IDD and Trauma ID Participant Manual

The Road to Recovery:
Supporting Children with IDD

Who Have Experienced Trauma
PARTICIPANT MANUAL
November 2015
The Road to Recovery Toolkit | November 2015

The National Child Traumatic Stress Network
www.NCTSN.org
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About the National Child Traumatic Stress Network
Established by Congress in 2000, the National Child Traumatic Stress Network (NCTSN) brings a singular and
comprehensive focus to childhood trauma. NCTSN’s collaboration of frontline providers, researchers, and
families is committed to raising the standard of care while increasing access to services. Combining knowledge
of child development, expertise in the full range of child traumatic experiences, and dedication to evidence-
based practices, the NCTSN changes the course of children’s lives by changing the course of their care.
About the Hogg Foundation

The Hogg Foundation for Mental Health has been promoting mental health in Texas since 1940, when the
children of former Texas Governor James S. Hogg established the foundation with proceeds from their beloved
brother Will’s estate. Will’s sister, Miss Ima Hogg, later established a separate endowment at the foundation
dedicated to providing mental health services for children, youth and their families in Houston and Harris
County. Over the years, the Hogg Foundation has awarded millions of dollars in grants and scholarships to
fulfill this mission and continue the Hogg family’s legacy of public service in Texas. Today, the Hogg Foundation
focuses on key strategic areas with the greatest potential to benefit mental health in Texas and awards grants
through a competitive proposal process. The foundation funds mental health services, scholarships, academic
research, policy work, public education and outreach.
The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of
SAMHSA or HHS.

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ACKNOWLEDGMENTS
This Toolkit was developed by the National Center for Child Traumatic Stress (NCCTS) and
the NCTSN Trauma & IDD expert panel, a national selection of individuals with expertise in
trauma and IDD.
Chair
Susan Ko, PhD DeAnna Griffin, MA Megan Mooney, PhD
UCLA/Duke National Center for UCLA/Duke National Center for DePelchin Children’s Center
Child Traumatic Stress Child Traumatic Stress Houston, TX
Los Angeles, CA Los Angeles, CA
Isabel Padura-Álvarez, MA
Richard Adams, MD Karyn Harvey, PhD Los Angeles Unified School
American Academy for Cerebral The Arc Baltimore District
Palsy & Develpmental Medicine Lutherville, MD Sun Valley, CA
Dallas, TX
Robert Pynoos, MD, MPH
Rebecca Cross Bodan, PhD, Colleen Horton, MPAFF UCLA/Duke National Center for
FNP Hogg Foundation for Child Traumatic Stress
CA State University, Fullerton Mental Health Los Angeles, CA
School of Nursing Austin, TX
Fullerton, CA
Nancy Rosenau, PhD
Kelly Decker, PhD Diane Jacobstein, PhD EveryChild, Inc
UCLA/Duke National Center for Georgetown University Austin, TX
Child Traumatic Stress Washington, DC
Los Angeles, CA
Sue Swenson, MBA
Lynda Frost, JD, PhD Octavio Martinez, MD, MPH US Dept of Education
Hogg Foundation for Mental Hogg Foundation for Washington, DC
Health Mental Health
Austin, TX Austin, TX
Brian Tallant, LCP
John Fairbank, PhD Monique Marrow, PhD The Intercept Center
Duke/UCLA National Center for Independent Consultant Aurora, CO
Child Traumatic Stress Lexington, KY
Durham, NC
Elizabeth Thompson, PhD
The Family Center at Kennedy
Jeff Garrison-Tate Veronica Meneses, MD Krieger Institute
The Center on Disability & Texas Scottish Rite Hospital for Baltimore, MD
Development Children
College Station, TX Dallas, TX Douglas Vanderbilt, MD
Children’s Hospital Los Angeles
Los Angeles, CA

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The Chair wishes to extend special thanks to:
§ The Hogg Foundation for Mental Health for their generous funding and support of this
project.
§ SafePlace for their administrative and logistics support for the NCTSN Trauma & IDD
expert panel meeting and pilot trainings of this Toolkit in Texas.
§ Carmen Rosa Noroña, MSW, MSEd, CEIS, The Child Witness to Violence Program at
Boston Medical Center, Angela Breidenstine, PhD, Tulane University School of Medicine
and the NCTSN Early Trauma Treatment Network (ETTN) for their valuable feedback on a
previous draft of this Toolkit.
§ Sue Oh at Sue Oh Design for the design and layout of the Facilitator Guide and the Board
Game.
Recommended Citation
Ko, SJ, Pynoos, RS, Griffin, D, Vanderbilt, D & NCTSN Trauma & IDD Expert Panel (2015). The road to recovery:
Supporting children with intellectual and developmental disabilities who have experienced trauma. Los
Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress.
Copyright © 2015 National Center for Child Traumatic Stress on behalf of Susan Ko, PhD, Robert S. Pynoos,
MD, DeAnna Griffin, MA, Douglas Vanderbilt, MD, the NCTSN Trauma & IDD Expert Panel and the National
Child Traumatic Stress Network.

www.NCTSN.org
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CONTENTS
Introduction ………………………………………………………………………………………………………………….…… 7
Essential Messages ……………………………………………………………………………………………………….….. 8
Learning Objectives …………………………………………………………………………………………………………… 9
Making the Connection: Why am I doing this work? …………………………………………………………….. 11
Action Planning: Essential Messages 1 & 2 ………………………………………………………………….…….. 12

Case Vignettes ……………………………………………………………………………………………………………..…… 13
Putting Into Practice: Case Vignettes—Trauma, IDD & Development ……….…………….……………… 19
Action Planning: Essential Messages 3 & 4 …………………………………………………………………….….. 20
Putting Into Practice: Case Vignettes—Responses to Traumatic Experiences ………………….…… 21
12 Core Concepts for Understanding Child Traumatic Stress Responses in Children …………… 22
Action Planning: Essential Message 5 ……………………………………………………….……………………….. 23

Post-Training Evaluation: Day 1………………………………………………………………………………..…………. 25
Local Resources …………………………………………………………………………………………………..………….. 27
Board Game Instructions …………………………………………………………………………………………………… 28

Action Planning: Essential Messages 6 & 7 …………………………………………..………………………….… 29
Putting Into Practice: Fish Bowl ………………………………………………………………………………………….. 30

Putting Into Practice: Case Vignettes—Accessing Services …………..………………………………………. 31
Protective Factors ……………………………………………………………………………………………………………… 32
Action Planning: Essential Messages 8 & 9 ……………………………………………….……………………….. 33

Stress Warning Signs ………………………………………………………………………………………..………………. 35
Self-Care Options ………………………………………………………………………………………………………………. 36

Balancing Your Self-Care …………………………………………………………………………………………………… 37
Action Planning: Essential Message 10 ………………………………………………………………………………. 38
Personal Trauma-Informed Practice Action Plan …………………………..………………………................ 39
Personal Trauma-Informed Practice Action Plan (Duplicate Copy) ……………………….………………. 41
Post-Training Evaluation: Day 2 …………………………………………………………………………………………. 43

References ……………………………………………………………………………………………………………………….. 47

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INTRODUCTION
This participant manual is part of The Road to

Recovery: Supporting Children with IDD Who
Have Experienced Trauma Toolkit, which also
consists of a Facilitator’s Guide, Slidekit, and
Supplemental Materials. Together, they are
designed to teach basic knowledge, skills and
values about working with children with IDD
who have had traumatic experiences, and how
to use this knowledge to support children’s
safety, well-being, happiness, and recovery
through trauma-informed practice.

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ESSENTIAL MESSAGES
1. Know that there’s hope; recovery from traumatic experiences is possible. (Module 1)
2. Recognize that a child with IDD may have had a traumatic experience(s), which can have
profound effects. (Module 1)
3. Recognize a child’s developmental level and how IDD and traumatic experiences are
affecting his/her functioning. (Module 2)
4. Utilize a developmental lens when making meaning of a child’s traumatic experiences
and responses. (Module 2)
5. Recognize that in the aftermath of trauma, understanding traumatic stress responses is
the first step in helping a child regain their sense of safety, value and quality of life.
(Module 3)
6. Utilize an IDD- and trauma-informed child-centered approach to support both the child
and the family. (Module 4)
7. Help parents/caregivers, and other professionals in the child’s life, strengthen protective
factors. (Module 4)
8. Partner with agencies and systems to ensure earlier and more sustained access to
services. (Module 5)
9. Ensure that trauma-informed child-centered services, treatments and systems drive the
recovery plan. (Module 5)
10. Practice ongoing self-care in order to increase effectiveness in delivering high quality
support, services and treatment. (Module 6)

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LEARNING OBJECTIVES
Module 1: Setting the Stage

In this module, participants will learn why a Toolkit that addresses the needs of children
with IDD who have had traumatic experiences is important.
Learning Objectives
§ Recognize that children with IDD are at-risk for traumatic experiences.
§ Recognize that recovery from traumatic experiences is possible.
§ Establish the important role of parents/caregivers and families on the road to recovery.
§ Describe frameworks that will be used to illustrate key concepts throughout the training.
Module Two: Development, IDD & Trauma

Participants will learn about typical milestones that occur throughout a child’s development
and how IDD and traumatic experiences can disrupt those milestones.
Learning Objectives
§ Define IDD and various types of disabilities.
§ Discuss developmental tasks across typical development.
§ Describe how IDD and traumatic experiences may disrupt typical development.
§ Identify the areas in which children’s functioning is affected by IDD and discuss subsequent
adaptations that must be made.
Module Three: Traumatic Stress Responses in Children with IDD

Participants will learn about how traumatic experiences affect development generally, and
children with IDD specifically, by learning and comprehending the 12 Core Concepts for
understanding traumatic stress responses in children.
Learning Objectives
§ Define child traumatic stress and PTSD.
§ Describe the 12 Core Concepts for understanding traumatic stress responses in children and
families.
§ Identify how traumatic experiences and their responses affect children with IDD.

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LEARNING OBJECTIVES
Module Four: Child & Family Well-Being & Resilience

Participants will learn the role of protective factors—such as a secure attachment and a
healing/protective environment—in enhancing family well-being and resilience, and how to
provide practical tools and support for caregivers and parents.
Learning Objectives
§ Explore the impact on parents/caregivers of learning about their child’s traumatic experience.
§ Explain strategies for strengthening protective factors to enhance child and family well-being,
resilience and recovery.
§ Describe frameworks for promoting a healing and protective environment in order to create a
safe and meaningful life for children.
§ Identify family-informed child-centered planning techniques to help children realize their
hopes and dreams.
Module Five: IDD- & Trauma-Informed Services & Treatment

Participants will learn how to augment the protective factors of children with IDD and their
families through IDD-informed trauma assessment and screening, and referral to
appropriate trauma-informed services and treatment.
Learning Objectives
§ Explain how to enhance protective factors of children with IDD and families through
appropriate trauma-informed services and treatment.
§ Discuss how to utilize adapted screening, assessment and planning tools to identify IDD- and
trauma-informed needs of children and families.
§ Discuss strategies for adapting the core components of trauma-informed treatments for
children with IDD.
§ Identify strategies for partnering with agencies and cross-system collaboration.
Module Six: Provider Self-Care

In the last module, participants will learn the difference between burnout, secondary
traumatic stress, and vicarious trauma and the steps to stress reduction and self-care.
Learning Objectives
§ Describe the difference between secondary traumatic stress, burnout and vicarious trauma.
§ Identify how burnout develops among providers.
§ Discuss potential sources, warning signs, and effects of secondary traumatic stress and
organizational stress.
§ Implement steps to stress reduction and self-care.

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MAKING THE CONNECTION: WHY AM I DOING THIS WORK?
Think about what brought you to this training today. Is the reason
professional? Personal? Is there a child or adult with IDD, in particular,
whom you are thinking about?
• What is it about this person that connects you to this work?
• What do you know about this person? Does s/he have an IDD? Has s/he experienced
a traumatic event?
• What would you like to know?

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ACTION PLANNING
ESSENTIAL MESSAGES 1 & 2
Think about the person you identified at the end of Module 1 that connects
you to this work. What can help that person and other children with IDD who
have experienced trauma? (Put an “X” in up to 3 boxes next to the ideas you
think you would MOST like to emphasize in your daily practice.)
1 ESSENTIAL MESSAGE 1
Know that there’s hope; recovery from traumatic experiences is
possible.
Es
☐ Over the next 3 months, I will identify my personal fears and/or biases of
working with children with IDD. I will begin to utilize the resources described in this
Toolkit and on the NCTSN website and Learning Center to help me to address those
fears with knowledge and skills training.
☐ Over the next 3 months, I will read at least 2 articles online, or in peer-reviewed
journals that describe the prevalence of trauma among children with IDD.
☐ Over the next 3 months, I will articulate that recovery from traumatic experiences
for children with IDD is possible, to at least 3 children with IDD and their families.
Recognize that children with IDD may have traumatic
experiences, which can have profound effects.
Es
☐ Over the next 3 months, I will identify 3 ways in which traumatic experiences are
impacting the quality of life for at least three children with IDD. I will review these
areas each time I meet with these children.
☐ Over the next 3 months, I will identify concerns and hopes, of parents of 3
children with IDD who have experienced trauma. I will review these areas each time I
meet with them.
☐ (Write my own.) Over the next 3 months, I will…

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CASE VIGNETTE: IVANA
Ivana is an 18-month old baby girl adopted from

Russia. She passed her initial medical screen
according to the adoption agency. Her biological
mother placed her in an orphanage at birth. Upon
coming to live with her adoptive family in rural West
Virginia 3 months ago, it was clear that she was not
a typically developing child.
Now her adoptive mother, Gwen, is having a hard

time feeding and calming Ivana. She has fits all
night and has trouble sleeping when left alone. The
loud noises cause her to startle, and putting on shoes results in prolonged tantrum
episodes. She has poor eye contact with her parents and ignores other children. She has
been diagnosed with global developmental delay and reactive attachment disorder. The
family is receiving early intervention services and is on a waitlist for an autism spectrum
disorder evaluation.
The lack of sleep and Ivana’s low weight has Gwen feeling like there’s something going on.
Gwen contacts the adoption agency they used to adopt Ivana, asking if there’s more
information about the birth mother than what was originally given to the family. A few days
later Gwen received a call back. Laura, Gwen’s case worker, discovered that Ivana’s birth
mother used drugs and drank while pregnant with Ivana.

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CASE VIGNETTE: SUZIE
Suzie is four years old and lives in San Francisco,

California. During recess, Suzie always plays with dolls
and re-enacts fight scenes over and over again. This
caught her teacher’s attention. Her teacher decided to
chat with the school psychologist about Suzie. She has
trouble making eye contact and likes to play alone. Suzie
was recently diagnosed with autism after a long process
of evaluations but still has not received behavioral
services. Her parents are constantly arguing with the
school district and are feeling unsupported in their
difficulties in managing her. She cries often and only
eats a few foods. She insists on lining up objects and
gets upset if someone interferes with her spinning in a circle.
The school psychologist was unable to complete a verbal IQ assessment but found she was
low in most of her developmental and adaptive skills. When the psychologist inquired about
the reenactment of fights in Suzie’s play, the mother disclosed that she and the dad
sometimes raise their voices and throw objects when discussing family finances.

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CASE VIGNETTE: JOSHUA
Joshua is a six year old boy who attends the Collegiate School
off West 78th in New York City. Joshua was born and raised on
the Upper West Side of Manhattan. He is also currently
attending Hebrew school a few blocks from Collegiate.
Last week, Joshua’s parents were notified by the principal at

Collegiate that he would have to repeat the 1st grade. His
parents were shocked and unsure of how to proceed. The
principal suggested some routine testing that the school has
available. About a week later the family received Joshua’s IQ
score: 75. Along with the IQ score Joshua’s parents met with his
1st grade teacher. Her progress report is as follows:
§ Joshua is a sweet kid.

§ He is behind in his reading level, even though he enjoys reading time.
§ He tends to space out during class, often staring out the window.
§ Following directions is challenging for Joshua.
§ He doesn’t seem to know how to make friends, and seems ”overly affectionate” with older
kids that help out with the class.
On the suggestion of the teacher, Joshua’s parents make him an appointment with the
school psychologist. After several weeks of work Joshua discloses that his babysitter
touches him in places that make him uncomfortable. Joshua also revealed that it started
right before his birthday party at the beach. The psychologist checked in with his parents
about that birthday—it was when he turned four. The psychologist felt his poor social skills
were characteristic of Autism Spectrum Disorder and a risk factor for this traumatic
exposure.
Joshua’s parents immediately fired the young neighbor they had watching him, and reported
the abuse to the police. Joshua was very confused and sad about everything that was
happening, and started hitting his head saying that he was a bad boy.

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CASE VIGNETTE: STEVEN
Steven is a 10 year old who was born premature and suffered a

large head bleed at birth. He had multiple medical problems
early in his life that overwhelmed his parents. His father was re-
deployed to Iraq, for his second tour, prior to his first birthday.
His mother became depressed and so stressed with his care
that she allowed him to live in a group medical foster home at
three years of age. Over time his medical needs receded in
intensity but his behavioral problems worsened. He was
identified as having intellectual disability and provided school-
based and group home-based services at five years of age.
Now his communication skills are at a two year-old level

consisting of a few two-word phrases of limited content. Staff
have a difficult time understanding his needs because he acts
aggressively towards them, and himself, at baseline. He has
been placed on an antipsychotic medication to manage his mood swings and aggression.
But he still exhibits challenging behaviors, especially around one of the male staff members.
The child welfare caseworker wonders if he has been exposed to domestic violence and
abuse early on in his life or if there is ongoing trauma in the group home.

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CASE VIGNETTE: JACQUELINE
Jacqueline is a 16 year old sophomore who resides in

Laredo, Texas. Jacqueline has always had a hard time
concentrating in class. Her grades are consistently low.
She began receiving reading and math help through an
Individualized Education Plan (IEP) in 3rd grade after she
was unsuccessfully retained for a learning disability. But
she has been resisting going to classes starting in 8th
grade and lies about her absences and homework
completion. The school kicked her off the basketball
team due to her poor academic performance in an effort
to motivate her. Jacqueline reports that she doesn’t
sleep well, feels tired and worthless, and has trouble
concentrating. She yells at her grandmother daily. She often has re-occurring nightmares
about loud crashing and bright lights. Often she wakes frightened, with her heart racing.
The summer before Jacqueline’s 7th grade year she was riding with her mother and brother
home from church. Out of nowhere a car ran a stoplight and smashed into the car
Jacqueline’s family was in. Unfortunately, the accident killed her mother and brother, and
Jacqueline was rushed to the hospital where she was induced into a coma in order to reduce
the swelling on her brain.
Jacqueline stayed under for almost two months, while doctor’s continued to run tests and
administer medications. For a while it was uncertain if she would come out of the coma.
Finally she did, but the road ahead was a long one, full of physical therapy. Jacqueline was
released from the hospital into her grandmother’s care after four months with a follow up
plan for her traumatic brain injury.
For a long time, Jacqueline was on prescription medication to help with the pain. It wasn’t
until the dose of meds was lowered that her sleep problems became apparent. Jacqueline
has been unable to sleep through the night since.
Something that is weighing on Jacqueline’s grandmother’s mind is the fact that Jacqueline
has not been hanging out with her friends as much as she used too. Now that the girls are
16, many of them are beginning to drive. She thinks Jacqueline should be going to the mall
instead of “hanging out at home with grandma.” The last time Jacqueline’s friends came
over they drove away and within three minutes Jacqueline walked back through the door
and straight to her room. She seemed agitated. Jacqueline recently failed the driver’s written
test.

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CASE VIGNETTE: JUSTIN
Justin is a 19 year old who grew up in McNichols, a low-

income area of Detroit. Justin was diagnosed with Cerebral
Palsy at birth. He can walk with the assistance of crutches.
He was identified with global developmental delay early in
infancy but was finally diagnosed with intellectual disability
at age five when he entered kindergarten.
A few weeks after being born, Justin’s mother left him at the
nearest Safe Haven site. Justin has been in foster care ever
since. Unfortunately, he bounced around from foster home
to foster home, until finally being placed with a loving couple
near where he was born. Justin is bonded with his parents
and calls them mom and dad. Even though Justin is an adult, they decided to gain
conservatorship and keep him living with them. They wouldn’t part with him for anything.
They are the ones who got Justin involved in the local disability employment center, where
he is very active in helping. He spends most of his time there. Recently, the Center even
hired Justin to help with administrative duties. He was excited.
After Justin has been working at the center for three months, the staff have noticed that he
becomes agitated in the evenings, especially after dark. He even ran out of the Center one
evening. His parents noticed some resistance to getting on the bus to go to the Center in the
morning. Most just chalk it up to Justin being Justin. His parents were concerned about the
change in his behavior and began asking what was happening at the Center. After some
investigation, Justin’s parents learned that an aide who worked evenings at the center has
been isolating him and verbally abusing him due to his messy work. His parents now believe
that his behavior change was his only way to communicate his fear of this staff aide. Justin’s
parents are now concerned with letting him attend out-of-home programs.

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PUTTING IT INTO PRACTICE
CASE VIGNETTES: TRAUMA, IDD & DEVELOPMENT
Read the case vignette your group has been assigned and identify the ways in which trauma
and IDD are/may disrupt development.
§ Identify any behaviors and responses related to IDD.
§ Identify any behaviors and responses related to traumatic experiences.
§ What are other ways that IDD and traumatic experiences may disrupt typical development for
the age range (e.g., young children, school-aged children, adolescents, young adults) of the
case you’ve been assigned ?

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ACTION PLANNING
Recognize a child’s developmental level and how IDD and
traumatic experiences are affecting his/her functioning.
Es
☐ Over the next 3 months, I will identify ways in which trauma and IDD have
disrupted development for at least 3 children with IDD. I will
review these areas each time I meet with these children.
☐ Over the next 3 months, I will identify at least one alternative way of
communicating/teaching a therapeutic skill (e.g. deep breathing, muscle
relaxation) to use in place of, or in addition to, verbal communication for at least 3
children with IDD. I will practice the chosen skill with children each time we meet.
☐ Over the next 3 months, I will review my bibliotherapy resources to determine if I
have enough books to share with children at different developmental levels about at
least 3 different types of trauma.
Utilize a developmental lens when making meaning of a child’s
traumatic experiences and responses.
Es
☐ Over the next 3 months, I will identify how living with IDD is affecting the quality of
a child’s life in specific areas (e.g., self-care, communication, etc.) for at least 3
children with IDD who have had traumatic experiences. For each of these children, I
will develop a plan, with the child and family that addresses these specific areas. I
will review this plan each time I meet with them during this 3-month period.
☐ Over the next 3 months, I will learn a new method of assessing a child’s
intellectual abilities that may be better-suited to working with a child with IDD
who has had a traumatic experience (e.g., learn an IQ test that is normed on a more
diverse population, non-verbal methods, etc.).

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CASE VIGNETTES: RESPONSES TO TRAUMATIC EXPERIENCES
Read the case vignette your group has been assigned and identify details related to trauma
and IDD. Keep in mind that not every case will touch on all of the Core Concepts we’ve just
discussed. Refer to the 12 Core Concepts handout to remind you of the main point for each
Core Concept.
§ Identify the traumatic experience(s) and any trauma/loss reminders.
§ Identify the Core Concepts that are applicable to the case.
§ Think about the child or adult with IDD that you identified in our first exercise on the Making
the Connection handout—how do traumatic experiences impact this child/adult? How would
you apply the Core Concepts to this child/adult?

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12 CORE CONCEPTS FOR UNDERSTANDING
CHILD TRAUMATIC STRESS RESPONSES IN CHILDHOOD
Core Concept 1: Complexity

“There’s a lot going on in the child’s mind and body.”
Core Concept 2: Life Experience
“What the child brings to the experience from within
and from the outside world effects the child’s response.”
Core Concept 3: Reminders & Adversities
“What’s the world like that the child is living in afterwards?”
Core Concept 4: W ide-Ranging Reactions
“A child’s reaction to traumatic events varies greatly.”
Core Concept 5:Danger & Safety
“A child’s ability to believe in and trust in a protective shield
has been broken and must be restored.”
Core Concept 6: Caregiving Systems
“Everyone is shaken up by what happened.”
Core Concept 7: Protective Factors
“Promoting and restoring”
Core Concept 8: Development
“Don’t just think symptoms—think development.”
Core Concept 9: Neurobiology
“How do you know what’s dangerous?”
Core Concept 10: Culture
“Culture is layered in its meaning and layered in its effects.”
Core Concept 11: Social Contract
“Protection has failed in some way.”
Core Concept 12: Provider Distress

“We are stewards not just of those who allow us into
their lives, but of our own capacity to be helpful.”

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ACTION PLANNING
ESSENTIAL MESSAGE 5
ESSENTIAL MESSAGE 5
5 Recognize that in the aftermath of trauma, understanding

traumatic stress responses is th e first step in helping a child
regain th eir sense of safety, value and quality of lif e.
☐ Over the next 3 months, I will identify the moment-to-moment reactions children
have during traumatic experiences with 3 children with IDD.
☐ Over the next 3 months, I will explore child-extrinsic factors (e.g., physical
environment, community & cultural responses to trauma & IDD) for 3 children with
IDD who have experienced trauma.
☐ Over the next 3 months, I will identify 2 trauma reminders for 3 children with IDD
who had experienced trauma. I will check in with these children about their
responses to these reminders each time I meet with them.
☐ Over the next 3 months, I will identify the impact of the traumatic experience on the
caregiving system for 3 children with IDD who have experienced trauma.
☐ Over the next 3 months, I will identify at least 3 protective factors that will help
children to recover more quickly from the harmful effects of trauma or loss for 3
children with IDD who had had traumatic experiences. I will check in about these
protective factors each time I meet with these children.
☐ Over the next 3 months, I will ask 3 parents/caregivers about their feelings about
their child’s traumatic experience to assess whether they need a referral to address
secondary traumatic stress.

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POST-TRAINING EVALUATION: DAY 1
Please take a moment to complete the following evaluation survey. The survey is
anonymous and voluntary. Your time and feedback is very much appreciated and will be
used to help improve the quality of this training.
What best describes the organization(s) you represent at this training? Check all that apply:
¨ University Center for Excellence in ¨ Federal Government Agency
Developmental Disabilities ¨ State Government Agency
¨ Public Mental Health Agency ¨ Private Practice
¨ Trauma Clinic ¨ Other:
¨ Other Behavioral Health
¨ Regional Center
Job Title:_____________________________________________________________________
What is/are your professional role(s)? Check all that apply:

¨ Mental Health Clinician / Counselor ¨ Researcher
¨ Physical or Occupational Therapist ¨ Administrator
¨ Speech and Language Pathologist ¨ Trainer / Consultant
¨ Residential/Group Home Staff ¨ Training Director
¨ Paraprofessional ¨ Other:
¨ Educator
What is/are your professional degree and/or credential(s)? Check all that apply:
¨ High School or GED ¨ MD
¨ AA ¨ PhD / PsyD
¨ BA ¨ OTRL
¨ MA ¨ SLP
¨ LMFT ¨ Other:
¨ MSW / LCSW
What is your relationship to the National Child Traumatic Stress Network?

¨ Currently funded NCTSN grantee site
¨ Organizational Affiliate
¨ Individual Affiliate
¨ I have no relationship with the NCTSN

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25
Please indicate the rating that best describes your level of agreement with
the following statements by marking the appropriate number, using a scale of
0 (No), 1 (Maybe), 2 (Yes).
ASSESS EACH INDIVIDUAL LEARNING OBJECTIVE NO M AYBE YES
1. I recognize that children with IDD are at-risk for traumatic
0 1 2
experiences.
2. I can describe how recovery from traumatic experiences is
0 1 2
possible.
3. I recognize the important role of parents/caregivers and
0 1 2
families on the road to recovery.
4. I can cite several frameworks used to illustrate key concepts
0 1 2
related to IDD and trauma.
5. I am able to define IDD and various types of disabilities. 0 1 2
6. I can identify developmental tasks across typical child
0 1 2
development.
7. I can describe how IDD may disrupt typical development. 0 1 2
8. I can describe how traumatic experiences may disrupt typical
0 1 2
development.
9. I can identify areas in which children's functioning is affected
0 1 2
by IDD and the adaptations that must be made.
10. I can define traumatic stress. 0 1 2
11. I can define PTSD. 0 1 2
12. I can cite the 12 Core Concepts for Understanding Traumatic

0 1 2
Stress Responses in Children and Families.
13. I recognize how traumatic experiences and their responses

0 1 2
affect children with IDD.
Overall, I would rate Day 1 of this training as:
Excellent Good Average Poor
What did you like most about today?
_____________________________________________________________________
_____________________________________________________________________
What did you like least about today?

_____________________________________________________________________
_____________________________________________________________________

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LOCAL RESOURCES
Begin this exercise by identifying 5 local organizations that you frequently refer children and families
to, or find helpful. Once you’ve created your own list, walk around the room and ask others to share
their list—find at least 5 new organizations to add to your list.
1. _____________________________________________________________________
2. _____________________________________________________________________
3. _____________________________________________________________________
4. _____________________________________________________________________
5. _____________________________________________________________________
6. _____________________________________________________________________
7. _____________________________________________________________________
8. _____________________________________________________________________
9. _____________________________________________________________________
10. _____________________________________________________________________

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BOARD GAME INSTRUCTIONS
§ In this game we will be exploring ways to support and strengthen child and family well-
being and resilience. The objective is to move your marker from start to finish. Along the
way you are going to encounter things that will help strengthen child and family
resilience—or protective factors—as well as situations or circumstances that could hinder
or lessen child and family well-being—or risk factors.
§ The person who traveled the farthest for the training will go first. Roll the dice and
move your marker the number of spaces shown on the die.
§ You may land on one of three spaces:

o A blue space where you have to pick up a risk factor card—the cards with the rain
on them.
o A red space where you have to pick up a protective factor card—the cards with the
bricks on them.
o A yellow space where you do
nothing and wait for your next turn.
§ If you land on a space where you have

to draw a card, please do so and follow
the directions outlined on the back. If
the card has a question on it, read it
out loud and see what the group offers
as answers.
§ If you are asked to move forward or

backward on a card, you do so, but do
not then draw another card.
§ You are going to be moving forward

and backward, as well as engaging in
dialogue with your table as you move
through the game.
§ The first person to reach the end, wins!

Adapted from: The Life Course Game that was created and developed by CityMatCH.
www.citymatch.org:8080/lifecoursetoolbox/gameboard.php

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ACTION PLANNING
you to this work. What can help that child and other children with IDD who
have experienced trauma? What can help? (Put an “X” in up to 3 boxes next
to the ideas you think you would MOST like to emphasize in your daily
practice.)
Utilize an IDD- & trauma-informed child-centered appro ach to
support both the child and the family.
☐ Over the next 3 months, I will identify at least 3 activities that children with IDD who
have had traumatic experiences find meaningful. I will check in with them about
these activities each time we meet.
☐ Over the next 3 months, I will identify at least 3 life goals (in their own words), that
children with IDD who have had traumatic experiences have for themselves. I will
check in about these life goals each time we meet.
☐ Over the next 3 months, I will identify at least 3 children with IDD who have siblings.
I will work with the parents/families to identify needs of the siblings.
Help parents/caregivers, and other professionals in the child’s
life, strength en protective factors.
☐ Over the next 3 months, I will identify 3 protective factors to strengthen for 3
children with IDD, who had had traumatic experiences. For each of these families, I
will review these protective factors each time we meet during this 3-month period
and develop strategies for enhancing them.
☐ Over the next 3 months, I will identify 3 children with IDD, with whom I can work to
increase happiness through activities that provide engagement and meaning. I
will ask these children about the activities each time we meet.
☐ Over the next 3 months, I will identify 3 families of children with IDD to work with on
building a recovery team. I will identify ways (in person, by phone, or by email) that
I can help facilitate the participation of other providers on the recovery team.

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PUTTING INTO PRACTICE: FISH BOWL
§ In this activity, we will be using a role play to consider the perspective of families and
providers when accessing services.
§ Let’s put this into practice. Split up into groups of 4. Once you have your groups, please
take your chairs and put them in a cross formation so a pair of them is facing one
another and the other pair is facing on another. It will look like a +.
§ At your tables, assign a pair of chairs facing each other to be a provider and a family
member, and the other pair to be two observers.
§ Now take a seat and either choose a case vignette from your Participant Manual or
think of a child/parent on your caseload to role play.
§ Once the activity starts the provider will begin asking the family member questions to
start the process of getting this family closer to a IDD- & trauma-informed recovery plan.
Think of everything we’ve already talked about.
o Do you want to get information on the IDD diagnosis, or maybe the traumatic
experience?
o Do you bring up screening and assessment?
o Identify risk or protective factors?
§ While the role play is occurring the two observers will watch and listen. At any point
during the role play, the observers have the opportunity to pause the role play and give
the provider helpful, supportive, or constructive feedback. When the feedback is done
the role play can continue.
§ When I say stop, everyone will freeze, each group will stand and rotate clockwise,
changing the roles of each group member. When I say continue, the group will carry on
where the last one left off. Observers will then be able to pause the game as seen fit.
§ This will go on until everyone has a chance to be the provider, family member, and the
observer.
§ Once everyone has gone through all 3 roles, we will have a large group report out to talk
about how that felt, what worked well, what you would chance next time you are
confronted with the same situation, etc.

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CASE VIGNETTES: ACCESSING SERVICES
Read the case vignette your group has been assigned and answer the following
questions. You may want to refer to the Protective Factors handout to give you some
ideas.
§ Are there protective factors that you want to keep in mind when identifying
screening/assessment and/or treatment for this child and family? Are there
protective factors that can be built upon in treatment? If you are unaware of any
protective factors how would you cultivate some with this family?
§ What challenges/barriers/risk factors do you anticipate coming up for this child and
family? Do you think the challenges/risk factors will impact their ability to access
services?
§ What are three things you could do to advocate for this family to help them overcome
these challenges?

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PROTECTIVE FACTORS
Protective Factors Checklist

! Ask & answer parents/caregivers’ questions
! Provide timely information
! Address traumatic experiences of parents/caregivers

! Promote secure attachment
! Promote a healing & protective environment
! Help families access IDD- & trauma-informed support and services

! Partner with parents to create a recovery team
! Help families navigate systems of care, including systems challenges

! Build positive school experiences
! Offer community resources
! Connect families with supportive peers and mentors

! Refer for formal support if needed
! Encourage connection with any spiritual communities

! Connect families with cultural community
! Build & encourage family cohesion
! Promote supportive parent-child interaction
! Build social skills
! Address cognitive functioning
! Promote self-efficacy skills

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ACTION PLANNING: ESSENTIAL MESSAGES 8 & 9
Partner with agencies and systems to ensure earlier and more
sustained access to services.
☐ Over the next 3 months, I will identify 3 local agencies that provide advocacy for
children with IDD. I will attempt to make contact with at least 1 person in each
agency.
☐ Over the next 3 months, I will identify 3 local organizations that provide intensive
case management or care coordination services for children with IDD. I will
attempt to make contact with at least 1 person in each organization.
☐ Over the next 3 months, I will identify 3 local clinics/providers that provide trauma-
informed assessments for children. I will attempt to make contact with at least 1
person in each clinic.
☐ Over the next 3 months, I will identify 3 local clinics/providers that provide trauma-
informed treatment for children. I will attempt to make contact with at least 1
person in each clinic.

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ACTION PLANNING: ESSENTIAL MESSAGES 8 & 9
practice.)
9
ESSENTIAL MESSAGE 9
Ensure that trauma-informed child-centered services, treatments,
and systems drive the recovery plan.
☐ Over the next 3 months, I will review the standardization, reliability, and validity
information for 1 of the trauma screening or assessment tools I use to
determine the appropriateness of use for children with IDD.
☐ Over the next 3 months, I will identify a trauma screening tool and use it with 3
children with IDD who have experienced trauma.
☐ Over the next 3 months, I will identify a tool to assess parent/caregiver trauma
and use it with 3 parents of children with IDD who have experienced trauma.
☐ Over the next 3 months, I will identify 3 adaptations I can make to my treatment of
choice for 3 children with IDD who have experienced trauma.

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STRESS WARNING SIGNS
Fill in the blanks below using the text in parentheses as your guide to learn more
about your own stress warning signs.
I know that my stress level is beginning to affect my relationships when I
________________________________, _______________________________, and

(Identify a behavior or action verb) (Identify a behavior or action verb)
__________________________________.
(Identify a behavior or action verb)
Other people in my life can tell that I am stressed out when I look
_________________________________ or ________________________________.
(Name an adjective that describes how you appear) (Name an adjective that describes how you appear)
Or when I sound like ___________________________________.

(Name an unpleasant sound or noun)
When I am feeling overwhelmed, staying connected is _______________________________.

(Write an adjective that says how you feel)
The relationships in my life often _____________________ when my stress level is elevated.

(Identify a verb)
Adapted from: Volk, K.T., Guarino, K., Edson Grandin, M., and Clervil, R. (2008). What about you? A workbook for those who
work with others. Needham: MA. The National Center for Family Homelessness.

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SELF-CARE OPTIONS
Below are some tips for using the time that you do have for self-care effectively. Carve out time each day to
engage in self-care, even if you only have 2 minutes.
If you have…
10 minutes
2 minutes
§ Evaluate your day
§ Breathe
§ Write in a journal
§ Stretch
§ Call a friend
§ Daydream
§ Meditate
§ Take your stress temperature
§ Tidy your work area
§ Laugh
§ Assess your self-care
§ Doodle
§ Draw a picture
§ Acknowledge one of your
§ Dance
accomplishments
§ Listen to soothing sounds
§ Say no to a new responsibility
§ Surf the web
§ Complement yourself
§ Read a magazine
§ Look out the window
§ Spend time with your pet
§ Share a favorite joke
30 minutes
5 minutes
§ Get a massage
§ Listen to music
§ Exercise
§ Have a cleansing cry
§ Eat lunch with a co-worker
§ Chat with a co-worker
§ Take a bubble bath
§ Sing out loud
§ Read non-work related literature
§ Jot down dreams
§ Spend time in nature
§ Step outside for fresh air
§ Go shopping
§ Enjoy a snack or make a cup of
coffee/tea § Practice yoga
§ Watch your favorite television show
Source: Transforming the Pain: A Workbook on

Vicarious Traumatization. Saakvitne, Pearlman &
Staff of TSI/CAAP (Norton, 1996)

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BALANCING YOUR SELF-CARE
This assessment tool provides an overview of effective strategies to maintain self-care. Look through the list and see
if there are one or two items you can start doing tomorrow.
Physical Self-Care
___ Eat regularly (e.g. breakfast, lunch and dinner) Spiritual Self-Care
___ Eat healthy ___ Make time for reflection
___ Exercise ___ Spend time with nature
___ Get regular medical care for prevention ___ Find a spiritual connection or community
___ Get medical care when needed ___ Be open to inspiration
___ Take time off when needed ___ Cherish your optimism and hope
___ Get massages ___ Be aware of nonmaterial aspects of life
___ Dance, swim, walk, run, play sports, sing, or do ___ Try at times not to be in charge or the expert
some other physical activity that is fun ___ Be open to not knowing
___ Take time to be sexual -- with yourself, with a ___ Identify what is meaningful to you and notice its
partner place in your life
___ Get enough sleep ___ Meditate
___ Wear clothes you like ___ Pray
___ Take vacations, day trips, or mini-vacations ___ Sing
___ Make time away from telephones ___ Spend time with children
___ Other: ___ Have experiences of awe
___ Contribute to causes in which you believe
Psychological Self-Care ___ Read inspirational literature (talks, music, etc.)
___ Make time for self-reflection ___ Other:
___ Have your own personal psychotherapy
___ Write in a journal Workplace or Professional Self-Care
___ Read literature that is unrelated to work ___ Take a break during the workday (e.g. lunch)
___ Do something at which you are not expert or in ___ Take time to chat with co-workers
charge ___ Make quiet time to complete tasks
___ Decrease stress in your life ___ Identify projects or tasks that are exciting and
___ Let others know different aspects of you rewarding
___ Notice your inner experience --listen to your ___ Set limits with your clients and colleagues
thoughts, judgments, beliefs, and feelings ___ Balance your case load so that no one day or part
___ Practice receiving from others of a day is “too much”
___ Be curious ___ Arrange your work space so it is comfortable and
___ Say “no” to extra responsibilities sometimes comforting
___ Other: ___ Get regular supervision or consultation
___ Negotiate for your needs (benefits, pay raise)
Emotional Self-Care ___ Have a peer support group
___ Spend time with others whose company you enjoy ___ Develop a non-trauma area of professional
___ Stay in contact with important people in your life interest
___ Give yourself affirmations, praise yourself ___ Other:
___ Re-read favorite books, watch favorite movies
___ Identify comforting activities, objects, people, Balance
relationships, places and seek them out ___ Strive for balance within your work-life and
___ Allow yourself to cry workday
___ Find things that make you laugh ___ Strive for balance among work, family,
___ Express your outrage in social action, letters and relationships, play and rest
donations, marches, protests
___ Other:
Source: Transforming the Pain: A Workbook on Vicarious Traumatization. Saakvitne, Pearlman & Staff of TSI/CAAP (Norton, 1996)

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ACTION PLANNING: ESSENTIAL MESSAGE 10
practice.)
Practice ongoing self-care in order to increase effectiveness in
delivering high quality support, services and treatment.
00
☐ Over the next 3 months, I will designate a time to consider whether I am noticing the
warning signs of stress in my relationships. I will utilize a self-care strategy when
I notice that I am experiencing stress.
☐ Over the next 3 months, I will choose 3 tips for engaging in self-care from the
Self-Care Options handout and practice 1 on a daily basis.
☐ Over the next 3 months, I will choose 3 strategies for maintaining self-care that I
identified on the Balancing Your Self-Care handout and practice 1 on a weekly basis.

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PERSONAL TRAUMA-INFORMED PRACTICE ACTION PLAN
Participant Name: ____________________________ Date: __________________

Email: ______________________________________ Phone: _________________
Go back to the strategies you identified under the Essential Messages at the end of each module. Then, select
three strategies that you want to commit to implementing as part of your Action Plan. Write each of these
strategies in the boxes provided below, and in the corresponding box in the right hand column, write in the
Essential Message number associated with each strategy.
Essential M essages:
1. Know that there’s hope; recovery from traumatic experiences is possible.
2. Recognize that a child with IDD may have had a traumatic experience(s), which can have profound effects.
3. Recognize a child’s developmental level and how IDD and traumatic experiences are affecting his/her
functioning.
4. Utilize a developmental lens when making meaning of a child’s traumatic experiences & responses.
5. Recognize that in the aftermath of trauma, understanding traumatic stress responses is the first step in
helping a child regain their sense of safety, value and quality of life.
6. Utilize an IDD- & trauma-informed child-centered approach to support both the child and the family.
7. Help parents/caregivers, and other professionals in the child’s life, strengthen protective factors.
8. Partner with agencies and systems to ensure earlier and more sustained access to services.
9. Ensure that trauma-informed child-centered services, treatments, and systems drive the recovery plan.
10. Practice ongoing self-care in order to increase effectiveness in delivering high quality support, services and
treatment.
Essential
Strategy (refer to strategies listed under the Essential Messages)
Message
Example strategy:
Over the next 3 months, I will choose 3 tips for engaging in 10
self-care from the Self-Care Options handout and practice 1 on
a daily basis.
First strategy:
Second strategy:
Third strategy:

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PERSONAL TRAUMA-INFORMED PRACTICE ACTION PLAN
Participant Name: ____________________________ Date: __________________

Email: ______________________________________ Phone: _________________
Go back to the strategies you identified under the Essential Messages at the end of each module. Then, select
three strategies that you want to commit to implementing as part of your Action Plan. Write each of these
strategies in the boxes provided below, and in the corresponding box in the right hand column, write in the
Essential Message number associated with each strategy.
Essential M essages:
1. Know that there’s hope; recovery from traumatic experiences is possible.
2. Recognize that a child with IDD may have had a traumatic experience(s), which can have profound effects.
3. Recognize a child’s developmental level and how IDD and traumatic experiences are affecting his/her
functioning.
4. Utilize a developmental lens when making meaning of a child’s traumatic experiences & responses.
5. Recognize that in the aftermath of trauma, understanding traumatic stress responses is the first step in
helping a child regain their sense of safety, value and quality of life.
6. Utilize an IDD- & trauma-informed child-centered approach to support both the child and the family.
7. Help parents/caregivers, and other professionals in the child’s life, strengthen protective factors.
8. Partner with agencies and systems to ensure earlier and more sustained access to services.
9. Ensure that trauma-informed child-centered services, treatments, and systems drive the recovery plan.
10. Practice ongoing self-care in order to increase effectiveness in delivering high quality support, services and
treatment.
Essential
Strategy (refer to strategies listed under the Essential Messages)
Message
Example strategy:
Over the next 3 months, I will choose 3 tips for engaging in 10
self-care from the Self Care Options handout and practice 1 on
a daily basis.
First strategy:
Second strategy:
Third strategy:

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POST-TRAINING EVALUATION: DAY 2
Please take a moment to complete the following evaluation survey. The survey is
anonymous and voluntary. Your time and feedback is very much appreciated and will be
used to help improve the quality of this training.
What best describes the organization(s) you represent at this training? Check all that apply:
¨ University Center for Excellence in ¨ Regional Center
Developmental Disabilities ¨ Federal Government Agency
¨ Public Mental Health Agency ¨ State Government Agency
¨ Trauma Clinic ¨ Private Practice
¨ Other Behavioral Health ¨ Other:
Job Title:_____________________________________________________________________
What is/are your professional role(s)? Check all that apply:

¨ Mental Health Clinician / Counselor ¨ Researcher
¨ Physical or Occupational Therapist ¨ Administrator
¨ Speech and Language Pathologist ¨ Trainer / Consultant
¨ Residential/Group Home Staff ¨ Training Director
¨ Paraprofessional ¨ Other:
¨ Educator
What is/are your professional degree and/or credential(s)? Check all that apply:
¨ High School or GED ¨ MD
¨ AA ¨ PhD / PsyD
¨ BA ¨ OTRL
¨ MA ¨ SLP
¨ LMFT ¨ Other:
¨ MSW / LCSW
What is your relationship to the National Child Traumatic Stress Network?

¨ Currently funded NCTSN grantee site
¨ Organizational Affiliate
¨ Individual Affiliate
¨ I have no relationship with the NCTSN

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Please indicate the rating that best describes your level of agreement with
the following statements by marking the appropriate number, using a scale of
0 (No), 1 (Maybe), 2 (Yes).
ASSESS EACH INDIVIDUAL LEARNING

NO M AYBE YES
OBJECTIVE
1. I am able to work with parents to help them
understand the impact (on them) of learning 0 1 2
about their child's traumatic experiences.
2. I can identify strategies for strengthening
protective factors to enhance child and family 0 1 2
well-being, resilience, and recovery for parents.
3. I can cite frameworks for promoting a healing
and protective environment in order to create a 0 1 2
safe and meaningful life for children.
4. I can utilize family-informed child-centered
planning techniques to help children realize their 0 1 2
hopes and dreams.
5. I can enhance protective factors of children
with IDD and families through appropriate 0 1 2
trauma-informed services and treatment.
6. I can identify IDD-related support needs of
children and families by utilizing adapted 0 1 2
screening, assessment, and planning tools.
7. I can adapt the core components of trauma-
0 1 2
informed treatments for children with IDD.
8. I can develop strategies for partnering with
0 1 2
agencies and cross-system collaboration.
9. I can differentiate between secondary
0 1 2
traumatic stress, burnout, and vicarious trauma.
10. I can articulate how burnout develops among

0 1 2
providers.
11. I can identify potential sources, warning signs,

and effects of secondary traumatic stress and 0 1 2
organizational stress.
12. I can implement steps to stress reduction and

0 1 2
self-care.

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ASSESS YOUR FACILITATOR(S) LOW HIGH
Level of knowledge in the content area. 0 1 2
Facilitator(s) were effective and helpful. 0 1 2
Level of consistency between content and objectives. 0 1 2

ASSESS YOUR OVERALL SATISFACTION W ITH THE
LOW HIGH
TRAINING
CONTENT
Appropriate for intended audience. 0 1 2
I am satisfied with the level of practical knowledge and skills
0 1 2
presented at this training.
TEACHING M ETHODS
Visual aids, handouts, and oral presentations clarified content. 0 1 2
Appropriate subject matter. 0 1 2
FACILITY
Was adequate and appropriate for session. 0 1 2
LOGISTICS
I learned about the training with adequate time to plan my
0 1 2
attendance.
Registration was easy and straightforward. 0 1 2
Overall, I would rate Day 2 of this training as:

Excellent Good Average Poor
What did you like most about today?

_____________________________________________________________________
_____________________________________________________________________
What did you like least about today?

_____________________________________________________________________
_____________________________________________________________________
Additional Comments:

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REFERENCES
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Adams, R. (2014). An Unseen Population: IDD and Trauma, Vulnerabilities among Children with IDD
in Abusive or Foster Homes. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic
Stress.
Administration for Children and Families. (2014). Birth to 5: Watch me Thrive! A Compendium of
Screening Measures for Young Children. Washington, DC: US Department of Health and Human
Services.
American Academy of Pediatrics Committee on Children with Disabilities. (2001). Developmental

surveillance and screening of infants and young children. Pediatrics, 108, 192-196. Reaffirmed
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American Association on Intellectual and Developmental Disabilities. (2013). Definition of

Intellectual Disability. Retrieved from http://aaidd.org/intellectual-
disability/definition#.VgQPodJVhBc
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th
ed.). Washington, DC: Author.
American Psychological Association. (2010). Individuals with Disabilities Act (IDEA). Retrieved from
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Baladerian, N. (2014). A Risk Reduction Workbook for Parents & Providers (2nd ed). Northbook, IL:
Spectrum Institute.
Bayley, N. (2006). Bayley Scales of Infant Development Manual. 3rd Ed. San Antonio, TX: Harcourt
Assessment.
Berkowitz, S. J., Smith Stover, C., & Marans, S. R. (2011). The Child and Family Traumatic Stress
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Bloom, S. L. (1994). The Sanctuary Model: Developing generic inpatient programs for the treatment
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therapy, a practical guide to intervention, treatment, and research. Westport, CN: Greenwood
Publishing.
Bodan, R. (2014). An Unseen Population: IDD and Trauma, Medical Trauma in Children with Rare
Genetic Disorders. Los Angeles, CA and Durham, NC: National Center for Child Traumatic Stress.

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47
Briere, J. (1996). Trauma Symptom Checklist for Children: Professional Manual. Lutz, FL:
Psychological Assessment Resources Inc.
Briere, J. (2005). Trauma Symptom Checklist for Young Children: Professional Manual. Lutz, FL:
Psychological Assessment Resources Inc.
Bronfenbrenner, U. (1994). Ecological models of human development. In International Encyclopedia

of Education, Vol. 3, 2nd Ed. Oxford, UK: Elsevier.
Burrows, H. C., & Kochurka, K. A. (1995). The assessment of children with disabilities who report
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child sexual abuse: Assessment and case management (pp. 275-289). New York, NY:
Brunner/Mazel,
California Permanency for Youth Project. (2004). Telling It Like It Is: Foster Youth and Their Struggle
for Permanency. http://familyfinding.org/resourcesandpublications/digital_stories.html
Center on the Developing Child, Harvard University. (2009). Brain Hero. Retrieved September 24,
2015 from http://developingchild.harvard.edu/resources/brain-hero/
Center on the Developing Child, Harvard University. (2011). Experiences Build Brain Architecture.
Retrieved September 24, 2015 from http://developingchild.harvard.edu/resources/experiences-
build-brain-architecture/
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IDD and Trauma ID Participant Manual

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The Road to Recovery:

Supporting Children with IDD

The Road to Recovery Toolkit | November 2015

About the Hogg Foundation

The Road to Recovery Toolkit | November 2015

The Road to Recovery Toolkit | November 2015

The Road to Recovery Toolkit | November 2015

Essential Messages ……………………………………………………………………………………………………….….. 8

Learning Objectives …………………………………………………………………………………………………………… 9

Making the Connection: Why am I doing this work? …………………………………………………………….. 11

Action Planning: Essential Messages 1 & 2 ………………………………………………………………….…….. 12

Putting Into Practice: Case Vignettes—Trauma, IDD & Development ……….…………….……………… 19

Action Planning: Essential Messages 3 & 4 …………………………………………………………………….….. 20

Putting Into Practice: Case Vignettes—Responses to Traumatic Experiences ………………….…… 21

Action Planning: Essential Message 5 ……………………………………………………….……………………….. 23

Local Resources …………………………………………………………………………………………………..………….. 27

Board Game Instructions …………………………………………………………………………………………………… 28

Putting Into Practice: Fish Bowl ………………………………………………………………………………………….. 30

Protective Factors ……………………………………………………………………………………………………………… 32

Action Planning: Essential Messages 8 & 9 ……………………………………………….……………………….. 33

Self-Care Options ………………………………………………………………………………………………………………. 36

Action Planning: Essential Message 10 ………………………………………………………………………………. 38

Personal Trauma-Informed Practice Action Plan …………………………..………………………................ 39

Personal Trauma-Informed Practice Action Plan (Duplicate Copy) ……………………….………………. 41

Post-Training Evaluation: Day 2 …………………………………………………………………………………………. 43

The Road to Recovery Toolkit | November 2015

This participant manual is part of The Road to

The Road to Recovery Toolkit | November 2015

The Road to Recovery Toolkit | November 2015

Module 1: Setting the Stage

Module Two: Development, IDD & Trauma

Module Three: Traumatic Stress Responses in Children with IDD

The Road to Recovery Toolkit | November 2015

Module Four: Child & Family Well-Being & Resilience

Module Five: IDD- & Trauma-Informed Services & Treatment

Module Six: Provider Self-Care

The Road to Recovery Toolkit | November 2015

• What is it about this person that connects you to this work?

• What would you like to know?

The Road to Recovery Toolkit | November 2015

☐ (Write my own.) Over the next 3 months, I will…

The Road to Recovery Toolkit | November 2015

Ivana is an 18-month old baby girl adopted from

Now her adoptive mother, Gwen, is having a hard

The Road to Recovery Toolkit | November 2015

Suzie is four years old and lives in San Francisco,

The Road to Recovery Toolkit | November 2015

Last week, Joshua’s parents were notified by the principal at

§ Joshua is a sweet kid.

The Road to Recovery Toolkit | November 2015

Steven is a 10 year old who was born premature and suffered a

Now his communication skills are at a two year-old level

The Road to Recovery Toolkit | November 2015

Jacqueline is a 16 year old sophomore who resides in

The Road to Recovery Toolkit | November 2015

Justin is a 19 year old who grew up in McNichols, a low-

The Road to Recovery Toolkit | November 2015

§ Identify any behaviors and responses related to IDD.

§ Identify any behaviors and responses related to traumatic experiences.

The Road to Recovery Toolkit | November 2015

The Road to Recovery Toolkit | November 2015

§ Identify the traumatic experience(s) and any trauma/loss reminders.

§ Identify the Core Concepts that are applicable to the case.

__, _, and

Participant Name: __________ Date:

Participant Name: __________ Date: