When a traumatized child returns to school, it takes a village to create a successful transition—and parents and caregivers are the biggest champions of this effort.
If you are a caregiver whose child is returning to school after trauma, here are helpful hints to ease the transition. It's important first to understand how traumatized children learn and what new battles they may be experiencing as a result of their trauma.
Learning is constant! In a typically developing brain, play and experimentation help a child build on existing skills in order to develop new context, perspective, and learning. But when a child has experienced trauma, their brain can get "stuck" in survival mode. There is no room for play and no confidence to explore.
This protective reflex overrides all other parts of the brain, inhibiting access to parts responsible for processing, logic, organizing, and storing. To reach the "learning" section, we first need the brain to understand that it is not under attack, and then we must reframe the mind into a calm state. With their limited expression and coping skills, children can find it difficult to return to a calm mindset alone.
In addition to typical developmental challenges that children go through, like acceptance among peers and mastery of new skills, children who have experienced trauma may exhibit these common characteristics:
Regression in academic skill or quality
Inability to pay attention
Forgetfulness
Withdrawal from friends
Inability to process/express information
Lack of motivation/inability to see a future
Overreaction to/misunderstanding comments
Difficulty transitioning/with unexpected changes in routine
Extreme fatigue/insomnia
Inability to form appropriate/trusting relationships
Aggression/bullying
Physical symptoms such as headache, incontinence, dizziness, gastrointestinal issues, and anxiety
To help bring the child back to a more realistic worldview, it takes the combined patience and consistent effort of many parties to restore feelings of safety, control, and trust.
Help your child learn to identify and express their emotions and practice several self-regulation and coping techniques. Practicing these skills during calm moments makes it easier to use them later. In these moments, your job is not to "fix," but being there to listen helps validate their experience and process their emotions.
Make sure your child knows the school's bullying policy and how to activate it. Self-advocacy and knowledge can help restore feelings of control and confidence.
Practice "Rehearse Your Response." Someone will inevitably ask what happened, and some may not ask so nicely. To reduce anxiety surrounding sharing their story, help your child develop a Rehearsed Response that they practice beforehand.
Maintain "house rules," boundaries, and limit setting to the same extent as before the trauma. Children dealing with trauma don't need the rules bent for them; they need structure, consistency, and limit setting to create feelings of safety
Elementary school children might find "Sara's STEPS" helpful. The book was created to help young burn survivors, their siblings, and children of burn survivors build confidence and gain tools to address staring, teasing, and questions.
Set up additional supports. When survivors feel alone and misunderstood, it can lead to withdrawal from family and friends, anxiety, and depression. Setting your child up with peers and/or counseling can help. This can be through 1:1 counseling sessions, support groups (virtual or in person), camps for kids with similar experiences, and trained peer supporters like the Phoenix SOAR program.
It's important to understand that children are naturally curious, and your child's peers will likely have many questions upon their return. This can be overwhelming and uncomfortable, but being prepared can really help.
Before your child's return to school, collaborate with their teacher and principal to provide context and create a plan. This might range from a phased re-entry (starting with half days) to scheduled breaks to a buddy system to in-school counseling. You might share:
A short summary of what happened and any special accommodations that are needed.
Triggers or signs of distress that can help their teacher intervene before an escalation.
Coping skills your child has developed so that the teacher can provide cues during an escalation.
Plan a school re-entry. A school re-entry should:
Be the choice of the child—children should feel in control of this process. Explain the process and its purpose as a way to reduce unwelcome questions and staring, talk about their concerns, and allow them to make the final choice.
Be general—provide classmates with the information they may be curious about (grafts, pressure garments, prosthetics, etc.) while not telling the child's story. That story is the child's alone to share.
Include the child if they want—they may want to lead the presentation, share a piece of their story, or not be present at all.
Help identify several teachers and/or peers at school who can provide support if they are feeling unsafe or overwhelmed.
Develop an emergency plan. This could be a visit to a quiet corner, going to the school counselor, or in extreme cases, going home. Having an "escape plan" can reduce anxiety just by being in place!
Above all, we recommend that children return to school as soon as possible with the right measures in place. While it's normal for children to feel anxious, keeping them home can increase feelings of isolation and academic failure. Further, they are unable to practice their reintegration tools. Building confidence is a process of practice, reflection, and repetition—you are their main support.
While the trauma may not have impacted them in the same way, siblings and children of survivors have also been launched into a long and stressful journey that could contribute to challenges at school. Their stressors relate to loss of routine, "survivor" guilt, fear of death of their loved one, separation from caregivers, fear for their own safety, and constant questions from everyone about their loved one. Consider preparing them with some of the strategies above as well.
While we can't get rid of the trauma, we can teach children how to feel safe and in control, arming them with coping skills and support systems to maintain a positive environment. Your child's needs will change over time, and you will need to adjust your approach, but the most important thing is that you are present and patient.
Survivors and loved ones often report feeling awkward, angry, or embarrassed when strangers ask questions about their burn injury. By memorizing and rehearsing a 3-sentence response, you can approach social situations and respond calmly to questions with courtesy, kindness, and warmth.
First sentence: How you were burned or when you were burned?
Example: “I was burned in a house fire.” OR “I was burned a few months ago.”
Second sentence: How you are doing now?
Example: “I’m still having surgeries.” OR “I’m doing better now.”
Third sentence: Ending the conversation.
Example: “Thanks for your concern.” OR “Thanks for asking.”
Helpful Tip: Memorize another option for when you don’t feel up to questions. Example: “That’s all I care to discuss today. I’m sure you understand.”
Christen Bradbury is Recreation Therapist and Certified Child Life Specialist who has been involved with the burn community since 2010, when she started her career at Shriners Hospitals for Children - Boston. While there, she started Team Brave, a program that partners with the Boston Firefighters Burn Foundation to provide supported and impactful community reintegration opportunities for patients. She is a passionate advocate for the burn community.