::Attendees visible::

Bonni Goodwin: 
And then I'm going to go ahead and let everybody in. Okay. I. Remember. Welcome, everyone. Thank you guys for joining us today. Go ahead Christy.

Christy Chandler: 
All right I just want to welcome everyone today to our lunch and learn. Today's lunch and learn is being brought to you by a collaboration between Oklahoma Human Services, the University of Oklahoma, and the Henry Zarrow School of Social Work. And our adoption Oklahoma Adoption Competency Network. We do appreciate everyone joining during this lunch noon hour. And we just seven and six started. We want to go ahead and get started today to respect everyone's time. Let's go over a few housekeeping things. For this hour that we're together, we are recording this meeting. So by participating, you do give your consent to be recorded. We have everyone muted just to make sure, we can hear our speakers today. Reduce any distractions If you have a question at all, just type it into the chat and we will also have some time at the end of this webinar to go over some
any kind of questions and answers. We want to see you if at all possible. So turn on your cameras if you can't. If not, that's totally fine. We get it. Let's respect and remember confidentiality. It's really vital that, in adoption work we do protect the confidentiality of, the children and the clients that we work with. So let's try to not share any specific details in terms of cases or names or anything like that. Also, at the end of this training, we will provide a survey link, to provide some feedback on the today's session. And also, if you are a foster parent, by attending this training, you will receive that one hour credit, towards those 12 hours of in-service learning. And you can, receive that by filling out the survey that will be added to the chat at the end. Please introduce yourself in the chat if you haven't yet. Kind of give us an idea of, how you fit into this, puzzle that is adoption and your email address. If you'd like to receive any additional information about upcoming events. So I'm going to hand, today's webinar over to Dr. Bonni Goodwin. She is going to introduce
an attachment activity. And then she will also introduce our guest speaker Katie Stewart.

Bonni: 
Thank you so much, Christy. Hello everyone. I'm so grateful that you're here today. We have a great group fantastic time talking about behind the behavior. And I know Katie will share this with you at the end. But this is part one. So you've got part one today. And then I hope you put down on your calendar May 2nd at noon. We'll get the information out soon. Will be the part two. So it's going to be fantastic at the beginning of every single one of our lunch and learns, we give a little two second, attachment activity. Just an idea for you to be able to whether you're a parent, to have something to try out at home tonight to do with your kiddos. We do, young version and then an adolescent version of an activity. If you're a professional on here, then we like to share that, with you as well. So you can have that as a part of, a tool in your toolbelt to share with families
that you're serving.
So today's attachment activity is really, focused on touch, safe touch, and, being able to receive, provide and receive care and nurture. So obviously with something that involves any type of touch or close proximity, you want to be very careful and, ask for permission from your child. But then also be aware of any type of previous, abuse and adapt, adapt as needed for the comfort level of the child. But, the activity today is, is being able to do something to, to care, doing hair, doing hair for someone. Now most of the time you're thinking automatically about a girl, female long hair. But but I also want to encourage you dads, there's some really cool, videos out there of dads doing hair and, expanding some of those gender stereotypes that we've had, with some of the stuff. 
So, so when you can embrace and really whether it's after bath time or something like that, parents spending that time with child, no matter the age, that's the coolest part about this activity is, even our adolescents. Everyone likes to have their hair brushed, and their hair done and something just to to enjoy spending that time together or trying a new thing like curling or straightening or braiding, all the things.
There's so many YouTube videos out there now that give, some good that show you how to do things. So trying trying some of that on together. And then the cool part of it is not just doing the child's hair, but flipping it and allowing the child to do your hair, or to, do some type of, you know, if, if it's not involving hair, the nails, nail care, doing clipping nails or painting nails or, you know, any of that kind of stuff, filing nails, anything like that, where not only are you providing that for your kiddo, but then you are able to allow the child to provide that for you can be a really fun bonding time. And like I said, it encouraged increases the proximity and, allows you to to have a bit of, just some fun nurture time together. All right. 
So no further ado, Katie, I'm going to turn it over to you. Katie is one of our brand new clinical social workers in our post adoption department here in, at DHS. And, I'm super excited to, mute myself and turn it over to you.

Katie Stewart: 
All right. Thank you. Bonni, give me a sec. Guys, I'm going to share my screen here.

::Title Slide - Behind the Behavior - Trauma's Effect on the Brain & Body::

Right. All right, so, like Bonni said, my name is Katie, and I am an DHS employee. I am brand new to our clinical team in post adoptions. And previous to that, I was a foster care and adoption caseworker in northwest Oklahoma
for about seven years. So throughout that time, working with foster and adoptive parents and walking through all the struggles and the, challenges, and the, also wins and progress with the children in their home. We had a lot of conversations about frustrations from them and confusion about how to understand and handle behaviors that they were seeing in from the children in their home. And so this training was born out of those conversations with my foster parents, with the goal of being able to give both parents and, professionals actionable tools
to help the children in their lives. So I'm going to open with a quote from a really excellent book that I encourage you to read, if you haven't already. It's called The Body Keeps the Score.

::Slide - Quote from The Body Keeps The Score::

And so it says, we've learned that trauma is not just an event that took place sometime in the past. It is also the imprint left by that experience on mind, brain, and body. This imprint has ongoing consequences for how the human organism manages to survive in the present. Trauma results in a fundamental reorganization of the way
the mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think. So today, we're going to take a deep dive into complex trauma and the effect it has on a person's brain and body. As the quote says, experience trauma physically changes the brain structure as well as the way the brain and body communicate, leading to a variety of unintentional and uncontrollable physiological responses that show up as difficult and often confusing behaviors. So next I'm going to play a brief video. Oh please hold. I just realized I did not share my sound when I shared my screen,

::Attendees visible::

so here in a second, I'm going to play a brief video that gives you an overview of what happens to the brain when, experiences, toxic stress. And so while you're viewing this video, I want you to just think about what is happening in the brain and body when there when it's undergoing toxic stress. And think, if you have had experience, with any children in your home or in your professional practice that, behaved this way.

::Video - Complex Trauma ACEs - throughout video, an illustrator is drawing graphics that emphasize the spoken aspects::

So hopefully our sound will be good to go. Now.

Video Narrator: 
A child's experiences early in life are important building blocks for the developing brain. Genes nature are like the blueprint they provide the basic framework for brain development. However, genes do not design the brain
completely. Environmental influences nurture fine tune how the brain works by shaping which brain connections get used. Connections that are used more grow stronger and more permanent, whereas ones that do not get much use
fade away. Together, genes and the environment build the foundation for all future development. Safe, stable and nurturing relationships early in life lead to healthy development, but children's brains capture other experiences as well. Stressful events. However, not all stress is bad. Positive stress involves normal childhood experiences like starting daycare or meeting a new person for the first time. This stress is essential for healthy development because it helps children develop coping skills and confidence. But when stress is frequent, chronic and uncontrolled, it is toxic to children, especially when they do not have a caregiver to provide support or buffer the stress. 
Adverse childhood experiences [thunder noise] ACEs such as abuse, neglect, exposure to intimate partner violence, parental depression, or addiction and poverty are toxic stressors which could lead to lifelong changes in learning and behavior. ACEs early in development can impact social, emotional, and cognitive functioning. Increased risk taking behaviors such as drinking and substance use, an increased risk of disease, disability, and social problems. Later in life. The question is how do adverse childhood experiences impact a lifelong  development? One of the most important systems in our body is our stress system. It's activated when we experience stress. [heart beating] We become alert, our heart rate increases, and so do our stress hormone levels. Cortisol and adrenaline. Our body is ready to react. What is known as fight or flight for a short period of time after the stress is over, or if a child received support from a caregiver, the stress response turns off and the body returns to a normal state. Adverse childhood experiences create stress responses that stay active and without the support of a caregiver, the system has difficulty shutting off completely. This constant and prolonged activation can affect immune system functioning and increase the chances of sickness,
infection, and disease.
Prolonged activation of stress hormones is also toxic to the brain. Certain areas of the brain are more vulnerable to toxic stress, including the executive center or the brain's control center, an area important for solving complex problems. Attention, reasoning, impulsivity, inhibition, and learning. A second area is the emotional center, the brain's alarm system, [alarm sounding] which is involved in processing and interpreting emotions and the ability to control impulses. The third area is the Memory and Learning Center, the brain's filing cabinet, which plays a major role in learning, and the formation and retrieval of memories. Science shows that adverse childhood experiences impact all of these brain centers. Behaviorally, what we begin to see is emotional distress, poor emotion regulation, greater impulsivity, learning difficulties, and physical and mental health problems. 
More recently, science has begun to look at how ACEs cause changes in gene expression through a process called epigenetics, which helps us understand how nature and nurture interact. Epigenetics causes changes in the way genes work without changing the DNA code itself. This occurs through chemical changes influencing how the code is used. In other words, genes are like the hardware in a computer. They determine the boundaries of what is possible. However, we need an operating system to tell the hardware what to do. Epigenetics is like the operating system directing the function of a gene's DNA hardware. The genes we are born with are the genes that we have for life. But experiences like nutrition, exercise, smoking, stressors, and relationships all affect our biology. Adverse childhood experiences are associated with epigenetic changes related to stress, brain development, cognition, and systems associated with mental and physical health. Changes that happen early in brain
development are more likely to be enduring and are possibly passed on to future generations as well. The good news is that positive, supportive relationships at any stage in life can make a difference. However, supporting families and children early on will help prevent many of these negative outcomes. 
One of the key ingredients for healthy development is having warm, loving and actively engaged caregivers. This involves promoting serve and return interactions where caregivers actively and warmly engage with the child, making eye contact, responding to sounds, words, gestures, emotional needs, and sharing experiences, like reading and play.  Providing programs that support caregivers to strengthen these abilities are the blocks that build healthy foundations for life. [music]

Katie: 
Okay, so that video gave us a good overview

::Slide - Trauma & Brain Development::

of how childhood trauma affects development and behavior. But let's break down some of what information was in that video. So the brain develops from the bottom up. So the first part of the brain that develops is the very bottom portion. So if you think of the brain as a closed fist, the bottom portion would be the heel of your palm. And this is the brain stem. So this controls all your basic functions, such as breathing, heart rate, blood pressure, etc. all those things that happen automatically without you having to think about it and this portion of the brain is fully formed at birth. So the next portion of the brain that begins to develop is the middle portion of the brain. And this is sometimes known as the limbic brain or the emotional brain. It includes the amygdala, the hippocampus and the hypothalamus, amongst, many other structures. And these areas involve processing and responding to emotions, our memory storage and retrieval, as well as attachment. And then the last area of the brain to develop is this top portion. So again, if you think of it like a fist, it's the your knuckles here at the top. And particularly the front, which would be right behind your forehead. This is known as the prefrontal cortex. This part of the brain controls all of your higher level functioning, such as impulse control, critical thinking skills, like being able to relate your actions to consequences and being able to think
through hypothetical situations. So this process of brain development is sequential, meaning it has to happen in that order from the bottom up.
And it's also dependent on the environment. So what we see in trauma is that parts of the brain, particularly those higher areas, are underdeveloped compared to similar aged children who have not experienced trauma. So as our brain develop, develops, it builds, pathways through synaptic connections. And these connections determine
how the brain and body are able to speak to one another and the degree to which they do that well. So our synaptic connections grow stronger with repeated use and conversely, they weaken and even die off when they're not used. It's that use it or lose that concept. So early childhood is particularly important because between the ages of zero and three, our brains are making 1 million synaptic connections per minute. This is a huge capacity for growth but it also means that those repeatedly used pathways become automatic and integral to the brain structure.
So traumatic experiences affect the directions that these synaptic connections or pathways are made. When a child's living in an abusive or neglectful environment, two things are happening that inhibit healthy brain development. So first, these environments lack important experiences. Like, needed to promote higher levels
of brain development, like healthy, playful communication with their parent or caregivers, as well as age appropriate life experiences and social interactions such as, you know, helping cook dinner, going to the grocery store, to the library, to the park, having playdates, all of those typical life experiences. Compounding
this is the fact that these children have to be in survival mode 24/7, meaning their brains are constantly being bathed in cortisol, which is our stress hormone. And again, this inhibits those higher level brain areas from developing. And it essentially locks the child into what we often refer to as the basement of their brains, which is, again, the lower portions, the limbic system and the brain stem. And these are survival focused only. And they govern things like our fight or flight response. So as the video mentioned, along with brain development,

::Slide - Epigenetics::

epigenetics are also affected by trauma. So the epigenome is like the instruction manual for our DNA genetics and our environment to determine what genes are turned off and on and the degree to which they're expressed. So our DNA is tightly spiraled into each of our cells like a spool of thread. And this is called a chromatin. So if you look at the graphic that I have here, the blue is the spool and then the orange wrapped around it is our DNA spiral that. So then we have genetic markers, which are the red and green dots that lay over top of a particular gene and tell it to turn on or off and these are epigenetic markers. This instruction manual is laid down in utero development. 
However, our experiences after birth in the world also changed these instructions. So everything a person experiences while pregnant affects the epigenome, the food they eat, the prenatal care they have access to, the stress they're under at home or work, and risky behaviors such as cigarette, drug or alcohol use. So, for example, if there's a high stress environment during the pregnancy, such as domestic violence, there are higher levels of cortisol being passed to the developing baby. And this directly impacts the instruction manual that's laid down on that baby's developing genes. So these instruction manuals are then affected by the environment
that the baby is born into. In our example, when the baby's born into this domestic violence environment, it's going to affect the interactions they have with their parents, as well as how well their physical and emotional needs are being met. So if their physical and emotional needs needs are not met as they should be, that continues
to solidify the instruction manual that was laid down while baby was developed developing in utero. And this comes out in experiences of an over-active alarm system in response to stress, as well as a reduced ability to self-regulate. Fortunately, epigenetics can also be reversed as the video mentioned, caregiver interactions modify these instructions in a positive way. These changes are easier in infancy and early childhood, but epigenetic changes
can occur throughout the lifespan, and we'll discuss more about how to do this in a little bit.
So now let's look at how these epigenetic instruction manuals for our genes show up in the way our body responds to trauma. So I live in Woodward, Oklahoma, which is northwest Oklahoma, and we have these gorgeous walking trails in the middle of town. And I


::Slide - Body's Response to Trauma::

walk there frequently with my kids, my dogs. It's a great place to just get out into nature for a little bit. Something else about me is that I am terrified of snakes. It doesn't matter how big or small they are, I don't like them. So I walk on these trails frequently. It's a comfortable, familiar place for me. But let's say one day
I'm walking on this trail and I come across a snake in my path. What happens? Well, immediately I start to have
all of these physiological responses that are normal when my body perceives that there's a threat, so my heart rate is going to increase, my breathing might quicken, my blood pressure elevates, but I'm going to get that shot of adrenaline to be ready to fight or get out of there. So I see this snake. It goes across my pathway, and then
my body starts to be able to calm down. Once the perceived threat is no longer there. However, what has happened to this comfortable, familiar place that I go to all the time? Well, for the next several times that I'm in these walking trails, I'm going to be more alert. So my natural, arousal level is going to be higher because I'm going to be watching for snake. So let's say time goes by, I don't see any more snakes. I become comfortable, and then one day I'm walking and in that same area there is a stick in the grass before my body or my brain can process that. That is a stick and not a snake. My body starts to respond with the same reaction. So my heart rate is going to increase. I'm going to get that shot of adrenaline and then very quickly my brain will process that. That is not actually a snake and we're safe. And I'm able to shut that response down. This is a very basic example of a trauma trigger.
However, when a child experiences this type of fear daily, they can't just turn it off like my body is able to. Their stress response is activated so often that it becomes automatic and uncontrollable.

::Slide - The Limbic System::

So their snake might be something as simple as dinner time, because that's when mom and dad begin drinking or arguing and things get scary. So then their stick becomes the kitchen table, which is an object that they encounter every day, multiple times a day. So you can start to see how frequently that stress response would be activated, and how well those connections in their brain are going to work, and how quickly they're going to work. So then what happens is, long after we remove the child from that environment, these stress responses remain in their behavior because it's built into the structure of their brain. So what we see is what looks like gross overreactions to small stressors or frustrations, like being told no at home or not getting something they want at school, or being forced to sit at the table for dinner.

So let's look at specifically what's happening in the brain structures when your stress response is activated
and when you encounter a trigger. So the important pieces for the limbic system are the thalamus, the amygdala and the prefrontal cortex. So the thalamus is like the data analyst of the limbic system. It's taking in information from the environment, analyzing it, and sending information off in two different directions to the amygdala and to the prefrontal cortex. So the amygdala is the emergency alarm. In this system, it's often referred to as the low road. And it takes about 8 to 10 milliseconds for information to get from the thalamus to the amygdala. So it's very, very quick. The amygdala responds whether it is a real threat or a perceived threat. So when I saw the stick in the on the walking trails, my amygdala responded immediately. It didn't take time to process or analyze. That's not its job. So it sends, an alert to the sympathetic nervous system to act. And the sympathetic nervous system is, what has all of those physiological responses that we looked at in the previous slide. So the body goes into fight or flight mode. 
Now the prefrontal cortex is like mission control for your brain. Again, that's the top portion where all those higher level critical thinking skills live. But the time for the information to get from the thalamus to the prefrontal cortex on the high road is several milliseconds slower than the low road. So mission control will analyze the message from the thalamus and decide if it's a real threat or not, and then respond accordingly. So if we think back to the snake example again, seeing the snake is information that my data analyst took in. And so then the next time I was in the park, the stick was information that my data analyst took in, and it sent a message straight to my emergency alarm, but also to my mission control. Now, my mission control was able to analyze the information that this was a stick and we weren't in danger very quickly, and my system was able to calm down. So that's how it works in a typical brain that's had the environment where all of the parts
can develop healthily.
And so in a traumatized brain, what happens is the thalamus or the data analyst is constantly sending inaccurate data to the amygdala or the emergency alarm. So if we think back to that, how the snake for a child might be the kitchen table or I mean, the stick might be the kitchen table that every multiple times a day that data analyst is sending messages of danger to that child's, emergency alarm. So then it becomes overactive because of how often it's activated. And in turn, that child's sympathetic nervous system is activated over and over again. So Mission Control cannot calm it down in the same way that it can in a developing brain, because that fight or flight mode is already fully activated and gone by the time Mission Control tries to send a message. So again, we get what looks like exaggerated or inappropriate reactions such as excessive fear or excessive anger, etc. and this is known as toxic stress or traumatic stress.

::Slide - Toxic Stress Reactions::

So children who are experiencing toxic stress stress show a range of symptoms called toxic stress reactions. And they're grouped into several categories. First is changes in physiological arousal and reactivity. So this is the one we've been talking about. Again they are more nervous, jumpy, quick to startle, quick to anger. The overreactions to typical life stressors. These children may have difficulty concentrating at school or at home, and may have trouble with falling asleep or staying asleep because they're in this hyper vigilance mode all the time and their body can't fully relax.
The second category is intrusions, and these are images, sensations, or memories of the traumatic event that keep coming uncontrollably into the child's mind. So one type of these is a flashback, which is, you know, a typical
what we think of as a typical like, PTSD flashback response, where you're thrust back into reliving the whole traumatic event scene, but it doesn't always have to be this dramatic, so it might be something much more subtle. For example, when a child tries to think about their mother, and instead of being able to remember, a happy memory, they can only remember the way her face looked when she was passed out on the floor. And for very young
children, intrusions, are often, they often come out in repetitive play versus words.
Next is avoidance. So, children avoid people, places, things that remind them of the trauma. And then they also might go to lengths of trying not to think about it at all. So they don't want to have conversations about it. They don't want to think about it. They don't want to have to deal with any of the feelings that come with processing these traumatic events. And this can really, inhibit their ability to, to process what they went
through and move through that. 
So some other types of reactions are dramatic mood and thought changes. So, dramatic mood shifts being tearful
one minute happy the next, suddenly becoming very aggressive or angry, seemingly, without being provoked. And then that changes. They can have trouble with, remembering. And they also might be stuck in negative beliefs or expectations about themselves, adults or the world, and they can really get stuck in a self-blame, guilt, and just like a negative emotion feedback loop and struggle with feeling and expressing joy and love.
And then finally is regression. And this is where we again see children, not acting their age. So their reactions
when they're, when they face a stressor, might come out as a much younger child. So, for example, an eight year
old has the emotional control of a four year old when they're stressed or when they're faced with a trigger. And this again, goes back to the fact that those upper level brain development did not happen as it was supposed to.

::Slide - Stages of Behavior::

So now we're going to talk about, stages that a child's brain and body goes through when they have complex trauma histories and experience triggering situations. So there's four stages. And they are regulating, revving,
re-experiencing and reconstituting.
So regulated is where we want kids to be most of the time. This is their normal calm state. So their heart rate is in normal range. All of these great upper levels of their brain are online and working well, and they have an internal state of calm. So they can, function in the classroom, they can eat a meal with their family, complete their chores, etc. they're able to manage their emotions and behaviors, but then when a trigger appears, they go into what is called the revving stage.
And this is the activity that leads up to what we would consider a full fledged, meltdown. So the child in this stage becomes more vigilant. They quickly become hyper alert, and they shift focus from whatever they were focusing on to whatever the perceived threat is, and their body starts to prepare for that fight or flight mode. So they might, have rapid breathing, increased heart rate, they might be tensing up their muscles. You can also see their emotions start to expand, whether it's, intensely angry or fearful or teary. And they can also, go into a freeze where they would become emotionally numb. You would see them start to disconnect and shut down. Like we mentioned earlier with the kitchen table example, triggers can be anything large or small. So sometimes it's easy
to figure out what the trigger is. And sometimes it's very, very difficult. So it can be something as simple as a sensory input. So smells, sights, sounds, physical contact, a taste. They can also be time driven, anniversary dates, holidays, seasons or times of day such as dinner time or evening. And then they can also be conditional. So loss of control, things being taken away, being told no or redirected or transition having to go from one activity to another or one place to another. So behavior is a really powerful communicator for kids. We need to understand in this stage what the child's behavior is trying to tell us. The calmer that we are as the adults,
the more clearly we're going to be able to think and to see what's happening with the child and try and figure it out. So we have to look past the behavior to the child and what their needs are. And if we aren't able to catch
what's going on with the child in this stage, then they go into re-experiencing. So if a child can't calm down
or no one else can help them feel safe, when they're going to go into re-experiencing or a meltdown. This is when they're in a full blown traumatic reaction.
And it also is in this stage when a child faces the greatest risk of harming himself or others. So when children are aggressive towards their siblings, parents or property, this is the stage that they're in. And what we find is when we later ask a child what happened in this meltdown phase, children may not be able to remember some or all of the details and that's because all of those higher level brain areas are shut down during this stage. So when they're in that low road, emergency activation, their brains don't focus on the details of the environment, they can't make conscious choices about their behavior. Instead, they're focusing on their five senses and scanning for threats. So the sound or tone of another person's voice, the look of another person's body posture, the intensity of eye contact, the feel of another person's touch, etc.. 
So this is the phase where we, often referred to as them being locked in the basement of their brain. So they're down here and that survival mode of their brain, and they cannot get up here to the critical thinking skills, no matter how much they may want to or how good they may be at using those areas of their brain when they're not triggered. They are physically stuck in this portion down here. So redirection and discipline in this stage
is not going to be effective because they do not have any ability to comprehend what you're saying to them, or any ability to talk to you about their behavior. They're likely just going to perceive you as a threat, which is going to make the situation worse.
So the final stage is reconstituting. This is where they start to calm down. They can understand words again. They can manage their emotions. And those higher level areas of their brain are coming back online and they're able to talk with you. This stage is one of the most important stages to connect with the child. Because some children can move from reconstituting back into re-experiencing very quickly if it's not handled correctly. So, something that's really important to remember in the reconstituting stage is not to shame the child for the behavior that they just exhibited. Likely, When they have access to all of their higher level thinking skills, they understand that their behavior was not appropriate for the situation or for their age, but when they were in that moment, they literally had no control over it. So it's not their fault, but they probably feel embarrassed
or shameful on their own. And if we then, as the adult, say something to them to further that shame, it can push them right back into that re-experiencing mode. So we need to take this moment to connect with them. Discipline and consequences do come eventually, but right now, what we're trying to do is help the child learn to regulate their behavior, and that requires our help as their trusted adult.
So self-regulation is actually developed along a continuum, from external regulation to co-regulation to self-regulation. Like we discussed with brain development, this process is sequential. You have to go from one step to the next and you can't skip over them. So a child who's never had a trusted adult to externally regulate and then assist with Co-regulation cannot self-regulate even if they've made great strides in behaviors and coping skills over time. When their brain and body are triggered like they are in the re-experiencing stage, they have zero ability to access that knowledge. So we sometimes have to go back to the beginning and be their external regulator. And I'm not talking about holding and rocking, you know, an eight year old like you would a baby. But we have to build connection through things like eye contact, safe physical touch and staying calm. If the reconstituting stage is handled well, then a child goes back to being regulated. The goal behind understanding
these four stages is to keep the child in that regulated state as much as possible, because when that happens, you start to see a shift in their general behavior over time, because those synaptic connections are starting to be rewired in their brain.

::Slide - Building Resilience::

So as we've discussed today, a child's reaction to trauma is an interplay between genes and their environment. Important adults in the child's life moderate this relationship through their interactions and connection,
and over time, help rewire those synaptic pathways and the epigenetic instructions for more positive outcomes. 
Positive and supportive relationships work to change those instruction manuals for children's genes. This begins first and foremost. Foremost with connection, particularly serve and return interactions. So serve and return interaction occurs when a child reaches out through facial expressions, vocalization, or actions, and a supportive adult responds in kind. So, for example, a baby crying and then being picked up and comforted, playing a game of peekaboo. Peekaboo with a toddler or an older child saying, hey, watch this cool trick I can do, and the adult watching and then giving them lots of encouraging praise. While this might seem like a small thing, over time, these interactions promote healthy development in a number of ways, one of which is increasing felt safety. So when children are taken from unsafe environments and placed in safe, nurturing, stable, permanent homes that we know as safe, we can be confused and frustrated when the child continues to exhibit survival mentality, behaviors. However, like we've talked about, these children have experienced traumatic situations repeatedly, and their brains have become wired to sound the alarm quickly and automatically. This shift happens so fast that children aren't consciously aware they can't process the details of their environment, or think through the consequences of their actions. Again, they're locked out of those critical thinking skill areas of their brains, so the environment might be physically safe, but they don't feel safe in that moment. Their brain has to be rewired over time. And every interaction that you, as the adult, have with the child has to counter
what they have seen before. And so over time, with consistent, stable, predictable adults in their lives, they have an increase in felt safety, which works to rewire all of those pathways and build new healthy pathways. Okay.

::Slide - References::

And that is the end of this portion of the training.

::Attendees Visible::

And we'll have a little bit of time for question and answers. As Bonni said, there is also a part two of this, it is called Behind the Behavior healing trauma through conscious connection. And it will be on May 2nd from 12 to 1. Again, we'll be sending out fliers just like we did for this one. And that part of the training will really dive deep into what do we, as the adults do now that we understand what's going on with the child's brain and body? What do we do day to day when they're having these behaviors and these experiences and how do we really work to rewire those negative pathways? So I hope you all can join us for that.

Bonni: 
So, Katie, it looks like you have one person who is asking for the references slide to be back up on the screen. I also want to let you all know that the, the recording that we're, that we are doing, of today's webinar we are uploading that, Christy, would you mind would you have a chance to put the link for the Oklahoma Adoption Oklahoma Adoption Competency Network link into the chat. We this is this is a part of a series of lunch and learn webinars that we're doing. And we're inviting anyone touched by adoption, including, parents, adoptees and,
adoption professionals. And these lunch and learns are really created for the sense of being able to, to to just kind of dig into some of the content and topic areas and, and some of the specific, unique characteristics of adoption. But I also on that, when we get that link into the chat also, it's on there. We've got book clubs that are going on. We've got one right now. That's meeting it for the third time next Friday at noon. And we're covering 20 things that adopted children wish adoptive parents knew. We're going to start in May. Another book club on Beneath the Mask, with about adopted adoptive teenagers. So there's book clubs or something that are open. You just, click on that and register to to join those book clubs.
But I also, I've had some, some, participants reach out and mention, man, we'd love to be able to have conversations with other parents. And so this is a great place to, start kind of that conversation and maybe even being able to, to, jump off from here and we could help facilitate a virtual support group. So something I mean, we've the sky's the limit here of what we're trying to and wanting to support, anyone on here. 
So, I don't know if you see in the chat we've got a question. How many on here have adopted in our walking this out? I'd love to connect to learn. So Katina, thank you so much for putting that in the chat. If you are interested in that, if you are a parent and you are wanting to connect and have something beyond here, and maybe even there's the book club going on would be a good next step. Or if you could, let's see. I think the best thing to do would maybe be I'm going to go ahead and put my email into the chat right now. And I would love if you're interested in going deeper

::Attendees visible::

and having a specific like virtual support group, get started in the next few weeks, please directly email me and I will take steps towards getting that group together and facilitating, with our team who's on here to support all of that. We'll we'll get one started. Okay. So if you have my email's in the chat, reach out to me directly
if you'd like to have more a deeper where everyone on here is a smaller group and it's just parents.
Additionally, if you are an an adoptee, then and you are interested in going deeper and having, virtual meeting with just adoptees, please email me that as well. And like I know Christy mentioned at the beginning, we will be putting, a link to an evaluation for your feedback on this. And I believe, Lynn, am I right that there's a question in that that's asking of what other what other support you're interested in? [Lynn nods] 

Bonni: 
Okay.

Lynn Smith: 
Support they're interested in. And also, different topics and feedback. So yes.

Bonni: 
So this is, this is all the things that we are in an effort to respond and try to fill in some potential gaps
that you have experienced. In walking, walking the walk and being a professional who is supporting those who are walking. Okay. Let's see. I'm going back to the chat here, Lynn, thank you for putting the link to the chat in. I'm sorry, the link to the evaluation in the chat. So it's in there and then we have a comment. 
"I'm concerned about children placed in our homes for an extensive period of time, then families or friends coming forward years later deciding when they want them. What does that do to these children? The stability
they have being in a loving foster home that they thought were going to. They were going to adopt, and then the trauma and stress everyone encounters is unfair." So the, I can't tell what your first name is. Child welfare nurse, thank you so much for being on here. So the question, I think, and correct me if I'm wrong, but what is the impact of whenever a child is in a home for a long amount of time and connected and building attachment
and then then have to move? Is that is that kind of a good summary of your question?

Child Welfare Nurse:
Yeah, I'm just kind of wondering like what? I mean, we know the trauma that they come with, you know, whenever they come into our homes. And then we have them and they get secure, they get, you know, they some of that stress and that cortisol level kind of goes down a little bit because we are there meeting all of their needs. And then just as they start to feel secure then and, and the families think they're adopting the, you know, whenever it's, it's terminated. And that's the direction that everything's going is you the whole family believes that that's where it's going. And then all of a sudden, family members come from other states or from other. And now they've decided they want them and they step in what it's doing to these children that are leaving these stable homes. And then all of a sudden, that trauma is being reinforced on them again, because now they're yanked from a stable home and placed in with these strangers that they've never some of them have never even met before.

Bonni: 
Yeah. You're that, such a critical conversation, that that actually hits so many different layers of the things
that we're talking about, about adoption. And in some of these sessions, I think what you're connecting to and what's really complex in that is attachment trauma. What we talked about today, the impact of trauma loss and grief. Right. And then also a piece of honoring biological family, and connection. And then what what goes from
there is adolescence and adoption and being able to, what's important in helping support our adolescents who have been adopted and forming identity? Who am I and what does that mean? So the the what you brought up really touches. So all those different plus more, potentially transracial adoption, the connection and understanding
of when you are adopted into a family of a different racial background or a different, you know, cultural background. So those decisions are so complex, and we really have to what I want to kind of say in the short amount of time that we have in response to that is, I think there are it's important to to focus on the sense
of recognizing the impact of what that means for that child, which I think is what you're saying. There's there's an impact, there's a loss. That's trauma. 
And so we have to weigh the impact of what we know is happening to that child with the benefits of potentially being connected and, and, having a, you know, being adopted by a family member who is biologically related and maybe have trans racial and cultural connection with the child, there's all different types of scenarios and possibilities. So it's, it's we have to be able to look at the whole picture with all the details and make that decision of which do we think. Does the benefit outweigh the, the, the trauma and the challenges there. And then if we agree that the benefits outweigh that, then how are we then going to support the foster family and the child and the adopted adoptive family and being able to recognize the trauma and then building some additional supports? Can we transition this? Can we continue an open relationship with foster family to where it's not that they're just totally shut out of this child's life, but there's they're continuing a connection and continuing
a relationship with the child and being able to be supportive on, for the rest of their life. Like, those things could be huge benefits. 
And also helping, there's a specific tool that I talk about a lot called A Good Goodbye Letter, and that is, facilitating and helping foster parents be able to write whenever a child is transitioning
out of their home, write a really good goodbye letter where they're able to include incredible memories. How much we loved spending this time with you, some of the wonderful things we got to do together, including some of the the challenges that we went through together. And then my hopes and dreams for you and your future. So there are some specific tools that we can, hopefully really support the child and the family with. And that's a lot of what we're talking about in the adoption competency piece, when we're talking to professionals, child welfare professionals, mental health professionals of trying to utilize some of those tools to really support whenever we when decisions like that are made, where children are going to experience more loss and some of that layered
those layered pieces. But thank you so much for bringing up that really complicated, thing that happens. How and how trauma impacts, in, in any move that a child has to experience.
All right. We have about six more minutes. Any other thoughts or questions? I see Brittany asked, is there a way to receive proof of attendance? Good question. I see

Lynn: 
I asked everyone to put their email in the chat, and I'm taking the list now and verification will be sent to the email that is provided.

Bonni: 
Thank you Lynn. All right. Well thank you guys so much. Katie, Great job. Thank you so much for everything that you shared with us. It was fantastic. Please make sure that you click on that link to see our upcoming information and events we do have this weekend in Oklahoma, If you've adopted from child welfare, we have, a retreat for adoptive parents, put on by Wellspring. So, very excited about that. You can get all the information
on that, website also, if you'd like to be included, everybody who's put their email address in here, we're going to go ahead and add you on to our mailing list for the Oklahoma Adoption Competency Network. So that you can, continue to receive information about our future events. So we do have part two on May 2nd at noon, we also have, two people on our team here, Toya Bell and Tammera Honer, who are, they are going to be presenting on transracial adoption on April 11th at noon. So I'm very excited. I know they're going to do a wonderful job. We'll we'll go in depth about exactly what we were talking about a minute ago, about the important aspects of understanding. What does that mean when a child is adopted in a home where they have, different cultural and racial background, potentially, yeah. 
And I'm excited to hear from anyone who is interested in going deeper and setting up some type of support group. Please, please reach out to me, I would love I know our team has been working on some great curriculum, to be able to utilize and support groups who are interested in getting together and going deeper together and sharing your your story and sharing some of the challenges that you're going through together. So, I look forward to that and I'll be reaching out to anyone who sends me that email very soon. Thank you guys so much and have a great rest of your day.