morning. A familiar and consistent key adult could meet the child and act as a “secure base”. There may need to be an explicit hand-over from the parent/guardian, with the use of a transitional object (e.g. a photograph, a key-ring, a scented tissue) as a concrete representation of their relationship. This can also be used if the key adult will not be present for the first classroom activity.
The child will benefit from encouraging messages about how happy you are to see them and how they are safe. We need to check in with their feelings – depending on the child’s developmental age, this can be through verbal questions or visuals (e.g. a feelings thermometer or a choice of emotional faces). Asking about the night before or past weekend – and talking about how you’ve been thinking of them during that time – can be a good way of emphasising how you remain connected during these separations. Good home-school communication, via a daily diary or email system, can also give advanced warning of heightened emotions and the need to reduce demands on a particular day.
As the child may be anxious about the day ahead, a review of the daily timetable will help to add structure and predictability. A visual schedule should be considered as a concrete means of checking what is happening now and next. Some children may need dedicated time to play or perform a calming activity; such as drawing, building with Lego or performing rhythmic exercise. This can help to mitigate the emotional dysregulation caused by the large crowds in the playground and the higher levels of movement as everyone heads to their respective classroom. We also need to check in with the child at the end of the day, reflecting upon and empathising with the positives and negatives of their overall experience.
Getting ready to engage in a learning task
Let’s first consider if the child is physiologically ready for engaging in the task. If it features prolonged sitting or listening, we may need to schedule a movement break or some form of proprioceptive input beforehand. This can help them maintain a calm and alert state. While such breaks should be part-and-parcel of the school day for a child with a background of trauma, we should take cues from the child’s behaviour (e.g. increased restlessness, higher levels of inattention, seeking frequent reassurance) as a means of recognising when they need a calming activity before or after a more challenging academic task.
Clear communication about the task is vital. The child will need instructions to be simplified, reinforced and repeated. We may need to model organisational skills – such as retrieving specific equipment and taking out certain books and materials – and promote these skills using visual checklists and explicit labelling of nearby shelves and folders. Visual timers can be helpful in giving feedback to the child about how long they have to work. Tasks should be broken down into small and discrete steps.
We also need to think about the structure of the task. Memory and processing demands should be reduced where possible. For example, we can highlight key words for a comprehension activity, provide a vocabulary list for writing activities and show worked-out examples of a maths problem with arrows or colours to signify the processes. There may need to be an emphasis on quality over quantity and opportunities to demonstrate understanding without excessive writing. Multiple-choice answers or fill-in-the-blank sentences can remove the daunting prospect of the blank page.
Managing changes in activity
We must be mindful of a child’s past experiences, where they may have been prevented from finishing something they enjoyed or lacked control over the beginning and ending of activities. Sudden changes may have been commonplace, leaving them hypervigilant to transitions in the school environment. We need to help them anticipate when a learning task is coming to an end.
For some children, verbal feedback may be sufficient in communicating how long is left or when they need to begin to tidy up. If this method proves to be stressful and is likely to escalate their emotions, visuals may be more appropriate. These could include periodically showing a 5 to 1 or coloured countdown strip, leaving a sand timer nearby for them to check or referencing a First/Then visual timetable. We may also have to model how to prepare for the next task.
If the child is transitioning from an activity which is highly enjoyable or motivating, we need to show empathy for how difficult this is. For example: “I know it’s really annoying that we have to stop colouring in now. You’re so good at it and I bet you wish you could colour in for another hour”. It’s important that we fully explain what is happening next and provide the opportunity to come back to the activity at a later point. We can provide physical reminders of this agreement, using post-it notes, bookmarks, a message on the whiteboard or a prompt in the Reminders or Notes apps on an iPad.
Coping with unstructured periods and changes to routine
While simple changes in activity can be tough for a child with attachment difficulties, just imagine what break and lunch time is like for them. Noisy and crowded dinner halls. Busy corridors as their peers gather their belongings. Stepping out into a big playground with lots of children playing tag or kicking footballs in every direction. All of this stimulation can be anxiety-provoking and trigger the fight/flight/freeze response which has been overly developed during experiences of trauma.
We need to increase the level of predictability at these times of the day. This could include having a designated seat in the dinner hall for the child. A key adult may need to get alongside the child to model what to say to the canteen staff and talk through the food which they are given. Clubs and group activities facilitated by an adult can be a great way of promoting social interaction in a structured and consistent manner. Social Stories can also be used to practice how to initiate play and conversations with peers in the playground.
Let’s consider other times of the year which can be very challenging for these children. When they experience play rehearsals and parties in the lead-up to Christmas holidays, we may need to schedule more sensory breaks and opportunities for relaxation. On Sports Day, they may need a visual schedule for greater predictability about the various activities. Giving them a job to carry out may help them to cope with long waiting periods. When a familiar teacher or classroom assistant is absent from school, we need to explain this clearly and sensitively. It will be important to think out loud about how they may be feeling and empathise with these understandable emotions. The child will also benefit from reassurance that normal routines are being followed and that the familiar adult will be coming back.
Preparing for bigger transitions
School holiday periods can be stressful due to the change from the normal daily routine. As children who have experienced trauma may lack a reliable sense of time, we need to help them anticipate these larger breaks from the normal routine. It may be useful to have a big calendar in the classroom as a means of providing a visual countdown to the holiday. For older pupils in secondary school, we could use colourful marking in their homework planner to show this date approaching.
The end of the academic year poses many challenges; whether it’s the child moving on to a new classroom and teacher in the same school or transferring to a new school entirely. We should consider providing photographs of the new classroom and the staff within it, so that the parents/guardians can discuss these changes with the child over the summer months. When moving to secondary school, photographs of the key areas of school (e.g. form room, PE hall, dinner hall, chill-out areas, etc) will help to demystify the new environment. Some settings now offer virtual tours on their websites, which I hope will become standard practice in the future.
Visits to these new environments with a key adult, in the months leading up to the summer, will be important in helping them safely explore the surroundings with the support of a secure base. I would also encourage communication with the child over the summer months or during the first term of secondary school. This could be a short letter, a postcard or even a scheduled visit to their new school once they have settled in. Going the extra mile to maintain contact during separations can show that we are keeping the child in our minds and that the positive relationship you shared continues to endure.