Health Manager Orientation Guide

Building Trauma-informed Services

A teacher watching a young boy working on a difficult assignment.Building a trauma-informed system is everybody’s job. The health manager can help to coordinate efforts in partnership with program administration. The IECMH consultants can also help to build trauma-informed services through programmatic consultation. Consultants can work with Head Start administrators and staff and give guidance and recommendations for staff education, program policy, and practices that will prepare them to work effectively with staff, children, families, and staff who have been affected by trauma. The focus of this work would include but not be limited to:

  • Understanding the impact of trauma on infants, toddlers, young children, their families, and staff
  • Having intake, screening, observation, and interview practices that look for signs and symptoms of traumatic stress
  • Understanding resilience and sources of strength in infants, young children, families, and staff who experience or have experienced trauma
  • Reviewing policies and procedures (e.g., for program emergencies; crises; reporting child abuse and neglect; community partnerships, resources and referrals) to be sure they address issues related to trauma
  • Having guidelines for classroom procedures, daily routines, home visiting, and other contexts that:
    • Consider the impact of trauma
    • Address the individual needs of children and families affected by trauma
    • Give reminders about avoiding unintentionally re-traumatizing a child or family in their care
    • Outline how to generally support these children and families
  • Training and supporting staff to help them cope with the challenging work of serving young children affected by trauma and their families, and to help them avoid secondary trauma and burnout
  • Building strong, collaborative relationships with community resources that are also trauma-informed or offer trauma-related services

The Pyramid Model offers universal support for all children through high-quality environments and nurturing and responsive relationships. It uses evidence-based practices to help adults — early childhood special education staff, early intervention staff, early educators, other professionals, and families — promote young children’s healthy social and emotional development. With this model, children who continue to struggle receive additional social and emotional support. A smaller percentage of children may be assessed for individualized support or treatment. Information, training, and support is available to learn more.

At some point, most children exhibit behaviors that are challenging for adults. Experiencing potentially traumatic events often affects a child’s behavior and can lead to them exhibiting challenging behaviors that are less likely to resolve with typical developmentally appropriate redirection and that often result in harsh discipline from caregivers. While expulsion is not acceptable in Head Start programs, research shows that children who have experienced trauma are expelled from preschool settings at a markedly disproportional rate. To learn more about preschool expulsion rates disproportionally impacting children of color, most significantly for African American boys, read Understanding and Eliminating Expulsion in Early Childhood Programs.

Challenging behavior is ideally first addressed on programmatic and systemic levels using a team approach that focuses on creating a strong foundation of emotional well-being, safety, and trust. It is important to have a system where staff can look at the full picture and put into place prevention and supports based on what they know about the needs of the children and families.

The health manager may work with the disability manager, mental health manager, or consultants to help with supporting children; for example, by offering trainings to help staff understand the connection between health, trauma, and behavior. Ensuring access to high-quality wrap-around services, and positive experiences for all children, especially those who are Black, Indigenous, and people of color who disproportionately experience inequities, is part of what makes Head Start programs unique and leaders in improving health outcomes for children and families. More improvement and growth in these areas will happen through improved family and community partnerships, examining implicit bias, and reviewing discipline practices regularly.

Tips and Strategies for Building Trauma-informed Services

  • Learn more about what early childhood programs do to support the mental health of children and families. This is particularly important when children and families are exposed to traumatic events or situations that overwhelm their ability to cope and require additional support and services. Explore the Head Start Heals resources to learn about:
    • Trauma basics and what it means to have a trauma-informed care approach
    • How trauma intersects with topics including mental health, substance use, domestic violence, and child welfare
    • How to approach trauma through a culturally appropriate and strengths-based lens
    • How programs can have difficult, trauma-related conversations with families
  • Advocate for trauma-informed policies and trauma-focused services and interventions in your Head Start community to help strengthen community partnerships and build much-needed supports for children and families affected by trauma.
  • Make sure teachers receive training in strategies to promote social and emotional learning and to prevent challenging behaviors.
  • Develop procedures for addressing challenging behaviors.
  • Use a multidisciplinary team approach (including a child’s caregivers) to create behavior support plans.