4 Proven Strategies To Combat the Effects of Childhood Trauma with Els O'Rourke

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Did you know that experiences like poverty, racism, discrimination, community violence, or living with a family member with mental health or substance abuse disorders can be traumatic? These traumas can manifest in various ways affecting task completion, project sequencing, bedwetting, mood changes, and learning difficulties.

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Join child development expert Elsa Roark and me in episode eight, four strategies to combat the effects of childhood trauma.

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Welcome to grandparents raising grandchildren nurturing through adversity in this podcast, we will delve deep into the challenges and triumphs of grandparents raising grandchildren as we navigate the complexity, complexities of legal, financial, and emotional support. I invite you to join us on a journey of exploring thoughts, feelings, and beliefs surrounding this growing segment of our society. Drawing from real stories and expert advice, we will explore the nuances of childrearing for children who have experienced trauma and offer valuable resources to guide you through the intricate journey of kinship care.

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We'll discuss how we can change the course of history by rewriting our grandchildren's future, all within a supportive community that understands the unique joys and struggles. This podcast was made especially for you.

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Welcome to a community where your voice is heard, your experiences are valued, and your journey is honored.

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Trauma occurs when overwhelming events surpass one's coping abilities. Even seemingly small incidents like a baby left crying in sore, soiled diapers or a hungry child with no food can have profound effects on brain development, self perception and learning capabilities. The early years of life are crucial, shaping a foundation for future well being and development.

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Trauma may have long lasting effects on mental and physical well being. Trauma that occurs during childhood can harm a child's brain development. The good news is, much progress in recent years has been made in holistic child treatment. That's why I'm so excited to share today's guest with you. Elza Roark is a mother of two with a background in pediatric physical therapy who has first hand experience in raising a child with complex learning and behavioral issues due to early trauma exposure. She believes in treating the whole child and that the brain can recover from anything. Today's episode of grandparents raising grandchildren nurturing through adversity promises insights into human development and resilience. It is with great pleasure that I introduce our special guest for today's podcast episode. Meet els O'Rourke. Not just a pediatric physical therapist, but but a compassionate advocate for the holistic healing of children facing learning and behavioral disorders. Els brings a unique perspective to her practice, one that extends far beyond the physical realm. With a profound belief in addressing the needs of the whole child, she tirelessly champions the importance of recognizing and addressing the emotional and psychological aspects of a child's well being, particularly those stemming from trauma.

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Her dedication to young patients transcends conventional boundaries. ELS understands that healing is a multifaceted journey, one that requires empathy, understanding, and a deep commitment to nurturing the soul as much as the body. Els began her journey with the ACE Physical Therapy and Sports Medicine Institute in 2010, where she delved into the realm of adverse childhood experiences, or aces. These potentially traumatic events occurring in childhood can profoundly impact a child's development, from emotional and physical neglect to witnessing domestic violence. ELS has encountered and addressed a wide spectrum of aces in her work. Tell us a little bit about how. You got involved with ACE. So, as a pediatric physical therapist, I work with a variety of children, all kinds of disabilities.

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And the whole ace thing kind of came about more through a personal journey that my husband and I ended up on. We had one child, and we wanted another child and chose to adopt through the foster care system. So we became foster parents. Had a little girl that came into our home. She was three and a half when she came to us. Initially, we were told, just love her, give her a good home, and life will be good, which was in many, many ways at the same time. We recognized very quickly that there were very many struggles, especially in how to raise our daughter. Our son we raised pretty traditionally. He was doing well, moving right along with his development. Our daughter, on the other hand, was not. As a physical therapist, I could definitely see where we could help her with some of her physical challenges and delays. We got her in speech therapy to help her with her speech, but emotionally and just joining the family was very, very difficult. And so I just kind of started kind of researching what's going on here. And I ran into the Ace study, which is a study that was done by Kaiser Permanente, which is a very big insurance company out of California, I believe, and the CDC center for disease Control. In 1995 and 1997, they interviewed over 17,000 adults, and they looked at what their childhood traumas and experiences were and then related that to their health concerns as adults. And what they found was people that were exposed to these traumas, such as abuse, neglect, a parent that is in prison, being raised by one parent, that there were ten criteria for that. And they found that these people had less life satisfaction, more mental health problems, more heart disease, diabetes. And so they really kind of started looking at, what can we do to eliminate, if we were to eliminate these childhood experiences, these traumas, would that then give better health outcomes? And so I kind of took that information into my practice and started looking at what do we actually see when these kids are exposed to traumas? And when you really start looking into it and you start looking at, there's ten criteria, and the higher your a score, the more challenges you have. And so when we started looking at our daughter, she came up with an ace score of, I believe, nine. So nine out of ten, that's a pretty high score. What do we see?

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I started taking some classes, and then from there, I started looking at, how can we help her recover or heal from this? And it was not an easy transition. We ended up with multiple counselors. We did end up seeking help with counseling. It took us multiple times to find a counselor that was working for our family. It had to work for her, it had to work for myself, it had to work for my husband.

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So it took us a while. We also had a neuropsychological evaluation done, which a neuropsych psychological evaluation looks at the whole child and how the brain works in relation to behavior. It's not just a mental health piece. It looks at how is the brain developing. And what we found with our daughter and what, over the years, I found with many kids from trauma is they have an underdeveloped frontal lobe.

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And so our frontal lobe is kind of the regulation system of the body. So if you look at the brain is that there's a primary area in the brain that looks at heart rate, heartbeat, breathing, digestive system, basic functions. Then the next level up is the emotional brain, which is a limbic system, which really then controls. Those two work together pretty close. For instance, if there's a trauma or a stressful event, what happens to the body? Our heart rate goes up, our breathing goes up, and we might get into a position of fight, flight, or freeze. So we might fight to try to control our situation. We might freeze and don't know what to do, or we might run. That's your limbic system. In kids with trauma, that limbic system tends to be very highly activated, and their primary baseline tends to be higher, so it's more easily activated than a child that is securely bonded and doesn't have those traumatic experiences. Then on top of that, we have our, what we call our human brain, and the frontal lobe is part of that.

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That's where we regulate those emotions, where we can plan and organize and think.

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Now, all of this develops over the course of 25 years. And within those 25 years, we have periods where there's an explosion of neurons that are being grown in the brain, and then there's a period of where those neurons are being pruned if they're not being used. So then the development keeps on going. Then there's another explosion. A couple of those times is like when a child is about two. We always talk about children when they're about two. They're like sponges, you know, they take in all this information. Well, that's one of those periods where that explosion of neurons, and if we give the proper amount of input and we interact with children during these times of growth, then those neurons and those connections strengthen. If they're not being stimulated, then they'll get pruned until the next period comes. That became very interesting because those are definite things as a physical therapist, and looking at the whole child is what can we stimulate at which times in a child's development. So really, those first three to five years, we can make a lot of changes, and we can put a lot of neurons in place that give that base for the child. So we've worked with our daughter, and over the years, we did therapy. We did neurofeedback, where, through vision, the doctors try to readjust those brain waves.

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It was very effective for her. She still has some challenges, but at the same time, we've been able to get her and help her through high school. She just graduated from a medical assistant program and is ready to get a job. So we feel, even though we had very many struggles early on, she's on the right path right now. That's wonderful. Resilience is something that comes up a lot. Children are resilient. Adults are resilient. And resilience doesn't necessarily mean that you can handle all these traumas easily, but it does mean you just keep moving forward and you keep pushing through. And what I see with a lot of kids that I work with is that they are surviving rather than thriving. So what we look for is we look for kids to be thriving. We don't want them to just survive, to be able to move from one day to the next.

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Have you found particular techniques to help with moving them from surviving to thriving. Within the home setting? You're really looking at that attachment theory. So attachment therapy looks at how is the child attached to their primary caregiver. This attachment already starts in the womb with the biological parent, because if that parent has high stress, then those stress hormones, that heart rate, that breathing, that becomes the pattern of the unborn child. So that process already starts. Then once the baby is born, then you really want that nurturing. We need to take care of those needs. For instance, if a baby cries and their need gets met, whether it's being fed or tired, being held.

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Every time that need is being met, there's an attachment and a security that's being built. If that is not done consistently, then that attachment can become disorganized. In the case of neglect, and especially severe neglect, the child's needs or the baby's needs were not met, period. And so that baby eventually will stop crying and they will start becoming self reliant and they will try to survive any way they can. So we see children that become very, as they grow up, very controlling. They want to control their environment.

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They will take care of themselves. They have a hard time accepting direction from other adults.

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I'm not a counselor, but within that, if you can build relationships with children, that's really a big thing. So within the home, that nurturing piece, what that might mean is if the child had the severe trauma, say, at age 18 months, what do you do with an 18 month old when they're upset? Well, you take them in your lap, you sit with them, you rock with them. You don't necessarily have long conversations with them. Even if this child might be five years old, if their trauma was at 18 months, when they get in distress, they will revert back to that time where that trauma occurred. It's almost like there's a block. So that's what you would need to do. And so even so, we did that with our daughter as well. She was probably seven, eight years old, and we would still have her sitting in our lap and we would just rock her just like you do with a baby. We would play with her just like you do with a baby. In the school setting, it's a little different because we have a different relationship, but we do a lot with connecting with kids at their level. So again, that might mean is that we play with them like you would play with an 18 month old. We may have some kids that sit with us when they're distressed. And so really looking at that developmental age, when the child is distressed, and then from there, look to see what you can do. I've heard that children that are raised by family members, in our particular case, grandparents, have an advantage over a child being adopted through a non family member. Does that connection alone provide an additional advantage to working with trauma children?

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I don't have any scientific proof, but from experience it does depend if the child has had contact with the grandparents or the aunts and uncles. I definitely think that makes a huge difference because there's already a relationship you'd still have to look at that initial three years, whether that attachment with a primary caregiver was established, it's a common. Complaint of many grandparents that I speak with that there's resentment about the fact that they don't get to just be the grandparent, the loving, nurturing grandparent that spoils their grandchild, that they have to become a parent now and a disciplinarian in their lives.

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Correct? Yeah. So the role of grandparents disappears, which then also, I think, potentially the outlet for the child disappears. So if the child is in a home that has a lot of struggles, but they have their times where they go spend their time with their grandparents, and they can be kind of carefree for a week or two weeks in the summer or over the holidays, that is now no longer there either. And so that could be a potential additional loss. And trying to find that balance, I think, is very difficult for grandparents.

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Have you seen grandparents in that role that have done that more successfully than others?

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Yes, and I think some of that has to do with their own security and ability. It also has to do with how large of a support system they have.

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So if they can build that support system where they can have that respite, where children can have another place to go from time to time, so that the grandparents one, they can still have their own relationships and their own life, but also for the kids to have a place to get away. The hardest part for myself was to figure out and realize to not be triggered by the traumas and the triggers that our daughter had. I think that there's a lot that the caregiver has to do in order to be successful with children that come from trauma. And that's hard because it's so easy to take things personal. It's so easy to get triggered yourself.

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I think lying is a very big, big thing with kids that come from trauma. They are not very rational about it. They don't really have any reasoning. I remember once our daughter said, well, how come this keeps happening? She says, well, you know, I've gotten away with it before, so why not try it again? It is better to come up with a story and hope that things go well than to know upfront that things are not going to go well. Do you believe that there are certain struggles that children with certain behavioral disorders never overcome? Do you think that's part of the caregiver's role, to accept the fact there are some things that will never change?

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I do believe that anybody can change anything. However, there are some things that I think can be changed when a child is definitely older and they make a conscious effort to change. I believe that the brain is malleable and can change throughout our life. We can learn throughout our life. We can change throughout our life. I do know from experience, both at home and in the school, we can't force anything.

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You can't force lying, for instance, out of a child. You can't force taking control out of a child.

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I think there's always going to be certain patterns, but once somebody becomes aware of those patterns, you can change it. With your experience and desire to treat the whole child, you must have a collection of therapy that you see has worked well for you. So you have ace, which is one integral part of that. But what else have you added to your collection of tools when you work with a child?

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We always split it up in basically three areas. One is what. What can the parents do that those are, those are your home programs. And in the school, it's like, what can the teachers do? And that's that knowledge base.

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You need to know your own triggers. You need to know how to self regulate as an adult. And this is the hardest one. Whatever the child does, it is not personal. That is so difficult. And again, that goes back to your own regulation piece. The second piece of that is, how can I help a child and then teach those strategies when the child is dysregulated?

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And how do we recognize the triggers?

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What I do in therapy is I poke the bear so I might go into a classroom, and I've done it at home, too, and it didn't always work out, poking the bear. Just for an example, we have a student that we work with, and all he wants is bubbles. And when he gets the bubbles, they're his bubbles and he's not going to share and he's not going to give them back. And so I will go in with two activities. One is the bubbles and the other and another activity that we want to work on. Then I use a strategy called first, next.

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Then first we're going to build the puzzle. Then we will do bubbles. We work very explicitly with that language first, then. So three steps and the child will go in and he'll get very upset because he wants those bubbles. He wants to be in charge. This is what I want, and I want it now. I mean, it could be anything. It could be. Could be candy, it could be not going to bed. It could be an iPad. It doesn't really matter. So I know that he's going to get upset. What can we do to try to help him regulate without getting totally out of control.

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We may have taught breathing exercises. We do a lot of breathing exercises. And again, those are taught when the child is not dysregulated. So we might have a group, and we start our group out and we start with some breathing exercises. We might do fire breathing, where we have them breathe in through your nose and blow out the candle or sun breathing, open up the flower, breathe in and breathe out. So we have taught that already. And so when the child is there, I say, first we're going to do the puzzle, then we're going to do bubbles. And he's like, bubbles, bubbles, I want them now and say, we're going to breathe. And then again, first puzzle, then bubbles. And it's a process. It doesn't happen the first time. And we've been working on this for quite a while, setting up the expectations for the kids, because kids that seek control want to know what is happening. Another strategy that we use is visual schedules. The visual schedule can be a visual schedule with pictures, but it can also be written out. This is what's going to happen then.

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This is what's going to happen. This was going to happen. What that does is it takes the argument out of what we're going to do. This is one that you can use at home very well. You build in those routines. So the bedtime routine might be we take a bath, put on pajamas, brush our teeth, read a book, lights out. That might be the routine. And so if you get that in pictures, then within that routine, you might have some

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00, some days

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00 but that bedtime routine is the same. And if the child says, well, I want my book first before I brush my teeth and say, well, the schedule says. And so the schedule dictates what we do, not the adult, you know, indirectly you do because you set that schedule, but you can refer back to that schedule. I think that works well for everyone.

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I think. So we have a regular plan. Yeah, to have a regular plan. We did visual schedules with our daughter. Like summer vacations were very long for her, and she was always kind of from one place to the next, three minutes of this, five minutes of that. I mean, she was just all over the place. Our son, on the other hand, he would get out his legos and 3 hours later he would still be playing.

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He could attend to that. Our daughter couldn't. And as she got a little bit older, we would help her out with it, and we had it set up, said, okay, you're going to get up and so you're going to have breakfast. What do you want to do after breakfast? Well, I'm going to color. Okay.

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So we said, okay, 45 minutes of coloring. What are you going to do after that? Play outside. Okay, play outside. Well, when do you want your snack? So, well, then after playing outside, we'll have a snack. Okay. What are you going to do after snack? And so we would set up our whole day, five days, Monday through Friday. And that's how we went through our summers. And we built in going to the lake or going to the library, whatever it is we would do, but we would have it set out. And by the time she was, I would say, eight, nine years old, she would just be able to go through her little day on her own. It was pretty rigid, but it did allow her to get to that point where she could actually attend to an activity for an extended period of time.

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Because you couldn't say, I'm going to color for three minutes, and I'm going to do something else. Well, no, the schedule says we're going to color for another 30 minutes. Now, what that does require from the adult is that you have to interact with the child. You can't just leave them on their own devices. And so I did a lot of coloring, I did a lot of Barbie playing, but also a lot of playing outside and a lot of lego. We would interact with our child. I was in a fortunate position that working for the schools, I had more time in the summers, so I was able to give that time to our children. But we also did some daycare during the summer in order to get her to socialize with other kids and again, to create some respite within our home.

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That's great. Yeah, I think the visual schedules are very important.

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One thing that we oftentimes overlook is sleep. Now, again, it's not necessarily therapeutic, but that sleep piece is very important. Our children in general, in our western society, do not get enough sleep. Five to seven year olds, they probably still need 10 hours of sleep. And sleep can be very difficult for kids that come from trauma, going to sleep, staying asleep, or just getting to bed on time. So, again, those routines will come in very, very handy, and it takes a long time to build those routines. We're looking oftentimes at several months.

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When our daughter came, she was used to going to bed her foster family that she lived in. She would go to bed anywhere from eleven to

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00 in the morning, and then they would sleep until 1030 ish in the next morning.

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When she came to us, I mean, we are

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00 you're on the go or you have to go to school. And so bring that sleep pattern back to more of a normal sleep pattern was very difficult just keeping her in her room. Kids have stuff in their room, and so she would get up in the middle of the night and she would play and be up, and then the next day it would be very difficult for her to attend.

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And that just would bring up that stress level.

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So getting a good sleep pattern and good sleep hygiene is very, very important.

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Physical activity, physical activity has been, there are studies out there, but physical activity in itself has shown that it is very good for brain development, for motor development, and it doesn't always have to be organized, just that movement piece. Movement in itself is very regulating. I do a lot of what we call heavy work. I use weighted balls to work with the kids. We use swings to get them, to get them moving to help with that regulation piece. And the more we can provide that throughout the day, the calmer the brain gets, and the calmer the brain is, the easier it becomes to regulate. So you suggest those four elements of therapy, those are the basic ones that you use?

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Yeah, it's great. It's been a real pleasure to be able to share my knowledge and to be available as a resource for anybody who has children who need help, but definitely kids that come with some baggage.

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I think there are a lot of valuable elements for grandparents raising grandchildren, and I'm looking forward to discussing some of these issues further in another episode.

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Okay, great. Thank you. Thanks so much for joining us today for another episode of grandparents raising grandchildren. Nurturing through adversity I encourage you to share your challenges and your successes with us. Your story is undoubtedly one someone else needs to hear. Submit your stories to the links provided in the podcast. Information contributions will enrich upcoming conversations, creating a more supportive community in which we can learn and grow together. If you like the show, share it with a friend. And if you love the show and you're listening on a broadcasting platform like Apple or Spotify, scroll down in your app and please leave us a review.

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Be sure to join us for episode nine of our podcast, where we delve into one of the many untold stories of grandparents raising grandchildren who have faced unimaginable challenges.

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From navigating the aftermath of trauma and neglect, to coping with the incarceration or addiction of their own children. Grandparents raising grandchildren carry burdens that many cannot comprehend. Their lives are a tapestry of resilience and sacrifice. Yet their stories remain unheard, unshared. In episode nine, the stories your friends don't want to hear, we shine a light on the struggles and triumphs of one of those unsung heroes. I hope you'll join us.

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Thank you for tuning in to grandparents, raising grandchildren, nurturing through adversity. Remember, you are not alone, and together we can find strength and hope in the face of adversity. Peace be with you. And I pray that you find some time this week to listen to your inner wisdom amongst the noise and the pandemonium of this world.