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Attachment B: Office of Head Start Guidance on Implementing a Trauma-Informed Approach

ACF-PI-HS-20-02 FY 2020 Head Start Funding Increase

Discover the key role Head Start programs play in buffering the impact of trauma by promoting resilience for children, families, and staff. Learn more about implementing a trauma-informed approach.

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Trauma occurs when frightening events or situations overwhelm a child or adult's ability to cope or deal with what has happened. These kinds of experiences cause an extended stress response and lasting effects on the physical and mental health of children and families. Traumatic events can be a single event (e.g., a terrible accident) or chronic (e.g., domestic violence), and there are many factors that affect the intensity of a person's response. Exposure to trauma is more common than most people believe. It is also multi-layered, with individual, community, and historical experiences.  That said, not everyone exposed to adverse experiences is traumatized.

  • Adverse childhood experiences (ACEs) are often used as a way to estimate traumatic events. According to a national survey, 45% of children in the U.S. have had at least one ACE.
  • One in 10 children nationally has experienced three or more ACEs, placing them in a category of especially high risk.*

Head Start and Early Head Start programs play a critical role in buffering the impact of trauma by promoting resilience for children, families, and staff. The effects of trauma are lessened by protective factors such as strong parent-child relationships; relationships between staff, children, and families in Head Start and Early Head Start programs; and through relationships and supports within the community. Supporting staff wellness is a critical part of any trauma-informed approach in Head Start programs.

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines a trauma-informed approach—using the 4R's—as one that:

  • Realizes the widespread impact of trauma and pathways to recovery
  • Recognizes trauma signs and symptoms
  • Responds by integrating awareness about trauma into all facets of the system
  • Resists re-traumatization of trauma impacted individuals by decreasing the occurrence of unnecessary triggers

Related terms used when discussing trauma include child and adult mental health; childhood and family adversity; ACEs; and toxic stress.

Head Start Considerations for Funding Trauma-Informed Approaches

There are many ways Head Start and Early Head Start programs can use quality improvement funds to implement a comprehensive, ongoing trauma-informed approach. Programs can implement activities that better equip all staff to implement the 4R's described above.

The following includes a limited, non-exhaustive list of examples:

Expand Mental Health Services

  • Improve preventive mental health screening, assessment, and interventions
  • Enhance mental health consultation for staff support and organizational improvement to help identify signs and symptoms of trauma and integrate supports and services to assist in healing
  • Ensure mental health consultation and other related intervention services include a trauma-informed approach and are integrated at intake and orientation
  • Build and/or enhance collaborative services with local substance abuse and mental health treatment programs, domestic violence service providers, disaster response programs, child welfare agencies, and others

Increase Classroom Quality

  • Hire additional qualified education staff to lower classroom ratios, enhance caregiver-child relationships
  • Provide ongoing coaching and support to education staff to address secondary stress and related turnover
  • Hire behavioral specialists to support children, classroom staff, and parents
  • Improve physical environments and learning spaces throughout the facility to help address the multiple domains of development and learning that are impacted by trauma
  • Invest in professional development and staffing patterns that foster continuity of care, and consistent, predictable, and nurturing environments

Strengthen Family Services

  • Enhance services that strengthen families, promote relationships, decrease parental stress, and improve family safety and financial security
  • Strengthen service provision related to housing access and stability
  • Provide enhanced job training, employment, education, and career services
  • Help families better access healthcare and nutrition services
  • Enhance transportation services to promote more regular participation by children and families in services designed to support development and learning and address trauma
  • Improve collaboration efforts and alignment with family-serving agencies to lessen family confusion and stress in dealing with multiple agencies

Support a Trauma-Informed Workforce

  • Provide training on trauma-informed approaches to all staff, governing boards, and Policy Councils, and ensure training is accompanied with coaching and opportunities for reflective practice and supervision
  • Support staff capacity with salary increases and additional benefits, such as employee assistance services and break times
  • Decrease family service staff and/or home visitor caseloads through hiring of additional qualified staff or other strategies

Create a Program-Wide Trauma-Informed Environment

  • Ensure any trauma-informed training implemented at the management-, governing-, or policy-level includes oversight to examine how the approach is being implemented
  • Conduct ongoing self-assessment to track program improvements related to integrating a trauma-informed approach over time
  • Expand Health Services Advisory Committee efforts to better support health and mental health services for children and families by implementing trauma-informed approaches

Resources for More Information

* Sacks, V., & Murphey, D. Research Brief: The Prevalence of Adverse Childhood Experiences, Nationally, by State, and by Race/Ethnicity. Washington, DC: Child Trends, 2018.

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