Distressed or Deliberately defiant? 

Managing challenging student behaviour due to trauma and disorganised attachment  

Dr. Judith Howard

Attachment - Bowlby and Ainsworth messages

• Healthy attachment meets the safety and protection needs are met
• Healthy attachment allows a young child to explore their environment with a feeling of safety and security.
• Healthy attachment helps a child to learn basic trust.
• Healthy attachment helps the child to coregulate their emotions and build to self-regulating.
• Healthy attachment creates a foundation for the formation of identity and a sense of self.
• Healthy attachment helps to establish a pro-social moral outlook
• Healthy attachment helps to generate a world view that people and life are basically good

Two broad categories of attachment – Secure and Insecure, secure shows healthy attachment. Insecure attachment is in 3 subgroups

• Resistant – is extremely distressed by separation, is unable to settle emotionally, can seem to desire and repel parental support and contact
• Avoidant – shows little interest in parent and can actively avoid contact and support from them.
• Disorganized - often display a confusing mix of behaviour and may seem disoriented, dazed, or confused. Children may both avoid or resist the parent as well as showing a need for strong attachment. Some researchers believe that the lack of a clear attachment pattern is likely linked to inconsistent behaviour from caregivers. In such cases, parents may serve as both a source of comfort and a source of fear, leading to disorganized behaviour.

The science…

The nervous system is the control centre for your body. It interprets the things your body senses, and it sends information to the muscles and glands, telling them what to do. It also runs the systems you don’t have to think about, like the digestive and cardiovascular systems. The nervous system is also responsible for your moods and your thoughts.

The somatic system ends sensory information to the central nervous system through peripheral nerve fibres. It sends the information coming from all your senses, touch, vision, hearing, taste, smell and position. It sends messages to motor nerve fibres to get the muscles to move the body.

The autonomic system in two parts the parasympathetic system and the sympathetic. The parasympathetic is responsible for making sure that all the automatic things that your body needs to do to keep you going, like breathing, digesting etc continue working smoothly without your having to think about them. The Sympathetic nervous system becomes more active when you are stressed. It is a part of the "fight or flight" response.

The Brain

The Brain stem is a part of your brain that controls many of the basic body functions that keep you alive. The brain stem is found at the base of the brain and is made up of three main parts: the midbrain, pons, and medulla oblongata.

• Your brain stem works as a bridge or relay station for messages travelling between different parts of your brain and messages travelling from your brain to the spinal cord. It also controls the movement of involuntary muscles i.e. your lungs, heart, and blood vessels etc
• It is the area of the brain that becomes particularly active during fight flight or freeze responses.

Cerebellum - This part of the brain deals with motor movement. It processes all the incoming motor messages from the nerves and figures out what to do with them. The cerebellum can learn motor movements with practice allowing us to learn to ride a bike or write or type etc.

• It continues to develop over the first years of life.
• Means young children are far more dependent on parents to meet needs 

The limbic system is a group of brain structures that are involved in various emotions such as aggression, fear, pleasure and also in the formation of memory. There are two important parts of this system...

• hippocampus: involved in the formation of long-term memory
• amygdala: involved in aggression and fear 

The cortex - The cerebral cortex is the most important part of the brain. ... Though this cannot be seen directly, different parts of the cortex have different functions. It plays a key role in memory, attention, perceptual awareness, thought, language, and consciousness.

• The prefrontal cortex (PFC) is the front part of the frontal lobes of the brain. It lies in front of the motor and premotor areas. This brain region helps plan complex cognitive behaviours, personality expression, and decision making. It helps correct social behaviour.

Early childhood and the brain

• The development of the brain is influenced by many factors, including a child’s relationships, experiences and environment.
• Nurturing care for the mind is critical for brain growth.
• Children grow and learn best in a safe environment where they are protected from neglect and from extreme or chronic stress with plenty of opportunities to play and explore.
• Exposure to stress and trauma can have long-term negative consequences for the child’s brain, whereas talking, reading, and playing can stimulate brain growth.
• Neglect in failure to meet the physical, cognitive, emotional and social needs of a child can have a significant impact on their development

What does this look like at school?

• Fight flight or freeze – low threshold for stress, behavioural responses at this stage are purely reflexive and under little conscious control by the student.
• Hyperarousal – aggressive and may hit out at people and or objects, need considerable time and careful support
• Oral language – will often be unable to use their words to explain themselves, miscommunication can occur
• Hypo-arousal – results in a freeze response, disassociate, sobbing crying for help, uncommunicative 

What can we do about it that works?

• Relationships – strategies to reinforce healthy neurological pathways supporting interpersonal interactions with adults, peers and self
• Emotional regulation – effective calming strategies for emotionally aroused students, ways to minimise a crisis, and healthy ways to address the crisis when it does arise.

Relationships

• Need for capable caring and informed teachers to support students
• Behaviour management systems will not work unless the relationships are there first
• Behaviour management systems that reinforce the trauma and insecure attachment issues will not work
• Groups work oral presentations, performance, team sports, games and busy playgrounds may cause anxiety
• Can cause confusion for teachers with overreactions to simply being close or a simple touch

Emotional regulation

• Schools need both proactive and reactive approaches to help the student to self regulate
• Not waiting until the student is in a calm state can be putting the student, themselves and others at risk
• Takes thirty minutes to come back to a calm state, and for older students longer
• Need to take into account that when calm, the student may not be able to communicate what is going on or what has happened due to their developmental delays and attachment issues

Six-element model for student support
1. Establish a strong support team – need to be resilient, willing to learn and to adapt their practice
2. Inform the team of the neuroscience and current research – reading web, and mental health services
3. Get to know and understand the student – discover key issues, what works what doesn’t, plans and practices need to reflect the students’ needs and their peculiarities.
4. Engage the support of the wider school community – whole staff support plans don’t work if some adults are unaware, unskilled or unsupported to in responding to a students’ emotional dysregulation.
5. Look after the people who are looking after the student, without support the teachers and other adults involved with the student burn out
6. Develop plans addressing relationships and emotional regulation-focused on the support process not merely a list of expected behaviours. Needs to be individualized and helps to teach and reinforce self-calming strategies as well as crisis management response.

Strategies and approaches

• Mentoring – is their significant person, focused on developing the skills in relating and managing stress responses. Works with calming and helping student to understand.
• Check in and check out – mentor, checks in before school breaks etc to see that the student has everything they need to cope with the day, can calm and preempt anything before it may happen
• Pick your battles – serious behaviours should be addressed carefully but avoid power struggles over lesser behaviours
• Using codes and symbols – communication systems helping to alleviate concerning behaviours while reinforcing positive relationships
• Scaling – assists in emotional regulation and student can identify and share how they are feeling at that time.
• Look for the gold in every child- finding the skills, knowledge or personal traits that they are good at
• Boundaries rules and consequences – need to develop self-control through boundaries, rules and expectations,
• A better way to manage detentions – try to create opportunities, for relating and teaching. Doing a particular activity with an adult who can help the student reflect on their behaviour and concerns around their behaviour, how to repair damage caused.
• Relational rewards, time with relationship building rewards
• Movement and rhythm activities – music, dance, drumming, ball bouncing etc
• Predictability – visual cues, timetables, consistency, repetition, timed warnings for the end of a lesson
• Helping students to relate to others – adults modelling and narrating social behaviour, needs plenty of opportunities and repeated practice. Crafts, inside games, soccer etc
• Social behaviours and physical contact – teach them about ways to interact appropriately

Crisis Management

• Need for proactive, reactive and reparative measures
• Safe space where they take part in low arousal activities, time to calm, left to self under the careful watch
• Physical restraint is last resort
• Time for the student to talk through what has happened with a focus on opportunities to learn from the crisis
• Time to debrief for mentor and teachers
• If suspensions or stand downs in place on return look at things with a fresh start approach rather than a prove yourself approach

Recognise difficulties with compliance for what they are… help them to experience the positive feeling and outcomes for being compliant. They need exposure to people wanting to be around them when compliant, teachers responding kindly, meaningful rewards. They are not used to this and noncompliance is associated with their attachment issues.