Lunch and Learn: Age-Appropriate Child Development for Children Ages 0-8 --- [Grace Cameron] All right. Good afternoon. Um, I want to welcome everyone today to our Lunch and Learn, um, and this Lunch and Learn is being brought to you by a collaboration between Oklahoma Human Services, the University of Oklahoma, Anne and Henry Zarrow School of Social Work and the Oklahoma Adoption Competency Network. We appreciate everyone joining during your lunch or noon hour. We want to get started so we can make sure to respect everyone's time and the great information being discussed today. And let us first go over a few housekeeping things, um, for our time together this afternoon. Um, so the first is that we are recording this meeting and by participating, you are giving your consent to be recorded. Um, the second is to please help us reduce distractions so we can all focus and participate. Um, we have muted everyone to make it possible for everyone to hear the speakers, and we want you to express your thoughts and questions, So please utilize the chat for this purpose. Um, we will monitor the chat and questions will be touched upon during our Q&A time during the last 15 minutes of the webinar. Um, we want to see you, so if you're willing and you can, please turn on your video. If you are unable, that's fine also. To receive information about other post-adoption events, please list your name and email in the chat and we'll make sure to add you to our contact list. Um, the third is that we just want everyone to remember confidentiality. It is definitely vital that we protect confidential information, so we will not share specifics like names, specific details, et cetera, about adoption cases or people or children. Um, the fourth is that if you are a foster parent attending this training, you will receive one hour of training credit toward the 12 hours of in-service training that you need each year. These trainings are not yet available as CEU credits for professionals, however, you may submit this certificate to your agency and request training credit for your agency's policies. Please indicate in the chat if you would like to receive a certificate of attendance and participation. Now, I want to hand everything off to Carlie, who is today's host. [Title Slide: Developmental Stages: Infancy to Age 8 Carlie Van Woerkom, PAS Outreach] [Carlie VanWoerkom] Hello everyone. We are so excited that you are here with us today. We're gonna kind of get things going. Um, welcome to our Lunch and Learn. My name is Carlie VanWoerkom. I have been in post-adoptions working directly with adoptive families for about five years, and I am so excited to get some spend-- to get to spend some time with you today. And I hope that our discussion will help bring some comfort and some peace in knowing that others are struggling with similar things. Um, I will do the best I can to answer all of your questions, but I am aware of my professional limitations. So if I'm unable to give you an accurate answer, I will ask for you to send me an email so that I can utilize the skills and knowledge of my coworkers to ensure that you get the most accurate information and support that your family or case needs. I am also not a physician, and since we are discussing some developmental things, um, and if there's any extreme concerns, then we would encourage you to reach out to your physician for some more in-depth discussion about that. Um, but hopefully this discussion will kind of help us all come onto the same page. Technical difficulty. My apologies. [Slide: Agenda Introduction Brain Development Age Milestones The Effects of Trauma Resources] [Carlie] So today we're gonna be talking about, um, uh, some brain development. We're gonna discuss some specific milestones for youth ages zero to eight, and then we're gonna talk a little bit about the effects that trauma might have on these milestones. And then, um, there is a list of resources at the end if you would like to, um, revisit some of the things that we discussed. [Slide: Introduction A large chunk of growth and development occur between birth and age 2. Here are some helpful hints: 1. Engage softly with your child as often and early as possible: Eye contact, Appropriate physical touch, Quality time 2. Consequences vs. Discipline 3. Don't compare your child in unhealthy ways 4. Healthy nutrition] [Carlie] So, first of all, a large chunk of growth and development occurs between the ages of birth and two. Um, so here are just some helpful hints to kind of help in that development and process. Um, spending time with your child early on helps to build positive attachments, um, and this attachment can help -- if you're spending time together, then this allows you to, um, get to know each other. So if your child is struggling with something developmentally, if you aren't spending consistent time with them, you might struggle to pick up on those needs. Um, but also it helps you to develop communication styles. Every child is different, every adult and parent or caregiver is different. Every caseworker is different. And so, um, spending some of that time with the youth will help you guys to develop your own communication styles together. Okay. Um, and then just talking a little bit about consequences versus discipline. Um, some of our kiddos have really, really big behaviors, um, based on things that have happened in their life. And so when we're talking about consequences, that's a learning technique, right? We're, it's, you make a choice, you make a consequence. And so if you choose to touch the hot pan after I told you, "Nope, don't touch that, that's hot." The consequence is, ouch. Now your hand hurts, it burns. Um, versus discipline, if you touch the hot pan, discipline is more, um, punitive and, um, aggressive. And so they touch the hot pan, they, they got the consequence, but now they get, uh, discipline. Well, now you're grounded for two weeks, and it's kind of, um, more to just diminish them. They've already received their consequences. So discipline just goes further than that and is usually unnecessary. Um, try not to compare your child or your client in unhealthy ways. Every child is gonna develop a little bit differently, and when we're looking through a child, or to a child through a trauma lens, it's gonna be even a little bit more different and more unique for each child. So, um, try to avoid that unhealthy comparison. And then healthy nutrition. Little bodies and brains growing really need some healthy nutrition. So making sure that they're getting fruits and vegetables and, um, nutrients and proteins that they need in order to, uh, allow their brain to focus on development is gonna be important as well. [Slide: Brain Development] [Slide: Which portion of the brain develops first? Amygdala, thalamus, or prefrontal cortex? Image: A line drawing of a brain with a yellow circle around the prefrontal cortex, a pink circle around the thalamus, and a purple circle around the amygdala. Amygdala (Primitive/Reptilian - Emergency Response - Survival - Sensory/Motor Thalamus (Limbic) - Data analysis - Attachment - Emotions - Processes info from the amygdala and sends it to the prefrontal cortex for appropriate response Prefrontal Cortex (Cortical) - Mission Control - Deep Thought - Learning] So when we're talking about brain development, um, which portion of, and you can unmute or you can put it in the chat. Um, we're gonna be a little more interactive today. So, um, which portion of the brain do you think develops first? This is the amygdala's purple. The thalamus is pink, and the prefrontal cortex is the yellow. [Elizabeth] The purple part. [Carlie] Yes. So perfect. [Man] It's on the porch. [Carlie] Um, if we can remind everyone just to mute yourselves, that would be great, but absolutely right. The, um, purple part is called the amygdala, and this is, um, also known as the primitive or reptilian brain. So this is where there's emergency response, the survival instincts, and the sensory motor skills. So this is the very first part of the brain to develop. So as a, as a child is, from birth, this is where it starts. So if you have a child that isn't getting a lot of that attention or a lot of one-on-one, or there's, um, you know, trauma in the home, there's significant ACEs that have occurred with that youth at an early age, um, development kind of halts here for a bit, because they're in that survival mode, they have to use those, the fight or flight to figure out how they're gonna survive from day to day. Moving beyond that, um, we go to the thalamus, which is, um, the limb-- also known as the limbic brain. It analyzes data, emotions, and processes the information from the amygdala. So from that, um, initial brain formation, um, location, to say, how, how should we react, right? So if we're kind of stuck in that primitive survival brain, um, we aren't able to move past that to start to develop the thalamus, or really um, uh, process the information appropriately. And then beyond that, um, we have the prefrontal cortex, and this is, um, I like to, or it's referred to as mission control. So the thalamus takes information from the amygdala. So let's say, um, a kid at school pushes you. The amygdala is telling, uh, that's the fight or flight. "Okay, what am I gonna do? Am I gonna respond? Am I going to run? Am I gonna push him back?" If we have an amygdala that has been properly developed, then we can, the thalamus takes the information, "Okay, this kid pushed me, now I am going to send that information to the prefrontal cortex." So that mission control, those deeper thoughts, additional learning, um, more complex thought process, processes, um, can then say, "Okay, he pushed me. I'm choosing not to push him back." "I'm going to say, 'Hey, that wasn't nice.' I'm going to..." It's a lot more complex thoughts and reactions. So, um, for kiddos, they get stuck in that primitive brain, um, development based on history and trauma that they have experienced. They maybe can't get to that portion of the thought process that allows them to really think things through logically and make appropriate decisions. And we have this, um, video clip from the UK Trauma Council that I think really, um, explains and kind of shows this well. So I'm gonna show this video. [Video starts] [Title card: Childhood Trauma and the Brain] [Narrator] Brain development is much more than a story about biology. From the earliest years, relationships with others play a key role in shaping how our brain grows and develops. [Animation of a brain lighting up in different areas inside of the head of a baby in utero. The mother is surrounded by connections to other people.] [Narrator] Early relationships where there is abuse and neglect have a long-term impact on children. A brain that has adapted to survive in a threatening or unpredictable world may not work so well in an ordinary environment. [A mother and child sit on the floor together. Someone comes up and begins shouting at the mother; all we can see is their shadow. Dots begin floating over the child's forehead, signifying connections in their mind. We see the child in other scenarios as they age.] [Narrator] This can create what is called "latent vulnerability," where early abusive or neglectful experiences with carers put children at greater risk of experiencing mental health problems in the future. [The child, now grown, walks beneath the term "Latent Vulnerability." The path under their feet cracks and sinks, causing them to jump to avoid falling and walk with great care.] [Narrator] For these children, compared to their peers, common experiences like moving to a new school can feel more daunting and stressful. New faces can appear threatening, while positive social cues can be missed. It can be harder to negotiate new social situations and learn to trust new people. [A different child walking into a school. She clutches the straps of her backpack tightly. Above her head we see "Stress susceptibility." She approaches two other girls, but through the lenses of her glasses, the expressions on the other girls' faces look angry or unwelcoming. Another girl runs up and begins talking to the other girls, leaving the nervous child alone.] [Narrator] Even fun experiences, like joining a new sports team, can be challenging. Too much focus on potential threat cues can mean missing out on positive social cues, such as a playful nudge, or it causes an overreaction which leads to an increased risk of conflict, and sometimes violence. These reactions can increase the likelihood of generating new stressful events. It's harder to deal with everyday challenges when you feel unconfident and anxious inside and harder to build and maintain relationships. [Two young people play around in a swimming pool. They appear to be trying out for the swim team while a coach looks on. The dark-haired young man splashes the other and pushes him underwater. The blond teen gets angry while underwater and shoves his friend. The coach whistles and points, crossing the blond teen's name off their list. He leaves, upset, and walks to the locker room and turns to look at himself in the mirror. Around his head he sees words like, "Weirdo," "Ugly," "Loser," "Weedy," and "Troublemaker."] [Narrator] Over time, this can mean a child loses friends and the support of adults and so misses out on opportunities to grow and develop. This "social thinning" can increase the risk of mental health problems in the future. [The young man from the pool is surrounded by boxes showing different social connections in his life. Some of them, like the coach and other members of the swim team, disappear, leaving him with fewer people around him than before.] [Narrator] Neuroscience research is beginning to shed new light on how vulnerability unfolds over a child's life. All children need care and stimulation from adults who value them and who show them attention and love. These experiences shape a child's brain development. [Lights, symbolizing thoughts, move along brain neurons. A scene with a family appears. There is a father at the sink washing dishes, a mother watching on with a cup in her hand, and a baby in a high chair. The parents smile and make kissy faces at the baby as he babbles and laughs.] [Narrator] When children face traumatic experiences like abuse and neglect, their brain adapts to help them cope. We know of changes in three different brain systems. The reward, memory, and threat systems. [Closeup of the anxious girl from the school with different colored dots floating over her head. Then the same with the blond boy from earlier. Beneath his head, "Reward System," "Memory System," and "Threat System" appear and disappear. The boy recalls an instance of being shoved out of a room, while his parents argue outside the door.] [door slams, voices shouting] [Narrator] Experiences of domestic violence or physical abuse can lead to hyper vigilance, where the brain reacts more to threat. This might help a child stay safe in an early adverse environment, but it can cause problems in more ordinary environments. [The boy sits on the floor, listening to the shouting, then we flash forward to the instance of him shoving the other boy in the pool.] [Narrator] Hypervigilance can best be understood as a pattern of adaptation rather than a sign of damage. Abuse and neglect can also mean a world where a child's basic needs for care and attention are not met. This can shape the brain's reward system, the part of the brain that helps us learn about positive aspects of our environment and motivates our behavior. Over time, the brain's reward system can learn to respond differently to things like positive social cues.Neuroscience studies have also pointed to changes in the autobiographical memory system. Our memory of everyday past experiences. Following trauma, negative memories appear to become more salient, which means they become more prominent than positive ones, and everyday memories can also become less detailed. This is a problem because we need to draw on past experiences to help us deal with new social situations. [Baby crawling toward their mother in a messy room. The mother is on the phone and watching television. The baby tries to pull up onto their mother's lap, but the mother turns away and the baby picks up a rattle instead. The baby tries to shake the rattle at her mother, who continues to ignore her, causing yellow dots to flash over her head. Flash forward to the girl at school, looking at the other girls with fear as they wave and smile at her. They turn to her and offer her a fidget spinner, and the dots over her head change to blue. "Autobiographical Memory System" appears while memories float above the girl's head. As she dwells on those memories, another girl runs up and begins showing off her own toy, distracting the other girls and leaving the girl alone.] [Narrator] Neuroscience research is showing how childhood trauma can create latent vulnerability, increasing the risk of later mental health problems like anxiety and depression. This vulnerability is not just located in the child, but arises through their relationships. Helping children who have experienced trauma still requires ordinary boundaries and consequences, but it also requires us to step back, and reflect, and see behavior that we find challenging in a different light. A child may simply be doing their best to survive now with brain adaptations from the past. [Return to the blond teen walking gingerly along the "Latent Vulnerability" path, then we see that as the dark-haired boy in the pool pushes him under the water, flashes of the blond boy when he was younger feeling danger from his parents' arguing. He shoves the other boy, but this time, when the coach blows the whistle, she doesn't send him away, she calls him over and talks to him. We see him as a member of the swim team, helping stack equipment.] [Narrator] We know a child's brain has the capacity to continue to adapt. For this to happen, they need our help to build and maintain trusted relationships, manage everyday stresses, and prevent ones from happening. We need to encourage them to try again and believe things can be different. This is far from an easy task and takes time. Science is helping reframe our understanding of childhood trauma. Seeing children's behavior in a new light can mean we respond differently, but there is much still to learn. Working together, we can develop more effective approaches that promote resilience and recovery. We can help children build trusting relationships and create opportunities for their brains to adapt in new ways. [Scenes of a child looking at a scan of their brain with a parent and a doctor, a child playing while their parents talk to a therapist or social worker, the blond teen facing his parents with his friend and coach standing behind him and lots of other connections around him in different boxes.] [Slide: Childhood Trauma and the Brain Animation developed by Prof. Eamon McCrory in collaboration with Anna Freud National Centre for Children and Families and the UK Trauma Council For more free resources on childhood trauma, visit UKTraumaCouncil.org Logos for UK Trauma Council, Anna Freud National Centre for Children and Families, UCL, and UKRI Economic and Social Research Council A Lucy Izzard Production] [video ends] [Carlie] So I really like that video because honestly my favorite part is when he gets pushed underwater and that kind of flashback of when he was younger, experiencing some domestic violence. And the tricky part about that is that sometimes it's, we understand where that is coming from, we understand exactly where that's related to, and other times we don't. So more often than not, we might have a youth that is experiencing behaviors that his brain is making connections to past experiences, but it's kind of more subconscious. And so when you ask them, "Why did you get so mad?" That, that boy in the video may not have been able to say, "Well, because the same thing happened when I was little, and this is how it made me feel." They may not be able to express that. And so, um, looking through youth in the, with that trauma lens to understand that behaviors talk when youth are experiencing certain things or behaviors, it's, there's something underneath. It's saying something, and so we need to take the time to really understand what that's saying. [Slide: Age Milestones 18 months old: "I do it myself!" 2-year-old: Terrible and Tender 4-year-old: Adventurous 6-year-old: Loving and Defiant 8:year-old: Lively and Outgoing] [Carlie] So kind of getting into the developmental milestone thing, what I would like to do is, I'm gonna stop sharing for one second and we are going to get a little bit interactive. So everyone get ready. Um, I am going to bring up a, uh, there's gonna be a QR code that you can scan and lemme get one. Um, this is going to allow you to kind of interact and present with me. Now, I will say that your answers are anonymous. Your names will not be posted with the answers. Um, but I do encourage you to, um, interact and kind of share with us some of your experiences. So let me share this screen. [Slide: QR Code Join at slido.com #2611 116] [Carlie] Okay. So go ahead and you can either scan the QR code with your phone or you can go to slido.com and then put in the little, um, number there. I'll give everybody a minute. [Slide: Results screen What is a milestone that you are concerned your child/client has not reached? (Include the age of the child and milestone) - My child age 3 still does not speak in sentences or respond without multiple words. - A 2 year old cannot talk or communicate what she needs at all. - 3 year old not potty trained yet - 5yo does not understand basic emotions, does not exhibit embarrassment or pride, and doesn't exhibit shame or guilt. - 2 year old still wearing 18 month clothes - He doesn't fit clothes for his age. He is smaller. 2yr old wears 18 month clothes - Eating solids and crawling - 14 months - 8 yo doesn't acknowledge own mistakes or behaviors or genuinely apologize. - Reading other children's social cues/lack of boundaries. Almost 6.] [Carlie] Okay. So hopefully you guys can see this first question here. [reading] So, "What is a milestone that you are concerned that your child or client has not reached?" Please include the age of the child and that the milestone that you're nervous about. And we won't be able to get to every single one. But if there really are questions, please let us know so we can, um, kind of guide you to at least who can answer those questions most appropriately for you. Okay. [reading] "My child age three still does not speak in sentences or respond without multiple words." So I'm guessing that means it, it's kind of one word responses or maybe like, "Do you want to have dinner?" And they kind, "Uh," you know, kind of a grunt. Um, we are going to talk a little bit about like how many words at certain ages are developmentally appropriate. So I'm gonna hold onto that one just for a second. Um, but really by the ages of two to three is when doctors are gonna start looking at that speech. And so, um, if you, your child is three and still really struggling, understanding are -- do they have the language, do they have the vocabulary knowledge and they are choosing not to use it, or is there a struggle? So maybe getting an evaluation done or talking with a speech and language pathologist would be a really great resource. Um, and they can help kind of, um, get your child to where they need to be. Or at least kind of answer that question, do they have the vocabulary and they don't wanna use it, or are they struggling to kind of get that vocabulary? Um, [reading] "A two-year-old cannot talk or communicate what she needs at all." Um, same kind of a situation there. If it's a language barrier, um, your primary care physician can, um, refer to a speech and language pathologist. Um, and one thing that we will talk about a little bit later is, um, that trauma lens. So when we have, trauma affects the way that the brain forms and when our brain is kind of stuck in that amygdala, that primitive brain, those deeper thought process, they may still be trying to work through and process some of the things that they've experienced, which might delay that a little bit more. Um, but getting a, um, a speech language pathologist or someone that can really work with your child on a consistent basis would be beneficial. And it looks like Bonni has some information. [Bonni Goodwin] Yeah. Yeah, I just wanted to hop in and, and support you, what you were just talking about, Carlie, that a lot of these, uh, milestones, even the ones that are talking about like physical size, right, that clothes are the smaller than the clothes that, that they should be fitting in. Man, that significant impact of that early trauma we see in all these different areas. But I think what Carlie's saying of, of talking about it with your pediatrician, um, and then also keeping in mind that, um, there's, there's some approaches within, there's the, there's different philosophical approaches to addressing some of these things. There's a medical and then there's a mental health. And hopefully, um, I would encourage you to be very aware and ask some specific questions of your providers, um, to make sure that they're thinking of both, right? Because we want it to be a holistic, uh, perspective, which is very much what Carlie was just talking about, that it's, that's a, that's a big piece of the mental health, the trauma impact. Um, and then also it's connected, it's all, these kiddos are all whole, whole beings where the mental health and the medical and the physical and all, all the cognitive and emotional development, um, is impacted. So anyway, I just wanted to hop in and, and support what you were saying, Carly, that, that there's definitely both of those things to keep in mind. Um, and, and being, you as the, um, parent are really the one who is going to, uh, continue to keep that perspective with whatever provider you're speaking to, um, and making sure that they're keeping that holistic perspective of, of all the above. [Carlie] Yes, thank you Bonni. Um, some of, there's a couple other ones that, um, are talking about similar things, the social cues, lack of boundaries, um, basic emotions. There's no guilt or concern or anything like that. Um, now if it gets to a certain point where it's kind of detrimental or harmful to self or others, that may be a good opportunity for you to seek like a psychological evaluation just to see if there's some additional supports you could glean from that. Um, also one thing we'll talk about in just a minute is, um, sometimes kids are selfish. Like, young kids, that's their moment where they kind of get to be a little bit selfish. Like, it's all about me, right? And so a little bit of that selfishness, not in a, to a certain degree is age appropriate. It is, um, unless it's like I said harmful to self or others, it kind of gets to a different level. But we'll talk about that a little bit more in just a minute. [Results Screen: What is a behavior, exhibited by your child/client, you are concerned about? - A 6 year old has a meltdown whenever we switch from any activity to another. - Still having toileting accidents at 7. - 8yo creates chaos if things are "going well." - 2 yr old hits himself when he gets upset. - My child age 2 repeatedly hits others and pulls hair even when redirected. - 6 yo Focus/at school or lack of rather - Preoccupation with other's private parts. No history of abuse. Age almost six. - Hitting and bullying older siblings. - Full blown melt down at meal time - 4 yr old always wants to argue back after you say something. - Unable to cope well with things they do not want to do.] [Carlie] Um, okay, so the next question. What is the behavior exhibited by your child or client that you are concerned about? Some of those were, um, kind of put in the last one as well. So we'll give this one just a second and we'll kind of do this one quickly and move on to the next one. 'cause we've already gotten a couple. Okay. [reading] "A six-year-old has a meltdown whenever we switch from any activity to another." Um, this one is, um, very common for any kiddo. But then when you talk about the inconsistencies that they might have experienced due to trauma and adverse childhood experiences, um, that change in, um, activity without knowledge or um, can, can really trigger some emotions. And, um, if you're talking about a child who's been in foster care, how many times did they have to move placements and they weren't told? And, you know, so if you kind of think about the experiences that they've had in their life, um, and that they're struggling with kind of looking through that trauma lens, um, this won't seem so far-fetched now. Um, one way to kind of help with that transition is, if they're going to school, maybe ask the teacher for a daily schedule and then you can talk, you can go over the schedule with your child before they go to school. You can talk to the teacher about, "Hey, could you give them like a five-minute, 10-minute warning before a change of activity?" And that can be something they add into their, um, routine is, uh, um, then the whole class knows, right? So the teacher can then start to say, "Okay, you guys, 10 minute warning until we have to change and go to gym," or, "Five minute warning and it's lunchtime." So that is something that can honestly help others as well. Um, so there's a lot of, um, the, uh, toileting accidents at seven. Um, that again, uh, as Bonni was mentioning for the last slide, you can look at that either as, as a physical, medical need, maybe there's something going on medically that they need addressed, or a mental health need. And so really talking that through with your pediatrician, um, can kind of help to try different things and see, um, what might be beneficial for that. Um, there's a lot of, um, there's a lot of hitting and, um, full blown meltdown, bullying other siblings. Um, so depending on age and circumstances and history, if we're looking at the full scope of what the child has experienced, um, that might determine how, I don't wanna say normal because every child is a little bit different, right? We're all experiencing things in a different way. Um, but what might be expected for your child based on their history and past experiences. Um, and I do see one in here about, um, private parts, no history of abuse. Um, we are going to be setting up, I'm not gonna talk specifically about, um, sexual behaviors in this Lunch and Learn because we are going to be setting up a, um, Lunch and Learn that is gonna be solely based on sexual behaviors with, um, experienced, um, therapists and people that can come in with that, that knowledge and certifications to talk about that. So we're not gonna be talking specifically about those today, but, um, we are gonna be setting that up soon. So, um, if there are concerns that you have regarding sexual behaviors, please keep checking our OKFosters, we'll send it out via email so you guys have access to that information in that specific Lunch and Learn. [Sarah Antari] Carlie, can I just make a statement real quick? [Carlie] Yes. [Sarah] Based on all of your questions, I was just wondering when we get back to our presentation and out of Slido, if we could show, um, a show of hands as to how many people see a physician that understands what adoption is. Um, and, [Carlie] Yeah. [Sarah] and some of the issues that kids that have been adopted or in foster care face. Um, so if we could come back to that question when we get back to our, our presentation, I think that would be really helpful for us to know. [Carlie] Absolutely. I'll bring that up and we have one more question and then we'll get back to it and I'll, we'll kind of go through that. Okay. Now we gotta lighten it up just a little bit because these kiddos are awesome. [Results Screen: What is the funniest thing your child/client has done recently? - He has decided the bath tub is a hot tub - My child told me he went potty and was so excited to show me, that he brought his poop to me in a cup - Used the restroom in the backyard because "The dog does it!" - Tried to capture the tooth fairy - 5yo was running, singing "I am who I am because the I am tells me who I am..." tripped pretty hard. Jumped up and said she was fine. It was a big trip though, one where she bounced and slid. She was fine! But she says that song is bad luck now. - Told his class on 80 years old!] And so what is the funniest thing that your child or your client has done recently? [reading] "The bathtub tub is a hot tub." I can totally relate to that though. So [laughs] Put little bubbles in it. Relax a little bit. Yep. [reading] "My child told me he went potty and was so excited to show me that he brought his poop to me in a cup." Yep, yep. And actually we'll talk about that might be, uh, a really fun opportunity to say, "Oh, that's so good. Now let's take it and put it in the toilet." Kind of have that learning moment. [reading] "Use the restroom in the backyard because the dog does it." Mm-hmm. Yep. [reading] "Tried to capture the tooth fairy." Okay. If that ever works, let me know. Five-year-old was running singing, 'I am who I am because I am tells me who I am.' Tripped pretty hard. Jumped up and said she was fine. It was a big trip though, one where she bounced and slid. She was fine, but she says that song is bad luck now." [laughs] [reading] "Told his class you're 80 years old." Yep. Awesome. Well, just a reminder that, um, for all of the struggles and the things that our kiddos struggle with, um, they're awesome and they're still learning and growing and developing. And, uh, oh, one more. [reading] "Greeted me when I came home from work with, 'Hello Daddy. I pooped' and grabbed his diaper." [laughs] Well good, I'm glad he was so excited to tell you that. He needed you to know. That's awesome. [Slide: 2-Year-Olds Intellectual - Does what s/he can and doesn't try too hard on new things - Better language skills and more easily understood Physical - More coordinated - Less concerned about balance - Runs and climbs more easily Social - Wants to please others - May not be willing to share, but will give a substitute toy to another child Emotional - Can stand slight or temporary frustration - Can wait a few minutes for what they want - Loving and affectionate Sexual - May be curious about different body parts - Self-soothing touch] [Carlie] Okay, so we are going to get into a little bit of now, um, individual development stages. Okay? So we're just gonna touch on a couple of things in each one just for the sake of time. Um, but for our two-year-olds, intellectually, um, they're gonna do what they can do and they're not gonna try too hard to do new things. Um, they, so for instance, they may kick a soccer ball once, and then they run up to it and pick it up instead of trying to dribble it more than once. 'Cause that's not something they've ever done before. Um, and they are totally fine with that. "I kicked the ball, yay!" And then they're done. And they're not gonna try super hard to con to try new things. Um, socially they may not be willing to share, but they're starting to learn to give a substitute toy to another friend to try to make that friend happy. So the friend wants the ball they have and they say, "No, it's mine." And they see a block on the floor. So they pick it up and say, "Here you go." And then keep their ball and, and walk away, right? We talked a little bit about that, a little bit of selfishness, and I hate that word because for a little, for, for these young ones, I don't really think it's selfishness. I think they're, they're figuring things out. And so, um, I think it's more developmentally, um, direct, I guess, instead of selfish. Emotionally, um, they can wait a few minutes for what they want. So if you have a child who, um, let's say they're so hungry and they want dinner, um, and you say, okay, but it's gonna be a couple minutes so I can heat up your chicken nuggets. They should be able to wait a couple of minutes, um, for you to do that. Now, typically it is fine to ask a child to wait that has grown up in a safe and stable environment. However, if you have a kiddo that has experienced, um, abuse or neglect, then, you know, if they're experiencing some food insecurities, then even that two minutes for you to heat up those chicken nuggets might be too much. And you either have a meltdown or, um, they get upset or they start sneaking food, things like that. Um, and those food insecurities, it, that's a survival thing, right? "I'm hungry, I am not sure that I'm actually gonna get food in two minutes, so I need it now." And, um, that is also developmentally appropriate, um, for that kiddo based on the experiences that they've had. Um, so what are some things that we could do to navigate away from this behavior? We can, um, ask the child that they wanna help us prepare the chicken nuggets. "Do you wanna help put 'em on the plate? And then you can open the microwave and we'll push the buttons together and you can stand there and when it dings, we'll open it and take it out together, and you can help me put the sauce on the plate, um, help them be a part of it." And so then that waiting time isn't, doesn't seem as long, um, or if you have room, you can set up their own little kitchen in your kitchen, um, to, uh, help them -- while you're making their food, they could make food for you, and then you pretend to eat their food while they eat their chicken nuggets. Um, or even ask questions, like, just be aware, when was the last time that your child ate and what did they eat? Like maybe they, it's four o'clock and they threw a fit at lunch, and so they took a nap and they didn't eat lunch, and so the last time they ate was a bowl, a small bowl of cereal at 8:30 this morning. Um, so maybe if that's the case, you can just give them a little healthy snack to tide them over or something like that, um, to kind of help navigate away from that. [Bonni] Yeah. And Carlie, I'm also gonna add to this that [Carlie] Yeah. [Bonni] One really great tool that we, that we use often for our kids who have some of that, um, food insecurity, so significant fear based off of actual experience in the past of not having that food available. Um, it's much more connected most often to that emotional and, and, um, the, the mental health piece of things, even than the physical. And so what we, we often, uh, recommend is allowing some type of healthy snack, even if it is five minutes before dinner is ready, um, but something that they can have in their pocket, always have the ability, and when I'm saying healthy snack, like fruit, uh, apple, banana, granola bar, something, you know, that's not going to totally spoil dinner, um, or meals, but, but something that is, is real food. So then they're able to actually have that, and that way we're able to try and avoid, um, some of that triggering of, of that anxiety of not actually being able to have that food when needed. [Carlie] Awesome. And having, um, maybe you have a little drawer in your kitchen and you, you always have like five little bags of goldfish or something like that where they know you don't have to ask permission to get in that drawer. You can have a snack anytime you want in that. Yeah. Mm-hmm. Awesome. [Slide: 4-year-olds Intellectual - Understanding past/present/ and future - Can draw head and legs in drawing people - Loves new things and adventures - May repeat why questions if they do not understand the explanation Physical - Has extra energy - More coordinated - Loves to be speedy - Can skip on one foot Social - Learning cooperative play - More willing to share and take turns - Likes to meet new friends - Likes the shock of "bathroom words" (poopey-head/doo-doo face) Emotional - Intense Emotions - Loves to laugh - Kick, hit, and spit when angry - Less stressed - May have some fears (fire, sounds, dark, animals, etc.) - May like more violent stories with a lot of details (especiallly about death) Sexual - May engage in "sex play" (playing doctor) - Curious about bodily functions of others] [Carlie] Okay, so moving on to our four year olds. Um, so for kiddos that are in, you know, safe and stable environments, um, the, the amygdala is still kind of forming. We're starting to develop some additional thoughts. So like intellectually, they might repeat questions if they don't understand the answer that you've provided. So, um, if they say, "Well, why is ketchup red?" "Well, because it's made out of tomatoes," "Well, why are tomatoes red?" "Well, because that's how they grow." And in their mind they're thinking, "That's not an answer," you know, um, but they're starting to develop those, those thought processes, um, those more in depth thought processes are starting to spark. And so we need to really find ways to nurture that. And, um, so these consistent questions are very, very common. They're trying to figure out the world, they're trying to figure out where they fit in the world. Um, and if it's a moment where, let's say you're in a public place and they ask you maybe, uh, a question that doesn't need to be asked in a public place, um, and you feel like you need to redirect that to say, "Oh, you know what? That's a really great question. Maybe let's talk about that at home, but I have a question. What sounds good for dinner?" Or, "What was your favorite thing about today?" Or kind of try and ask them something to kind of redirect, but then also allow them the opportunity to ask those questions again later, um, so that they can get the answers that they're looking for. Um, okay. Also, so for like the question thing, the ketchup thing, "How was ketchup made?" You give them the information and then maybe give them the opportunity to share what you shared with them to somebody else. "Why don't you go tell sissy what we just talked about? Can you explain to her how this works?" Allow them, it's so cool when you learn something new and you get to share it with somebody else. And so then the questions kind of are twisted that also that gives them the opportunity to teach. But that also, um, helps you to understand if the way you explained it is making sense to them or not, because maybe it isn't their, their ability to, to understand what you're saying, but it's how you're saying it to them that isn't quite making sense. So that gives us, as caregivers the opportunity to reframe how we're explaining things to our younger kiddos. Um, socially, they like the shock words or the shock affected bathroom words. So they'll start, you know, "doody-head" or "poo-poo face," um, and they're extra funny. Um, as they start to use these words, you can calmly just say, "Oh, okay," you know, and redirect, you know, "Maybe we don't need to call them that. What's their name?" You know, kind of try and talk through that. But again, it's that shock effect. They like when, "Oh! What did you just say?" That's part of it for them. Um, and then they do, um, for the sexual, they do start becoming more aware of others' bodily functions. So something like they may say, um, they notice that, um, boys stand up to go to the bathroom. Well do girls do that too? And they might start asking you some of those questions or, well, "Why do boys only wear swim trunks? But girls wear a full swimsuit?" You know, those kinds of questions. Those are all, um, yeah, [crosstalk] they're starting to recognize differences. [Slide: Pediatric Milestones - Speech/Language Chart divided into four vertical columns: Age Milestone Trick (memory aids) Speech/Language Hearing/Understanding Each row corresponds to a specific age milestone, progressing from 3 months up to 4 years. The rows are arranged in chronological order from top to bottom. 3 Months Milestone Trick: “3 Letter Word = ‘Coo’” Speech/Language: - Coos and smiles - Cries differently for different needs Hearing/Understanding: - Recognizes your voice - May stay quiet or smile when spoken to 6 Months Milestone Trick: “6 Letter Word = ‘Babble’” Speech/Language: - Babbles - Laughs and giggles more - Vocalizes excitement and displeasure Hearing/Understanding: - Notices sound and music - Detects changes in tone of voice - Moves eyes toward sound 9 Months Milestone Trick: “9 Letter Word = ‘Imitation’” Speech/Language: - Imitates speech and non-speech sounds - Babbles longer strings of sounds Hearing/Understanding: - Imitates actions and gestures - Looks at objects when they are talked about 12 Months Milestone Trick: “1–2 Words” Speech/Language: - Has a 1–2 word vocabulary - Uses “mama” and “dada” meaningfully Hearing/Understanding: - Understands simple phrases - Recognizes words for common items 18 Months Milestone Trick: “18 Words” Speech/Language: - Vocabulary of about 18 words (10–20 words range) - Repeats words heard in conversation Hearing/Understanding: - Follows simple commands or questions - Points to pictures or objects in a book 2 Years Milestone Trick: “2 Word Phrases” Speech/Language: - Uses 2-word phrases - Vocabulary of 50 words or more Hearing/Understanding: - Follows 2-step directions - Uses gestures during pretend play 3 Years Milestone Trick: “3 Word Phrases” Speech/Language: - Uses 3-word phrases - Vocabulary of 200 words or more Hearing/Understanding: - Understands spatial and time concepts - Understands pronouns and plurals 4 Years Milestone Trick: “4 or More Word Sentences” Speech/Language: - Uses sentences of 4 or more words - Uses connected sentences to tell a story Hearing/Understanding: - Understands “how” and “why” questions - Groups objects - Identifies colors] [Carlie] So we talked about the words, um, and this is all in our resource guide, and so if you want a copy of that, let us know. Um, but these are some, uh, milestones as far as vocabulary goes. Now, um, up to a certain age, sounds also count towards your word count. So they may not be able to say cow, but if they see a cow and they say, "Moo," that counts as a word. So in their word count, you can kind of, um, consider those things as well. [Slide: EVALUATION OF A CHILD'S LEVEL OF PHYSICAL DEVELOPMENT Form Fields (Top Left): Blank lines for "Name:", "Birth date:", and "Date:". Introductory Notes: Note: "Although on these guides physical and mental skills are separated, the two are often closely interrelated." "These charts show roughly the average age that a normal child develops different skills. But there is great variation within what is normal." Grid Layout and Timeline The chart is structured as a matrix. The horizontal rows represent 7 functional development areas, and the vertical columns track time increments. The final column provides intervention notes. The timeline columns from left to right are: Average age skills begin - 3 months - 6 months - 9 months - 1 year - 2 years - 3 years - 5 years Row-by-Row Milestone Data 1. Head and trunk control - Average age skills begin: Lifts head part way up. - 3 months: Holds head up briefly; holds head up high and well. - 6 months: Holds up head and shoulders; turns head and shifts weight. - 9 months: Holds head up well when lifted (illustrated with "NO" and "YES" examples). - 1 year: Moves and holds head easily in all directions. 2. Rolling - 3 months: Rolls belly to back. - 6 months: Rolls back to belly. - 9 months: Rolls over and over easily in play. 3. Sitting - 3 months: Sits only with full support; sits with some support. - 6 months: Sits with hand support. - 9 months: Begins to sit without support; sits well without support. - 1 year: Twists and moves easily while sitting. 4. Crawling and walking - 3 months: Begins to creep. - 6 months: Scoots or crawls. - 9 months: Pulls to standing. - 1 year: Takes steps; walks; runs. - 2 years: Can walk on tiptoe and on heels. - 3 years: Walks easily backward. - 5 years: Hops on one foot. 5. Arm and hand control - Average age skills begin: Grips finger put into hand. - 3 months: Begins to reach towards objects. - 6 months: Reaches and grasps with whole hand. - 9 months: Passes object from one hand to other. - 1 year: Grasps with thumb and forefinger. - 2 years: Easily moves fingers back and forth from nose to moving object. - 5 years: Throws and catches ball. 6. Seeing - Average age skills begin: Follows close object with eyes. - 3 months: Enjoys bright colors/shapes. - 6 months: Recognizes different faces. - 9 months: Eyes focus on far object. - 1 year: Looks at small things/pictures. - 2 years: Sees small shapes clearly at 6 meters (see p. 453 for test). 7. Hearing - Average age skills begin: Moves or cries at a loud noise. - 3 months: Turns head to sounds; responds to mother's voice. - 6 months: Enjoys rhythmic music. - 9 months: Understands simple words (e.g., "Touch your nose."). - 1 year: Hears clearly and understands most simple language (e.g., "Where is dad?"). Right-Hand Column: "What to do if a child is behind" This column provides specific cross-references to diagnostic or therapeutic activities located elsewhere in the source manual: - Aligned with Head/Trunk & Rolling: "Activities to improve head and trunk control (see p. 302)." and "Activities to develop rolling and twisting (see p. 304)." - Aligned with Sitting: "Work on sitting. Special seating if needed (p. 308)." - Aligned with Crawling/Walking: "Activities to improve balance (see p. 306)." - Aligned with Arm/Hand Control: "Eye-hand activities. Use toys and games to develop hand and finger control (see p. 305)." - Aligned with Seeing: "Have eyes checked (see p. 452). If poor, see Chapter 30." (Accompanied by a small illustration of a child looking at an eye chart from 6 meters or 20 feet away). - Aligned with Hearing: "Have hearing checked. If poor, see Chapter 31."] [Carlie] Um, this is a physical development chart. So at certain ages, the things that they typically would see in, um, in kids at certain ages. [Slide: 6-Year-Olds Intellectual: - Likes to learn - Can be confused if school/daycare and home rues differ - May reverse letters and numbers Physical: - Dramatic and loud - Asks a LOT of questions - Stubborn - Can be demanding, contrary, or combative Social: - Can be excitable, emotional, aggressive, quarrelsome, or belligerent - May cheat to win/accuse others of cheating Emotional: - Hard dealing with failure - Loves to be praised - Easily hurt, emotionally - May have trouble making choices Sexual: - Self-touch - More aware of privacy] [Carlie] So for our six year olds, um, socially they can be excitable, emotional, aggressive, quarrelsome or belligerent. So they've got really, really big emotions in a tiny little body. And this can be really difficult to navigate, especially if they haven't had the opportunity to build self-regulation skills. And so, um, it's important to kind of recognize, are, are the behaviors happening consistently? Are they happening after the same thing every single time? Um, because like I said before, behaviors talk. So let's look at what they're saying. Um, something like maybe the teacher assign -- changed the assigned seating in the classroom, and then all of a sudden you start getting notes from school that's saying, "Your, your kiddo is doing this. They're misbehaving, they're, um, disrupting their peers." Um, and just being aware, okay, what, what was it that happened last? Well, the seating changed and they moved away from the window. So maybe they, maybe there's a reason, maybe they feel, um, better being able to be close to the sunlight, or maybe they moved towards the window and they feel uncomfortable with that. Or maybe they were upfront and they moved back and now they can't see the board and they don't know how to say that or what that means. Um, so being aware of those things. Physically, they can be demanding, contrary, or combative. Um, they're starting to test some, [slides jump forward, then back to 6-Year-Olds slide] ooh, they're starting to test some boundaries, um, and [slides jump forward and back again] -- oh my gosh, my slideshow wants me to move on -- um, and develop their own personality. So for dinner, um, giving them options. "So for dinner, would you like chicken nuggets or fish sticks?" Giving them options that you can live with. Or, "Would you like to do your chores now and earn an extra 10 minutes of screen time? Or would you like to wait and do them later? But then you won't have time for the extra 10 minutes before bed." Giving them those options. [Slide: 8-Year-Olds Intellectual: - Not a great self-starter - Can reason deductively - Beginning of abstract thinking Physical: - High energy - Easily shifts from one activity to the next Social - Wants things to be fair and even - Beginning "secret clubs" - More willing to cooperate and conform Emotional: - Dramatic, exaggerates, and likes a challenge - Blames others - Can over-estimate abilities - Likes to bargain Sexual: - Starting to notice other gender(s) - Boys may start dirty jokes/smutty talk - Increased curiosity about life, sex, and marriage - Some sex play may occur] [Carlie] Okay, for eight year olds, intellectual, not a great self-starter. So chores, if they have the same chores every single day and every single day, you have to tell them or remind them to do their chores. This is age appropriate. At this age, they're focused more on what they've got going on, what's in their brains. They've learned a lot during the day. They get home, they're tired. Um, so this is age appropriate. Um, socially they want things to be fair and even, so if they've got siblings, the chores might be a thing, "Well, why do I have to do the dishes? And they, all they have to do is pick up the shoes." Well, that gives an opportunity to talk about age and what's appropriate for different ages. [Slide: Parent Site Handouts - ENG.indd (plannedparenthood.org) Birth-2 Years Old (Infants) Children at this age may: - Explore body parts - Experience genital pleasure - Learn expected behaviors for boys and girls 3-4 Years Old (Toddlers) Children at this age may: - Become aware of and very curious about gender/body differences. - Begin masturbating - Play house, play doctor, or explore other forms of sex play with friends and siblings - Establish a sense of their own gender - Copy adult sexual behaviors - Be curious about their origins: "Where did I come from?" Questions that 3-4 year-olds may ask include: - Where do babies come from? - Will I have breasts or a penis when I grow up? - How come you have a penis or breasts and I don't? - Why do boys stand up to go to the bathroom? - What is a tampon for? - How does a baby get into or out of its mother? 5-8 Years Old (School Age) Children at this age may: - Be very curious about pregnancy and birth. - Have strong same-gender friendships. Children of another gender are also seen as gross or yucky. - Begin to focus no peer group style of dress and speech. - Discover their sexual orientation (this does not mean that the child is acting on the orientation) Questions that 5-8 year-olds may ask include: - How does a baby get food when it's inside its mother? - Does having a baby hurt? - What is sex? - What is a condom? - How can I find a friend? - Why do some people have penises and some don't? - Why do some people have breasts and some don't?] [Carlie] Okay. Um, this is a, uh, resource at the end as well, but this is some questions that might be typical for kids at certain ages, um, that, uh, and some behaviors that might be typical for kids, those at certain ages. [Slide: A List of Age-Appropriate Chores for Kids 2 to 18 (thespruce.com) Chores for Kids Ages 2 and 3 - Assist in making the bed - Pick up books and toys - Put small items in dishwasher - Dry mop small areas with help - Help feed pets - Dust with socks over hands - Aid in wiping up messes - Put laundry in hamper Chores for Kids Ages 4 and 5 - Make bed - Dust - Help set and clear table - Sort laundry whites and colors - Water plants with small container - Wash small dishes - Assist in cooking - Put away groceries Chores for Kids Ages 6 to 8 - Take care of pets - Vacuum, sweep, and mop - Take out trash - Rake leaves - Fold and put away laundry - Empty and load dishwasher - Walk dog with pooper-scooper supervision - Make snacks and bagged lunches Full list at: https://www.thespruce.com/age-appropriate-chore-charts-1900357] [Carlie] Um, here's some chores. It's hard as parents to know what's appropriate chores at certain ages and what's not. So ages two to three, making the bed. Um, this may be just laying out blankets flat, their stuffies are all lined up, and that's that. Um, and that's okay. Um, age four to five, sorting laundry whites and colors. This can also help them to, um, kind of distinguish between colors and what that looks like. This also helps them to help other members of the family. Um, and then age six to eight, taking out the trash. This is a consistent chore, so it kind of gets them in a really good routine. Um, and, uh, while at this age, they may need reminding that they, um, they can complete the process, start to finish, on their own. So they can take the bag out and put a new bag in. They can do it all by themselves. [Bonni] Hey, Carlie, let me hop in real fast right there too. [Carlie] Yes. [Bonni] Because that's a really, that's a really good slide of the different chores. I don't know if you saw in the chat, we have someone asking for the slides afterwards. So we will definitely get the slides sent out to those, to everyone. Um, I do with this too, this brings up a really critical, important piece of the impact of trauma, which I know you're gonna go into next, but it's important because of the population that we're talking about or talking to, is everyone, uh, whose kiddos are in your homes have been impacted by loss and trauma, right? So chores is such a, a key piece of one of the, uh, the aspects of a relationship between a caregiver, a parent and a child, is the ability to set appropriate challenge, which is like, "Okay, here's something that I know that you are, uh, age-wise and physical, you know, physically of, uh, capable of doing." And then having the awareness and flexibility to be like, "Okay, you're probably very capable of doing this, so I'm gonna set the bar here and I'm gonna help you succeed by jumping over that bar and showing yourself that you can do these things that you can, that you can take care of pets on a regular basis. And you are, you are strong, you are capable." And then recognizing, um, those times, whenever something has happened and there's been some type of, um, impact of traumatic experiences or memories or even like growth spurts that bring back some, you know, perspective of, "Hold on, this is what, I'm having a tougher time," right? Like all of us, whenever you have something significant happen, it, it decreases your, uh, typical capacity level. So like parenting, these chores are really good. Um, like, uh, understanding of average, on average, and then recognizing when my kid is maybe melting down whenever they've been able to accomplish this chore on a regular basis, that I can be flexible for a time and lower the bar of expectation while, while supporting the child and understanding the need for flexibility, that it's not that they are just, um, pushing back and, you know, having some behavioral issues, but that there's actually literally times where we've got to lower that bar of expectation and challenge that we're setting for our kids, and then you can move it back up. You know, like after there's a time of, um, connection and a time of building that felt safety and security, then being able to say, okay, "Now we can get back to it because man, I know you feel, um, we were able to have some good time to talk through things." And that is such good modeling for, uh, future, right? Because there's gonna be ups and downs in everybody's life. And if we can teach our kids younger that there are times that you need to be flexible with yourself. There are times that you need to recognize that, "I'm struggling today, so I might need to take a mental health day." And that's self-care and that's good and really good practice. So I love that you've included these, 'cause I think it's such a helpful range of us being able to understand what our kids are capable of doing. So we know we can kind of set that bar and say, 'cause it strengthens them, it helps them in that process of, uh, growth and, and even building attachment of being able to go out there and say, "I'm capable. I'm strong, I can do this." And then yet also being able to know there are days whenever I'm not gonna be strong and my parent understands that and they're able to, to be flexible and adjust some of those expectations for a time. [Carlie] Yeah, I love that. Thank you. It is important to recognize that while, everyone wants their kid to be average or above average. And I mean, I have bad days, kids have bad days too. We all have things that affect how we engage with others and how we can meet those. So that's awesome. Okay, so we are going to kind of slide through this trauma thing, and I'm gonna put it in the chat. [Slide: The Effects of Trauma] [Video plays] [Scan of a brain with lightning effects around it. Zoom in to blue neurons being struck by lightning over and over again, with a red spot growing larger in the neuron every time the lightning strikes. Continued strikes lead to the red spreading across more neural pathways until entire areas are red.] [Narrator] The emotional effects of childhood trauma are well-known, but new scientific research reveals the child's positive and negative experiences can shape and reshape the brain. Research suggests that the more a child witnesses violence, the more neural connections are created in regions of the brain that involve fear, anxiety, and impulsiveness, while fewer are created in regions that involve reasoning, planning, and behavioral control. [A red part of the brain is overtaken by blue again, signaling the growth of new and healthy associations and connections that overtake the harmful ones. We move through the brain, with a symbol for each healing gesture appearing on different neurons.] [Narrator] The good news is, the young brain is malleable, or plastic, and fostering stable, supportive relationships can prevent or help reverse this damage, resulting in lifelong benefits for the child's learning behavior and overall health. So how can you help a child in your life? Just remember these five healing gestures: Celebrate them with a compliment or by applauding their efforts. Comfort them by staying calm and patient. Listen to them and show an interest in their passions. Collaborate with them by asking their opinions, and inspire them with new ideas. With these everyday gestures, you can help a child look forward to a bright future. [End on the scan of the full brain again.] [Video ends] [Carlie] So I like that video, but I also want to end it with the caveat that adoption doesn't solve everything and that love doesn't solve everything. You can love your child or even your client with the deepest parts of your soul. And they're still gonna struggle and they're still gonna have to work through the things that they have experienced in their life. [Slide: TRAUMA'S EFFECTS ON DEVELOPMENT Two brain scans side by side. First, a "Healthy Brain" with circles around the temporal lobes. "This PET scan of the brain of a normal child shows regions of high (red) and low (blue and black) activity. At birth, only primitive structures such as the brain stem (center) are fully functional; in regions like the temporal lobes (top), early childhood experiences wire the circuits." The second scan is of An Abused Brain. "This PET scan of the brain of a Romanian orphan who was institutionalized shortly after birth, shows the effect of extreme deprivation in infancy. The temporal lobes (top) which regulate emotions and receive input from the senses, are nearly quiescent. Such children suffer emotional and cognitive problems."] [Carlie] I am going to, um, in a minute when I get out of my slide, it won't, lemme do it right now, but, um, this just talks about the brain, um, a healthy brain. So if you look at the very bottom, the red parts at the back of the brain, that's kind of by the spinal cord, that's where the amygdala is, right? That's the, that primitive brain where we're starting to form, um, at birth. And then, uh, as you come up into the center, that's the thalamus, that's the second kind of level. And at the very front we're looking at the prefrontal cortex. So looking at what we talked about before, um, kiddos that have been kind of stuck in that amygdala, that that primitive brain, um, these are scans that show that those other parts of their brain have not developed appropriately, um, because of the experiences that they have had. Um, and so it is important to recognize, just like Dr. Goodwin was saying, that trauma and experiences affect all of this. This is a really good kind of baseline informational thing, but trauma affects everyone, and it affects everyone differently. So you can have three kids in the same exact situation that grew up in the same exact situation and they will be, they will experience it and have different behaviors because of that trauma. And so, um, we're just touched on that quick. I am gonna put a link in the chat in just a minute, um, because there was a previous Lunch and Learn that actually covered trauma. Um, it's called Behind the Behavior, um, on March 18th and or March 28th, excuse me. Um, and it goes really in-depth about trauma and how it affects the brain. And so if you're really curious about more about how this affects your kiddo, I'm gonna put that link in the chat so you can kind of go back and watch that. [Slide: Symptoms of Traumatized Brain Children aged 0-2 exposed to trauma may 1. Demonstrate poor verbal skills 2. Exhibit memory problems 3. Scream or cry excessively 4. Have poor appetite, low weight, or digestive problems Effects | The National Child Traumatic Stress Network (nctsn.org | https://www.nctsn.org/what-is-child-trauma/trauma-types/complex-trauma/effects] [Carlie] Um, For kiddos that are younger and maybe don't have the verbal cues to tell you, right, we had some earlier saying, "My two-year-old, my three-year-old, they're struggling. They can't communicate." Children age zero to two exposed to trauma may demonstrate poor verbal skills. That's something that we kind of talked about earlier, um, exhibit memory problems, scream or cry excessively, or hit or act out in that way, or have poor appetite, low weight, or digestive problems. So for those kiddos that maybe are non-verbal or are struggling with that verbal aspect of telling you how they're coping with their experiences, just kind of keep that in mind, um, that those, those kiddos are, are trying, they're working on it. [Slide: Resources CDC's Developmental Milestones | CDC Child Development: Milestones, Ages and Stages - Children's Hospital of Orange County (choc.org) Ages and Stages of Development - Child Development (CA Dept of Education) Parent Site Handouts-ENG.indd (plannedparenthood.org) Tip Sheet: Age-Appropriate Sexual Behavior | Stop It Now CHILDHOOD SEXUAL BEHAVIOR | National Center on the Sexual Behavior of Youth (ncsby.org) https://okfosters.org/competency-network-events QUESTIONS? Slido.com 8001491 Carlie Van Woerkom Post Adoption Outreach Services carlie.vanwoerkom@okdhs.org] [Carlie] Um, so here are resources. Um, and uh, I'm gonna, we're gonna cut everything short 'cause we have four minutes left for any questions or anything. Um, but I'm gonna post a couple of things in the chat. We've got some really great links to, um, some resources for you. So if anyone has any questions, please feel free to drop it in the chat. Unmute yourself. Um, now is the time. [Bonni] I'm gonna jump in and just say that question that Sarah had mentioned earlier. I'm super curious, um, how many of you on here feel like your pediatrician or medical provider, um, has a really solid handle on adoption and foster care? Like, the impact of trauma when they're doing all of your well-child visits and, you know, looking at developmental milestones and all of that. So maybe like a, you know, the little reaction your hand raised or something like that. How many feel like your provider is really, uh, competent and understands exactly all the things that your kiddo's been through? Good. I'm glad we have one. Darian, I see you kind of going like this. We got another thumbs up, Emily. Good. [Carlie] It looks like we have a hand, uh, T. Davison-Beverly. [Bonni] Good. How many? So now, how many feel, um, that maybe there's some questions and some times whenever, uh, that's not quite, uh, a part of the conversation, or you wonder if there's a full understanding of trauma? Okay, I'm not sure if we have all, uh, if ever -- maybe everyone else on here is all professionals, which is great. Um, but that's a, that's a really, it's a, I love that Sarah asked that earlier because I think that's something, that's one piece of things. Adoption competency, foster care competency is something that we talk about a lot on these Lunch and Learns. And one of our goals is to be able to increase that awareness of the holistic approach and how critically and important all of these, uh, developmental milestones is, but also understanding the impact of trauma sometimes halves the age like a child might be chronologically nine, but where they are, uh, mentally, socially, physically, uh, can sometimes half that age based off of the impact of trauma. So it's really, um, something that is important not just for mental health professionals and child welfare professionals, but also for medical professionals. There is a thing about adoption competency for pediatricians and psychiatrists and, um, psychologists and all the, all the people from the medical, uh, profession as well. So if you, if you, um, are interested in having any type of further conversation about supporting you in seeking, um, and, and connecting and consulting with other professionals, please feel free to reach out, um, to us and let us know how we might be able to support you. Um, Carlie, thank you so, so much for such a great presentation. I know, um, you've got, you put, just put some great links into the chat of some of the other events and also that, uh, behind the behavior that Katie Stewart, who's actually was on here at some point, there she is, she's still here. Um, she presented, there's actually two parts to that one. So, uh, great, great, uh, resource to look at. We also have a YouTube channel with all of our previous, um, Lunch and Learn recordings. So if you wanna go back, we cover a whole ton of different topics and we're still trying to put these out at least twice a month. So we hope that you all will come back. Um, we've got your email addresses if you dropped it in the chat. I know we've got, uh, kept track of who asked for a certificate of completion, so we'll be getting those out to you in the next day or two. Um, and we're so grateful for being here. Thank you. Good job Carlie. Really appreciate, have a wonderful rest of your day.