Some young children and their families who experience acute trauma need assistance with post-traumatic stress symptoms. Others, with more chronic or complex trauma experiences, have poor attachment histories, and show associated developmental, relationship, and behavioral problems. Early Head Start and Head Start staff and early childhood mental health consultants are in a unique position to recognize when children are in need of special help and when their ongoing behavior warrants a referral for more intense services provided within the program or in the community. It is not uncommon for parents and family members to also have experienced trauma in their own early years, suffer from post traumatic stress disorder, and need their own therapeutic support in addition to intervention to repair the parent-child relationship.

Collaboration with community partners

When consultation and intervention strategies implemented by Early Head Start and Head Start teachers and staff are not enough to address the impact of trauma on young children and their families, community partners and other resources may be necessary. A clear and timely decision making process and steps to link families to these resources should be in place. Developing and nurturing these community partnerships can help to build and maintain collaborative relationships and facilitate working together.

Community partners for supporting children and families affected by trauma may include:

• Community mental health services (with infant, early childhood, and family trauma expertise)
• Child protective and child welfare services
• Department of social services
• Domestic violence services
• Shelter services
• Early intervention services
• Agencies that specialize in trauma and specific types of trauma

Every Early Head Start and Head Start program should be familiar with all community partners and resources as well as have a list or directory available to support collaboration and assist in connecting families to community resources. (See Head Start Program Performance Standards 45 CFR 1304.41, Community Partnerships). In working with community resources, consultants should collaborate with other Early Head Start and Head Start staff (Teacher, Home Visitor, Family Advocate, Disabilities Coordinator, etc.) to make the most of already established working relationships with community partners as well as those trusted relationships with families and caregivers. Early Head Start and Head Start mental health consultants can also assist in building strong partnerships with community agencies and other resources that specialize in addressing the impact of trauma.

Considering the role of the consultant and consultation in addressing trauma in the early care and education setting, use this "stop action" scenario to identify what should happen next after each brief segment. Write down your answers and check them with the Possible Answers listed at the end of the activity.

Stop Action Scene 1:
Justin Santos was an energetic and verbal child who enjoyed being in his Early Head Start classroom. After having turned three over the summer, Justin moved into Mrs. Huggins Head Start classroom. Unlike last year, Justin seemed less settled and focused. His behavior was sometimes aggressive. He had difficulty sustaining play and a hard time finishing any activity. With other children, he was bossy and irritable, sometimes acting abruptly and pushing whoever was in his way. When approached by his teacher to interrupt this type of behavior, he would shrug and duck his head, appearing startled or afraid.

Stop Action Scene 2:
Mrs. Huggins and the mental health consultant met with Justin's mother, Maria Santos, and shared their concerns with her. Ms. Santos said she hadn't noticed any change in Justin's behavior at home. The consultant invited Ms. Santos to share information about herself and their family life. Ms. Santos described herself as a single mother who worked two part-time jobs to make ends meet. She also admitted a history of alcohol use, but had quit drinking after going through rehabilitation and attending AA meetings. Ms. Santos claimed to be proud of her accomplishments and her continuing sobriety, but admitted having few supports in the community, often feeling alone with her struggle to raise Justin on her own. They agreed to continue to observe Justin's behavior in the classroom, implement some strategies to reduce his aggressive behavior, and stay in touch about how Justin was doing. A week later, Justin came to school with a dark bruise on his wrist. When Mrs. Huggins asked Justin about the bruise, he hid his hand behind his back and said he was" just wrestling with Roger". Mrs. Huggins learned from the Family Advocate that Ms. Santos had recently started seeing a new boyfriend that she had met at an AA meeting.

Stop Action Scene 3:
In her next communication with Ms. Santos, Mrs. Huggins described the bruise on Justin's arm and asked Ms. Santos what happened. She responded by saying that Justin had been wrestling with a family friend and that it was an accident. Mrs. Huggins asked if anything had changed at home. At first Ms. Santos said no, but then when Mrs. Huggins asked about Roger, she admitted that she has been seeing him and he sometimes spends the night. Ms. Santos described Roger as caring about her and Justin, and acknowledged that they sometimes disagree on how to discipline Justin. Roger had a tough childhood and was stricter than Ms. Santos, but she said Roger would never hurt Justin. Mrs. Huggins was concerned about Justin's family situation and now his safety. She was also becoming increasingly frustrated with his behavior. She wondered if some of his fearful behavior when an adult would approach to stop and redirect his behavior was linked to possible strict discipline from Roger. However, she could not understand his continuing aggressive behavior and his insistence on pretending to be a powerful, villain superhero. She began to wonder what else might be going on and if Justin was becoming a bully.

Stop Action Scene 4:
Mrs. Huggins remained vigilant for any signs of physical punishment or harsh treatment from Roger. Justin had no further bruises or marks that she could see. Ms. Santos continued to deny any difficulties at home. One day, Justin says, "I'm not supposed to tell, but my mommy keeps a special secret bottle in the closet by her bed. She says it's medicine and not for kids. Sometimes she shares it with Roger, but not me." Mrs. Huggins supports Justin having shared this information and asks if he is worried about his mom. Justin nods silently. From this revelation, Mrs. Huggins, the Family Advocate, and the consultant suspect that Ms. Santos is drinking again. When they invite her to meet to discuss Justin's progress in the classroom, she says she is too busy or too tired from her jobs to come in. The consultant and the staff work together to explore other strategies to reach out to Ms. Santos, help her connect back to her AA supports, and seek additional assistance for herself and Justin.