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Societal trauma, like school shootings and racial injustice, have become all too commonplace in our kids’ lives. It’s tough for families to help any child process the feelings that come along with these traumatic events. And it can be extra challenging for families of kids of color with learning and thinking differences like ADHD.
In this episode of The Opportunity Gap, we explore trauma: its causes, how to identify it, and how it impacts us. Listen as Dr. Kristin Carothers, a clinical psychologist, explains:
How trauma shows up in kids’ behavior
Supports for parents and educators of kids of color
Tips for talking to your child
Julian: Hi, everyone. It's Julian. Before we begin the episode, I wanted to let you all know that my guest, Dr. Kristin Carothers, and I talked about trauma and how events like gun violence and school shootings can impact kids in more ways than we think. I hope you all enjoy our vulnerable and transparent conversation.
From the Understood Podcast Network, this is "The Opportunity Gap." Kids of color who have ADHD and other common learning differences often face a double stigma. But there's a lot that families can do to address the opportunity gap in our communities. This podcast explains key issues and offers tips to help you advocate for your child.
My name is Julian Saavedra. I'm a father of two and an assistant principal in Philadelphia, where I've spent nearly 20 years working in public schools. I'll be your host.
Welcome back, listeners. Today, we're going to be exploring trauma — its causes, how to identify it, and how it impacts all of us, especially kids with learning and thinking differences and parenting adults. Trauma has become all too commonplace in our lives and in our kids' lives. Trauma impacts all of us, and there are many forms of it that one may experience in their lifetime.
There's forms of trauma that can include loss of a loved one, a tough divorce between caregivers, even an abusive living environment. Not to mention the forms of trauma we witness in the world like racial injustices, school shootings, and other violent acts. It feels nearly impossible for many of us to process these emotions of anger, grief, and anxiety. It's even harder for kids who learn and think differently.
Today's episode is a great opportunity for us to shine light on the impact of trauma and identify ways we can help one another together. To help me get into this, I want to reintroduce — she's an OG to the OG — Kristin Carothers. Kristin is a clinical psychologist who's returning to "The Opportunity Gap" after doing a great episode with us last season on ADHD parenting tips. Welcome back to the show, Kristin. We're so glad you could join us.
Kristin: Thank you so much for having me, Julian. I'm really happy to be here.
Julian: Of course. Of course. Welcome back. Welcome back. I'm excited to kind of talk through something that is a necessary conversation. And I believe there's a necessity in being able to understand trauma and work through it.
You know, as I was thinking about our conversation today, I started processing my own experiences with trauma. I haven't actually talked about this yet openly, so I want to put it out to the listeners that, as you know, I'm an assistant principal at a comprehensive high school in Philadelphia. Last fall, there was a school shooting that occurred right outside of our building. We had five students who were shot, and one of them lost their life. It was a national news story.
The aftermath of being a leader in this environment has been absolutely overwhelming. Meeting with the parents, working with the student who was a victim of the shooting, working through all the different things that occurred, to just deal with all the stress that came from trying to navigate all that. And so obviously, it saddens me that not only did my students experience this, but the adults working with the students also had to deal with that.
And so when we think about the idea of trauma, I can only imagine that so many of my students, especially those with learning and thinking differences, are feeling it. For somebody that learns and thinks differently, how does trauma impact them? How does it show up in their behavior?
Kristin: I'm really sorry that happened. So, Julian, I know you want me to answer the question, but I want to take a minute to acknowledge you and your experience. And the process is called vicarious traumatization. Vicarious means you don't have to be present to feel the same effects of the traumatic stress. You could be someone who witnessed. You could be someone who was close to somebody who the trauma impacted. You could experience vicarious traumatization from constant like news exposure when there are traumatic events that occur.
But for educators specifically, what happens is you are tasked with playing multiple roles. And in being tasked with playing multiple roles, the burden of stress can be just even heavier, right? So for, I think, first parents and educators, have to make sure you're putting the mask on for yourself, and that you're aware that you're having symptoms.
Because for a kid with learning and thinking differences, yes, they're going to have struggles processing what's happened. But they really need the adults around them to be able to be in a position where they are stable, where they are cared for, where they're breathing, so they can help them breathe. I think when we're thinking about kids with learning differences, one of the things to remember is that these kids may be struggling with trying to filter out important information from extraneous information, or just things that are happening in their environment where it may feel as if they're just getting hit with one thing after another.
And the demands on their attention or the demands on their ability to cope with stress can be taxed. It can get to a point where it feels like too much, even for people who don't have learning differences. And so what we really want to be aware of is how are they processing or understanding what happened? What are they doing behaviorally in attempts to manage their experience?
So if a kid has ADHD or kid has anxiety or depression, they may be trying to avoid reminders. And in their avoidance, you may see an increase in behavioral symptoms — acting out. You may notice that they're talking more. Or other kids might withdraw. And so it's just important to know that we may need to slow things down. It may not be the time to process the trauma right after the trauma's occur. Routine is important, but it may be that there's a modify routine to give kids an opportunity to recalibrate into grief.
Julian: Before the event occurred, we still had a large amount of students who had experienced traumatic events. A lot of the things I describe, whether it be gun violence, whether it be extreme poverty, whether it be that racialized trauma that comes with being part of a marginalized group. And we saw a lot of that. And we still see a lot of that come out in the ways you describe, whether it be kids walking the halls aimlessly. Right? They just are kind of wandering.
Kids who blow up really fast for something that's a small thing — or what we deem small — they blow up. They go 0 to 100 really fast. So it's kids who are already have experienced this day to day in their own personal lives. Now, this breach of this safe space, it doubles down on it. And with the population that has a lot of learning and thinking differences, we see that deeply even now, right? Like we're deep in it. This was back in the fall, but we're still deep in, trying to unpack a lot of that.
So I appreciate how you're describing how the adults also live vicariously through some of that trauma, and how we as the adults have to really make sure we take care of ourselves so that we can help assist our students.
Kristin: Because you just said something. You said this happened in the fall, but we're really unpacking it now. And that's one of the things that happens with trauma. So with trauma, the impacts of the traumatic stressor may not necessarily be felt immediately after. There are some things that happen immediately, right? There's a child whose life was lost. That child is no longer there. That grief happens, right? There's five kids who are shot. Right? So physically they're having some issues.
But in terms of like the things that may happen cognitively, for some people you may not see that for three to six months. And typically when we diagnose a post-traumatic stress disorder, we're not giving that diagnoses until three to six months post the event. So the fact that you've got kids who are presenting now is pretty typical, right?
That first period right after the event occurs is called the acute stress period. And that's when we think, OK, this has happened within the last two to three weeks or within the last few months, and a person is really struggling. And that we think of as normative stress, and we hope that over time it'll balance out. Well, for some people, those symptoms get even stronger or more difficult to deal with as you go further away from the time of the trauma.
So when you talked about kids walking the hallway, kids not being focused. It could be that some of those children who are dealing with what we call complex trauma, meaning they've experienced multiple traumatic stressors at a time, they may be actively re-experiencing aspects of the traumatic experiences they faced as a result of some trigger, or just when their minds wander.
Julian: And I appreciate that a lot of the things you're saying are things that our parents listening have probably seen, especially the intersection of trauma and learning and thinking differences is starting to sound familiar. Let's move on to this idea of that intersection between trauma and learning and thinking differences.
Processing and treating trauma can be challenging for any child. And parents may wonder, where do you start when helping their child manage trauma? Like, what do you do when you start to try to embark on this journey of unpacking and managing it?
Kristin: OK, I'm going to start with the supports. So when a school community, family, group has experienced a trauma and they're really concerned about how to get kids the supports they need, whether or not those kids have learning or thinking differences, the best resource is the National Child Traumatic Stress Network.
The National Child Traumatic Stress Network has done — has funded research from schools across the country. They provide evidence-based resources for supporting school communities, kids, parents. They provide resources in multiple languages and formats. So we know for kids with learning and thinking differences, it's really important that information is not just presented in a written form, but that there are also visuals, that there are also things that you can hear, right?
And most importantly for the adults in the situation, NCTSN gives you the language to use when discussing traumatic stressors with kids. Right? They give you steps, processes that you can use to try to recover from a traumatic experience. Right? If you're a parent and you have a child with learning and thinking differences, and you're really struggling about how to get them that information that you know they need, National Child Traumatic Stress Network is gold standard.
Julian: OK. So you start there, you go on the website, you find the resources that you need. But maybe you're also trying to find the therapist. And again, going back to my own experience, I know that, yes, therapy is restricted. It's an income-restrictive situation. It may be an insurance situation, where your insurance does not cover that type of therapy. Or you may not have insurance to even be able to get a therapist. And when you do find a therapist, there might be a waiting list that's three to nine or twelve months long.
And so I'm wondering, is there another avenue to go to? Can school psychologists provide this type of therapy? Are there other ways where schools can provide access to therapy?
Kristin: OK That's an excellent question. I really like the aknowledgement that access to therapy is restricted often for communities where there are not financial resources to go through like a private practice route, or where there's just the resources are overtaxed. So the community mental health centers are full. All the therapist who accept insurance are full.
In terms of resources, there are two programs: Cognitive Behavioral Intervention for Trauma in Schools, which was created in California. It's also known as the CBITS program. And then trauma-focused cognitive behavioral therapy. Those are two evidence-based models that are implemented often in school and community organizations.
What the program does is first teach basic coping skills to manage any symptoms. So we get active coping skills. Those are the skills that we use when we're in control or when we could problem-solve, right? We can cope actively, because we could have some control over the situation. And then we've got adaptive coping strategies. And what happens with trauma treatment is we typically focus on adaptive coping strategies first.
School psychologists may not be in the position to administer these interventions because of the load, the burden that they're under to do testing, to do evaluation, to get kids IEPs, individual education plans. That's really the role of school psychologists in most school settings. What I've typically found is that guidance counselors, teaching staff are great people to do CBITS intervention. Social workers who are in the school are typically joint case management, just making sure basic needs are met.
So we've got a family whose child is killed. How can we make sure that this family has the resources they need to just take care of their basic daily living needs? Then can we refer them for therapy? But first we got to just take care of their basic needs. They've lost a child. When you're in a situation where you can't find support, one of the things that I've found helpful is to reach back to those organizations that have done a lot of the work and provide free resources online. OK?
So when it comes to learning and thinking differences for me, when I teach, I'm telling the psychiatry fellows that I work with, you send those parents to Understood.org. They will explain what an IEP is. They will help them to write letters to request an IEP. They will explain what learning and thinking differences are. I do the same thing when I'm talking to families who aren't able to access a therapist necessarily, saying, check out ChildMind.org. They provide lots of information on lots of different issues that children and families may face.
In my experience, when you live in rural communities, you may not have access to lots of different resources in terms of community mental health. And when you live in urban communities, you often face the same challenges. What I typically recommend is finding the academic medical center. What is the hospital in your region or area that is also a training hospital? That place will usually have a resource for behavioral health.
The waiting list may be long. Get on it. Time is going to pass anyway. They tell you we don't have any appointments until October. That's cool. Put me down. You keep calling back. Somebody is going to cancel an appointment. Somebody is not going to show up. If that doesn't happen, October will be there. And guess what? Your traumatic experience that you faced will still be there as well. OK? It is never too late. There is not an expiration date on traumatic experiences.
Julian: And I think that a lot of this boils down to the idea of trust, where I know when we talked before with families of color trying to manage ADHD and learning and thinking differences, and understanding the process of getting resources, it boiled down to finding somebody that you trust that can help you navigate the experience. And so I think that I always, always recommend for any of our families, and especially after dealing with this event, if you're struggling to find the services you need, ask questions. Find somebody that you trust in that building and ask questions.
You know the buzzword of trauma-informed education. Tell me about your trauma-informed education program in school. Tell me what resources you have available at school. I'm an assistant principal. If a parent comes to me and ask me that question, I've got to have an answer. And I got to make sure that I can speak to what are we providing, given the fact that is something that schools are supposed to provide.
When we're thinking about the intersection of learning and thinking differences, especially ADHD, a lot of the things that I describe the — hallway walking, the going 0 to 100, the gazed-out looks, the triggers, the fidgeting behavior, the tears, like just all these different things. Some of those can also be symptoms or a way that ADHD manifests itself in children, too. Sometimes they look very similar, right? The symptoms of trauma, the symptoms of ADHD might look the same.
If I'm a parent and I'm a parenting adult, and my child is either getting misdiagnosed and saying these are symptoms of ADHD, and I know that this is because of trauma, or my child has experienced trauma, but they're saying this is ADHD instead, how do I make sure that my child is getting what they need? What should I do? How do I approach that?
Kristin: I love this advocacy question. You, as a parent, are the expert on your child, right? Always. You may not know how to treat your child medically, but you are the expert on your child. The — what we're looking for is a change in behavior that is distinct. With ADHD, previous versions of our "Diagnostic and Statistical Manual," we needed to see symptoms before age 6. With the revision of the manual. Now we see symptoms before age 12.
But what I want to really point out to parents is that we are looking for changes in behaviors that are consistent across settings: school, home, social, right? If you've got a kid who up until a certain point has been doing well in school, has been following through with requests at home, things are going well at home. Socially, they're not having any issues. And all of a sudden, boom, you're noticing a shift? In my opinion, something has happened.
Or if you're a parent and you know that something has happened, and that your child's behavior prior to that experience was very different, then your job is to advocate for your child. And sometimes it takes getting a second opinion when the first person won't listen.
You want to make sure that when you're going for diagnostic assessment, people are actually using measures to diagnose. What's a measure? A survey, a questionnaire. Are they getting information from multiple raters? Have they asked to speak to your child's teacher? Have they asked to speak to both parents or whoever the caregivers are? Have they asked your child to independently rate their symptoms? Having multiple raters of information lets know whether or not these behaviors are consistent, or whether or not there's been some change at some point in time.
We know that in certain communities there tends to be an overreliance on certain diagnoses. Right? And so we want to make sure that when we're going to treatment providers, these are providers who are aware of contextual issues that might be impacting your family. So is the provider listening and taking into account that you said, "My child witnessed a murder two years ago. Since that time, they've really struggled in school. They haven't been able to sit still. Prior to that point, we did not have these issues." Right? Context is everything.
Now, if you should happen to work with someone, and you get a diagnosis or you get some prescriptions or some things that don't seem right to you, you always go for a second opinion. It's the same thing you would do if you were having a physical health problem and somebody was proposing this diagnosis or this major treatment course and you weren't sure about it. It is OK to get a second opinion. Now, in our case, it might take you a little while because it's hard to find people in the first place. But your goal is to make sure that you are getting the treatment that's indicated for your child — especially if your child has a learning and thinking difference.
Julian: So again, when I think about my own experience as an assistant principal dealing with this life changing situation, like life-changing for the students, life-changing for the faculty, life-changing for me as a leader trying to lead through this situation. And at the end of the day, I think about my own children and the nervousness I had with just making sure I got home to them myself.
And so since it happened, I've been working alongside our guidance counselors, our social workers, different people from around the city, to support — not only to make sure that the space is safe for our students and physically safe. We've had safety upgrades. We've had a lot of different building external things done. But also emotionally safe, spiritually safe. But also to provide a place where they can talk and they can express what they're feeling. And I say all that because as the expert, I'm very interested from your perspective, what are some concrete tips that you can give to parenting adults about helping their child deal with trauma?
Kristin: So I am also a parent. I also have vicarious trauma as related to gun violence. I would say as a parent and as a professional, the advice I would like to give to other parents is to be sure to acknowledge the fact that this awful thing happened, acknowledged that it was so stressful and it was so hard and it was so scary. Allow your children to talk openly about how they felt. You've got to be able to hold that, though. You've got to be able to manage your own moods and emotions while your children share their moods and emotions with you.
And so in order to do that, you really have to know how you feel. Process with your friends and other adults first, and then be ready to go in there and get with your kids. The second thing I would say as a professional and as a parent, the parents have to be ready for is the fact that they may their children may display some regressed behaviors.
For little kids, they may wet the bed. They may start having nightmares and not want to sleep alone. Older kids may be really irritable. Older kids may start to not follow through with directions or rules or things that they typically would do. You might see them to stop doing, right? We want to be on the lookout for changes in behavior — using alcohol, smoking marijuana or using other drugs. These things happen, younger and younger.
And so we want you to be open with your kids about the fact that what happened was awful. Want to be open with your kids about the fact that they can come to you to talk about it. And we want to let kids know that when they feel this way, they don't have to turn to something to make them numb.
Often it's like we don't want to feel anything because we felt so hurt. So let's just escape. Escape actually makes anxiety even worse till it gets to the point where you are so uncomfortable with feeling that you don't know how to just feel and be OK with discomfort.
I really think — I was talking to one of my clients today about attachment. Parents, it's your job to be a secure base for your kids in these times. A secure base is someone who is consistent and available. Think: you, as a parent, you are supposed to be that secure base for your kids. That stoop is always there. That tree is not falling down. We know what the rules are when we get back to the secure base. If I'm — no matter what the world is presenting me with, I'm safe here. My parent can handle my difficult emotions. My parent isn't triggered by my experience. Secure, warm, consistent. That's what your kids need. They need at least one adult who can do that for them. If it's not you, then you have to find somebody who can do that for them.
Julian: Now, in a perfect world, we would have parents who are comfortable doing all that, right? We would have people that are all good to do that. But we know that there's a bunch of situations that happen, whether it be parents that are dealing with their own trauma themselves, or parenting adults that may not have the relationship or the ability to feel comfortable enough to have this conversation with their children.
So let me ask, what about the folks that are not comfortable doing that? Where do we start? What do they do to get to that point where they can be that home base, as you say?
Kristin: I think we have got to get comfortable with asking for help. We are constantly telling kids, especially kids with learning and thinking differences, they've got to learn to speak up for themselves, empowering them. We want them to be empowered. We want them to be empowered.
But you as a parent have to model being empowered. Being empowered is knowing how to assert yourself in a situation even when you don't know what you need. So if you as a parent are like "I am not warm and fuzzy, I cannot do this. I can't tolerate my kid having this discussion." The least you can do is think who in our circle can do this? Who can help me? It is OK to ask for help.
And it may not be a professional right away. It might be a family member. It might be a close friend. It might be the parent of one of the other kids. But you've got to be willing to say something, right? If you are so closed off and so scared that you're not willing to open your mouth and ask for help, how can anything get better? You as a parent have to take a risk to put yourself out there, because this could be life or death, right?
Julian: And I will say that one thing about our community in general, African American communities specifically, we do a great job of finding folks to talk to. And it might not be in the formalized setting. It might be playing cards, it might be at the barbershop, it might be at the hair salon, it might be at church, it might be on the stoop, it might be somewhere.
But I love the idea of saying "I need to find somebody to talk to." And once those feelings start to come out, then it may be the next step of saying, "I need to go and find some more professional help." But modeling modeling that with and in front of your children is paramount.
Kristin: I appreciate that you are having direct conversations with students with learning and thinking differences about the fact that as they mature and go out into the world, having this learning and thinking difference does not have to be problematic for them. Right?
Julian: And I would say the same exact thing for those of us that have experienced traumatic events and the idea that this is part of who you are. It makes it — we're the sum of our experiences. And making sure that we understand that there are ways that we can find support, there are ways that we can speak up to advocate for what we need, but ultimately to find the folks that are going to be out there to help you.
Before we go, I want to share some really helpful resources from Understood that you find in our show notes. The first is an article that breaks down how to have those hard but necessary conversations. The second is an article that explains the impact of scary news on kids with learning and thinking differences. The third is a resource Dr. Carothers herself shared with us, the National Child Traumatic Stress Network. Please check these out.
And remember, we can't always control life's experiences, but we can choose how we show up for one another. I appreciate all of you for listening. Dr. Carothers, I really appreciate you. Thank you so much.
Kristin: Thank you so much, Julian. And I appreciate the opportunity.
Julian: You've been listening to "The Opportunity Gap" from the Understood Podcast Network. This show is for you. So we want to make sure you're getting what you need. Is there a topic you'd like us to cover? We want to hear from you. Email us at OpportunityGap@understood.org.
If you want to learn more about the topics we covered today, check out the show notes for this episode. We include more resources as well as links to anything we mentioned in the episode.
Understood.org is a resource dedicated to helping people who learn and think differently discover their potential and thrive. Learn more at understood.org/mission.
"The Opportunity Gap" is produced by Tara Drinks and edited by Cin Pim. Briana Berry is our production director. Our theme music was written by Justin D. Wright, who also mixes the show. For the Understood Podcast Network, Laura Key is our editorial director, Scott Cocchiere is our creative director, and Seth Melnick is our executive producer. Thanks for listening. See you next time.