By Vien Nguyen, CEI Intern
As a part of the Childhood-Trauma Learning Collaborative, Dr. Hilary Hodgdon, Director of Research Operations at the Trauma Center of the Justice Resource Institute, presented a webinar on neurobiology and executive functioning (EF). EF is the key set of skills children need to adapt from one environment to another and to achieve goals. Deficits in EF skills, which often stem from underdeveloped brain regions in response to chronic trauma, can lead to many problems in school.
Executive Functioning Deficits Lead to Problems in School
When children first enter the classroom, they must navigate new social and academic demands. They must decide when to raise their hands and how to transition from a written activity to story time. Students, especially those who have experienced trauma, may be deficient in a few key ways.
Students low in impulse-control will have difficulty foregoing immediate gratification for long-term rewards (Igniter Media, 2009). Strong praise and positive reinforcement are still important, but will not always work. Dr. Hodgdon emphasizes the following additional strategies:
Be consistent with rewards.
Change rewards up.
Ask them what rewards they want.
Other students are deficient in the executive functions directly used to take in academic content. Children low in working memory may only be able to hold onto half of the numbers required to learn fraction addition, or may have difficulty following a long string of directions for a science lab. Students with impaired attention find it harder to filter out distractions while learning. For all these students, chunk instructions and transitions into manageable pieces. Discourage multi-tasking, which is actually impossible. Our brains actually switch very quickly between tasks, which discourages attention building skills.
Yet other students are deficient in planning and decision-making. These students will find it difficult to manage their time to complete longer assignments. For these students, create rubrics and timelines for accountability. Check in frequently with them to monitor their progress. These students may also have difficulty considering different courses of action and thinking about possible consequences. Role playing difficult situations can help these students build decision-making skills.
How Trauma Disrupts Brain Regions Responsible for Executive Functions
Dr. Hodgdon outlined the cascade of physiological events that happen when a child encounters a stressful situation. When a child is bullied or witnesses abuse within their family, their fight, flight, or freeze defense circuitry takes control. Energy is diverted from the prefrontal parts of the brain that support executive functions, so they completely shut down. Traumatized children spend much of their time in survival mode, so their brain and body functions gradually deteriorate.
Children under chronic stress have lower overall cortical maturity, so their brains are not as “awake” as typically developing kids’ brains. Key regions distributed across their brains are consistently smaller (Nelson, Fox, & Zeanah, 2014). Maltreated children are also typically lower in impulse-inhibition (Teicher & Samson, 2016; Hart & Rubia, 2012) and working memory (Carrion, Weems, & Reiss, 2007). Specific types of maltreatment result in additional deficits:
Emotional maltreatment is associated with lower self-awareness and sound decision-making. (Harmelen et al., 2010).
Extreme early deprivation was linked to attention deficits that were greater than those observed among “standard” ADHD cases. (Beers & De Bellis, 2002; DePrince, Weinzierl, & Combs, 2009; Nolin & Ethier, 2007).
Interventions that Increase Executive Functioning
Dr. Hodgdon and others agree that EF is a “modifiable resilience factor” (Zelazo, Blair, & Willoughby, 2016). The earlier the intervention, the better for the child. The following interventions have been shown to increase EF across the board:
Mindfulness and yoga (Zelazo, Forston, Masten, & Carlson, 2018)
Predictable routines and expectations
Protective adults as buffers against trauma
The number one predictor of success of a treatment is the supportiveness of the protective adult that the child discloses to. Indeed, almost every person in one study said that there was a singular person who was there for them, who made the most impact on their life (Vanderbilt-Adriance, & Shaw, 2008). Dr. Hodgdon notes that protective adults rank higher than the specific type of treatment and the number of sessions.
For more on executive functions, see the CEI’s blog post on “Executive Functioning and Academic Achievement” or watch Dr. Hodgon’s webinar, archived on CEI’s YouTube page. Subscribe to our YouTube channel for more webinars to help educators address the effects of childhood trauma on their school communities.
References
Beers, S. R., & Bellis, M. D. (2002). Neuropsychological function in children with maltreatment-related posttraumatic stress disorder. American Journal of Psychiatry, 159(3), 483-486.
Carrion V. G., Weems C. F., Reiss A. L. (2007). Stress predicts brain changes in children: a pilot longitudinal study on youth stress, posttraumatic stress disorder, and the hippocampus. Pediatrics, 119, 509–516.
Deprince, A. P., Weinzierl, K. M., & Combs, M. D. (2009). Executive function performance and trauma exposure in a community sample of children. Child Abuse & Neglect, 33(6), 353-361.
Harmelen, A. V., Tol, M. V., Dalgleish, T., Nic J. A. Van Der Wee, Veltman, D. J., Aleman, A., … Elzinga, B. M. (2014). Hypoactive medial prefrontal cortex functioning in adults reporting childhood emotional maltreatment. Social Cognitive and Affective Neuroscience, 9(12), 2026-2033.
Hart, H., & Rubia, K. (2012). Neuroimaging of child abuse: a critical review. Frontiers in human neuroscience, 6, 52.
Igniter Media. (2009, September 24). The Marshmallow Test.
Nelson, C. A., Fox, N. A., & Zeanah, C. H. (2014). Romania’s abandoned children: Deprivation, brain development, and the struggle for recovery. Cambridge, MA: Harvard University Press.
Nolin, P., & Ethier, L. (2007). Using neuropsychological profiles to classify neglected children with or without physical abuse. Child Abuse & Neglect, 31(6), 631-643.
Teicher, M. H., & Samson, J. A. (2016). Annual research review: Enduring neurobiological effects of childhood abuse and neglect. Journal of child psychology and psychiatry, and allied disciplines, 57(3), 241–266.
Vanderbilt-Adriance, E., & Shaw, D. S. (2008). Protective factors and the development of resilience in the context of neighborhood disadvantage. Journal of abnormal child psychology, 36(6), 887–901.
Zelazo, P.D., Blair, C.B., and Willoughby, M.T. (2016). Executive function: implications for education. Washington, DC: National Center for Education Research, Institute of Education Sciences, U.S. Department of Education.
Zelazo, P. D., Forston, J. L., Masten, A. S., & Carlson, S. M. (2018). Mindfulness plus reflection training: Effects on executive function in early childhood. Frontiers in psychology, 9, 208.