J Child Fam Stud (2017) 26:2728–2741
DOI 10.1007/s10826-017-0774-9
ORIGINAL PAPER
Creating Supportive Environments for Children Who have had
Exposure to Traumatic Events
1
Katrina P. Cummings ●
Samantha Addante1 Jami Swindell1 Hedda Meadan1
● ●
Published online: 13 May 2017
© Springer Science+Business Media New York 2017
Abstract The prevalence of trauma among young children
and its impact on educational outcomes is gaining attention.
It is probable that the needs of children who have experi-
enced or been exposed to trauma have long gone unmet due
to identification challenges and a lack of knowledge con-
cerning best practices. For this study, qualitative interviews
were conducted to gather perspectives of 14 community-
based service providers who worked with children and
families regarding trauma-related concerns. Each shared his
or her perspectives on knowledge and skills early childhood
education teachers need to support children who have
experienced traumatic events and partner with their famil-
ies. Research questions were: What should early childhood
teachers know about (1) trauma experiences among young
children; (2) the emotional and behavioral patterns of chil-
dren who have experienced traumatic events; and (3) sup-
porting the social and emotional well-being of children in
the classroom setting, including partnering with families,
who have experienced or been exposed to traumatic events?
Participants indicated that teachers might not readily con-
nect children’s behaviors and emotions to trauma. However,
teachers can use approaches and strategies (e.g., being
attuned and supporting positive social and emotional and
communicative responses) that promote social and emo-
tional well-being for children who experience trauma. Par-
ticipants also noted that teachers can resist re-traumatization
by making adaptations to social, physical, and temporal
aspects of the classroom environment. Findings indicate
* Katrina P. Cummings
ksangute@illinois.edu
1
University of Illinois at Urbana-Champaign, 1310 S. Sixth Street,
288 Education Building, Champaign, IL 61822, USA
that trauma-informed care might be viable in early child-
hood classroom settings. Implications for research are
discussed.
Keywords Early childhood education Early childhood
●
special education Trauma Socio-emotional development
● ● ●
Parent-teacher partnerships
Introduction
About 1 in 4 children experience potentially traumatic
events before their third birthday (Briggs‐Gowan et al.
2010; Mongillo et al. 2009). By age nine, 13% of children
will have experienced 4 or more traumatic events (Finkelhor
et al. 2007). The American Psychological Association
(2013) defines trauma as “an emotional response to a terrible
event like an accident, rape or natural disaster (para. 1).”
The Substance Abuse and Mental Health Services Admin-
istration (SAMHSA 2014) further conceptualizes trauma by
indicating, “Individual trauma results from an event, series
of events, or set of circumstances that is experienced by an
individual as physically or emotionally harmful or life
threatening and that has lasting adverse effects on the
individual’s functioning and mental, physical, social, emo-
tional, or spiritual well-being (p. 11).”
Children who experience potentially traumatic events are
more likely to display clinical symptoms than children who
do not (Briggs‐Gowan et al. 2010). Posttraumatic stress
disorder (PTSD) is the common diagnosis for persons who
have display a range of clinical symptoms following
exposure to traumatic events. The American Psychiatric
Association sought to better capture trauma in young chil-
dren in the fifth edition of the Diagnostic and Statistical
J Child Fam Stud (2017) 26:2728–2741
Manual of Mental Disorders (DSM) by including a pre-
school subtype of PTSD (APA 2013). The preschool sub-
type is characterized by (a) exposure to a traumatic event,
(b) re-experiencing, (c) avoidance or negative alteration in
mood or cognition, (d) hyperarousal, (e) 1 month duration,
and (f) impairment in functioning.
Substantial evidence suggests that the symptomology
among individuals that experience trauma in early child-
hood differs from symptomology in individuals who first
experience trauma later in life (Jones and Cureton 2014).
Generally, young children exhibit symptoms related to re-
experiencing, avoidance, and hyperarousal just as older
persons do, but with different intensity and in varied
amounts (De Young et al. 2011). Re-experiencing includes
reenacting themes from the traumatic event, having dis-
turbing nightmares (Lieberman and Knorr 2007; Scheeringa
et al. 2003), and exhibiting distress upon exposure to
reminders of the traumatic event (Scheeringa et al. 2003).
Avoidance symptoms involve efforts to avoid people, pla-
ces, and activities that bring about memories of the trauma
and also loss of developmental skills, such as toileting and
speech (Scheeringa et al. 2003). Avoidance might be subtle
(e.g., avoiding eye contact) or obvious (e.g., refusal to make
contact with objects) and manifest as social withdrawal or
diminished participation in activities as children get older
(De Young et al. 2011). Rather than avoidance, young
children might display negative alterations in mood and
cognition that is characterized by numbing positive emo-
tions (Jones and Cureton 2014). Finally, hyperarousal
manifests as difficulty concentrating, hypervigilance,
exaggerated response, anxiety, and aggression (Scheeringa
et al. 2003). The American Academy of Pediatrics (2014)
has also identified several eating-related symptoms (e.g.,
rapid eating, hoarding food, loss of appetite) that might be
categorized as hyperarousal or avoidance symptoms.
Many children who experience trauma also display
internalizing and externalizing behaviors. Understanding
the links between trauma and internalizing and externalizing
behaviors during early childhood years is complex, yet
essential for a supporting children who have experienced or
been exposed to traumatic events (Jones and Cureton 2014).
In a random sample of 917 18 to 36-month-olds, about 20%
of children who had been exposed to traumatic events
exhibited challenging behaviors (Mongillo et al. 2009).
These children scored higher on the Child Behavior
Checklist and the Brief Infant Toddler Social Emotional
Assessment internalizing and externalizing scales compared
to children with no trauma exposure. Finally, the children
who had been exposed to traumatic events and also
exhibited challenging behaviors demonstrated more re-
experiencing and hyperarousal than children who had been
exposed to traumatic events, but did not display challenging
behaviors. Other studies go a step further by identifying
2729
mediators between trauma exposure and challenging beha-
viors. In a longitudinal study, Briggs-Gowan et al. (2012)
found that among a random sample of 437 preschool and
kindergarten-aged children, PTSD symptoms mediated
longitudinal pathways between violence exposure and
internalizing and externalizing behaviors. Milot et al. (2010)
reported similar results from a cross-sectional study with
children who were either maltreated or nonmaltreated
between ages 46 to 72-months-old. They found that trau-
matic stress symptoms mediated the relation between early
maltreatment and later internalizing and externalizing
behaviors.
The support needs of children who experience trauma
requires a range of knowledge (Chafouleas et al. 2016). Yet,
early childhood teachers receive limited training on the
promotion of social and emotional competence (Han 2014).
Thus, they likely lack the competencies for supporting
social and emotional well-being among children who have
been exposed to traumatic events. Limited awareness of
potential environmental triggers and the multiple ways in
which child trauma manifests could lead to inadvertently
triggering stress reactions in children, thereby provoking the
presence or exacerbation of symptomology (Lieberman
et al. 2011).
Holmes et al. (2015) described the only known trauma-
related professional development material designed speci-
fically for early childhood teachers. Holmes et al. adapted
the Attachment, Self-Regulation, and Competency Model,
which was developed to address trauma (Blaustein and
Kinniburgh 2010), to include nonclinical language, age-
appropriate resources for children ages three to five, and a
training format appropriate for program participants. Other
researchers draw foundational trauma-informed profes-
sional development content (e.g., prevalence and impact)
from organizations and governmental initiatives (Chafou-
leas et al. 2016). At this time, neither the transferability nor
effectiveness of trauma-informed professional development
materials for classroom use have been adequately studied.
Given the prevalence of trauma and the emergence of a
literature base depicting clinical needs among young chil-
dren who experience potentially traumatic events, it is
important to explore knowledge and skills that teachers can
use to support young children who are impacted by trauma.
Thus, this study explored information that might be helpful
to teachers as they shape educational experiences for young
children who have experienced trauma (e.g., child physical,
sexual abuse, domestic violence). Four guiding assumptions
were that trauma-informed environments include service
providers who (a) realize the impact of trauma, (b) recog-
nize the signs of trauma, (c) respond by integrating
knowledge about trauma within the environment, and (d)
actively resist re-traumatization of individuals who have a
trauma history (SAMHSA 2014). These assumptions are the
2730 J Child Fam Stud (2017) 26:2728–2741

basis for trauma-informed care set forth by SAMHSA Table 1 Participant demographics
(2014). They provided a useful means to frame this study, Category Variable n (%)
which explored the perceptions of community-based service
Gender Male 1 (7.14)
providers, e.g., social workers and family counselors, on
training and preparation considerations for teachers of Female 13 (92.86)
children in early childhood education settings who have Discipline Education 3 (21.43)
experienced or been exposed to traumatizing circumstances. Social Work 8 (57.14)
The three questions that guided this research were: (1) What Human development 2 (14.29)
or family studies
should early childhood teachers know about trauma
Psychology 1 (7.14)
experiences among young children; (2) What should early
childhood teachers know about the emotional and beha- Years of experience 1–10 years 3 (21.43)
vioral patterns of children who have experienced traumatic 11–20 years 4 (28.57)
events; and (3) What should early childhood teachers know 21 or more years 7 (50.00)
about supporting the social and emotional well-being of Highest degree earned Master’s 11 (78.57)
children in the classroom setting, including partnering with Bachelor’s 3 (21.43)
families, who have experienced or been exposed to trau- Populations served Child protective 11 (78.57)
matic events? service involved
Low Income 10 (71.43)
Homeless 7 (50.00)
Method Top SOURCES of trauma for Abuse/Neglect 10 (71.43)
children served
Domestic violence 7 (50.00)
Participants
Area of life affected by trauma School 11 (78.57)
This study included individual interviews with 14 Home 10 (71.43)
community-based service providers across a state in the Relationships 5 (35.71)
Midwest. Participants had worked with or on behalf of
young children (ages 0–5) who had experienced or been
exposed to traumatic events for a range of four to 43 years. individuals expressed interest during the initial contact and
The participants’ primary job responsibilities involved pre- additional recruitment continued via follow up contacts.
vention of child maltreatment and/or enhanced parent-child Prior to data collection, the questionnaire and interview
relationships. A few of the positions held by participants protocol were piloted with a doctoral student who had field
were: Mental Health Consultant, Child Life Specialist, and experiences with the target population and amended for
School Social Worker. The diverse group of participants clarity. Both measures were administered by the first author
presented a wide range of work experience; however, 12 to each participant in person or by phone at a time and place
(86%) of the 14 participants delivered family-oriented ser- convenient for the participant. Data collection continued
vices rather than or in addition to child-oriented services. until data were saturated, or no new themes emerged during
Additional details about participants’ work experiences are data analysis (Guest et al. 2006). All interviews were audio
in Table 1. recorded. Interviews ranged from about 30–80 min in
duration and were 48 min on average. Participants received
Procedures a $20 gift card after completion of the interview.

The key informant sampling technique was used to select

participants whose work exposed them to firsthand knowl-
edge of the population of interest and relevant information
regarding the identified research questions (Marshall 1996).
The lead author contacted individuals as well as local and
state agencies that primarily focus on prevention of child
maltreatment and/or enhanced parent-child attachment
relationships for children ages 0–5 and their families. The
lead author spoke with 48 individuals by phone or email
and, consequently, distributed recruitment flyers via email
to allow individuals and agency staff to share information
about the research project with colleagues. Some
Measures
Participants completed a questionnaire and a semi-
structured interview. The questionnaire included 12 items
related to the community based service providers’ work
experiences and characteristics of persons with whom they
work. The questionnaire included items regarding partici-
pants’ job title, degree, and years of experience working
with young children who have experienced or been exposed
to traumatic events and/or families as well as subpopula-
tions typically served, sources of traumatic experiences and
J Child Fam Stud (2017) 26:2728–2741
exposure for young children served, and areas of life
affected (home, school, community, work). The interview
protocol was developed by the lead author following an in
depth review of literature on trauma during early childhood
years. The interview protocol included 13 questions, as well
as prompts, that were used to understand service providers’
definition of trauma, further delve into their work experi-
ences, and gain detailed insights about each of the research
questions.
Data Analyses
Data were analyzed by the first through third authors who
had 10 years of field experience in clinical mental health
services and early childhood mental health consultation.
The first and third authors coded open-ended questionnaire
responses (e.g., populations served, area of life affected by
trauma) and then calculated percentages where appropriate
to provide descriptive data. Interviews were transcribed
verbatim and checked for accuracy by a research team
member. The first and second authors then analyzed tran-
scripts via a constant comparison process (Creswell 2013).
Specifically, the authors coded transcripts line by line, one
at a time, independently. Afterwards, they met to come to a
consensus on codes. Concurrently, the authors developed a
coding index that included definitions for each code. This
process continued until one half of the transcripts had been
coded. Next, the authors refined the coding index to reflect a
final set of themes and categories that emerged across
transcripts. Then, the first and second authors used the
coding index to code across the 14 interview transcripts.
Finally, for transparency, the authors calculated frequencies
and percentages to denote how many participants referenced
each category.
During analyses, authors used three indicators to foster
credibility and trustworthiness: thick descriptives, colla-
borative work, and member checks (Brantlinger et al. 2005;
Tracy 2010). Thirteen participants (92.86%) engaged in
member checks, which included reviewing one to two page
summaries of their interviews to provide feedback on their
accuracy and comprehensiveness (Tracy 2010). Feedback
included minor changes (e.g., clarification of work
responsibilities, clarification of word usage—resiliency as
amazing vs. surprising, etc.). The authors refer to each
participant by a pseudonym in the findings that follow (see
Table 2).
Results
Findings are organized by themes and related categories.
Themes were: (a) Realizing the Existence and Impact of
Trauma among Young Children, (b) Recognizing Reactions
2731
to Trauma, (c) Responding to Trauma: Promotive Approa-
ches and Strategies, and (d) Resisting Re-Traumatization:
Environmental Consideration. The alignment of each theme
and related categories with guiding research questions and
SAMHSA’s trauma-informed assumptions that were pre-
sented in the introduction is provided in Table 3. Frequency
counts and percentages are provided alongside each
category.
Realizing the Existence and Impact of Trauma among
Young Children
Participants were not provided with a definition of trauma,
but rather encouraged to share their own perspectives of
defining aspects of trauma. Participants noted that young
children as well as their families experience trauma and its
impact.
The existence of trauma: Defining characteristics
Across participant responses, two key characteristics of
trauma were identified: external influences and an impact as
a result of these influences. External influences were men-
tioned by 11 participants (79%). External influences were
described as events that occur within the home, community,
or other systems (e.g., divorce, abuse, natural disasters).
Additionally, four participants (29%) mentioned internal
influences, which were described as a person’s ability or
inability to integrate a potentially traumatic experience.
Thirteen participants (93%) mentioned the existence of an
impact, maybe over time, that results in biological, emo-
tional, or behavioral changes. In general, participants agreed
that trauma resulted from an influence, mostly a negative
event that interrupted typical functioning. Lisa summed up
these sentiments in her definition by noting, “Trauma to me
would be any type of experience that leaves a lasting scar, I
would say for a child, or has any type of latent or immediate
effects.”
The impact of trauma: Adaptive behaviors
All participants provided examples of ways trauma might
manifest for children and their families. Participants shared
an array of adaptive behaviors that children use as a result
of experiencing traumatic events. Patricia noted,
I think a lot of our kids, if they have been hurt,
particularly by a caregiver, when they start to feel that
level of intimacy, they react by maybe portraying a
really negative behavior to try to create some distance
between them and that person because they’ve kind of
learned that maybe the caregiver isn’t necessarily a
safe concept.
2732 J Child Fam Stud (2017) 26:2728–2741

Table 2 Participant pseudonyms and work characteristics

Participant Years of experience Discipline (degree) Current services provided
pseudonyms with trauma

Tim 43 Psychology (master’s) • Family therapy

• Assessment
Marla 11 Social work (master’s) • School services
Joan 9 English and education • Home visits
(bachelor’s) • Social emotional screenings
• Support groups
• Crisis counseling
• Referrals
Terry 27 Social work (master’s) • Residential services
Lisa 4 Family studies (bachelor’s) • Parent support groups
• Home visits
• Play groups
• Crisis counseling
Joyce 35 Social work (master’s) • Counseling
• Supervised parent-child visits
Patty 20 Social work (master’s) • Foster care
• Residential services
• Case management
Linda 26 Early childhood education • Parent and professional
(master’s) consultation for challenging
behaviors
• Home visits
Jo Anne 20 Social work (master’s) • Foster care
• Family counseling
Patricia 28 Social work (master’s) • Foster care
• Transitional and independent
living
• Vocational rehabilitation
• Counseling
Suzanne 5 Human development and • Family support and advocacy
family studies (master’s)
Shayna 23 Social work (master’s) • Mental health consultation to
service providers
Amanda 20 Social work(master’s) • Counseling
Annette 30 Education (bachelor’s) • Family support and advocacy
Linda 26 Early childhood education • Parent and professional
(master’s) consultation for challenging
behaviors
• Home visits
Jo Anne 20 Social work (master’s) • Foster care
• Family counseling
Patricia 28 Social work (master’s) • Foster care
• Transitional and independent
living
• Vocational rehabilitation
• Counseling
Suzanne 5 Human development and • Family support and advocacy
family studies (master’s)
J Child Fam Stud (2017) 26:2728–2741
Table 2 continued
Participant Years of experience
pseudonyms with trauma
Shayna 23
Amanda 20
Annette 30
Similarly, Joan shared:
Infants sometimes will sleep and sleep for a long
period of time because it’s a way of avoiding what’s
going on. Some children become extra-clingy and are,
you know, very people-pleasing and then others kind
of ward everybody off. They do everything they can
to keep somebody from liking them.
Yet Linda shared,
They will strike out first. So they are aggressive as
well, like, “I’m going to hurt you before you hurt me,”
kind of “I’m going to be on guard all the time.” And
so, it’s kind of their first reaction to things might be
kind of aggressive and push away …to protect
themselves from hurt. We’ve certainly seen that.
Linda also noted that a teacher might think that a child is
“not listening” or “ignoring” when instead they “check out”
because they are overwhelmed.
All participants noted that trauma-related challenges
often exist within family systems. When asked specifically
about the functioning of families of children who have
experienced trauma, Patty stated, “Well what I’ve seen its
chaos. Because they’ve gone through trauma themselves
and they’ve never been treated or had treatment for their
trauma so they just perpetuate that generational thing so it’s
chaotic. They don’t function well at all.” Terry emotionally
expressed the challenges some families face, saying,
I think there is a lot of resilience and I think people
who are getting by and people who are moving on and
continuing to kind of move through their day-to-day
functions. I think it’s, it’s hard to see people that, that
they- they’ve decided that’s as far as they can go, that
they can’t- that this is as good as it’s going to get, I
mean that’s kind of sad.
Recognizing Reactions to Trauma
A recurring theme that was found across all participants
included the mutual understanding that although children
who have experienced or been exposed to traumatic events
may display behavioral and emotional patterns in childcare
2733
Discipline (degree) Current services provided
Social work (master’s) • Mental health consultation to
service providers
Social work(master’s) • Counseling
Education (bachelor’s) • Family support and advocacy
or preschool settings, behaviors and emotions appear dif-
ferently across individuals based upon individual char-
acteristics, context, and the traumatic event experienced.
Lisa highlighted the complexity of trauma in early child-
hood by explaining, “It’s difficult when it comes to trauma
because you can’t ever place a child or situation into a box. I
mean there’s just so many situations, so many reactions, and
every family is unique.” Regardless, participants indicated
that emotional and behavioral signs exist for children and
their families. A section on emotional and behavioral signs,
including biological and developmental considerations
(e.g., sleep patterns and age, respectively) is presented fol-
lowed by sections on identification challenges and adaptive
behaviors and resilience.
Emotional and behavioral signs
All participants discussed emotional and behavioral indi-
cators of trauma. Commonly discussed behavioral patterns
included aggression, clinginess, demandingness, violent,
attention-seeking, low self-control, pestering and hypervi-
gilance. Tim noted, “… aggressiveness with other children,
withdrawal from the caregiver, high levels of demanding-
ness of the caregiver, clinginess and signs of depression.”
He further noted that most caregivers do not recognize signs
of depression, but identify behavioral displays of depres-
sion. For example, caregivers might say, “he’s just real
poopy” or “he doesn’t play with the other kids” or “when I
fix snack he doesn’t come.” Terry shared,
I think you can see the gamut of emotions, you can
see kids that are very flat-affect, that just kind of are
expressionless. I think you kind of see kids that are
very high-energy, super-hyper, you know, just kind of
everything.
Eleven participants (79%) agreed that children who have
experienced or been exposed to traumatic events might
display signs that are influenced by biological and/or
developmental trajectories. Patricia referred to being “age-
appropriately-delayed” whereby a child might need more
support than his or her same-aged peers in order to
demonstrate various social and emotional competencies.
Lisa shared examples that highlight potential intersections
Table 3 Aligned trauma assumptions, research questions, themes, and categories
2734

Research questions Trauma-informed assumptions Themes Categories

What should early childhood teachers know about trauma Service providers realize the impact of Realizing the existence and impact of • The existence of trauma: Defining
experiences among young children? trauma and recovery paths trauma among young children characteristics
• The impact of trauma: Adaptive
behaviors
What should early childhood teachers know about the Service providers recognize the signs of Recognizing reactions to trauma • Emotional and behavioral signs,
emotional and behavioral patterns of children who have trauma in children, families, and others including biological and developmental
experienced traumatic events? involved signs
• Identification challenges
• Resilience
What should early childhood teachers know about Service providers respond by incorporating Responding to trauma: Promotive • Be attuned
supporting the social and emotional well-being of knowledge about trauma into practices approaches and strategies • Convey positive regard
children in the classroom setting, including partnering • Collaborate with parents and other
with families, who have experienced or been exposed professionals
to traumatic events? • Support positive social and emotional and
communicative responses
• Engage in proper reactions
Service providers resist re-traumatization Resisting re-traumatization: • The social environment
environmental considerations • The temporal environment
• The physical-sensory environment
J Child Fam Stud (2017) 26:2728–2741
J Child Fam Stud (2017) 26:2728–2741
between behaviors, emotions, developmental age, and bio-
logical characteristics. Regarding trauma in young children,
she noted,
I think it differs depending on age and child, but some
of the typical ones are, definitely for younger children,
just overly emotional and some…they can be
fearful…night terrors are something I’ve seen or
trouble sleeping. The fear of being alone, maybe just
constant crying is something that I’ve seen as well.
Inability to be consoled. I’ve also seen, I guess
reclusion would be the word, where a child just wants
to be isolated just kind of has a fear of adults or maybe
attaches to one adult, but is afraid of interacting with
others. For different types of physical or sexual abuse
I would definitely say changing and bathing and
things like that. There is a definite fear surrounding
that. You can just kind of see the fear in crying, in
body language, stiff bodies when they are picked up.
Eleven participants (79%) also indicated several indica-
tors of trauma that parents might display while interacting
with teachers. Despite the many other responsibilities tea-
chers have, one participant noted, “… you’re kind of there
for the whole family… you don’t just get children … you
get the whole package deal whether you want them or not,”
Terry shared. Participants noted that parents might be
defensive, afraid, or even envious of teachers. However,
most comments were related to parental distrust. Joan
acknowledged that, “Sometimes it might be kind of hard to
talk with the parents about what’s going on with the child.”
Marla concluded, “Parents and schools, sometimes there’s a
lot of distrust and maybe I can never fully build that rela-
tionship but whatever we can do for that child is what brings
us to the table.”
Identification challenges
While describing the range of behaviors and emotions that
children who have experienced or been exposed to trauma
may display, 10 participants (71%) referenced the chal-
lenges that exist with identifying these patterns of behavior
and emotion. “I think it’s hard to say this is what a child
looks like that’s been abused or neglected,” Terry shared.
Participants explained the importance of investigating the
purpose of and reasons behind these behaviors and emo-
tions, rather than making assumptions. For example, Patty
noted,
We have kids that wet their pants. We have kids that
hoard food. We have kids that want to be by
themselves. We have kids that act out and throw
temper traumas from the least little kind of thing, [for
example] trying to give them direction. It can even be
2735
an issue of it’s a certain color of a shirt that someone
has worn because maybe their perpetrator wore that
shirt when they were attacked. So, some people…they
think it might be a typical behavior but when you get
down to the nitty gritty and start digging into that kind
of stuff, the trauma, it’s not typical behavior. It’s not
something a pill’s going to cure.
Several participants also noted that children’s inability to
identify or articulate what they are experiencing can be a
challenge. Terry noted, “We think things are obvious…we
don’t get that whole picture because they’re not verbal
enough to tell us.”
Resilience
Despite challenges that experiencing trauma might pose to
children and their families, participants unanimously agree
that children who have experienced or been exposed to
trauma, as well as their families, are capable of displaying
signs of resilience. All participants acknowledged the resi-
lience of children and twelve participants (86%) talked
about the strengths of families. Participants described the
resilience of children as “remarkable,” “amazing,” and
“impressive.” Most participants described resilience as a
trait. For example, Shayna stated, “Children are resilient,
and even though children go through really traumatizing
things, they can grow up and be strong successful adults.”
On the other hand, some participants described resilience
that existed on a spectrum, as did Amanda who noted,
I have a child right now who recently went through a
horrible situation, but this child immediately went to
stay with his grandparents who are providing so much
continuity for him … I think that really makes a
difference for children in helping them to be resilient.
Then there are some children who’ll develop resilience
and you just kind of wonder how. But I truly think
that they are, most children will need and benefit from
an adult who’s really consistent and loving, and that
could even be the preschool teacher, the one
consistency in their lives, especially if they get moved
out of, out of their home, that, keeping children in the
same day-care setting, preschool setting can really
make a big difference in helping them be more
resilient.
Regarding families’ strengths, Lisa stated, “They
always find a way.” Joan explained,
Just the fact that they have stayed together and con-
tinue to go on so long, I think that deserves some
respect, the fact that they’re still present and they do
still get their child to school in the morning, that they
2736
do continue to try to work. I have some families that
are really special to me, and it isn’t because they have
become super successful or I’ve seen them go from,
you know, homelessness to extremely stable housing
and a much better job. It’s because they always get
back up. It’s because they, maybe mom lost her job
and lost her car, but she took the bus for 3 months to
get another job and piece together child care all that
time, and just kept going. And just because, and I see
it all the time, people fall all the way back to the
starting line, and you would think that they would go
back even further than that, and they would be done…
But they don’t. They put everything back together as
best they can and go on. I’ve seen people have entire
households of stuff that’s just gone and they built up a
new household and it’s, it’s not any better than it was
before, but it’s continuous and I think there’s some-
thing really big to be said for that, just being still
standing.
Responding to Trauma: Promotive Approaches and
Strategies
Participants were asked to identify classroom strategies to
build social and emotional competence among children who
have experienced or been exposed to traumatic events and
also to provide recommendations for partnering with
families. Participants identified several promotive approa-
ches that teachers might use while interacting with children
and their families, including being attuned, showing posi-
tive regard, and collaborating with parents and other pro-
fessionals. Additionally, regarding interacting with children
in classroom settings, participants suggested that teachers
support positive social and emotional and communicative
responses and engage in proper reactions to children.
Be attuned
Being attuned to children and families’ needs was men-
tioned by all participants. Moreover, participants referenced
being attuned twice as often as any other category when
referring to both children and families. Participants descri-
bed being attuned as understanding and anticipating the
needs of children who have experienced trauma and their
families and then responding accordingly. Terry explained
that when a child has gone through something potentially
traumatic “looking at the bigger picture” is important. Linda
recommended “staying open and curious.” In tandem with
understanding and anticipating a child’s needs, participants
noted that teachers should respond with sensitivity to
identified needs. For example, Annette proposed that tea-
chers modify classroom observances. She noted that if a
J Child Fam Stud (2017) 26:2728–2741
child’s parent died or divorced, the teacher might have
Family Day rather than Mother’s Day or Father’s Day.
Participants shared similar ideas regarding partnering
with parents. Linda stated,
Parents are often times doing their darndest to
problem-solve it, but it looks to the outsider, out of
context, it looks like pathological … We don’t really
know what their story is in the home that they’re
trying to respond to.
Lisa commented, “Most people who have experienced
trauma don’t feel that others have the best intentions for
them, so I think just unconditional support, showing those
good and pure intentions is really important.” Yet Marla
noted the importance of being attuned by saying, “I think
parents if we are having behavioral concerns, it’s like oh my
god it’s one more thing that they have to deal with right.”
She then reflected on being attuned and showing sensitivity
toward parents:
“Here’s what we want you to do. We want you to go
home and try this positive behavior strategy….” It’s
4–6 weeks of an intervention before we can say it’s a
success or not. How do I tell a parent who is so
stressed out “give it 4–6 weeks?”
Convey positive regard
Eight participants (57%) recommended that teachers show
positive regard to children and four (29%) recommended
applying this principle when partnering with parents. Terry
referenced a child who “was always suspended from her
classroom” and wondered “…is there a way to incorporate
her in the classroom. Is there a way to build her as a leader”
as opposed to isolating her as the “bad kid.” She further
noted,
We’re always worried that we don’t want to reward
negative behaviors, but, but maybe rewarding and
pulling that child in as the assistant to the teacher, it
might appear as a reward but if it fixes- it fixes the
other problem then what’s wrong with that, you
know?
Marla reasoned, that children will have challenging days.
When they do, teachers should respond by saying, “We’ll
see you tomorrow and we’re going to start again tomorrow.”
Similarly, regarding families, Marla recommended, “If we
do have to have hard conversations, truly finding the
strengths of that child and that family and bringing those to
the table.” Amanda suggested, “include the parent in any
kind of positive that you see in the classroom” and “greet
J Child Fam Stud (2017) 26:2728–2741 2737

each child as if he’s the most important wonderful child in
the world.”
Collaborate with parents and other professionals
I think art is a really huge tool that a teacher could use
to kind of foster, um- it doesn’t have to be just specific
to that child’s loss or traumatic event … Give, you
know, the children as a whole in their classroom that
avenue to express themselves through their art.

Several participants suggested using a collaborative

Engage in proper reactions
approach when supporting children (n = 8, 57%) and part-
nering with families (n = 4, 29%). Suzzane said, “I think
Six participants (43%) shared the importance of teachers
keeping a respectful relationship with the parents is going to
having proper reactions to children who have experienced
make sure that you’re more knowledgeable of what your
trauma. The participants shared a range of strategies focused
kids are going through and what kind of mindset they’re
on non-punitive responses and allowing the child to practice
bringing into the classroom.” Jo Anne noted,
adaptive behaviors. Joan suggested that teachers be
Probably the single most and importantly thing “informed and well-aware of why the child might behave
[teachers] can do is build that positive relationship- the way they do instead of being quick to anger or judge or
the teacher-child relationship and anything they can punish, think about where that behavior might come from
do to kind of bridge that with maybe a positive and adjust their ways of handling that child accordingly.”
caregiver. From one school year teacher to the next Similarly, Lisa shared,
school year teacher, I mean, you know, if there’s
I think being able to have a safe and proper reaction to
mentoring opportunities once a kid leaves your
the language that a child displays … remaining calm.
classroom and you’re able to still check in with them
Just being informed as … how to respond so that the
or, kind of follow their progress, see them in the
child never feels bad or like it’s their fault, like it’s
hallway, you know, that kind of stuff, I think is
inappropriate to discuss that.
important.
Regarding proper reactions to adaptive behaviors, Linda
When asked about partnering with families, participants
depicted a child who may not have developed language
shared similar ideas. Marla acknowledged, “I want [parents]
skills but is able to efficiently move around the environ-
to come and feel like I’m here as an equal and as a person as
ment. She explained,
we’re all collaborating to help my child.” She also
acknowledged the importance of helping parents navigate It’s not important whether they can talk a lot, what’s
the school system and other services, by noting, important is that they can move quickly to get out of
the way, and so how do you use those motor skills to,
I don’t think it can all be on [school staff]. I think we
instead of [saying] “Sit down, sit down, sit down, sit
have to somehow work with other agencies … but
down,” how do we use those motor skills to, to kind of
then you run into time and coordination … I think
offset the language barriers that children might have.
until a student, what’s sad, is in such far need you get
It’s becoming creative, um, instead of making children
like wrap around plans, involving more people.
feel ashamed for some of their resiliency skills.

Resisting Re-traumatization: Environmental

Support positive social and emotional and communicative
Considerations
responses
In addition to responding to a multitude of emotional and
Ten participants (71%) talked about facilitating positive
behavioral patterns that children who have experienced or
social and emotional and/or communicative responses
been exposed to trauma may present, participants indicated
within the classroom setting. Several participants indicated
that teachers should be knowledgeable about various
that teachers might promote self-regulation through parti-
aspects of the classroom environment (i.e., social, temporal,
cular means such as play, music, and books. For example,
and physical/sensory considerations) that might trigger
Amanda noted, “I think music, rhythm, dancing, kind of
trauma responses. Joan noted that the classroom might be
that, those kind of activities that kind of bring us into a kind
the only safe, secure setting the child experiences
of more relaxed state, I think [those] kind of activities are
throughout the day, so teachers should try to
really important.” Others focused more on the necessity of
providing means for children to express themselves. For …keep all your interactions as positive as you can,
example, Annette shared, being as respectful to the child as you can, and being
2738
as loving as you can… when a child might not have
access to that much love and respect at home, at least
we know we can give it to them [in the classroom].
Participants noted that one way to promote a sense of
safety is by minimizing potential triggers of trauma in the
classroom setting. For example, Jo Anne noted that teachers
might arrange children in circles rather than in rows during
group meetings so that children can all see each other
because “people don’t trust people.” Considerations that
teachers might make pertaining to aspects of the social,
temporal, and physical/sensory environments in order to
minimize negative or potentially harmful reactions from
children who have experienced trauma are shared below.
The social environment
Participants shared numerous considerations for shaping a
sensitive social environment that mainly revolved around
interactions. Participants highlighted considerations for
child–child interactions as well as teacher-child interactions.
Eleven participants (79%) discussed social-related triggers
when asked what environmental considerations teachers
should make when supporting children who have experi-
enced or been exposed to trauma. Specific considerations
included the gender of teachers, the demeanor of teachers,
and physical contact. For example, Terry reflected, “I mean
for kids that are in homes of violence, I think fighting,
yelling, could be a trigger, um, raised voices could be a
trigger for them. For kids that have been sexually abused,
just a touch the wrong way [might be a trigger].” Lisa
pointed out,
I think children pick up on an adult’s demeanor and I
think if an adult is maybe not warm or friendly to an
extent and represents a coldness of maybe of someone
whom they’ve experienced trauma with before that
could be a characteristic. Social interactions with
children with other children as well. A lot of times in
homes we’ll see large families where abuse has
occurred with an older sibling or cousin and that will
trickle down to the younger children… That can cause
anxiety as well from child to child.
The temporal environment
Considerations related to the temporal environment, or
aspects of the environment that are relative to time, were
discussed by 11 participants (79%). Terry expressed that
scheduled events (e.g., mealtime, naptime, bedtime) and
changes in climate or seasons could impact children who
have experienced trauma. For example, she shared,
J Child Fam Stud (2017) 26:2728–2741
Fall was very much a trigger for [my son]. So, I think
just the change in temperature and he would get very
emotional and it would- it would trigger him and [he
was] a normally well-behaved child, and then he
would just be more difficult and more challenging…
His response eventually would get to, you know, “I
miss my birth mom,” or “Why didn’t my birth mom
love me.” So that, because he came into foster care in
the fall, his birthday is in the fall, his last contact with
his birthmother was in the fall. So, you know,
something that nobody could control because Fall’s
gonna come, but it was very much a trigger for him…
It took me a couple years as a trained person, you
know, not as a mom, but as a trained person to
connect- we just need to adjust things just a little
different in Fall.
Linda noted,
…especially after a weekend,…I’ve heard teachers
say, “It’s the worst time, I hate that period of time,”
because they’re very, like, they’ve experienced- and
they have to come back in to the classroom and
reacclimate to a system or a schedule, um, at the end
of the day, um, or at the end of the week, that’s
difficult for some children. I think, um, around meal
times, around, uh, certainly around nap times- nap
time really starts out- or if they have to use the
restroom, if they have to use the bathroom, so all of
those basic functions…they’ll throw up after they eat,
or they just fight going to sleep, they won’t even won’t
even lay down on the pad. Those are all, you know
they could be indicators of trauma, I don’t want to say
that it always is.
The physical/sensory environment
Physical or sensory-related environmental considerations
were mentioned by 10 participants (71%). A number of
participants specifically referred to darkness and loud noises
being sensory triggers. Linda explained, “Fire alarms,
slamming of a door, chaotic environments where they see a
lot of movement in the room is very disorienting to the
child.” Linda, as did others, described links between a
chaotic physical/sensory environment and social con-
siderations described prior by further noting that such
environments could lead to inadvertently touching a child
and, thus, result in the child reacting aggressively or cow-
ering. Several participants noted that considering physical
proximity might minimize unwanted social interactions
(e.g., unwanted touches).
In general, participants noted that trauma-related envir-
onmental considerations differ across individuals because
J Child Fam Stud (2017) 26:2728–2741
events or sensations that bring a child back to the time of
trauma, causing them to present adverse behaviors and
emotions reflective of that chaotic state, are highly indivi-
dualized. “… I feel so sorry for a teacher who had to keep in
mind fifteen children’s responses to a variety of environ-
mental arrangements or stimuli in the room. That would be
tough, but geez what a gift to the children,” noted Tim.
Discussion
This study presents key themes gathered from a group of
individuals from diverse disciplines about knowledge and
skills teachers might use to shape classrooms that accom-
modate the growing number of children who have been
exposed to or experienced traumatic events. Guiding
research questions were: (1) What should early childhood
teachers know about trauma experiences among young
children; (2) What should early childhood teachers know
about the emotional and behavioral patterns of children and
families who have experienced traumatic events; and (3)
What should early childhood teachers know about sup-
porting the social and emotional well-being of children in
the classroom setting, including partnering with families,
who have experienced or been exposed to traumatic events?
Participants revealed that children and families might
experience any of an array of traumatic events that result in
adaptive behaviors to guard against the adverse effects of
those events. Second, the emotional and behavioral patterns
of children and families who have experienced trauma
depend on individual experiences and characteristics and
these patterns might not be easily connected to trauma.
Third, while teachers can use individualized approaches and
strategies to promote social and emotional well-being for
children who have experienced trauma, many approaches
and strategies might be implemented at the classroom level.
Among a group of young children who had experienced
an array of traumatic events, use of the preschool subtype
criteria rather than DSM-IV criteria resulted in a spike in
PTSD identification from 13 to 69% (Scheeringa et al.
2011). Widespread use of the preschool subtype of PTSD
criteria will lead to increases in the number of children
identified with PTSD, and likely heightened realization of
the impact of trauma exposure during early childhood.
Eleven participants (79%) in this study reported that the
children whom they serve have challenges in school settings
due to trauma. However, they suggested that teachers are
often unaware of trauma among the children they serve and
its impact. A realization of the existence and impact of
trauma might be particularly valuable for early childhood
education teachers who work with vulnerable populations
because they are disproportionately affected by trauma.
Young children experience a higher rate of maltreatment
2739
than any other age group (Administration for Children and
Families 2015). Also, children who experience poverty are
at greater risk for exposure to traumatic events than children
living in higher socioeconomic conditions (Briggs‐Gowan
et al. 2010). Thus, it is not surprising that a majority of
participants reported working with young children who
were involved with child protective services (n = 11, 79%)
and families with low incomes (n = 10, 71%). One-half
reported working with families who are experiencing
homelessness.
Although trauma treatment is often person-focused,
participants reflected that supporting the needs of children
who experience trauma is largely dependent upon teachers’
ability to understand, anticipate, and respond to the needs of
children with curiosity, rather than based on assumptions.
Given the implicit bidirectional processes surrounding
trauma, teachers’ development of understandings and skills
pertaining to trauma aimed at universal promotion and
prevention in classroom settings appear to be noteworthy
goals. Participants shared various principles and strategies
related to children who have experienced or been exposed
to trauma that might be embedded at the classroom level
despite difficulties identifying trauma-related experiences of
individual children and making connections between
environmental factors and traumatization. The aforemen-
tioned difficulties come with the nature of trauma and
should not deter from efforts to improve the classroom
experiences of children who have experienced or been
exposed to trauma. For instance, there might be no way to
avoid potential triggers in a classroom (for example, a male
teacher or meal time); however, teachers can resist, or
prevent, re-traumatization by thinking creatively about
classroom level accommodations that minimize the poten-
tial deleterious effects of such triggers.
The Pyramid Model, a positive behavior interventions
and supports model, might be an effective tool for guiding
the development of trauma-informed classroom settings
because its multi-tiered design (i.e., which includes uni-
versal, preventive, and intervention components) espouses
the key elements needed (i.e., nurturing and supportive
relationships, high quality environments, targeted social and
emotional strategies, and individualized strategies) to shape
supportive environments for children who have experienced
trauma (Hemmeter et al. 2006). Recently, the Head Start
Trauma Smart (HSTS) program was developed to address
trauma among young children (Holmes et al. 2015). Like
the Pyramid model, HSTS involves a multi-tiered approach
whereby universal practices are employed across the
classroom and individualized interventions are implemented
with children who have clinical needs. Holmes et al.
implemented HSTS at three Head Start programs. Evalua-
tion results showed that HSTS led to improvements in
teacher practices within several domains of the Classroom
2740
Assessment Scoring System (e.g., emotional support and
classroom organization) and also significant increases in
attention and decreases in challenging behaviors based on
the Achenbach assessment. Although little evidence exists
on the effectiveness of HSTS, it includes the first known
intervention model that targets trauma among children in
early childhood settings.
Finally, participants provided meaningful considerations
regarding realizing, recognizing, and responding to trauma
in the family system. Twelve participants (86%) reported
providing family-oriented services. When asked what type
of trauma the children they serve most often experience, 10
(71%) said abuse or neglect and seven (50%) said domestic
violence. Given that these sources of trauma are situated
within the family system, partnering with families should be
a priority. Despite the emphasis participants placed on
families, majority consensus existed for only one approach
(i.e., being attuned) when they were asked for recommen-
dations for partnering with families. Such a disconnect was
reflected in an article on the crisis in children’s mental
health services by Huang et al. (2004) where they noted that
“partnering with families in treatment is not readily under-
stood or accepted by many professionals (p. 169).” Fur-
thermore, they noted that these realities are reflected in
service delivery trends. So while consensus on the impor-
tance of partnering with parents may now exist, service
delivery trends might not necessarily reflect these beliefs.
Overall, findings of this study reflect ways that teachers
might demonstrate the trauma-informed assumptions set forth
by the SAMHSA (2014): realizing the impact of trauma,
recognizing the signs of trauma, responding by integrating
knowledge about trauma, and actively resisting re-
traumatization. Thus, findings suggest that teachers can
develop the capacity to create supportive classroom environ-
ments for children who experienced trauma, despite children’s
individualized experiences with trauma. Moreover, interven-
tion models exist that might guide these efforts.
Limitations
This study drew from the experiences of non-teaching
professionals. Therefore, as mentioned above, the feasibility
of implementing trauma-informed care in classroom settings
should be closely explored. Also, nine of the 14 participants
(64%) worked in public agencies and the majority of them
reported receiving consumer referrals from public agencies.
Therefore, participant perspectives might be most applic-
able to children and families who receive public services.
To better understand the competencies that teachers need
to support young children who have experienced or been
exposed to trauma, future research should examine what
trauma-informed practices teachers are currently using as
well as what teachers’ attitudes are toward trauma in relation
J Child Fam Stud (2017) 26:2728–2741
to children’s social and emotional development. These
studies should provide recommendations for practice,
including resources needed to implement trauma-informed
principles in classrooms. Additionally, research should be
conducted regarding the effectiveness of existing interven-
tion models (e.g., the Pyramid Model and HSTS) for
addressing the social and emotional needs of children who
experience trauma and their families. Additionally, school-
level implementation of prevention and promotion strate-
gies (e.g., the addition of ongoing professional development
for teachers, access to trained clinical staff, voluntary stu-
dent support groups) rather than discipline should be
examined given the punitive consequences that children
who experience trauma are prone to experience due their
propensity to engage in challenging behaviors. Finally,
future research is needed to understand key skills for part-
nering with parents of children who have experienced
trauma. Research on positive behavior interventions and
supports suggests that parents are open to partnering with
teachers and actually want more information from their
children’s teachers regarding the promotion of positive
social and emotional skills (Cummings 2016). Considera-
tion should be given to ways that teachers might partner
with families experiencing unique circumstances (e.g.,
foster care arrangements, homelessness) and referral to
specialized services (e.g., special education, mental health).
Research in these areas can further the contributions of this
study aimed at fostering effective trauma-informed care
practices within early childhood settings.
Author Contributions K.P.C.: designed and executed the study, co-
led data analyses, and wrote the paper. S.A.: co-led data analyses and
wrote part of the results. J.S.: assisted with data analysis and wrote part
of the results. H.M.: collaborated in designing the study and editing the
final manuscript.
Compliance with Ethical Standards
Conflict of Interest The authors declare that they have no compet-
ing interests.
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