Hello and welcome. We've just clicked over till to 6:00 so I think we'll get started. Welcome to the session this evening on Allergy and Anaphylaxis Management. To begin, I would like to acknowledge the traditional custodians of the lands on which we're all meeting. I'm coming to you from the land of the Darug people and I would like to pay my respects to Aboriginal elders past, present, and emerging and extend those respects to our Aboriginal and Torres Strait Islander colleagues joining us today. is the word for children in Djinang language that I just recently learned. So I'll also take a moment to acknowledge all the in our collective care and thank you for your ongoing commitment to keeping them safe, healthy, and engaged in their learning. A quick note on housekeeping. So your microphone video and chat functions will be disabled during this webinar. We do encourage you to use the Q and A function though, which you'll find at the bottom of your screen to ask questions during the session. You can type your questions straight into the Q and A and you can also see and vote on other people's questions which you would like answered using the thumbs up button. We'll aim to prioritize the questions with the most votes and try to answer these during the webinar. If there are questions that don't get answered, we will collate them and send them around afterwards to everyone who attended. We'll also be using Menti during the session. So if you could please just have your phone or another web device handy and ready to scan or the code or enter the URL and the code on the screen when it comes up so you can participate in the interactive components of the session. This session is being recorded and it will be published on our website over the next couple of weeks. Onto the agenda. So we're here tonight to talk about a really important aspect of children's health and safety, and that's allergy and anaphylaxis in early education. So my name is Diana. I'm one of the managers in the New South Wales Regulatory Authority also known as the Quality assurance and Regulatory Services Directorate within New South Wales Department of Education. I'll be talking for a few minutes around risks and regulatory requirements of allergy and anaphylaxis before I hand over to Kath. So Kath Mulligan, she's a clinical nurse specialist in the area of allergy and anaphylaxis from New South Wales Anaphylaxis Education Program. We're really grateful to have Kath join us. She's an expert in the field, and we hope that you get a lot out of the conversation tonight. Any questions we don't get to through the session, we'll try and have a bit of a Q and A at the very end as well. So to get us started, we have just a quick couple of Menti questions for you. So if you wouldn't mind taking a moment to scan the QR code that's on the screen or alternatively visit menti.com and enter the code on the screen. So there's two questions that you should find when you get into the Menti, and the first is have you experienced an allergy incident, non-anaphylaxis at your service? So we're really just interested to understand what the experience is, I guess, in the room relating to allergy and anaphylaxis. The second question is a follow one then about have you experienced an incident of anaphylaxis specifically at your service? Are we able to flick over and see the results of the Menti? Okay, so for the first question, have you experienced an allergy incident and non-anaphylaxis? So we've got 75 yes, 86 no. And then more specifically, have you experienced anaphylaxis at your service? So we've got 33 yes, and 127 no. Thank you. It just helps us, just give us an understanding and we'll take a moment to acknowledge that these incidents of anaphylaxis and allergy reactions can be scary and stressful and we're all too aware that the reactions do present a serious risk to children. I guess this is why we're here tonight to have an important conversation around allergy education. So really, as early childhood educators and supervisors and teachers and cooks and directors and trainees and any other member of an ECE service, we all have a responsibility to protect children, particularly from harm and hazard. So ensuring that we have confidence in recognizing the symptoms of an allergic reaction, understanding how to respond appropriately, how to follow medical instruction, how to support children who may be experiencing the reaction means that we're able to undertake our day to day work with confidence and support all children in participating fully in our, in the activities that we have planned while in our care. So we just flick to the next slide. So at the department, we work closely with New South Wales Anaphylaxis Education Program to identify emerging risks related to allergy management in services across New South Wales. We have seen a concerning number of incidents occur where a child has been fed or exposed to their known allergen, and part of what we're looking to achieve tonight is really just raising awareness in the importance of processes, procedures around allergy management and to provide practical guidance and assistance from the experts so that we can reduce these risks to children. Before I hand over to Kath, I will just touch on the regulatory requirements as specified in the Education and Care Services National Law and National Regulations. I won't go into each of these in detail, but there are regulatory requirements related to allergy and anaphylaxis stipulated specifically in regulation 136, regulation 90 and regulation 91. These are largely relate to training requirements for anaphylaxis and that services must include anaphylaxis management as part of their medical conditions policy. Section 167 of the National Law also applies and that every reasonable precaution is taken to protect children from harm and hazard. I'll now pass over to Kath. As I mentioned, she's from New South Wales Anaphylaxis Education program and she's a subject matter expert on allergy and anaphylaxis. Thanks, Kath.

Hi, everybody. Can you hear me? Yay, I turned the microphone on. That's a good step. Okay, so thank you so much for inviting me to be here today. I'm really honored to have such a big audience. So I have, I'm a clinical nurse specialist. I have lots of experience with anaphylaxis, and in fact, I lost count of how many anaphylaxis I've handled myself. I understand from your point of view how stressful it can be and how nerve wracking it can be when you have children in your service. Hopefully, we can get some strategies or ideas for strategies. These strategies are by no means exhaustive. I'm sure lots of your services have great ideas that I haven't even thought of. I'd love to hear them, but hopefully, hopefully, you can get something out of tonight. Next slide please. So, well, I'll just go through some of the resources because there are some really helpful resources out there that you might not be aware of. So next slide. This is one of the best practice guidelines were released last year in October, and these guidelines are a really good starting point for you. They are, there's lots and lots of resources on this website, and they're kind of embedded with the national guidelines. So when it has a suggestion, it kind of tries to link those suggestions with all those policy ideas with the national guidelines. Keep in mind when you're looking at this website that the resources are a national resource. They're not specific to New South Wales, and when you're looking at them, it's really important that you do adjust, you do kind of compare the resources to what you know you have to do in terms of regulation, and I'm sure the directorate is happy to help you if you do have any questions relating to the guidelines, sorry, the regulations. The website is allergyaware.org.au and I'd encourage you to actually bookmark it on your browser because you may find it helpful just to check back with it regularly, especially if there's any incidents or questions that you have. Next slide. So the best practice guidelines were developed using the best practice, using best practice kind of guidelines and they are based on evidence so and that's a really important part of making good decisions is basing the decisions on evidence. These guidelines are best practice. So just keep that in mind. So when you're looking at them, these aren't minimum standards. So minimum standards might say, for instance, that one staff member should be trained in anaphylaxis management for instance, the best practice guidelines will say as many staff as possible should be trained. So just keep that in mind when you're looking at them. Like I said, please make sure that you do compare to the, or it's your responsibility basically to make sure that you are complying with the regulations in New South Wales, and the terminology is a little bit different. So for instance, the best practice guidelines refer to the anaphylaxis care plan, and in New South Wales, it can be called something different. Next slide. So this is just a list of what resources are actually available on the website. So there's a best practice guidelines document. There's an anaphylaxis management checklist. There's a document for the key principles of reducing risk. There's a risk minimization strategy document. A lot of these are Word documents too so you can actually go in and amend it to suit your service. Things like a management policy document, there's a sample letter to families and that's really well-worded so that you can just fill in the appropriate details, send them off to the families of the children in your care, and asking that certain foods aren't brought into the service, things like that. It's a good place to start. There's anaphylaxis care plan template, a risk management plan, incident reporting template, and that's a really important that incident reporting template is really helpful from our point of view because if you were to use that to record your incident even if you were to then adapt it to report to the directorate, it gives lots of details. So if you needed to contact us, for instance, for some support, we would actually be able to get lots of information and important information about the incident and what could have been done differently or what may have caused or contributed to the reaction. It's really, really helpful. And there's also a few allergy record templates. So they're just, that's just a straight list of what's on the website. Next slide. There's also some free online training, and this is a really helpful resource for you as well because these training sites are, again, evidence-based and that's really important and they're thorough, they're helpful, and it's not full of lots of information that you don't need. Please make sure when you do go to these websites that you are doing the correct training because on the launch page of these sites, there's lots of different modules that you can actually click on. So make sure you're doing the children's education and care modules when you go there. Next slide. And these are the places you can go for, again, evidence-based allergy information.

So that's ASCIA, the Australian Society of Clinical Immunology and Allergy. That's the allergy professional body for Australia and New Zealand, There's Allergy and Anaphylaxis Australia, which is like a, what's the word, a patient support website. Got lots of great information there as well. And of course, you can contact us at the New South Wales Anaphylaxis Education program. We are more than happy to answer questions to help, support. I do lots of site visits to kind of get a feel for what's going on and have a really good sit down and talk to staff about what needs to happen, and we also supply, we can also provide, sorry, a ACECQA accredited anaphylaxis training. So please make sure if you've got any questions that can't be answered elsewhere, feel free to contact us. Next slide. So let's talk about risk management strategies. So as Diana was mentioning at the beginning, there's a concerning number of incidents that are occurring where children are being handed, essentially handed their allergen at mealtime, and I know how easy that is to do. You go into kind of an autopilot almost and this is where some accidents can happen. So we need to have some risk management strategies in place to make sure that children aren't exposed to their allergen. And so hopefully this will give you some good suggestions, and as I said at the beginning, they're not, it's not an exhaustive list and you can adapt it to your own service because each service is different. Next slide. So there's two ways that you can come in contact with allergen. The first one is through direct contact and that's been when you consume or fed food with an allergen in it, drink, which is an allergen or contains an allergen, and through contaminated food. So that's a direct route. There's also the indirect route, which is when an allergen gets onto hands or objects or from objects to hands and then into the mouth, and it's important when you're looking at risk management that you understand to have anaphylaxis. So a severe allergic reaction, you actually need to ingest the allergen, and sometimes it's not as black and white or as easy to figure out as you think. So sometimes, the allergy can get into the mouth without you realizing how. So we need to have some really tight strategies in place to try and prevent that happening. Keeping in mind that the best laid plans sometimes fail. Children can have anaphylaxis or I have an allergic reaction, and sometimes we just don't know why, and parents don't, parents of children with allergies also don't come into put their children into a services expecting a guarantee that their child's not going to have an allergic reaction or be exposed to the allergen. Trust me, they're realistic enough to know that that's not possible, but what they do need is sound strategies put in place to minimize the risk. So next slide please. So it's really important when you have a child that has allergies enrolled in your service that you develop an individual healthcare plan, an individualized anaphylaxis care plan. It could be, you might call it a medical management plan in your service, and this document needs to have examples of risk management. It's not examples, sorry, have really clear risk management strategies. So it needs to be, you can use the best practice guidelines document as a launching pad for you to get some ideas from it. There's also a New South Wales Anaphylaxis Education program template, which we developed which has really specific strategies on it. So this document needs to list specific strategies to minimize risk. We don't want just an overarching objective of the child's not going to be fed their allergen while in the service. That's a great objective to have, but what are the strategies that are gonna be put in place to ensure that objective is met? We want this individual healthcare plan to be developed in collaboration with the parents or carers because they are the expert in their child, and they risk manage these children every single day. Those strategies that you do put in the document and develop as part of the plan needs to be communicated to all staff and it needs to be adhered to whenever, each end every day. It's not just an ad hoc kind of thing that sometimes we do it, sometimes we don't. These strategies need to be adhered to. Next slide. So this is just a snapshot of the best practice guidelines documents that you could access and use them as to compare what you have in place at the moment. It can give you some really good ideas of where to go if you need to tighten your risk management strategies. The colorful document there on the right has lots of sample documents, not documents, suggestions, some strategies. It's a good document to compare your current risk management strategies with. Next slide. So this is the individual healthcare plan template that we came up with. It is very, very prescriptive, but I find that that's quite helpful in services. It's available, you can contact us if you'd like a copy of it just to use and adapt if you need to. Next slide. When you have risk management strategies, so it's important that you know that risk management strategies need to be put in place for any child that has an action plan for allergic reactions or anaphylaxis. So any child that has an ASCIA action plan for anaphylaxis, for an EpiPen or Anapen, either device, or if they have an action plan for allergic reaction. So the green and blue action plan you can see on the right there. Even though these children with the action plan for allergic reactions don't have a prescribed EpiPen or Anapen, it doesn't mean they're not at risk of anaphylaxis. The doctors just believe their risk is less than some other children. You need to put risk management strategies in place and stick to them for either kind of document for children with an adrenaline injector and those without. It's really, really important. Next slide, please. So we'll just go some through some general strategies. So it is strongly recommended that in the best practice guidelines and New South Wales Anaphylaxis Education program strongly recommend that every service has at least one first aid adrenaline injector. They are used as second doses. If a child has uses their own device, they can be used if the device misfires, the child's own device misfires, and it can also be used for a first presentation of anaphylaxis. So we know that in Department of Education, primary and secondary schools, 22% of EpiPens that are deployed in those schools, given to children having their first reaction, and when you look at the under five population or under six population, that age group has the most or the highest incidence of allergies. So the risk is there that a child in your care may have their first reaction, and when you think about the beautiful food that services provide to children, some children have a very limited diet at home. They go into a beautiful service. Some of the food that I, when I go into a service and smell the beautiful aromas, it's makes me hungry all the time. So children go into these new services, they get exposed to new foods from all across the globe, which is absolutely fantastic, but it may actually be their first introduction to new foods, which may end up developing into an allergy. The other recommendation is that adrenaline injectors are kept in an unlocked central location, not necessarily in rooms. So we know from our experience that when EpiPens, and I shouldn't say EpiPens, I should say adrenaline injectors, but EpiPens are the most common one, are moved around with a child, sometimes things go awry. So the child might be in a different room than normal because of ratios in the early morning or late afternoon, and if somebody forgets their kind of role to move that device around, it can actually go missing, it can be left behind, and if an incident were to occur, then there's confusion. Where is it? Sometimes the device is found, but it's been broken or it's been fired or it's out of date because that auditing process is harder when the device moves around. They don't have to be locked in first aid cabinets. So they can be unlocked and they absolutely shouldn't be behind a lock and key because locks and keys take time. So they do need to be out of reach of children. Often, they're kept in places like the director's office or it could be the kitchen. Find a central location. If you have a big service with lots of different rooms or over two stories, for instance, you may have to look at have a bit of a risk assessment and decide where they should be kept and how many first aid devices you need. All staff should be aware of the location of the devices, whether it be the kitchen staff or the educators. Everybody should know because it may be anybody in the service that is called on to go and retrieve a device. Next slide. So for OSHC and vacation care. So for most early childhood services, the EpiPen Jr. is the only device that you really need to have as a first aid device. For OSHC's and vacation care, you need to look at your population of children and decide on which device is more appropriate. So the 0.3 milligram EpiPen, or Anapen 300 is the device for anybody over 20 kilos. So you do need to do a bit of a analysis of the children in your care and decide which first aid device is more appropriate. It's also important that you consider that families are only given two devices subsidized by the government. So they can get two devices, whether it's EpiPen Jr. or an EpiPen subsidized by the government, and if the OSHC is asking for one device to be kept there permanently plus school is asking for a device to be kept at the school permanently, then that potentially leaves the family without a device at home and we do find that in places where in families, where they are financially not so well off. Yes, you can go into a pharmacy and buy a device over the counter, but it can be cost anything from $70 to $120 for one device. That's a financial burden and that's a financial burden that some families can't afford. So please have a discussion with the family when you are talking about the EpiPens or the Anapens and say, "If you keep one here full time, will you have one for outside of hours?" And you may have to come up with another solution. So it might be that the child carries one device in their bag so that's accessible when they're at the OSHC or vacation care. Next slide. So staff training is really, really important. There's that e-training that is available online, and I would highly recommend everybody does that. There's also a 20-minute refresher. So you could do the full training every second year, you could do the 20-minute refresher every other year, and I want you to have a look at the minimum standards for practical training, the best practice guidelines, and compare the training that you've had up to this point. A lot of first aid providers give fantastic education. Some of them don't focus much on anaphylaxis and if they do, often it just focuses on this is how you give a device. Good anaphylaxis training needs to focus on the ASCIA action plan as a tool because that's exactly what it is. It's a tool that tells you what to do, when to do it, and how to do it when a child is having an allergic reaction and or anaphylaxis.

So I would encourage you to do that, and if your, if you feel like your anaphylaxis training has been less than ideal, then perhaps look at finding a new first aid provider. Next slide, please. And you can also contact us for training. So we provide a ACECQA accredited training. All of the people that deliver our training are specialist nurses. We do travel to regional areas. So if any of you in regional areas, we do try and get to regional areas often as possible. We absolutely love it. And if we can't actually get there, we can do training over Zoom, and we also provide EpiPen and Anapen training devices. So Anapen training devices are a little bit hard to come by, especially first aid providers are finding quite hard to get enough, we will actually send you some in the mail if we're doing it by Zoom. So we do provide training devices for you to practice with and for everybody to practice with one each. Next slide. So some more general strategies. In the kitchen, there is an all about allergens for CEC free e-training session, which I touched on before that talks about things like standardized and documented menus. So if you have menus, you should have documented recipes so that if I were to go into a kitchen because the cook is sick, I can get out the book, I know what's meant to be made today, I can follow a really specific recipe, and I don't deviate from that recipe. If you don't have recipes to work from, people start making things the way they do at home or have no idea or they'll adjust things, they'll add things that shouldn't be in there. So those standardized and documented menus really help, especially in those troubleshooting times when the cook or the chef is not there and it helps to avoid mistakes being made with food ingredients. The training talks about food matrix's, it talks about labor and appropriate storage, talks about food preparation and how to avoid cross contamination, it talks about label reading, and it is important that label reading and ingredients are checked regularly even if you order, have ordered and used that same product the last 10 years. Food producers have no obligation to put on the label that the ingredients have changed. So it's important that you do a check of each ingredients list as you receive the product, and I can probably hear some virtual groans there. It is the probably the most annoying part of having allergies and anybody who has a child with allergies knows the pain. It is awful. The other thing that's important to do is avoid decanting foods without packaging. So for instance, if you were to get rice crackers out, you use half of them and you need to store the rest, it's important that you store them with the packaging so that the ingredients can be checked when they're needed next time. So the website for that is foodallergytraining.org.au, and like I said earlier, make sure you do their CEC module. Next slide. So the other thing that often happens is a lot of services order online from Woolworths or Coles. It's important that if there is products that are substituted by the store, that you check ingredients and you should be checking them anyway, but here's a good example of why. So on the left, you can see a plain rice cracker packet and the ingredients, and on the right, if this store decided that we can't provide plain rice crackers so we will provide this yellow packet, which is a cheese cracker. You can see that there's milk products in there. So it is really important that for substitutions, the ingredients are checked. Next slide. If I had to choose only a few of the risk management strategies and I couldn't choose any other, hand washing would be my number one. Hand washing before and after eating. That really helps the stop the indirect contamination with food allergens. So children are notoriously messy, my teenagers are messy so young kids are just 10 times as bad. So they get food on their hands, if you don't wash their hands, you're then transferring the allergen onto objects like toys, then it can go from toys into mouth. So washing hands before and after eating is a very, very, very important risk management strategy. Next slide. It is important that their hand washing is done with soap and water running water preferably, not hand sanitizer. So hand sanitizer is great for viruses and bacteria and the dreaded COVID, but it doesn't help with removing food allergens. The other important thing to note is when you are using hand washes, make sure you are checking for food items in it. Avoid using hand wash that has food items. There's lots of hand washes that have almond and honey and they might have goat's milk. So if someone's allergic to cow's milk, they are probably allergic to goat's milk. So you need to kind of avoid food items in hand wash. Next slide. So meal times. So let's talk about meal times. This is the high, obviously, the highest risk time in a day in a childcare center. One of the things that I suggest is some kind of color coding system. So color coding of plates, cutlery, cups, placemats, mats, bibs, and I usually suggest the traffic light system simply because in most people's mind, red is a danger color, orange is a warning color, and green is a go for life kind of color. So that's the suggestion I often make to services. I believe red is a hard color to get plates and cups and cutlery in. You could choose any color scheme you like as long as it's consistent, and the color coding in the kitchen is also really helpful. So storing food that has allergens of the children in your service within containers with red lids, for instance, can be helpful. Just really taking that color scheme throughout the service. So for children with allergies, so they have a red or a green action plan for children with FPIES, EoE, or celiac disease, those children should have red color coding. So anything where food may make them sick, that should require kind of a red color coding. So for orange color coding, something like or whatever color it is, orange, people within intolerances, which is very different to allergies. If it's a religious choice, if it's a cultural choice or if it's a family choice, those should have orange because we still want to avoid giving, for instance, a vegetarian child meat, but if they do eat meat, it's not gonna make them sick. So having an orange color, it's a warning color. And give the green food color coding to those children with no food restrictions. It sounds to me like that's becoming less and less common to have no food restriction or restrictions of any sort. That's just a suggestion. You guys might have more suggestions, and like I said, I'm really interested to hear any good suggestions, but that seems to work. The other thing that really helps is to have that color coding in the handing out of food so you, to minimize chaos at mealtime. So you have a system where you go, "Okay, red meals first," hand out the red meals, orange meals next, and then green, and that really can help minimize the chaos when food or meals are being handed out. Next slide. The other really important risk management strategy that I would put in place if I could only pick a few would be treating food similar to the way you have to treat medicine. So that means the right food is given to the right child and that two permanent staff check all food and drink before giving to a child. So that might mean it's the chef or the cook plus an educator. The director might come in at meal times just to be that second person. There could be two educators. Permanent staff, I know, is hard at the moment due to illness, but there's lots of casual staff, but it's still a helpful kind of principle to have in place as much as you can. So you are saying something like, "Okay, this is a, this is Ruby's meal. It's in a red plate, it's got Ruby's name on it." And this is being put in front of Ruby, and there's two people saying, "Yep, Ruby's meal going in front of Ruby." You don't have to necessarily sign it to say that you've checked it like you do with medication, but it's still that system of having two people checking what can be quite dangerous if the wrong food's given to the wrong child, and it needs to include milk products if there's milk allergic child or there's a child with FPIES that reacts to rice and things like that and if there's rice milk being dispensed. So milk drinks need to be included in food because milk is one of the biggest problems in services. If that you've got children who eat, bring food from home, you need to check that the child is eating from their own lunch box, and as you all know, labeling is extremely important. So this is Ruby's lunchbox, and it's being put in front of Ruby and it's all labeled and it's the right child, right food. Next slide. For milk drinks and formula bottles. Labelling is, again, really important, and two people should be checking. So if you have formula in a dispensing container, like you say on the screen there, that should be labeled and there should be people checking, two people checking that that is the right labeled milk powder going into the right bottle, and it's given to the right child. The other thing you can do to minimize risk and the potential form mixing up formula into the wrong bottles is that formula bottles are made up at home and brought into the service. According to raisingchildren.net and other health services, the formula can be made up and stored in a fridge for 24 hours before it needs to be thrown out. So you could have families make it up the night before or the morning of care and send it home if it's not used that day for chucking out, or you could just discard it yourself. Any kind of milk or milk alternative. So the milks in tetra packs should be labeled and checked when dispensing. I know it sounds like a big deal, but it is, when it goes wrong, it is a very big deal. So I think the prevention might be inconvenient, but having a child that reacts is even more inconvenient. Next slide. So when you're talking about risk management, I probably should have said this earlier, but it's important to know that contact to have anaphylaxis, you need to ingest the food. I did touch on that, but just looking at ways that children can actually inadvertently ingest the allergens.

So if that little boy there had, was allergic to milk, he's got yogurt all over his hands, where the yogurt's touching his hands may become itchy. It might become red. They might be hivy. If you wash the yogurt off his hands, the reaction could settle down. The problem though is that that little boy who might not be allergic to milk has just eaten yogurt. It may be mess, he goes to play with the toy elephant, puts yogurt on that, and next slide please, then somebody else picks up that little elephant and puts it in their mouth. So we know babies and young children are very orally motivated so lots of things go in the mouth. Hence, all it takes is fingers in the mouth. So when you're looking at risk, you need to minimize the risk of ingestion. So that's where hand washing comes in, toy washing, things like that, and also drink bottles. So anything that goes in the mouth is a potential source of contamination. So that's drink bottles, straws, cutlery, wind instruments, anything like that. Next slide. So continuing with meal times. Having a no food or drink sharing philosophy is important. So that means that you don't encourage children to share food, to share cutlery. So you have to kind of say, share your toys, but not your food, and that gets back to that contamination of drinking vessels or cutlery. So we are trying to avoid that from happening. Supervision is really important. So an educator might sit next to a child with allergies at the same table. It is important to know that we don't want children to be excluded. So children with allergies should not be on a table by themselves. They need to be included as much as possible and as safely as possible. For young, young children, high chairs can be really, really helpful. So the child being in their own high chair that's not used by other children. If it is a shared high chair, please make sure it's really easy to clean, and I'm sure that makes your life easier anyway. You need to clean the floor after eating, the table after eating, chairs, and even underneath the tables 'cause if your children in your care are anything like my children, they like to scrape their hands, wipe their hands underneath the table. I don't know why they do it, they just do. Also, things like a spill kit in your room might be helpful. So having a bucket with a towel, some gloves, dustpan, and broom, things like that to make it really easy for you to contain a spill or some spilt food that you can clean up quickly and easily. Next slide. For anybody who knows me and who has had me come to their center, you'll probably be aware that I have a big problem with drink bottles because this is where I think there's a lot of contamination that happens amongst children. So when children have their drink bottle in a group with other children's drink bottles and then they go and help themselves to drink bottles, there is a big risk that they're gonna pick up someone else's because it looks the same or because they like the bluey drink bottle more than they like their train drink bottle, and if the straw is contaminated with their allergen, that could set off a reaction or they could contaminate someone else's drink bottle. It is an allergy risk, but also it's an infectious disease risk so if you want gastro to go through your service, get them to share drink bottles. So rather than children going to get their own, and I understand that you have regulations around empowering children to develop skills to meet their own needs, for safety reasons, you might need to hand them out. So you might need to say, "It's drink time. Come to me," and you hand them out. These really well-labeled, it's a really well-labeled system. You might have a water dispenser if you can manage that so they can go up and help themselves whenever they want water. There are ways around the system to, that sounds bad, it sounds like you're supposed to dodge a system. That's not what I mean. You can empower the children to make their own decisions and to help themselves to water and keep them safe. If you do hand out drink bottles, please make sure that you have an alarm to make sure that you are offering regularly. So it's not three, four hours before a child is actually offered a drink. But that is one of the areas I think there's lots of kind of cross-contamination in services and you wouldn't know what happens. A lot of the time, you just wouldn't be aware of it. Next slide. So playtime is also a time where you need to kind of be aware of where allergens might be. So when you're curriculum planning, have a think about where there's potential allergens. So things like play dough. If you have a wheat allergic child, play dough, standard old play dough that you buy has wheat. It's made with wheat flowers so you'd need to avoid that. Now, I'm not saying avoid doing the sensory play with a play dough type thing. What I'm saying is substitute. So you might want to use gluten-free flour and make the service your own play dough type stuff. Substitution is an important strategy. So I'm not saying don't do things because sensory play's really, really important. What I am saying is that try and substitute. So when you've got play time and children are handling toys, if you've got solid toys that can be washed in hot soapy water, that is a really good strategy, especially if it's been mouthed by a child, and if you are doing the hand washing before and after eating, hopefully the there would minimum contamination of toys and things with allergens. Think about craft or game activities and think about food allergens when you're planning, and that can include things like counting games or threading games. If you are using food items, you need to be aware of whether there's potential allergens in it. So for instance, if you thread with penne pasta and you have a wheat allergic child or an egg allergic child, you need to make sure you're not using egg pasta or wheat pasta to do that activity. Next slide. So for craft and cooking activities, check the ingredients, check the equipment, check everything for allergens, and again, it's about substitution, and if you can't think of any substitute for a certain ingredient, ask the parents of the child with allergies because they are the experts in allergens and risk managing. So often, families where there's a child with allergy, they'll know that you can use apricot nectar instead of egg as a binder and things like that. There's lots of really good information out there. It's important that you don't let children with allergies cook with their allergens. So they might not say, for instance, doing an activity where they're making pancakes or they're making cake, it's really important that you are not allowing them to make the cake if it's got allergens in it, and that's again where substitution can come in. Rather than them making a cake with egg in the batter, you might substitute with egg replacer so that they can be a part of that activity, but they're not put at risk. Even though they're not eating it, there can be transfer of, there can be hand to mouth transfer. So if a child is stirring egg, sorry, cake batter that has egg in it, it may get on their skin and it may get on their hands and then it may get from their hands to their mouth. So it's not okay to have kids making food that contain their allergens even if you are not planning on feeding it to them, and try and avoid using containers which originally contain allergens like milk or egg cartons. Use juices cartons instead. Again, it's about substitution. Next slide. So for special events, you also need to do some planning. We don't want children excluded from special events. We don't want you to say, "We are doing this, but unfortunately your child can't be a part of it." Modify the activity where possible substitution, again, is a very important strategy. So talk to the parents. Parents are, again, as I said, they're experts in risk management. They'll be able to, they might be able to spot allergens that you might not be able to just 'cause they're used to it, and for things like parties, birthdays, end of year celebrations, Easter, things like that, it's important that you have strategies in place so that children don't consume food brought in by others.

So for instance, if you allow families to bring in cupcakes for birthdays, it's helpful to have a safe cupcake brought in by the child's parents that's kept in the freezer, for instance, so that the child with allergies can still be included, but they're not put at risk. You might have a strategy where you say you can bring food in your child's birthday, but it needs to be store bought and it needs to have ingredients, like an ingredients list on it. Keep in mind that some people's knowledge of food and food preparation is limited. So be wary of people that say, "Yes, it's nut free and I made it myself," because you can't really assume that everybody knows that cashew is actually a nut and you can't use cashew in a service. If you're having lots of food and lots of people, then you need to increase supervision, and you might say to the family, "We need you to come and supervise your child." You might get an extra employee to come on that day and add some supervision or if you've got trusted volunteers, that's also something you could do. As I said, you guys are much, much more across what you do as a service, and you are one of the most creative and imaginative group of people that I've come across. So I'm sure you can come up with lots of different strategies. Next slide. So just to summarize, risk management strategies are really important. That's the prevention side, but you also need to have adequate staff anaphylaxis training. That's the, "Okay, things have gone wrong. What do we do and how do we manage this side?" You need to implement and communicate specific strategies to staff and make them make sure it's, the strategies are put in place every day, not just the days that the child is there. If you put strategies in place only when there's an allergic child there, it can lead to complacency, and then last for, the strategies last for a couple of weeks and then they fall by the wayside. So things like the color coding system should be put in place every day that a child, every day. So you might say, "Okay, well, little Ruby's here Wednesday to Friday, but we're gonna do the same kind of strategy when we're handing out food. So we're gonna go red, red children in the red plans, then the orange, then the green." That way, when the child is there, those strategies are going to help to keep them safe. I hope that makes sense. And please access the best practice guidelines. They are a great resource, but please adapt them to your service and to the New South Wales regulations. Thank you for time. Next slide.

Thank you, Kath. Certainly great information and great strategies in there, and we really hope that you've been able to take something away from it. We do have some questions in the chat. I'm happy to read a few out if you don't mind answering them, Kath.

I'll do my best, yep.

So we've got one about the printing of the plans.

Sorry, the what? Sorry, printing of plans?

Plans, yeah. People often print them in black and white. There's a question about is it regulation or best practice to have these plans in color?

To my knowledge, the plans do not need to be in color. Everybody prefers color, as do I. One of the ways to help you get a color copy is to when you are aware that the child's device is going to expire, you can print off a nice color copy. GP's often don't have color copy, color printing available to them so all they have available is black and white. You can print off a nice blank color copy of an action plan, hand it to the family and say, "Can you go and get this building by your GP?" It's really hard to insist on color because it's just not possible for some places to supply them. The other thing that you really shouldn't be insisting on is stamps, doctor stamps, 'cause a lot of doctors, including all the allergist at my hospital that I work with, they don't have stamps with their names and titles on them. So a doctor's signature is fine, preferably with their last name written that is legible afterwards would be great, but we don't always get what we want. I hope that answered that question.

Thank you. Got another one about, "So any suspected allergens or food intolerances mentioned by the family, should the service request the family to obtain a letter from the GP and complete a risk management plan?"

This one's a really hard one because a lot of families don't even understand the difference between allergies and intolerances themselves. What I would suggest is that you encourage them to go and see a doctor to have the allergy or the intolerance diagnosed properly. There's lots of kids whose parents say, "Yeah, they're allergic to mosquitoes or they're allergic to milk," but it's actually an intolerance. Proper diagnosis is really important. If you can't get the information, then I guess it's about putting risk minimization strategies in place because even if a child's intolerant, they really shouldn't be given that food. So if they're lactose intolerant, for instance, you still shouldn't be, they still shouldn't be given anything that's got lactose in it. So it's a really hard one, I do acknowledge that, but my suggestion is to encourage the family to go and get a diagnosis from the, and start with the GP.

And we have a couple of comments around the cost of devices. I'm not aware of the cost, but just in terms of the financial cost to services in having a device available, and I imagine that would have to be weighed up in terms of the risk mitigation.

Yeah, absolutely, and I absolutely acknowledge that as well and it's the same with families they have, if they have to buy any over the counter, it's a financial burden. Thankfully, with the introduction of the Anapen into Australia late last year, competition's sometimes good and it's amazing how the Anapen has all of a sudden gone from anywhere from 80 to $160 down to 70 to $100. So I do acknowledge that it's a financial burden for the service and it's and most of you have, that your businesses, your out of pocket expenses are important. The problem is in from our point of view, it's probably well worth the money because things can go awry. Children can have anaphylaxis. Sometimes, second devices are needed. Sometimes, a child without any history of allergies can have their first reaction. So I guess it's absolutely a, you have to weigh it up, but they're invaluable in our eyes and the Department of Education for primary and secondary schools has kind of, they're aware of that, the benefit, because of statistics that we have that 22% of kids can, EpiPen, sorry, used on first reactions. It is a risk and it is a financial burden, I understand that, and I'm not here to absolute point finger and say you must have one, but our recommendation is that every service has at least one.

Thanks, Kath. And are there any ideas to ensure that updates to children's risk minimization and communication plans are regularly communicated to all staff?

So the risk minimization plan should be updated every year in collaboration with the families because child's development changes, their curriculum changes. In terms of communicating that to staff, staff meetings are a really good place, and even having a huddle in the morning might be a good idea. A room huddle or a service huddle. We do it in hospital, we all get together for a few minutes every day on ward and say, "This is the things you need to know for today." That might be an idea that you wanna introduce to make sure that that it's communicated. Having like a pamphlet thing an A4 piece of paper that is in the staff room, on the back of the staff toilet door. That's a very underutilized space in my opinion. There's lots of ways that you can communicate and remind staff about what needs to be happening, but do update those plans, those risk minimization plans every year.

I notice we're right on time. So maybe just one final question. Is there any specific asthma plan sheet that services can use to be a variety coming from hospitals or GP's?

Yes, it is a problem. Asthma's not my area of specialty, but I do know that there is a New South Wales health asthma plan that is basically, it's based very strongly with on the ASCIA action plan. So it talks about escalating flareups and what to do, and that is what we would recommend because it's, you guys, as educators don't need to know what kind of preventer or child's on at home. All you need to know is what you need to do if a child becomes symptomatic or if the flare, if their symptoms flare. So there is a document and I can provide the website that can be disseminated to everybody. I just don't have it off the top of my head.

No problem, we can circulate it afterwards with the outstanding questions that we haven't been able to get to.

Perfect.

So thank you so much, Kath. We really appreciate your time and your expertise on this very important topic, and thank you to everyone who was able to attend. Just on the slide, we have some additional resources that may be useful to you. So the Department of Education has an allergy and anaphylaxis website as well, in which we do also point to resources from New South Wales Anaphylaxis Education program, and certainly, if you have any more specific questions, you are free to contact us on our information inquiries line and the details are on the slide there. And just before you disappear, it would be great if you could follow us or stay up to date. We've just got our QR codes and the Facebook page. So we do post regularly updates that I think you'll find are interesting and relevant. So you will also receive a survey, I believe, following your attendance. So we really appreciate it if you could give us some feedback, that would be great. Thank you so much.

I'm Donna Richards, and I'm from Australian Childhood Foundation.
And today it's really just an exploration, and an introduction to why do we have, and why do we need trauma-responsive practice in early childhood and about building a framework for effective practice with children and families
But also for their network of relationships and why relationships are really important.
And I'm just a senior, I'm a senior advisor with Australian Childhood Foundation, and I'm passionate about trauma-informed practice, so that's my introduction to me.

I would like to start the morning by acknowledging the Traditional, Aboriginal and Torres Strait Islander people as the Traditional Custodians of this land and the waters, and where each one of us sits to meet today
And I'd like to pay our respects to their Elders, past and present, and to their children who are the leaders of tomorrow.
I would also like to acknowledge their history, living culture, and the many thousands of years in which they have raised their children to be safe and strong.

So today, we will be exploring childhood trauma.
And we know from the neuroscience that around about 30% of the adult population do not have memory, which tells us that a very high proportion of adults have experienced childhood trauma
So sometimes the content, when we start exploring and looking at trauma, can evoke really strong emotions and may trigger personal experiences of trauma
So please be mindful of your wellbeing throughout the webinar
And if you need support, just take a moment for yourself or find something that makes you feel comforted in that moment
And I'm always happy for you to email me at the end of the session if you like
Just to start the morning though, I'd like you to really think about a child that you work with
And just take a moment to think about the children that you work with, but bring to mind one child that you bring your relationship in your work to and what that child needs

This is the model that Australian Childhood Trauma uses in terms of creating an example of what the child needs
And so the child always sits at the centre and that heart means that this child needs love and needs special connection, but they need connection to their culture, regardless of what culture means and where you sit
So each community may have a different culture, or you may come from an Aboriginal or Torres Strait Islander background, or you may have been a refugee or an immigrant, but the culture that sits around you and your family and community is what a child needs connection to
As well they need to make meaning of their story and of their world
They need safe, attuned relationships and we will explore relationships in lots of different ways today, looking at the importance because when trauma occurs in relationships, we know that the healing occurs in relationships as well
We need, children need, a really protective and child-friendly community
And often that's what early childhood centres provide is a sense of community and a belonging, both with families and with the children as well
We also need trauma-informed and -integrative systems, the collaboration between systems and what does each child need to reach their full development potential as well
We also know that culture impacts, and think about culture from a point of safety, relationships, making meaning of their story as well
So how does culture influence each of those experiences? So what I want you to take a moment, just take a moment and with your pen and paper, or if you've got some nice colours, just draw a symbol of that child that you bring to mind, and keep that at the centre as we go through the webinar today
So just take a moment just to draw a symbol or draw the child and just draw a little stick figure, or if you're Picasso you can draw a beautiful image of the child or just a little symbol such as the one that's on the screen about that child that you work with
Just so you keep the child in mind as we work through this and keeping the child at the centre of our work
And so it just reminds us, no matter what we are doing, we're keeping the child at the centre
So just take that moment
If you've got questions about the child, pop some of those questions around the child
If you have any concerns, put some, write down some of those concerns for the child
Or if you can think about what are some of the child's strengths as well, what are some of the things that the child, that shows you that this child has resilience or some strength in the face of trauma? So think about that child and bring them to mind
And hopefully that symbol, you can keep that throughout the day and bring it to mind as we move through the webinar today
So to start with, we're going to understand neuro sequential brain development, and then what the impact of trauma is on that
And so the key thing to remember is that the brain develops sequentially from the bottom to the top, from the back to the front
And we use an analogy like a house, that this, we build the brain as a house, with the foundations of the floor and then the walls and all the furniture inside
And then the roof on top, which is our cognitive brain
Some of you might know Dan Siegel's hand model, which is a similar picture of how the brain works
So we know that the brain develops through a mixture of both genetics and environmental factors, but key to all brain development in children and infants is relationships
And we know that the relationship is the most important part of brain development and the most essential thing
So thinking about culture and about that connection to culture, what we know is the importance of culture, that culture actually, the brain starts developing culture even before our brain understands what culture is
Our relationships are influenced by culture and our culture influences what we bring to relationships
So we also know that the sensory data that's interpreted by infants and small children is felt and experienced long before our ability to even think about or understand culture
And if you think about, when we talk about villages bringing up the child, or if we think about what was the culture in my family that made me feel safe or what were the things in my family that I have taken (indistinct) to work that come from my culture and from my family
So culture influences the experience of brain development as well
And it's really important in that sense of safety, meaning making the story of the child as well
But also we know that culture can be a protective factor
We also know that over centuries of colonisation and dominant cultures it changes for an example, the aspect of Aboriginal people's lives
So don't just think about the tip of identity of culture
Think about the really meaningful things around food, dress, music, language, relationships
How a community sees the child
How the community brings up the child
And I want you to take a moment to think about what is the culture of your early childhood centre? What does your culture look like? Does it create that sense? And we'll explore sense of safety a little bit more
What are the relationships like within the centre between the children, between the carers and children, between the educators and children, between the centre and families? Which is really important around how do we bring that importance of culture to our work as well? So think about that as we go through
So just in terms of the new newborn brain, this is just understanding the developing brain
It is around about approximately somewhere between 200 to 400 grams depending on the child
Then the average weight at the age of three is around about 1
2 kilograms, so about 1200 grams
And then at adult, it's only about 1400 grams
So essentially between newborn and three, the brain grows, puts on about a whole kilo if you're thinking in cooking terms
A kilo of brain mass neurons, synaptic pathways
And so the importance of early childhood in this space is really essential in thinking about this is a really key part of brain development
In those first three years of life is where most of our brain mass is acquired
So think about how important that is
And think about what are the things that we are doing, what are the things that we know? So an adult brain has about 100 billion neurons
So in actual fact, by the time a child is three their brain is not much less than an adult brain
So we have to think about what are the brain's building blocks
We know that neurons grow in relationships is the key thing
And we know that one of the connecting things around connecting brains is eye contact
But the child's brain, the job of the child's brain, infant and child if you're really thinking of a very small infant as well, is to lay down as many neuronal connections as possible
And often we're really thinking about physical development, but not about the brain's job around laying down all those beautiful pathways and connectedness that develops in those first three years of life
So the only other time the brain change is in adolescence where it prunes and builds some new ones as well
But most of the work is done in those early years
So there's this whole proliferation and that's part of what your role is, it's a really exciting time
Also, what we know about the brain has changed completely in the last five years, we have so much more information now
So if you've not been looking at the brain and looking at neuroscience, do start looking at some of the neuroscience that's happening, that's occurring and some of the new areas that are arising around how do we develop great brains
We also know that when we are doing things in relationships it builds stronger, faster neurons and synaptic pathways
We know that when we do activities in relationships, is much you know, actually builds a much better brain than things that are done as an individual child or infant
We also know that imaginative play builds beautiful


So when you're thinking about your play, when you're thinking about how do we build these amazing brains for these children, because we're thinking about development, really think about what are the structures that the child needs to make decisions
What are the things that we're doing to problem solve? What are we doing together? So most of the work that happens for children is around doing it together as well
So this is what it looks like
And I think this is a really important one because by two years, all of the neuronal and synaptic pathways and all the neurons have been built
From two to six years, they're just strengthened
So the brains are built from both the bottom to the top and back
But as it's constructed, that process begins at birth and continues into adulthood
But simpler neuronal pathways, you can see it at three months, are formed first and then after that they're built on, but mostly from two years they're just strengthened and embellished, is how I use it as well
It's about, you know, they're laid down beautifully in the first two years in a whole range of ways
So it's the most active time, most active period for establishing connections and really creating new connections on a day-to-day basis because it's a dynamic process that really never stops, but it's also importantly the connections that form early provide either strong or weak foundation for connections that form later
The other thing that we know is within that first 12 months, our template, our schemers for relationships are laid down as well
So we also know that we carry those through into adulthood
So interaction between genes and experience shapes that developing brain
And it's a beautiful part of work that you are doing
If you're thinking about the brain architecture, you're almost like the architect of this child's brain
So in the absence of really connected relationships or responsiveness, then the brain doesn't develop those really high dynamic processes that's required
And that's when you will have and lead to disparities in learning and behaviour
We also know that really attuned attachment is at the core of regulation and that is set up in that first six months
We know that who children have beautiful attuned, attached parenting or caregiver in that first six months, we know that they actually have much better regulation and have better construct of brain architecture
So this is a sequential brain development and it's a bit like building blocks or Lego blocks if you want to think about that, is that the foundations, that the more stable the foundations of the brain are in that first two years, then the higher areas of the brain become much stronger as well
So the first part of the brain is the survival brain, which develops pre-birth
And so we know that stress, family violence, trauma in utero has an impact on the brain stem, on the survival brain pre-birth as well, but it's mostly mature at birth, and then finally is mature at around about eight months
And then the movement brain is between birth and two years
And then emotions and memory brain is developing and is mostly mature at about age four
Some people have earlier memories, but we know that most, and we still don't know why, neuroscience in 2022 does not know why we do not have earlier memories
They haven't uncoded that bit yet, most of the memories we have pre-four are really implicit memories
And then the thinking brain is really developing between three and five when all those other areas have completely developed
So this is what it looks like
The brain stem is the core survival part of the brain
It develops in babies in utero, it's the first part of our brain to develop
And it's like the foundation of our house
It's laying down beautiful foundations of our house
We also know it's the first part of the brain that develops and matures first
It also is responsible for those core things like heartbeat, breathing, sucking, temperature control, blood pressure
So, it's a really, it controls the flow of messages between the brain and the rest of the body
It also controls basic function, such as breathing, swallowing, heartbeat, all those things that are on the slide and consciousness, whether you are awake or sleepy, and it consists of different parts of the brain
It is also the really core survival for you, thinking about triune brain, the brain stem is our survival brain
We also know that for children who have impact in utero and what the impact in utero is mum's high cortisol levels across the placenta, is often, they have a whole sense of dysregulation when they're born, difficult to settle often come with this long term dysregulation that starts from very early age
So there's a part of the brain stem that's, and I always share this because I just love it, that is called the periaqueductal gray, which is like a little cockroach sitting on your brain stem
And that's a part of your brain
And I sort of always imagine it sitting like, "Nah, hello, am I safe?" Like, even when you're coming into a Zoom, your brain is actually saying, "Am I safe?" It also is a part of the brain that really is, it's wired, hard wired with millions of years of evolution to actually keep it safe as well
When we understand brain stem and the impact of early, impact of trauma, family violence, neglect, poverty, transience, all those things that impact on a child, what we recognise from this one is that children who have very poor body temperature control, they are the kids who are in the middle of winter, are running around (indistinct) feel the cold, or in summer have got layers of clothes on
So sometimes that's an indicator that they've had very early impact on the brain stem
But if you think about the brain stem, so these are some of our really, I've just popped in some of our primary developmental goals that sit alongside the brain, because one of those key things with the brain development are those primary developmental goals as well
The state of regulation, we now know that, we used to have a theory of attachment
We now call it the theory of regulation because we know that in the regulation state is attached to my ability to attach and be attuned and have really attuned caregivers
It's our primary attachment, that is really important for my brain development and for me to learn emotional regulation
It's also around flexible stress response and resilience
We know that attachment and attunement build resilience
So we also know that along the way in early childhood, between one and three, we have sensory integration, motor control starts to develop, relational flexibility, 'How do I negotiate my way through the world?', attunement
And when we are talking attunement, I want you to really think about relationships because relationships that are meaningful actually change the child's life, they resource them
If your relationship with a child, and every child needs a relationship that resource them to build the best development they can
It also tells their story and a relationship between a worker and a child can actually make meaning to the child where no one else is listening to them
And also it needs a whole community that's compassionate to them, that integrates
So this is around fine motor control as well
And we know that we need really beautiful fine motor control to read and write once we go to school
Also, it's about emotional states and social language, this is where we build empathy and emotional regulation, but also around tolerance as well
So children at this very early age, it's the relationship that helps us build those really key areas around attunement and attachment, and then around regulation and empathy and tolerance
The cerebellum is the second part of the brain
It is around about 10% in volume, but it holds about 40% of the new neurons of our brain
So it usually develops throughout the first two years of life, post-birth
So when a child is up and running and not falling over is usually when the cerebellum is very beautifully developed
It's a core part of development around the push and yield of arms and then floor time, building the core muscles in the body, and then starting to crawl and roll over
We now know that crawling, the research is showing that sitting, crawling are really key parts of the cerebellum development
We also know that this is where children learn coordination, learn how to skip, catch a ball, ride a bicycle, cut, draw, and eat with a knife and fork and spoon
It's really about posture and balance and spatial awareness
What does this look like? These are the children, if I have poor cerebellum development in that, or very poor floor time, or very poor crawling time, if I've been in a relationship with my caregivers where my needs aren't met and I'm left in a cot and I'm not stimulated to roll over, crawl, and I'm not picked up then often I'm clumsy, I'm klutzy, I run into things, I'm always knocking myself and I don't have an awareness of where other children are in terms of my spatial awareness
And for some adults, you know, when we're training there's some adults that say, "Oh, that's me
" And often children who are hospitalised or children who have lots of illness, often the cerebellum, but remembering that no matter what we are doing, part of our work is looking at each part of these brains
Even at my age, I do things that build, I do lots of balance exercise, 'cause it builds your cerebellum
Our brain is a bit like our body we need to be building it and looking at the different parts of it and what are the activities for it
So we know with the brain stem, it's rocking, soothing, rhythm, dance, movement
We know with the cerebellum it's things like marching, crossing the midline, crawling, activities of balance, balance boards, balance bikes are things that actually build the cerebellum
And so when we know that the brain has huge plasticity up to about nine, we know that we can change the impact, in actual fact, of what has been happening if there's poor development from family as an example, or caregivers
So this is really the development around babies, gaining head control, sitting, and then really it's responsible for movement and really develops in that first two years of life
And it has its own two connective pathways between the two parts of the brain as well
Then, now diencephalon, and this is the one that's really important that we are doing that there's lots of current exploration and looking at from the child development perspective, 'cause it actually sorts out the messages coming into the brain
And it's part of the limbic system, the emotional brain
So we've gone from the brain stem, which is our really survival brain into our cerebellum which is movement, spatial aware, and now we're starting to move into what is our emotional brain, and this part of the brain develops mainly after birth
It's also the part of the brain that develops beautifully in terms of being my needs being met, so if I'm hungry, I'm fed
If I'm lonely, someone picks me up and talks to me
It's also about if I'm not feeling okay, someone comforts me
So this is how the messages, the hormones, the neurotransmitters of our body tells us what we need, food, water, love
And I need my needs to be met as an infant and a small child for this to develop beautifully
So that the hormones, the messaging around food and water and love don't become, perhaps not normative development that they may get mixed up so that children often think, don't understand if they're full or if they're hungry
And so one of the areas, if you think about the sensors introception, which is our number eight sense, which is around core body functions, people say that introcept, and we'll explore introception a bit later
introception is at the heart of regulation
So I know that people have really beautiful diencephalon when their needs are fully met
And this is about that children's needs are met at the time that they need them
So when we think about trauma, we know that children aren't fed, or they're not picked up, or they're not nurtured, or they're just not given that space and time to fully develop these messaging in a normative way
And then the limbic system is our emotional part of our brain, and it helps us attach an emotion to an experience or a memory
So if I asked you what do cut lawns remind you of? Most people will think about, you know, nice spring days, playing outside, having fun
And sometimes if you know, I know if I ask people, what does coffee, the smell of coffee, remind you of? We know that it reminds us of like nice fun times with friends or going out and having coffee and catching up and having those really nice things
So we know that the limbic system attaches an emotion to an experience or a memory
It stores and helps interpret it, our emotional state
So if I'm in a constant, under threat or my life, my needs haven't been met, then my limbic system is not able to provide me with experiences of being calmed or being nurtured or being held or feeling safe
And for some children, the limbic system developed in a state of being aware of being unsafe all the time
And often that's a really unconscious implicit memory as well
So the limbic system is also the emotional centre of the brain, and we know that it rules the life of young children up to around about four years
So if you really think about the emotional brain, this is a key part of the work that you do
So we know that during toddler years, like from two to four, that the limbic system goes through really rapid development
So this explains the two-year-old, sometimes the behaviours that occur, the tantrums, because their brains are really getting into this emotional development
And so we need them to help manage their strong feelings in a really safe, connected, relational way
Young children feel before they act, they don't think then act, that comes much later
And this is due to that emotional part, the limbic system of their brain developing before the cortex, which is a higher functioning part, or the thinking part of the brain
So really they just are viewing the world through an emotional lens after birth up 'til about four when their cognitive brain starts to come on board
It's a beautiful time, but if we think about this as really, it's the emotional brain that's actually developing, then it's fantastic
And a really important part of the brain, especially when we are thinking about children from trauma, who perhaps don't have the input and the nurturing and the comforting that allows them to actually explore the world in a beautiful way and use those emotions in positive ways
And then amygdala and the hippocampus, which are really core in our work around trauma, are part of that limbic system, and they form part of the limbic system as well
So the amygdala is often, and there's two amygdala and they're like little almonds or lima beans in either hemisphere, left and right hemisphere
So the right hemisphere amygdala is responsible for negative emotions
And the left amygdala is responsible for positive emotions
The amygdala is really active at birth and is really highly responsive and sensitive to sensory input, particularly those from other humans
So when it senses danger, it quickly recruits other parts of the brain and the body to respond
So it recruits the brain stem, it recruits the adrenal glands to distribute adrenaline and cortisol levels
So it's very controlling, the amygdala
The other thing about amygdala is that it holds the sensory information around trauma
So for children who come from family violence or experienced huge trauma
And when we think about the things like bushfires, floods, the trauma of that is held in the amygdala
And so anything will trigger that
Smells, signs, faces, voices that are linked to that experience will quickly trigger the amygdala and trigger the body into that sense of feeling unsafe or a fight-flight stress response, either a hyper response or a hypo response
And then the hippocampus is involved in the formation of memory and of explicit narrative memory
So it's really about the brain filing system
The hippocampus is able to file that information so that you can pull that out and have the story
It really plays a key role in ensuring that experiences are stored with contextual information about time and space, and the hippocampus matures around about two or three years of age
Hence we don't have narrative or explicit memory until about four
And for some people that's older, but we know that people have beautiful attunement and attachment often have earlier memories as well
We also know when the amygdala fires, when the amygdala says I'm unsafe, we know that the hippocampus goes offline
We know that we don't have memory, that often children don't have memory around what occurs to them when they're in really heightened states
We also know that when they're in that heightened state, that the information is not laid down for them to recall
We also know that children who have high levels of dysregulation, constant threat, fear, and we see this in children often in out-of-home care or children where there's been lots of family transience, poverty, homelessness, family violence
Often they're just in a state and they do not have access to their hippocampus at all
So some of the really preschool, some of the primary developmental goals are starting to think about abstract reasoning, creativity
I'm starting to think about social, emotional integration
This is where we start building those social skills
We know that if I'm in a state of heightened awareness or in a fight-flight response, whether it's a hyper or a disassociated submit collapse state, we know that we often don't build that social emotional integration, because I'm in such a fear state that I'm unable to allow people to come into my space to respond to
Yet social emotional integration is one of the key things that children need moving into school
Also it's around where moral and spiritual foundations are laid down
So this is a really essential part of development for the child alongside that limbic system as well
And then our complex thinking brain is our really high functioning cortical thinking
It's the largest part of our brain, and it's responsible, and most people think of this as the brain
In actual fact, with children from trauma, they are usually driven from their limbic system
We also know that when we have constant impact around family violence or trauma in the community, we know that often children cannot access their cerebral cortex, so it's really conscious processing
It stalls the really explicit memories of events and the narratives and people and experience
It provides a basis for self-reflection or the capacity to think, it has the capacity to think about thinking
If we didn't have our cerebral cortex online, if we're just operating from the limbic system, we can't think about what thinking is
We're just operating from a purely emotional, that sounded a bit blah, blah, blah
I hope that made sense
So really the normative development for the cerebral cortex and the complex thinking part, and remembering that this is sort of the last part, this is the roof, and we want the roof to develop beautifully
So we need all those other layers to develop accordingly
So this develops, starts developing between the ages three and six, and it's the last part of the brain to start developing
And then the prefrontal cortex doesn't mature until you are in your late twenties, early thirties, but they're interconnected
The prefrontal cortex is really CEO of the brain, but for children, we are really looking at this complex thinking, the largest part of the brain
It enables humans to think before they act
And this is where children start being able to think before they act
Before this they're actually acting from the emotional brain
So as children grow and develop, if they're able to have a really calm, safe environment, the cortex is usually then able to help them pause, when you think about when we're flooded with emotions
So this allows us to feel, think, then act
For children from trauma, often it's just acting from that emotional brain they're not able, and this part of the brain doesn't develop in the same way
And often it's offline
If you think about the roof of the house, when the emotional centre is activated by the amygdala and the hippocampus is offline, then the higher cognitive brain, the roof just goes off the house, and children are just operating that purely and feeling unsafe or feeling distressed or feeling not connected
So unlike the brain stem, the limbic system and the cor


Unlike the brain stem and the limbic system, the cortex is really susceptible to change due to experience and to the environment of where the child is and operates throughout any environment that they


So it can be home, it can be early learning centre, kindergarten
So we can actually have a huge impact in terms of the cerebral cortex and the development of this, if we can keep that emotional brain feeling safe
But it's really highly susceptible to change, which means we have this huge opportunity to create real change for children
Often we don't think about that, we tend to be responding to the emotional brain rather than thinking about how do we get the cerebral cortex online and then changing it, because we know that if I can get the roof onto the house, it can actually control and change the emotional brain
So I want you just to think about, and you can, I'm happy to go back, but I want you to, I'm just gonna flip back through this just for a minute
I want you to think about the child that you drew this morning
And I want you to think about where you think the child, where the development has occurred, and what are some of the impacts that you are seeing
So in terms of, is it brain stem? Is it cerebellum movements, spatial awareness, coordination, fine motor skills, gross motor skills
What are you seeing with this child and what do you think? This is their ability to know when they're hungry, when they need love, when they need water? What are their body signals telling you about the child and the impact in terms of their normative development around the limbic system
And the amygdala and hippocampus, what is their memory like? What's their attention like? Are they in this constant fight-flight response or disassociated? Are they hiding? Pleasing? Which when the amygdala fires, we also know that that disassociated, submit, collapse, flop, some people call it flop, hide response, we know that those children have experienced the most trauma
We tend to focus on the child who's in a hyper-dysregulated state rather than the hypo and think that's outside their window of tolerance as well, often get missed in that they're very quiet
Or is it around complex thinking for this child, if they're an older child? Where is the child at? So we'll just take a few minutes
I just want you to start thinking about coming up and thinking about different parts of the brain for this child
What does it look like? And you can Google this if you want to, you can have a Google and think about the impact
Just take a moment to actually reflect on the child that you work with and what does this look like
And think about the children who have beautiful coordination, think about the children who have really normative development as well
What has (indistinct) that brain development from the bottom to the top and from the back to the front
Brain stem, cerebellum, limbic system, amygdala, hippocampus, and then the higher cognitive brain
I need some nice music, but I'm sure if I tried to put some music on it, I'd just lose the screen
And the entire webinar would just go, and then my amygdala would be firing
I'd probably in a state of complete collapse maybe
Think about the children in your centre who are pleasing or who fall asleep
How do they respond? 'Cause falling asleep is a disassociated response sometimes as well, or the children who hide, who aren't seen
So there are really good reasons why these things start to happen and we're starting to see behaviour from a different lens is one of the things that starts to happen
Remembering often that the brain stem is a really survival, so will set off the emotional brain really rapidly, that fight-flight
Often the child will orientate, there's something about orientating to the predator as well that they'll come in really close to the adult
That's part of feeling safe
And for some children in the hypoaroused state, the sympathetic response, they shut down completely
So just write some notes around that child
Okay, there's a couple of questions
I'm happy to answer those
So the first one is, we have just enrolled a child three years from the Ukraine with little spoken English
So non-verbal language and connection will be important
Hoping to find some ideas of how educators will develop our relationship with him
I do have an email address at the end, I'm happy to, if you have particular things or information that you're looking for
So one of the things is there are some beautiful, if you're thinking about beautiful, for non-verbal, for children who don't have English, there are some beautiful non-verbal tools that are available and using lots of pictures
But also really around getting down to the child's level, but also really having lots of eye contact and those things that tell someone that we are really attuned to them
The other thing that is really important in that state where we don't have words, and I think this is really important for all children from trauma, 'cause often children from trauma sit in their right hemisphere
So they don't have access to language anyway
So whatever you are doing for this child is anything that we would do in a trauma-informed space
So it's really lots of eye contact, taking delight in the child, but also really showing and expressing to the child that I'm seeing them and I'm hearing what they're seeing and what they're actually doing at the moment
But also lots of, one of the things we know that makes the child feel safe, which brings their cognitive functioning online is things like real predictability, not having bowels, doing beautiful cues around


And some people play some nice regular music
Having routines that are really predictable for the children so that they feel safe when they come to the centre, but also about making parents feel safe
How do we make parents feel safe when they come to the centre as well? 'Cause often if you are working in communities where there's lots of trauma and lots of intergenerational trauma, or lots of natural disasters, also people will be affected, families will be affected
And definitely the brain stem can be affected by alcohol and drugs through pregnancy
We know that FASD has a huge range, you know, it's a disorder that's on a spectrum
There's beautiful research out of South Africa that says, one glass of wine at a particular times, at any time (indistinct) impact
We also know that often with young people, they're binge drinking when they get pregnant
So lots of information
If you're looking for really fabulous, there are some really fabulous resources around FASD
There's actually a website, I have to find that one
I'm sorry, I don't have it at my fingertips at the moment, but I think it's Australian FASD Association or something like that
But I'm happy to find that for you, if you are interested
Can TV time affect its growth? Yes, cerebellum is all about activity
Cerebellum is all about balance, you know, those little balance bikes that children have, I always say they should be on them at nine months
Walkers are really a no-go
What we know from the current research that is available that came out last year, the evidence shows that the longer a child crawls, the stronger the cerebellum
So we know that the cerebellum links to every other part of the brain as well
So it's a very core, important, but we know getting kids to do like, come out, crawling across the carpet, crawling, we know that marching universally develops a cerebellum
But anything, if you're looking for balance boards, stepping stones, there's a whole range of just activities
We know there's lots of activities that early childhood do that in actual fact, build the cerebellum, anything that's around balancing across, walking across boards or stepping stones, or walking on stilts
But yes, certainly too much TV time without that activity


If the child has got lots of things to engage them, rolling over, if it's an infant rolling over, getting children to move is a really big thing around the cerebellum, early infancy getting and things like push and yield
So tug wars using those rubber straps, let me just find one
I'm sure I just had one here
Can't see it
But just those rubber straps, getting kids to push and pull is very much about developing the cerebellum
Where do you think giving eye contact sits at? So we know that eye contact is a really key part of developing the brain
We know that only about seven years ago, Marco Iacoboni is a profession, is a professor in Italy who discovered mirror neurons
We know that mirror neurons light up when the baby and the mum have eye contact
We also know from the research from, there was a piece of research in the late 19th century, no 18th century, there was a piece of research at a Romanian orphanage in the 1980s that showed that when children aren't, don't, they can be kept warm and fed


We know that eye contact, and there's beautiful research from the Center for Child Development out of Harvard University, Cambridge University, that eye contact is the essential brain development, like a really early infancy newborn baby has eye contact
And sometimes it's not about constant eye contact, but it is about if you actually meet a child's gaze and then look away and look back, they'll be having eye contact with you
We also know from the research that mirror neurons are implicated in autism
The academic argument that's going on at the moment is do faulty mirror neurons cause autism, or a faulty mirror neuron is a result of autism? So I hope I've answered that to some degree
It's a really fascinating subject
Start Googling, start looking at the evidence and research
Body language plays
The role body language plays
Our body language plays a huge role because remembering that 80% of our communication is non-verbal
So about having joy and delight, we know as adult having joy and delight in other people engages our brain
We also know that when we fully engage and we have hand, you know, you can see my hands
We know that when we are doing those things that we are actually saying to someone, and when we are nodding and we are really enjoying, and enjoying with a child, we know that they know that I'm seeing them and hearing them and connecting to them
And sometimes for children it's difficult because they're not used to that
So you have to find really unique ways of engaging them
If a child had an experience of trauma, may he or she copy the cruel, sick situation to other children? What we know from some of the evidence is that's not always the case
There are two ways of looking this, that sometimes children will take an example, and if you look at the Bobo doll research from the 60s, what they found was the children would extend the violence without seeing it
We also know that children from trauma don't have empathy, so they don't understand the role of what they're doing, how it impacts on the other person
So the things that we know that children from trauma really require and need are relationships
Attuned, connected relationship that says, I see you, and I'm gonna start making meaning of your world with you
That you aren't bad, that you don't (indistinct)
I wanna join with you and I wanna make your world better
Empathy can be taught even to adults
We know that children and adults who've come from trauma have very poor empathy, so teaching empathy
And there's lots of tools around teaching
I'm not even gonna give you some of those, 'cause they're online, you can just Google tools
The other one is impulse control when they're a little older
So in that sort of three to five, lots of impulse games and activities
So again, there are a lot, naturally they're some of the games that we do, Simple Simon Says
Freeze
They're all impulse control, teaching impulse control
But do they copy? So the information is, they may see a behaviour, but they may also extend that behaviour
So if I am pulling the hair of a child, doesn't necessarily mean that someone has pulled my hair
It may have meant that my mum might have been combing my hair and I felt that, and so I've then gone to the next level
So often they extend that as well
I hope I answered that
It's really hard when I don't see people
Since COVID we have seen trauma in an adjusted light, how can we go be responsive to this? And do you find it differently to behaviour issues
Yeah, so that's a really fantastic one because as I go around training and especially, I've recently been back face-to-face in Melbourne, and one of the things that schools are seeing is that children coming into prep have very poor cerebellum development
So that loss in two years of exercising and those really key things about being outdoors and doing all those fun things that would normally be continuing, they've got very poor coordination, very poor
And the other thing is that what they're seeing is children coming into kindergarten and school and not understanding friendship roles and treating friends as siblings
So definitely we will see children


The only other thing that really gives me some joy and delight is that connectedness for infants was enhanced in some, some families saw that as an opportunity and some people decided not to return to work in the way they were because they found that connection to family
We know that connection, that relationship, that togetherness is what really helps children in terms of regulation and resilience
So yeah, so your difficulties in behaviour, toileting and eating issues are really connected to that development of the limbic system as well
And I'll talk a little bit more later about introception, which is really connected
And introception is very much about body awareness and it is connected of course, when children don't have that beautiful sequential brain development
So think about going back and thinking about the rocking, soothing
So rocking can be things like hammocks, rocking chairs
Things like, you know, the floss dance
Anything that's rhythmic
Dance, drumming
Anything that builds the brain stem
And then of course the cerebellum, I think I've said this a million times I cannot tell you how important the cerebellum is
So the other thing that we know and have known, having done research into mental health, we know that childhood trauma is linked to mental health issues in adulthood
So the more work we do in the early childhood space, around reconnecting and building the brain and having beautiful brain plasticity, of course, and before the age of nine, we can do lots of great things
Ahh, of course, crossing the midline is fantastic
It's also integrating two hemisphere
So painting in circular motions, getting children


Don't have walkers in your early childhood centres, let children crawl and don't encourage children to walk
The research and evidence is saying, that children should be encouraged to crawl longer, but painting and crossing over the midline is beautiful
If you look at Brendan O'Hara's work in the 1980s brain gym was all about circular motions, elephant ears, just things like crossing the midline and just getting kids to hold their left ear or their right ear
Marco Iacoboni, so it's, if I remember correctly, I-C-O-B-A-N-I
I would focus, if you think about the sequential brain development, really think like every day we can do activities that are brain stem, every day we can do cerebellum
So really think about, but when you are starting that, if you do it in a sequential way, you will probably have a much better impact 'cause that's how the brain develops or divide up your curriculum
So that this week we are really focusing on brain stem, next week we're really focusing on cerebellum
So what we know is when we are doing emotional activities around children learning emotional regulation, we also know all the children benefit
We know that all the children will benefit from this
Even children who have normative development
For an example, Melbourne University released a piece of research looking at children in COVID in February 2021, sorry looked at 12 months, found that children where teachers in schools had taught regulation those children did much better throughout COVID
Can stuttering, I don't know a lot about stuttering, but one of the things I do know is that stuttering is associated with and can be just a one-off event, like a mum going into hospital
But it's usually around about the age of two
There seems to be a connection
I don't know a lot about it, happy to explore it
Jessica just email me and I'll see what I can find
That's what I know is that it's usually associated around about two years old with a traumatic event
If you think about things like the fires and floods, those things would be sort of one-off events
Or my understanding is it's often about the caregiver
Stuttering is really linked to the caregiver
Oh gosh
I think this is about safety
I would explore when he does this, from a trauma perspective, and I'm not sure if this is a mental health or it's probably a trauma experience, I would explore the antecedents and I would map the antecedents before he says this
What has happened? Is he feeling unsafe with you at that time? Or have you raised your voice and he's hearing that voice, because it's a trauma response
I would have some concerns for this child, I think he needs a referral
I would be using your collaborative systems around the child, but I would also map for a 10-year-old, I would be mapping what is happening
Is it in mid-afternoon when he's tired, or is it when other children are doing things to him
If you're looking for some good mapping tools for a 10-year-old, have a look at the Victoria and New South I'm not sure about New South Wales
I'm happy for someone from New South Wales to jump in on this one
But the Department of Education Victoria have something called ABC scatter plots, which is on their website, which allows you to map so you start understanding that this is when the child is feeling hungry or tired or something and map what has happened around them when this is happening for them
Hope I've answered that one
Okay, yes sure
Look, we know that the brain has huge plasticity, even in adulthood
We know that we can change our brain
We know that the brain up until nine has huge plasticity
So my emphasis in early childhood and early primary school is really do the work in those years now, and really focus on these children so that we can build and change for the child how they see themselves
Also, we know for adults who do trauma training, they suddenly say, "Oh my gosh, I thought I was just this really bad, terrible child, but it was trauma, it was my dad being really violent
" We know that it's in the relationship with workers that heals trauma
We also know that a single childcare worker, a single teacher, we know that the canteen person or the receptionists, who takes an interest in me, changes my life
It's when someone sees and connects and actually says you are okay
We know that that's what changes for the child
I'm just aware of time, but that's okay, we've got time for a few more, yep, okay
I think I've just add that one around positive neuronal
Certainly, when we know that, when we work and we think about the brain from brain stem forward, that we can change the brain
We also know that when children, we also know that the children who are socially disconnected, are recognisable in kindergarten and in reception we know, I'm not sure
So in that four- to six-year-old, we know that we're already identifying with children
So think about social skills, think about empathy
And there're things that you naturally do, that teachers and early childhood educators are doing this all the time
Also, the thing that if you are working in primary school, have a look at early childhood planning for children because their plans, early childhood do this much better than any other sector
It gets a little bit lost once children go to school
So think about what does this child really need and start looking at that lens
So all the research now is not letting babies cry themselves out
Sorry, for those of us who went through that state
We also don't do sleep clinics now until they're 18 months old
So it's really about building that, and also that core attachment and attunement in centres, childcare centres around really creating a more, one or two people who connect to the child, not lots of people interacting with a child
So crawling longer is about building the cerebellum, which is a really core part of the brain development and circular motions
I'm hopefully I'll explain that a little bit later
It's around hemispheric development, around integrating left and right hemisphere, children from trauma tend to sit in their right hemisphere
We know that the corpus callosum, which links left and right hemisphere is developed usually around, really core development is between the ages of four and six
We know that children who have music lessons before the ages six have highly developed corpus callosum as do people have highly integrated left and right hemisphere
So anything that crosses the midline, starts to integrate left and right hemisphere
Children who have trauma often get stuck in the right hemisphere
So don't have access to language
Language is not a great tool for children from trauma or for children pre that cognitive development
So walking on, yeah, tippy-toes is two different things
On tippy-toes it is a developmental indicator, but for some children, it feels good, but definitely linked to development as well
You should have an OT referral for a child on tippy-toes just to check it out
But some children like walking on tippy-toes
So be aware that sometimes it's an enjoyable thing, but it's a very clear indicator often around a developmental stage or poor attunement and attachment as well
OTs would answer that question much better than me
Are children who say they're hungry all the time


No, often it's about that diencephalon, about their messaging, about their hormones, their neurotransmitters, around what is my messaging in my body
And if my needs haven't been met often that, and this is really common across the board in trauma from zero to adolescents
Children have very white diets in trauma, what we call white, when I say white diets, it's a bit of a phenomenon that everyone names that children will eat white bread, chicken and chips, and that's about it
Texture is not good
We also know that eating crunchy foods is a normal part, impacts on brain development
We also know eating crunchy foods impacts on attention and learning
So there's lots of different connections that we are starting to see and evidence is starting to come out as well
How am I doing? I'm up to 11 o'clock
So there seems to be multitude
I'm just going to leave questions at the moment and then come back to them so that we just move through the webinar
Is that okay? How am I doing, Kate? - Can you hear me? No, yeah
- All right, so what you're doing is you're starting to think about the child's brain
What is really beautiful about your questions, and is that you are really starting to think about the child, not from a behaviour perspective, but from a brain development perspective
And I'm really excited about that, because that is absolutely beautiful
And we don't want people just thinking about the child, because often when we think about behaviour, it's about how we then connect with the child
When we start seeing the child through this lens of what does this child need and how do I connect, and how do I use my relationship to really change things and have this child create the best development
There's a sort of a bit of a movement, and I have some papers in regard to this one, is about, we don't talk about parenting anymore
That, you know, parenting is fairly value laden and it can be quite critical
But when we talk to parents about what your child needs, and about full development in terms of brain and cognitive function, we start changing the language
And also when we are saying to parents, "You know what, when Donna does this in the centre or at school, we are doing this
How about you try this at home at well, we'll all be doing the same thing, which will build Donna's cerebellum, or build Donna's emotional brain beautifully
" Most parents love this, they, they come on board with it
So we talk a lot about psychoeducation for parents, psychoeducation through the centre, like, through your newsletter
What you are learning is sharing it with parents about them understanding what a child needs in terms of development
Now, my slides are just frozen for a bit
So now we're just going to look at trauma, and think about what is the impact of trauma on the brain? We've looked at the developmental, what's required for developmental, and I've talked a little bit about some of the impacts of trauma as I went, so this won't be too extensive
So really think about, what is trauma? What does trauma do? And often it's a word that's thrown around, you know, a little bit
Triggers and trauma, you know, have become a bit jargonistic at the moment, but really what is trauma? And how is it different from stress? And then what is different about traumatic experiences that occur early in life? And then how can trauma impact on a child or young person? So what I want you to do is just take a moment alongside that child that you drew earlier, and I want you to just draw what you think trauma is
It's good to draw, it engages your right hemisphere
So just draw, what is trauma? What does it look like? And then we'll explore the definition of trauma, and what trauma looks like for children
I think I have sort of covered trauma as I've gone along
So what is trauma? So it's an understanding that any single ongoing or cumulative experience, which is perceived as a threat, overwhelms our capacity to cope, feels outside our control, but evokes both a physiological and a psychological set of responses based on fear or avoidance
And there is alongside the responses with the children, their behaviours that are linked to trauma, is also neurophysiology
There are lots of things that happen in a child when they're experienced that threat of trauma
So really understanding child development is pivotal to recognise and distinguishing the impact of trauma from what is normative behaviour or misbehaviour
But we know that children, infants and children who experience chronic traumatisation frequently experience delays across their development spectrum, like, cognitive skills, language, motor, social skills
So simple trauma is overwhelming and painful
It's usually a single incident
It might be that you have a car accident and children end up in hospital
It doesn't have a lot of stigma
Often, community responses to simple trauma is much more supportive than helpful than complex relational trauma, 'cause complex relational trauma are multiple, extended incidents over an extended period of time in blaming or stigmatising the child
It's usually based in the relationship and associated with shame
Isolates the child, impacts on their identity
Sometimes it's underpinned by intentionality
So if you think about intentional family violence, or if you think about sometimes intentional not feeding a family, or intentionally targeting a child and victimising the child in the family
So what it does, it induces a sense of disconnection from others and from support
So often, the child who has the most extreme impact from complex relational trauma struggles to survive
Also, if you think about children's behaviour from a survival perspective, that children and women die every week in Australia from family violence
So often, what we call maladaptive behaviours are survival behaviours
They're developed by the child to survive in a world, either running away or hiding
Or some of the things we see is, you know, enuresis and encopresis, wetting pants, pooing pants, faecal smearing, because it's a perfect tool to keep the perpetrator away
And there's lots of behaviours
If we start to put them in a context of looking at them around, how did this help the child survive? What we know from children who come from extreme and multilayered trauma, is often they become very black and white, and very inflexible, and don't connect to you, the worker, because their trust in adults has been severely damaged, they've not had attuned and attached relationships
Children who can join in and connect to us have had beautiful, attuned relationships in their life
Children who can't connect, and often it's difficult for us to work with them
To be honest, I often say to people, "Let's be really serious
These are the children who are the most difficult children to work
" And often when I'm in an early childhood centre, I look across, and all the other kids are playing the educator is reading to the story, and there's this child, and you just have to look at them to know that this child is sitting on his own, and not joining in, 'cause often, they are difficult to engage, because they see the world as unsafe, and they just see you as a bear
And they'll do things to prove that you are unsafe, and then when you punish them, is perhaps a really strong word, or you remove them from the other children, or you put them into time out, then you are actually saying, "I am a bear
" And you're just enhancing their mistrust of the world
The other ways of engaging these children is really to have time with, eyes on, hands in, in here with me like a toddler, like a baby
I want you front and centre in my world
And if you look at Dan Hughes' PACE, if you look at Kim Golding's work, it's all about bringing in the child and creating this sense of attunement with the child as well
And then developmental trauma occurs in those crucial stages of brain development
So the child's development can be slowed down or impaired, often then leading to the children experiencing really splinted development
So these are the children who are neglected, abused, sexual abuse, physical abuse in really high-level family violence
Or high-level family conflict in the context of separation or divorce
We also know that high stress levels can also create intransigence
We know that just transience creates a sense trauma for a child
And then these are sort of when we layer on, so for some children, they will have all of these in their lives
So they may have simple traumas on a day-to-day basis because you know, we become homeless, or we don't have food
They have complex trauma across their world in terms of what's happening in their world
And then in relationships and their needs being met
And then developmental trauma is that it impacts on particular stages of my life
So we know that high stress levels in mum, in utero, impact on brain development
We know that at certain points of time, children who often are removed, like, at four to eight months, often have very poor cerebellum in out-of-home care, one of the things that we see is very poor cerebellum
But when they have great caregivers, they often then have beautiful cognitive development
We have intergenerational and transgenerational
So sometimes some people use intergenerational and transgenerational interchangeably, but intergeneration means that it comes between two generations
Most of us, as we get older, we start saying, "Oh my God, I said something, I sounded like my mom
" That's intergenerational
And there's positive things that are intergenerational as well
Like, my love of babies comes from my mom, comes from my grandmother, that's intergenerational
And then transgenerational are the things that occur across a multiple layers of generations
So if you think about our Aboriginal communities where, you know, you had genocide and stolen children, then the community were sad
And then you have violence where, you know, 'cause men's roles were removed, children were removed
So there was this huge, deep sadness
Women were removed and put into, you know, servitude in houses, and were often abused and then unable to share and connect to their children
And often that has come across a range
So often those things that change transgenerational outcomes
Historical, if you think about historical in Australia, even white people coming to Australia, came out on convict boats, they weren't P&O Cruises
You know, there was lots of violence
We had the Second World War and First World War, where men came back after experiencing horrific things
So if you think about historical events that is really, starts to impact in lots of ways
And then epigenetics is our response on our DNA
And a really simple way of putting that is that our coding can be switched on or switched off
And the major research has occurred after the First World war, there was famine in Holland where Dutch people started to store fat, and that has remained switched on for five generations
I thought my heritage was Irish, but if you have a look at my hips, I think there's a Dutch ancestor in there somewhere
And then Rachel Yehuda, it's a very new science, epigenetics, but worth having a look at, it's fascinating
Rachel Yehuda did work on the epigenetic changes for people, children of Holocaust survivors
We know it's a response to pollution, to the environment that happens in our DNA
But we also know that when violence switches on particular coding in our DNA, it takes around about three to six generations of really beautiful, nurturing, and caring to change that our DNA coding
That's a very simple form
I'm happy for you to jump on and do one of our trainings around epigene


Or have a look, there's some beautiful YouTube podcasts and evidence papers around epigenetics
And then collective trauma is the collective trauma within a community
That often if you are sitting in a community where there's lots of violence, low socioeconomic, homelessness, poverty, then you have a collective trauma
So for some of our children, some children will have all of these in their lives
And then how do we change that for them? So these children need to be at the centre
If you remember that little heart right back at the start where the child is at the centre, we need to have them there, we need to give this child the most love and delight that we can actually share with them to change their world
But also, to change things like intergenerational violence or intergenerational trauma
The other thing is about, you know, stress is different to trauma
Stress is difficult, and we feel we have to cope
And sometimes it's difficult in this world to cope with the level of stress, but trauma leaves a lasting impact, that's the difference
And we don't have those inheritable changes in the gene function as in epigenetics when our world is normative, and we have attached and attuned people in our lives
So these are the ways that children experience trauma, and really understanding that cognitive impacts language, impacts motor skills, social skills, that children and young people who experience chronic traumatisation often have these delays across areas in their life as well
Often they have gaps
And if you think about the house, often, for some children, the floor is not fabulous
Or the walls, which is the cerebellum, are not fantastic
But don't think just because they've got poor four wall, some kids have fantastic roof
You know, it's like the house that they built the beautiful roof first
But for some children, in actual fact, the impact from in utero will impact on all layers of their brain development
So even when we are working with disabilities, what we do in this space around brain development impacts beautifully and creates the best outcome for children who have a disability as well
We also know that relational, the relationship is really important
We know that attuned, attached relationships, have a look at the evidence and the research, there's some really fabulous new evidence and research about very attuned and healing in attachment through your role with them as well
And it doesn't have to be lots of time, people say, "Oh, I'm only here 9 am to 5 pm or 9 am to 3 pm
" Okay, so this is just a really, just a nice, little thing saying trauma can impact all those areas, all those domains of a child's life, brain, body, memory, learning behaviour, emotions, relationships
Excuse me, I'm just, I need to drink water
So things like, children will push away the memories of pain
They shut down their feelings
We know that emotional literacy, we do lots of things like, emotional Jenga, emotional bingo, things like zones of regulation
There's some beautiful zone, you know, ways of getting children
When they come in, I talk to a lot of educators who say, "The first thing in the morning is we just have a little rhythm singing song because I know that they've had mum yelling at them and mum (indistinct) the day
" So we know that all those things that we do just naturally, this gives meaning to them as well
Remembering also children who have all those trauma impacts, often stop believing in and trusting adults
Also, prolonged exposure to trauma and stress for a child (indistinct)
So they start scanning the environment constantly
When I'm in a fight, flight stress response, I don't have access to my memory
So it impacts on how people see me, but I'm not even remembering, you know, that two plus two is four
I was gonna say six, 'cause that's what I normally do, but I just thought you all might think I've forgotten
But you know, that's sort of thing that if the child next to me is annoying me, or if your voice is raised, I might be in a fight-flight remembering that the hippocampus, which is our memory, goes offline
But if I've just got, you know, if I'm living in this household of not getting to bed at night, constant arguing, drug and alcohol, family conflict, not being fed, all those things will mean that I'm in a heightened state, and I'm unable to learn until someone assists me in regulation
But they're also relying on you to protect them and to help them find that sense of safety as well
Complex trauma results in a loss of core capabilities like self-regulation and being able to have interpersonal relationships
So often, the young person, the child, or the infant will then have lifelong problems that place them at extra risk of additional trauma, are not being invited to play dates, not being invited to other children's parties
That starts happening at kindergarten age, at a very early age, labelled with names
But we also know, if you look at Gabor Maté's work, it's linked to addictive disorders
We know that it impacts, we know that disassociation in children, if not addressed, leads to chronic mental illness in adolescents as well
So if you think about Dan Hughes work, he says that severely traumatised children, actually always present with a combination of biological effects, such as being, you know, in constant fight-flight-freeze
The active freeze difference as opposed to the hyperaroused flop disassociate is the heartbeat is faster in the active freeze
It slows down in the disassociated state
So emotional effects such as hyper vigilance, always looking out, little things will impact on me, just another child moving, or a raised voice, or a face, or unable to read people's faces or emotions
Unable to label and describe feelings, difficulties communicating my wants and needs, unable to say, "I need to go to the toilet
" And then the behaviour effects that we see, and you can add to my list, if you want to, as I go, the behaviour effects are hyperactivity, poor impulse control, demanding, attention seeking in a really odd way, violence
You know, and then we start talking about oppositional behaviour, we start labelling
Difficulty hearing, difficulty following rules
We see stealing food, often children in disassociated states steal food, or steal lollies, or go and find places where they can steal food
Then often don't remember
Often, extreme risks almost at the edge of self-harming
And then they lack curiosity because in those hormones, in the diencephalon around hormones, one of the key things that gets impacted in this state are dopamine and oxytocin
Oxytocin is our connecting neurotransmitter, and dopamine is what is essential for learning about having curiosity
So they usually often have really poor problem-solving skills
So even when we are giving them, we need to be much more defined and actually often demonstrate, and do it with them rather than just trying to get them to do it
And lots of problems in terms of that really higher brain functioning, higher cognitive functioning around planning, goal setting
Very often, very poor, low self-esteem, sense of shame and guilt, always blaming others or blaming themself
And then just having a really poor sense of belief about relationships
Sometimes need to control others or control themselves, because that means I stay alive, it's a survival skill
If I don't let you in, and if I manage everything around me, if I'm really black and white
Inflexibility is one that we see, and especially in early primary school
Really unhealthy boundaries with others, sometimes withdrawn socially
So children with attachment difficulties from, attachment remember is very early infancy, often mask anxiety about their relationships and learning, by really controlling behaviours or aggression
So really think about, as educators, that we have to embrace this child's brain as it has huge plasticity, and what are the changes that I can create? I think it's a really exciting time
So this is just implicit memory, thinking for these children
Often, implicit memory is what they respond to
Often, they don't have narrative memory, and people do like, child protection, the justice system, education, often want narrative
Often, children in a disregular state don't have narrative
I want you to just have a think about, how does this hand feel? And it will be unique to each one of you
I want you to consider, how do you feel in the relationship to this gesture? What are the emotions you attach to it? How tall are you? How old do you feel? Is the hand offering you something, or wanting something? Is this hand safe to you, or is this hand unsafe? So how we respond just to this simple hand gesture will be different for each one of us
And the way we interact with this hand has to do with the procedural cues that we have implicitly coded over the years
We don't even know why we respond to the hand in that particular way
And it does change, each time I see this hand, I now have a different response
But when we think about how strong that response is just to a simple hand on a slide, and some of the feelings that are attached to it, think about the implicit memory that these children who come from trauma have, that hand may not be safe, and it may not be saying, "Come with me," but it may be threatening
So we often forget about the implicit memory, and the implicit responses that are coded for the child that they have in our classrooms, or in our centre every single day
And the implicit responses come from very early infancy onwards
So it's quite an interesting phenomenon that implicit memory, and often when children don't have explicit memory, they will have really strong implicit memory
So this is the, like just having a look at the impact of trauma and disrupted attachment across those developmental stages
Behaviour changes are changes to the neurobiology of the brain in the central nervous system, are altered by that alarm system
Fear responses to reminders of trauma
And it may be things like a smell or a perfume
It may be a face, if I frown, the child may respond
Or it might be just sudden movement
Or it might be about me waving my hands around
The implicit responses that are embedded into that fear response are really strong
Often, some of the signs, and I do recommend that you have a look at the child development and trauma guide, which sets out what does the impact of trauma in each age stage look like from zero to 18? There are particular ages where the impact of trauma creates particular behaviours
Like, as an example, between five and seven, the impact of trauma often leads to hurting animals and lighting fire, it's pertinent to that one
Sleeping disturbances are in all age stages
I might be hyperaroused, constantly in that hyperaroused state
I'm hypervigilant around like, watching people, watching the other children
Or I might be insecure, anxious, or just withdrawn and hiding, or I might be pleasing
People talk about fawn, it's become quite common, it's not evidenced, and they don't know in research at where fawn fits
They think it sits in disassociation, but it's a word that people are using a lot
But we talk about pleasing as sits in the disassociated where I will


To actually orientate to the predator, I please the predator, and I learn in pleasing that I keep myself safe is how that develops
Loss of capacity
We know that when I don't have great attunement and attachment, and I don't have someone who gives me that attunement and attachment as I move through my developmental stages, I lose the capacity to manage my emotional states and to self-soothe
Adults who are very emotionally self-regulated, you know that they had an attuned safe person
We know that children who grow up in villages have this really calm, emotional regulation, because their needs were met
And I'm talking about where they have a whole family that are responsive to the child
And then these are some of the responses in terms of preschool developmental stages
Regression, often, regression in acquired developmental gains
Loss of capacity, again, to manage emotional states, they can be really insecure and anxious
And we know that sleep disturbances happen across all these
A loss of, or reduced capacity to attune to the caregiver
And in this, you would say loss or reduced capacity attuned to caregiver, educator, or teacher, or the people around them
I'm focusing on the perpetrator, I'm focusing on feeling, trying to make myself stay in this state where I'm responsible for surviving
And then these are some of the other things that happen
We would see, if the trauma actually impacts these particular, these are some things that you would see in these stages as well
Key behaviour changes
We might just do some more questions and answers, just for about five minutes
So how do we prepare ourselves as educators to guide and support a new child coming into the centre, who has experienced trauma? As an educator, one of the things I always recommend is that you, and if it's early childhood, you do this really well, anyway, I know that you do this really well, that you see the whole

But think about, what are the impacts? Where is this child sitting? Are they in a hyperaroused state, or a disassociated state, in a hypoaroused state? The other thing is don't focus attention on the child, because what we know is that in a group, or in a classroom, when we do activities that address the individual child, we know that we actually change the outcomes for all the other children
When there's a regulated, calm environment, children will learn better
When children play connected and in a relationship with the educator, we know that that builds brain capacity
We know that when children connect, and are seen, and felt, and heard by the educator, that then they actually build something really unique
I know from my work in early education centres, that early educators say that when children come to them because they connect and hold the child, that the behaviours that everyone else is talking about, family, child protection, who else is in the child's life, completely dissipate in the centre, because the child feels safe
So I think the key thing is around thinking about safety, and looking at, how do we create safety for the child who has experienced trauma
But also for the child's parents, so the parent feels


Cause of two year old not talking, sometimes selected mutism, but one of the things we're seeing more, an epidemic of children coming, both to kindergarten stage and school stage, is dysregulation, and no language
It's across Australia
So one of the things about that is around lack of attunement and attachment, is around parents not talking, not connecting
Lots of sociological reasons
I could go on for about two hours
The other thing is the child of two who is not talking needs a referral to a speech pathologist
And lots of language skills, lots of language opportunities
Leanne talks about nutrition, sits with brain development
Nutrition's not really key at this point
Of course, nutrition is important, but we know that nutrition doesn't have a huge impact until a little bit later
Most babies are getting bottles or breastfed, but we know that nutrition, of course, builds better physical
We know if the brain fails to thrive, then we have physical failure to thrive
We know that it's in the brain development that the physical development happens, so they sit alongside each other
There's lots of different advice, but I would be talking to dieticians in regard to the importance
Some people think it's not as important at the early stage until about three or four is when nutrition is essential, when the bottles go
Lots of talk, you know, there's lots of this information around formulas for toddlers and things
There's lots of nice debate happening, so jump online and have a look at the debates that are happening, that in actual fact, children need to be starting, you know, to experience food across a whole range of things
That in actual fact, some of those toddler formulas are impacting on nutrition
It's not my area of expertise, but they're just some of the things that I do know
Oh my gosh, you can see three weeks of him enjoy, and you see improvement in his behaviour and connecting with us
I would be doing some upstairs brain, upstairs, downstairs brain
I would be teaching the children that, like, things are happening for him
Things are making him feel unsafe
I would be doing, because there's some beautiful songs about the brain
There's some beautiful activities about the brain, but we know that when we teach children about other children's brains and about their own brains, that we also know, you know, one of the things that I see is very young children is saying, "Is your upstairs brain off?" Or, "Is your roof gone?" They stop, and you actually see them start to regulate
But obviously, you're doing all the beautiful safety things
And just making the other children feel safe in this is probably the important thing as well
But also around, if you think about behaviour, and this is Donna-ism, this is not based in evidence, but this is Donna-ism, his behaviour or her behaviour is designed to enable that I survive extreme things happening in my life
If you just change my behaviour, I'm left feeling like I'm going to die
That's how these children describe it
This is how they feel
That I use this behaviour to keep me


So I'm in a dysregulated state, so I'm not reasoning, I'm just surviving
I'm fighting a bear, I'm fighting a crocodile
So when we are changing behaviour, I want you to think about, what do I replace that behaviour with? How do you find that behaviour? Where is it? All right
Where do we find the trauma guide? New South Wales have a trauma guide
WA is the easiest one, because all my students and participants, 'cause it's an easy one to download
And it just comes in beautiful, little


It's much easier
Victoria has one, it's huge, it's lots of chapters
New South Wales have one
I'm happy for someone from New South Wales to pop up where they can, if you have access to it
Go Kate, can you answer that? - Can you hear me, Donna? Yeah, we will locate it
And when we send out the recording for the session, we'll include the trauma guides as well
- I'm not sure what happened to that question
I do know, if you just Google WA Child Development Trauma Guide, it pops up
A simple yoga, breathing yoga, drumming, we know that marching, universally singing, are all regulation
We know that drumming helps the hyperaroused child
And the hypoaroused child, we know that things like, body tapping, body drumming, lots of scripts
You don't need me to give you the scripts, but simple yoga is a beautiful way, mindfulness
Children love it, there are simple activities
You know, I see children as young as three and four doing, you know, peace and quiet
You know, crossing their legs and doing little yoga activities, perfect way, 'cause it helps regulate the whole class
But the things that you know that regulate your class, the other thing is if you're taking your class, and these are just activities where we get children really in a beautiful natural, because that's how we want them to be across the day
Don't just bring them down, because for a child who is easily disregulated, think about and map the child in your classroom
We know that around about midafternoon is a normal time for dysregulation, around tiredness
Lots of schools are moving lunchtime out, and then having very quiet activities in the afternoon
Some schools are going to quarter to two for lunch, 'cause it shortens the afternoon, but it is just hitting that mark when kids are really tired and need some time out
Also, the other thing is around transitions and changes
Any change, change of educator, relief teachers coming in, change of transition from inside to outside
How do we manage those, and how do we make them really predictable is great
I would just say for this little, the two siblings, I just think you're doing exactly what this child needs
That you are actually giving him people who are safe
People who are caring, and people who are attuning and attaching to his needs
And yes, we really do struggle with it, but remembering that you are making the difference in his life, that we know that just that connection can change his life
The other thing is also is to greet mum and make mum feel safe as much as possible
Often, there's this thing about that parents don't feel safe, and the more unsafe they feel than their children
The other thing is when we connect to adults who come from trauma, we often get them to then start seeing that we're a safe place for their children to come
I've got lots of stuff around, and there's lots of stuff
And I'm sure that you will have other webinars around connecting to parents, and how do we connect to parents, but there's lots of really good information out there
Happy to share some that I've got
But I would just say, just keep doing what you're doing so that these children have a moment in their life that means they have an attuned, connected relationship, and that someone is really caring for them
Can trauma be caused by parents? Yeah, definitely, worked with lots of adults who say, "Oh, my father took a horse whip, I deserved it, didn't impact on me
" But it's really visible the impact, so definitely, yeah
Our ACF's mantra is connection before correction
And if you are really connecting to a child, and working with a child, and teaching them problem solving, then you don't have to punish a child or correct them
It's about connecting
And when we really humanly connect, we actually then start changing a child's state
Oh, okay, so this is just a classic, disassociated child
Disassociation, read about disassociation, we'll explore that
Well, no, we're not exploring that today
Have a look, whose work is really good in disassociation? Dan Siegel does some work, Bonnie Badenoch, Kim Golding, Pat Ogden, all do work in disassociation
So the response in the hyperaroused, which is indicator of huge trauma for a child, the lowest evolutionary response to trauma, is around contracting of bowel and bladder, where children pee themselves, enuresis and encopresis
It means they're in a really heightened, same as a really heightened child, but they're in a different state
And they will go into a state and then come out, look really hyperaroused and they'll move between the two
But in actual fact, the bowels, or it is a behaviour that is meant, it has kept people away, so it's a survival
So the child needs something to replace it
Again, connection before correction
But also children need to know that it's predictable
Children love consistency
We say in trauma, the biggest things you do is relationship predictability
So I'm just looking at time
I might just leave some more questions, and just go back and finish our webinar
But we know the consistency, predictability
Consistency and predictability, the things that make children feel safe
They're also about predictability about how you are going to respond
We know that that creates something really spe


It's like the mum, if you think about the infant, the baby cries, I pick them up, I soothe them, I feed them, I change them, and then I talk to them
That's the response, we want children to know that at this particular time, and if you think about how we build our services, it's about predictability and consistency
And often for children from trauma, when we move and change those, is when we have dysregulation
Lots of information around consistency and predictability
So this is the Department of Education, New South Wales Department of Education and Training
This is the childhood online trauma development programme that's available to you, that you can just enrol in and do, and it's a self-paced work through module, and that's the site for it
And I'll get Kate to pop that link into the chat, into the question chat as well
So this just will build, today's just an introduction
So that's available to you at no cost, and it's a fabulous, little programme that's got lots of interactive, and lots of information for you as well
The eight senses, so we know, and I'm just gonna briefly do these
We know that visually, that trauma impacts
So what happens is because I'm looking for the, and we know that our peripheral vision changes when we're in a fight-flight stress response
We also know that we need to be able to make sense of non-verbal cues and map people as they move
Often, this is missed for children from trauma
They have hard time processing a visual stimuli as well
And often, you know, have other impacts in terms of visual, unable to sort of make sense of colours or letters
Because when I'm focusing on a bear, and remembering if I'm trying to remember these things and my hippocampus is not online, then I can't hear it
We know that auditory, there's huge changes
We call it listening to the bear, and that's like, the auditory, the canal changes for children from trauma
The hearing, they often have hearing tests and they're fine
But it's where my attention goes, my attention goes to listening for the bear
And often, they have difficulty, often, they have really difficulty in filtering out background noises, so a fan
If you just stop and listen for a moment, there's lots of noises that we just filter out that you don't hear
For them, like, a fan or an air conditioner can sound like a jet engine
Or someone clicking their pen will sound like a jack hammer
So often they have auditory overload
Also they can have visual overload
One of the things I say is, don't have lots of bright lights on
Like, if you are mapping when children become, if it's, you know, afternoon or a particular time, turn the lights down
There's a really nice sense when we turn lights down for the brain as well
You know, I want you to think about, you know, nice, warm grandmother hugs
Warm, cuddly beds
What does it feel like? How do we create that in our centres? What does it feel like? 'Cause that's when we feel safe
And then touch, we're seeing lots of children now with sensory disorders
And often, touch is, you know, they're unable to bear particular fabrics or a tag of their clothes
Or if I handed out cotton wool balls, some of you would just love them, and some of you would go, "Oh, no way
" So often, there's a sense of touch that is different
And sometimes, the things that we think are really safe, these children won't feel safe
So often, we have to play with lots of things to find the things that, like a soft toy may not work for a child who has been, you know, seriously abused and then handed soft toys as a makeup
The soft toy is part of the abuse
So it might be something completely different, might be a different texture
Often, you know, the slime, those sorts of texture seems to run across the board
Those metallic beating things that move that kids often have on their T-shirts, they're fabulous, the kids mostly like those
It changes with each child
And sometimes, it'll work for a child for a little while and then not others
And taste, I talked about taste a little bit earlier
And then we know that smell, the sense of smell, olfactory, umm, old factory, no it's olfactory (laughs) is considered the oldest system in the brain but it's also the one that is most connected to the amygdala
We know that just the smell of another child, or the smell of someone's food, or the smell of your perfume
I recently was at school, and they were talking about every time a particular art teacher came into the school, this child dysregulated
And when they worked with the child, what they found was, they changed their perfume and the child stopped being dysregulated
So that was their really strong sense of smell triggering them
So it's the one that is most likely
And then vestibular, we know that children have this really sense of head movement in space, where my head is like, when you're sitting there, I know exactly where my head is, it's here, it's in space
The children often from trauma, they have no idea, and so they'll bang their heads on things, or they'll, you know, bang their head on other children
They just don't have a sense, but it also helps the body to maintain balance
And it's really strongly connected to the cerebellum, 'cause it's a vestibular is about, I'm aware of where I am in space, and that's the cerebellum
So they can be really clumsy
Dancing, jumping, swinging activities, are really good to develop vestibular opportunities
And then proprioception are the sensation of really being aware
It's a similar to vestibular, but it's more about where I am in my whole body and space, where my arms and my joints are, where my elbow and my knee are
They often have difficulty navigating their muscles and joints where they're located, and how different body parts respond to external stimuli
And then introception is really the awareness of like, hunger, toileting
Most people, OTs will tell you that introception is at the heart of regulation
If you have very poor introception, you will have very poor regulation
Occupational therapist, neuroscience, Jane Ayres, it's a
jean Ayres, I think it's A-Y-R-E-S, liken sensory processing disorders to the brain receiving information, and it doesn't receive sensory information correctly
Introception is doing things like kangaroo jumps, and frog jumps, and getting children to be really aware of their body
And then self-identity, often, children from trauma have very poor self-identity
It gets mixed
So this is our hierarchical nervous system
We need safety
Danger is diminished
The body responds in these different ways
Immobilised responses is the thing that is indicative of very high trauma for children
And if you read, this is Stephen Porges work
Please explore Stephen Porges 'cause his research reveals how our nervous system reacts to our environment
And it's a neuroception of safety that promotes the ability to really utilise our higher cognitive and our neural systems to overcome those responses to fear, both the mobilised fear and the immobilised, which is our disassociated-submit-collapse state
So the window of tolerance is its own in which, you know, is where we operate, where our hippocampus is online
Relationships feel available
The brain shifts from the emotional into the really high cognitive function
When we slip outside of that, either in a hypo-dysregulated state, or a hypo submit-collapse state, our cortex is no longer online, we don't have learning
And top down doesn't manage the emotional brain
So the window of tolerance, and our accessing all of our brain the way we should, if they're around helping children feel safe in their body
So this is, the yellow part of this is our window of tolerance
And what we want to keep children is in that window of tolerance
So the submit-collapse hyperaroused state is, you know, where children feel emotional numbness, emptiness, and sometimes almost paralysed
So that window of tolerance is where I feel safe, and I can move up and down in the window, but I don't
Lots of work now happening
The research and the work in the trauma space is very much about, how do we build the child's window of tolerance? How do we create connections between me, the educator and the child, and then the child and other children? And then how do we connect that to the whole community? So it's really about that we are building and moving the child's window of tolerance to a much great

'Cause some children's window of tolerance will be really tiny, really small
Think about what is the baseline for your community? What's the window of tolerance in your community? What does it look like? Is it a really hyperaroused community, or is it a really calm? All of you will be in different communities, but also think about what is the baseline for your centre? What might it be? Is it in a collapsed state 'cause it's overwhelmed? Or is it in a really dysregulated, hyperaroused fight-flight response, responding to all the chaos? Responding to COVID and everyone is out their window of tolerance
So think about, how do we maintain those things in our centre, but also in our children? And this is just from Cathy Malchiodi he is another beautiful neuroscientist who does lots of work around play
So children are to engage in pleasurable activities without becoming hyperaroused before they develop the capacity to play with others
So we need to teach children how to regulate in both states before they can even start to play
And one of the things we do see is that sense of not having social skills
I think I've said enough about safe, attuned relationships
I can't say enough about the human safety that the child needs for their internal world to feel safe
And what is the parent's sense of safety in your centre? How do you create that? The environment, is it safe? What does it smell like? Is it visually overwhelming? So human safety for the children, are all the people around them really safe? So think about, you know, it's neural safety, do you have beautiful, safe spaces for the children? Do you have activities that make

And how do you engage in the safe spaces with them? Because it's in the relationship that the child needs to feel safe, just as much as in the safe
So safety is really embedded in our bodies, and it's a relational experience
So remembering that child abuse is that really deep sense of violation of the child's sense
And these are some of the strategies that we talk about
And this is very embedded in the polyvagal theory from Stephen Porges
So really about environment, looking at the environment
How close can I be to a child before they feel unsafe? Or do I need to feel, be close for them to feel unsafe? What's my eye contact? And we know that the brain is a social animal, and it connects if you've got dogs or cats
As soon as you see your dog, it'll have eye contact
Mammals need eye contact for the brain to say, "I'm seeing you, I'm connecting
" What are my facial expressions? Do I have resting bitch face? that kids read as, "Oh, she's angry at me
" What's your tone of voice? We know that prosity of voice creates safety
You know where the voice moves
What are our postures and gestures? Am I like Donna, like lots of arms and hands
So think about, what does that feel like? And then think about how do I really connect to the child in terms of lighting up their mirror neurons? You know, that sensation in our brain when we really connect to someone
And then how do I really help the child to make meaning of their experiences, and their world that they're moving through? In all those environments, how do I do that? But they make meaning of it about how I reflect back from you
And even, I've asked Kate today to stay with her camera on, 'cause it's the only phase, and it's really important to me to be connecting to Kate, so that my brain is making that I'm actually connecting to people out there, the question and answers were great, but that's what the child sees
So to cope, children from trauma use adaptive responses
They will be different for every child, and they will change as soon as they think you are safe, they'll do something that makes them think, "I'm just gonna poke them to see if they're really safe
" Think of a, really a range of combinations of appropriate developmental behaviours that you can swap in to help the child survive when you are thinking about changing their behaviours
When we make meaning for the child to understand that some of this isn't about you, it's about what you've experienced
Then if we just tell them, "You're okay," that they're loved
And that sense of that, "I see and delight in you
" That sense of taking great delight and the person says, "I see, and I really care about you
" We need really trauma-informed and -integrative systems
We know that from trauma work, every single framework across the world talks about collaboration
We need collaboration with people who support us
We need collaboration with the community, with parents
The parents are our partners in this
We need collaboration with our OTs and speech pathologists
We need to be building those networks
We also need to have those networks of child protection
One of the questions earlier, how do we create that connection? And how do we have those networks that they're responsive to us as well? And then reflective practice is really essential
And today is really about that you are doing some reflective practice, reflecting on the children that you work with
So that's some of the resources that are available for you
Online, we have lots of resources, lots of nice little things
I know this is "The Handbook of Therapeutic Care for Children," and it's designed for children in out-of-home care
But it works really well in schools and in early childhood
Some of the information, especially from Martin Teicher, about understanding dysregulation is beautiful
Cathy Malchiodi, that's how you pronounce her name
Cathy Malchiodi's work around activities for children is beautiful
Kim, like all of those, are amazing people
So that's also a list that you can follow up on all the different researchers
They all have beautiful podcasts and YouTubes that they share with people
Here's some of our references, and that's my email address, and we've got about five minutes of questions and answers
All right, here we go
Okay, how do we respond of an eight year old? One of the things I would, this is a Donna challenge, but it's across ACF, is sometimes an eight year old is not sexualised behaviour
If you change that and call it challenging behaviours, we deal with it exactly the same as we do in any other behaviour
We manage it, we actually take control of it
We talk about that it's not appropriate to talk about sex in the classroom, that's in private
So manage and stop thinking about it as sexualised behaviour, but as a really challenging behaviour that I need to actually identify, what is the need for the child? And probably the need is to be connected to other children, even though it's adverse
So think about what sits beneath behaviour, like you would any other behaviour
And it's really common, but often it's labelled, and then the child is seen as a perpetrator, rather than a child who has challenging behaviour
A lot of information on that one, Marika
Okay, so in this one, we've got child separation anxiety
We know from lots of different reasons for separation anxiety, and you probably need to explore what the different reasons are so that you can actually analyse why
One of the things that pops into my mind around separation is a lack of attachment, really solid attachment and attunement
Children who have solid attachment and attunement are actually quite confident
That's one of the things we know about letting go
If you look at attachment theory, we know that children who are solidly attached
So one of the things I would do is build that, and Dan Hughes' work around saying, have that child with you, and eyes on, hands on the entire time they're there for about six weeks
If they're still not ready, if they're still showing that, then do it for a bit longer
But he says that's what builds that sense of confidence for the child
But also the child, it sounds like the child is feeling quite safe as well, just keep building on that
How always wonderful? When they feel valued, at least, can you choose

Beautiful comment
Yeah, probably (indistinct) is sensory integration, definitely
Marika, that is the most

Oh, no, Deb
It is and it is that delight in the child that they feel valued and listened to, but it's attunement
If you think about it, it's really core attunement and attachment, because that's what good attunement and attachment is for, from parents, with infants as well
Ah, so the book, let me just skip back to the book
"Handbook of Therapeutic Care for Children" available through the ACF shop
I have to say, it came out, and I didn't read it, and then I started reading it as part of GCDT
And I now use it in when I'm training in early childhood or schools, 'cause it has such beautiful information in it

So I apologise for not grabbing hold

Lots of beautiful books out there Kim Golding, Sharon Phillips, Relationships in Schools is probably one, and Kim Golding is part of this one Kim Golding and Sharon Phillips have put out one about dyadic relationships in schools and using that
Okay, I think that's about it

I apologise for too much information
I want everyone to know everything that I'm so passionate about trauma-informed practice, especially in early childhood and schools, because this is where you will do the most valuable work as well
That's the reference page as well
All right, I think that's all for me, thank you.

Hi, everyone. Welcome to our session today, Communicating with Families: Professional Boundaries and Challenging Conversations. My name is Karin Humphrey, and I'm a Be You consultant with Early Childhood Australia. I'm based in Adelaide as Be You is a national initiative. So, I'm joined here today by my colleagues, Karina, who will be presenting with me, and Paola, who will be monitoring the questions that come through the chat. So, I'll hand over to them to briefly introduce themselves. I'll start with you, Karina.

Thanks, Karin. Hi, everyone. I'm Karina from Be You, I'm one of the Be You consultants with Early Childhood Australia, as is Karin and Paola. And I am coming to you from South Hedland, which is in WA. So, Paola, over to you.

Hi, everybody. Thanks, Karina and Karin, for having me here today. My name's Paola, I'm also a Be You consultant, and I will be available in the Q&A space in case anybody has any questions in regards to Be You or any of the content that's coming through. And we also have some Department of Education staff who are also answering already lots of participants who are adding into the Q&A, which is going to be great. Today should be an interactive session where you have that space to join us in the conversation. And I'm joining you from Darkinjung land, so Yaama to you all, which is hello in Darkinjung language. Thank you.

Okay, moving on. We've just got a bit of a housekeeping slide if Karina you can change the slide for me. Thank you so much. So, this is your housekeeping slide, so we're just doing this based on instructions given to us prior to this session. So, your microphone, video, and chat functions will be disabled during this webinar, but, as Paola has already said, we do encourage you to use the Q&A button at the bottom of your screen to ask any questions that you may have. You can type your question into the Q&A, and you can also see and vote on other people's questions that you might like answered during using that thumbs up button. We'll prioritise the questions with the most votes, and we'll try to answer these during the webinar. And I'm going to say try because we have to be really conscious of time, but, and we'll mention this a few times, we will send you a follow
up email after and any questions that we grab from the Q&A, we'll answer those in that follow
up email. So, the session is being recorded as well, and it will be shared with everyone that registered for the session in a week or so once it's all finalised. Okay, as we've already mentioned, we all meet with you from different lands today. Be You being a national initiative, we are learning so much about the countries that we meet on, so I'd like to start with my acknowledgement. So, I'd like to acknowledge the Aboriginal and Torres Strait Islander people as the Traditional Custodians of the lands on which we are meeting today. I acknowledge their continuing connection to country and pay respects to Elders past and present. I honour and respect the unique cultural and spiritual relationships Aboriginal and Torres Strait Islander people have with their land and the water. I celebrate their languages, traditions, culture, and customs, and the rich contribution to Australian society. I live, work, and play on Kaurna country in Adelaide. So, I'd like to greet you by saying Naa Marni, which is welcome to everyone. Karina, would you like to do your acknowledgement?

Thanks, Karin. Yes, and I would like to extend my acknowledgement to the lands in which I am meeting you from today, which is Kariyarra country, so Wayiba. So, Kariyarra country is part of Port and South Hedland, which is about 17 hours north of Perth, about six, seven hours south of Broome. So, yeah, we really do have a national reach here at Be You, and we do meet from all parts of the land. Paola, would you like to share your acknowledgement?

Yeah, thank you. I was going to share in the Q&A space, but I can unmute myself. And once again, I'll say Yaama, which is hello. And I am joining you from Darkinjung land, which is the Central Coast of New South Wales. And it's lovely to see people already adding into the Q&A space where they're joining us from. So, we are reaching far and wide in this lovely country that we're on today.
Thanks, Paola. So, one of the big things we endeavour to do here at Be You is to embed and honour Aboriginal and Torres Strait Islander perspectives in all of the work that we do. We have a suite of resources called the Always Be You suite of resources, and they can assist the learning communities to embed these perspectives into everything that you do. We recognize the contribution of Aboriginal and Torres Strait Islander in the development of these resources. Recently, we have also released a Cultural Actions Catalogue, and that was developed in collaboration with educators teaching in regional, rural, and remote communities in the Kimberley and Pilbara. This, the ebook, was developed with Aboriginal Elders, communities and educators, and identifies actions from quick wins to long term activities to create inclusive and respectful learning environments that embrace the histories and cultures of communities. So, these resources will form part of that resource list that we send through to you later. Okay, on our next slide. On the screen, you can see one of our Always Be You symbols, which is the Make Safe symbol. So, our Always Be You symbols were developed to represent the ways of knowing, doing, and being that we consider to be important in our work to support the mental health and wellbeing of children. So, this symbol prompts us to think about creating a safe space for sharing and learning, and considering inclusive practices, confidentiality, and privacy. I'd also like to remind people to really consider your own wellbeing during this time as we move through this session. Our conversations are going to include topics such as stress, wellbeing, and mental health. And these discussions can trigger thoughts and emotions that you may not feel very comfortable with, so please consider what works to support your own wellbeing today. Okay, I'm going to hand over to Karina now to give you an overview of the rest of today's session and some information on Be You.

Thanks, Karin. Yeah, so as Karin mentioned, we are going to be talking quite a bit today about mental health, and stress, and recognising reducing stresses all around how you can support yourself in participating in difficult conversations, and we're going to discuss some support strategies. So, and we're also going to have a brief introduction to Be You and the suite of resources that Be You has available to you and your learning community. We're going to split this workshop into two parts, with a wellbeing break in the middle. So, because we are all about wellbeing and looking after yourself, and that's one of the things that we really work hard on. So, that's why we thought we've got a lot of content to cover, but we wanted to really make it meaningful and not overwhelm you too much. So, there might be, there is quite a bit of information, but, as we said, we'll be sharing that list of links and tools that we've discussed today after the session, so you don't need to worry about trying to save links or trying to find and Google the Be You website and try and find all that stuff, we're going to send you that after the session, so just relax. If you do have any questions, as we've said, please put them in the question and answer section so we can really kind of discuss things because this is really about what you would like to know more about as well.
And that's where I will pop up and provide any of these questions that you put in there. And I can pose them to both Karina and Karin to possibly answer and give you more context around answering your questions and tailoring it, tailoring this session to your needs, to participant needs. So, on that note, I will go off camera until you need me once more, and see you later.

Thanks, Paola. So, what is Be You? Might be a question as some of you may have already heard of Be You and be registered with Be You, but some of you might not, this might be the first time that you've heard of Be You and what Be You is. So, Be You is a national initiative that equips educators to support the mental health and wellbeing of children and young people from birth to 18. Be You is delivered by Beyond Blue in collaboration with Early Childhood Australia and Headspace, and funded by the Department of Health. So, there is no financial cost to participate in Be You, and all members of your team can register as individuals with Be You. And you can also become a participating organisation with Be You, which means you get additional tools and resources and access to a Be You consultant. So, our vision, as you can see on the screen, is that every learning community is positive, inclusive, and resilient, a place where every child, young person, educator, and family can achieve the best possible mental health. And when we use the term educator, we're actually referring to all staff in a learning community as all staff have a role in building a mentally healthy community. It's pretty lofty aspirations, but I think working together and creating learning communities that have a focus on mental health is a really big step in achieving those goals. So, with Be You we provide free interactive sessions and events, accredited professional learning, we've got fact sheets, planning, and implementation tools and other resources, which you'll see and when we get to that Be You buffet of suite of resources. And our resources can support learning communities to meet national, state, and territory requirements that relate to mental health and wellbeing. Be You is for all stages and roles within early childhood education and care. And once you complete your registration, it follows you throughout your career, so you can update your details at any time to reflect career changes or movement into other roles. So, you know, if you do register for Be You and complete the Be You learning modules, you don't have to redo those every time you go to a different learning community, they all stay with you in your registration. You can log in and there's a little red circle at the top of the screen, and then you can, there's a drop down arrow next to that, and that's how you can access your details and update your details as you go. So, it's really important to remember that it does follow you through your career. So, Be You consultants like myself, Karin, and Paola, all work with learning communities to support the implementation of Be You, and ongoing access to consultants is a unique part of Be You and really sets the initiative apart from others. So, we're available for... We are online a lot, so we do sessions and events quite often. You can call us, you can email us, you can set meetings with us. You know, we're really here to support you and your work and make it as authentic and reachable for you and to have Be You sit as part of all of the work that you're already doing. So, that's a little bit about Be You and that those visions and aspirations, pretty lofty, as I mentioned, but I reckon we can do it. All right, so on the screen now you'll see the Be You buffet or suite of resources. So, as you can see here, there's quite a wide variety of resources and tools that you can access with Be You. Be You is innovative, it's different, it's online, it's flexible, and we're growing and adding to Be You all the time. So, you know, even if you have been with Be You for a while, you may like to go and you want to really regularly add time to access the website and have a look at any new resources. So, some of the new resources we've added recently is an educator wellbeing landing page that you can access through the resources tab. We've added some community trauma resources that are all in their own tab as well. So, we're always adding to those, there's always new fact sheets being developed, there's implementation stories you can access to engage and have a look at what other learning communities have done with Be You and how they're implementing Be You. And we've also got online interactive sessions and events, which you can register for and have conversations with Be You consultants and other professionals who are engaging in Be You. We also do webinars, so there are webinars on the Be You website that can register for, and all of our webinars are recorded and added to our website as well. So, you can watch those at any time, what suits you, you can watch them as a team, you can watch them as an individual, just depending on what you would like to do and what suits your timeframe. In the additional suite of resources, which are only for action team leaders, which we are, which are kind of our organisation leaders and people who are leading Be You, we are wellbeing champions, some learning communities like to call them. There are action plans, we've got implementation reflection toolkit, and there's also an actions catalogue. So, there's a whole lot of resources that if you are not an action team leader that are there and available, so, but you do need to be a participating organisation to access those. What we really like to iterate is that Be You is more than just a framework or a resource for professional learning, it's really about how you implement and embed Be You in your learning community. So, yes, there is the suite of resources and there's the, the professional learning modules that you can complete, but it's what you do with those resources that really make the difference in your learning community. So, it's something to kind of think about, and we really encourage people to have those reflective conversations as they're engaging in Be You to get the most out of Be You and to get that whole learning approach. So, some of the ways that you can utilise Be You is really adding actions to your quality improvement plan. So, we also have this, some videos on our YouTube channel that explain and explore how Be You fits into the quality improvement plan and how you can really implement Be You. So, there are some videos to watch on our YouTube channel, so if you have some time, some of those videos are three or four minutes that can be a really good tool to think about accessing. So, you'll see on screen now we've got our Mental Health Continuum. So, in a lot of our work, we refer to the Mental Health Continuum. And mental health can be thought of as existing on a continuum. So, we fluctuate through this continuum all the time. Sometimes we might be flourishing, sometimes we might be struggling, sometimes we've got things that are going on that are really impacting our everyday activities. So, you know, and that's okay, that's absolutely okay, and that's part of what we do at Be You is really trying to reduce the stigma around mental health. So, what we want to think about is that we all have mental health in the same way that we have physical health. And one of the aims of Be You is to reduce the stigma, as I mentioned, we do this by learning and talking about mental health. Some communities prefer the term social emotional wellbeing, but we do challenge you to really use the term mental health in your learning communities to, again, reduce that stigma and to explore what that means for you and your learning community. So, if you when you do have a look at the Mental Health Continuum, if you haven't already, it outlines developmentally specific signs and symptoms that can be indicators of mental health across all ages. So, you know, there's what flourishing looks like, what it looks like when you're going okay, what it looks like when you're struggling, and what it looks like when you're severely impacting everyday activities. So, we do encourage you when you do get that resource list to have a look at the Mental Health Continuum, and to think about how you can utilise that in your learning community. So, throughout our presentation today, we would like you to consider your own mental health, and also where you sit on the Mental Health Continuum. So, it might be taking a moment to kind of think about where you're sitting today, where you're sitting in half an hour from now, and to be actually aware of where you are sitting on that Mental Health Continuum, and to think about protective factors that you can put into place to support your own mental health. So, the Mental Health Continuum would underpin a lot of what we discuss today, and we encourage you to check in with yourself, as I mentioned, as we go and consider how you might think about looking after yourself, those protective factors, and what you might like to do after today's session to really support your wellbeing. So, Karin, I'm going to pass back over to you.

Thanks, Karina. Moving on from the Mental Health Continuum, I think it's really important to acknowledge that first because it's something that, as Karina has mentioned, we really want you to keep in your mind as we go through the rest of today's session. So, I'm now going to move on and talk about what stress is, and how it impacts us. You may have heard before in the background one of my stresses is my puppy that has decided that when she's outside and I'm inside, but I'm talking, she's not happy so she barks. So, she was barking outside my office window, so my apologies for that, that will be on the recording as well and it may happen again. Okay, so before we start exploring the ideas of professional boundaries and difficult challenging conversations, it's a really good idea to discuss stress and look at how stress impacts us because it impacts us all differently. So, difficult and challenging conversations can trigger stress, so it's important for you to understand how you may react. So, please remember that's an individual reaction. So, we're going to have a look at some stress behaviours, which I'll do in a little minute. So, as Be You consultants, we often talk to educators in learning services about stress because it really can impact our mental health, but we need to acknowledge and really need to acknowledge this, that stress is a normal part of life, everyone has both positive and negative stress. And I know you're probably saying, "How can stress be positive?" But it can be, and you can probably think of situations where it has been stressful for you and you've used it quite positively. So, positive stress motivates us and gives us some energy, it's short term, and at that time we actually think it's within our coping abilities. And as a result, we feel that as a result of that we feel that we can improve our performance. However, there is negative stress and this can cause anxiety and worry. And no doubt, we've all felt that at some stage and to various levels. And again, and I'll get you to think about that Mental Health Continuum as to how you have reacted to negative stress. So, a negative stress, again, can be short or long term, and we can think that it's outside of our coping abilities when this happens. It feels unpleasant, it decreases our performance, and it can lead to poor mental health and even some physical problems as a result of that. Stress is our bodies' response to pressure. It alerts us to a challenge or a danger, how we respond in times of stress depends on our environment, our past experiences, and our window of tolerance. Keep that little notion of the window of tolerance in your head because Karina will be talking about that in a little minute. Okay, so next slide. Thanks, Karina, sorry. Right, so when we're presented with stressful situations, our body creates a chemical reaction in our brain. So, it floods our body with hormones and prepares the body to respond to the challenge or danger. So, you've probably heard of the term fight, flight, or freeze. I really have to slow down to say that because I can't get them all right. So, these are ways our bodies respond to challenges or dangers. We may want to fight and to like try and get through it, we may feel like we want to run away from it, or we may be frozen and not able to do anything about it. So, stress behaviours are attempts to self
regulate and may maintain an optimal state of self regulation, so your body will respond in a way it needs to in order to self regulate. So, we can better understand stress behaviours by considering the function of the parts of the brain. So, we've got that little picture of the brain up there, so when you have a look at the neo cortex, which is that larger blue section, that's the rational part of our brain. It gives us the ability to reason, form thoughts and words, and hold specific memories, it allows us to plan and solve simple and complex problems. So, that's the part that it is the largest part of our brain. The Limbic system, which is that little bit in the middle that's red, is responsible for experiencing and recognising emotion, attachment, love, and social interactions, so very important. The reptilian brain, so that's the brainstem and the cerebellum, supports basic functioning required for survival. So, when our brain senses threat, and this is really important to remember, it will turn off that rational part of the brain, so, it turns off the neo
cortex side of the brain and we only use the areas for emotions and survival, so the limbic and reptilian sections of the brain kick in. And so as a result the rational part of the brain sometimes disappears, so that's why our stress reactions can be different to what we would normally be thinking. Okay, Karina, I'll hand back over to you now.

Thanks, Karin. Yeah, so, when we're thinking about our stress triggers and our stress responses, a really good kind of thing to think about is our window of tolerance. So, it can be helpful to think about our nervous system being constructed into those zones. And these zones provide a simple way of understanding how our nervous system's level of alertness, also known as arousal, changes through the day and response to stresses. So, as Karin mentioned, stress creates our chemical reaction in our brain, which floods our body with hormones, which prepare the body to respond to the challenge or the danger. The window of tolerance is a term coined by Dan Siegel, and the concept suggests that we have an optimal arousal level. This is when we are within our window of tolerance, which is this blue section that you can see on the screen. The window of tolerance is the arousal zone in which a person is able to function most effectively. When we are in the zone, our brain is functioning well and can receive, process, and integrate information, and respond to the demands of everyday life. When we are in the zone, we can think rationally, make decisions calmly without feeling overwhelmed or withdrawn. So, this is really where we want to be the majority of the time, and this is where we want everyone to be. So, children, families, ourselves, educators, our teams, we want to be in that window of tolerance. In response to various stresses, we may still experience emotions such as sadness, anger, happiness, and exhaustion that brings us close to the edges of our window of tolerance. But generally, we are able to utilise strategies to keep us within our window. When you're in your window of tolerance, this is a regulated and balanced state where we can think, reason, socialise, and reflect. You may feel stress or pressure, however you are able to manage this. So, hyper
arousal is a reactive state where the nervous system moves into mobilisation and is ready to fight or flight from the stimulus, so this is our fight or flight response. And I have to say that really slowly too because they're quite similar. So, when we are in this hyper
aroused state, our blood pressure, heart rate, and adrenaline increase, and you may feel angry, irritated, frustrated, or anxious, or fearful and panicked. So, those are some of those kind of things that you might feel in your body. So, your heart beat might quicken, you might get the butterflies a little bit, you might start getting a little bit shaky, and that's all physical symptoms of going out of that window of tolerance and into hyper
arousal. So, you kind of feel your back arching, all of those kind of things. And we can probably all recall a time where we've been in that hyper
aroused state. Hypo arousal is an under responsive state. So, where the nervous system and body begins to immobilise or shut down, energy levels decrease, and you may feel depressed, hopeless, or overwhelmed disassociated or that feeling that you can't move forward. So, you know, when we think fight, flight, freeze, the freeze is the hypo
aroused and the fight and flight is the hyper
aroused. And I think sometimes we can really identify which one we are or we may be, we may go into hyper or hypo arousal at different points, depending on the stress trigger that we're facing at that time. Oh, sorry, I've gone forward when I didn't mean to. Sorry about that, I'll go back. So, with this narrow window of tolerance, seemingly small events or experiences that used to have no impact on ourselves or children or families can push us into a hyper or hypo arousal. And a stressed or shut down response, it can become harder for us to access the tools and strategies that help us to regulate, making it more difficult for us to return to the window of tolerance. How these parts of the brain experience the world can react as stresses and can trigger us to move beyond our window of tolerance and into those hyper or hypo aroused states. When experiences and social interactions send messages of safety, belonging, connection, and pleasure, we have access to the rational brain again. We are functioning within our window of tolerance and using all the areas of our brain to regulate and respond to the environment and situation. So, becoming aware of what our stress responses are, and how to regulate ourselves back into the window of tolerance takes a lot of self awareness and reflection. And sometimes you need to do a lot of work to really identify what those stress responses are and how you can get yourself from a hyper
or hypo aroused state back into that window of tolerance. So, some things we might do might be deep breathing, and different strategies will really work for different individuals and at different times. So, sometimes what works in one situation may not work in another situation. Sometimes you might need some calming activities to decrease your arousal, and other times you may need stimulating activities to increase your arousal. So, regulation strategies may include, as I mentioned, deep breathing, a hug from a loved one. And if we think about children, that co
regulation is really important, so those hugs and that heart to heart kind of feeling help us to co
regulate, and that's kind of the starting of self regulation, we need to co regulate before we can self regulate. Doing some mindful activities, chewing on something crunchy is really what works for some people, listening to music, writing a list. If you're feeling like you're hyper
aroused, sometimes writing a list of things that you need to do can really support you. And we really recommend practicing strategies when you are within your window of tolerance as this will build your capacity to access those when you start to move inside and outside of your window of tolerance. So, you can monitor over time the effect and notice how you're feeling throughout the day. So, sometimes we may be within our window of tolerance most of the time, and then things will happen, we may have a bad night's sleep, you know, some of those kind of things, we might be moving house. So, these add extra pressures and we're not as able to self regulate as we usually are, and we might be easier going into those hyper or hypo aroused states. So, on the screen now, you'll see the five key areas of stress, which can positively and negatively influence our mental health and wellbeing. And it's really important to think about what your stresses are in each of those key areas. So, you know, what biological things might put you into hypo
or hyper aroused state? So, it might be having mess. Mess can be a real trigger for some people, noises, being too hot or too cold. You know, if you've got for children, it might be having things on their body that are irritating them. So, some children just won't wear buttons, for example, because they irritate them and that can put them into a hyper or hypo aroused state. You know, and thinking about ways that you can mitigate some of those stresses. So, if mess isn't something that you cope with very well, you may, the first thing you do might be to have a bit of a tidy up before you can settle into what you need to do for the day. And if we think about learning environments, sometimes if there is lots of stuff out, sometimes we might need to put some things away to support that keeping in that window of tolerance for some people because they might easily become overwhelmed with what's happening. Emotional factors might include anxiety, big emotions, grief. If people are grieving, again, tiredness can be a really big factor. I'm a person who needs a lot of sleep, so if I don't sleep well, that can impact my mental health quite a lot and my window of tolerance is a lot smaller, and sleep is a big thing for me or doing some mindfulness practice during the day so that I can keep that rested, keep myself rested. Some cognitive factors might be having an overload of information. So, thinking about what your information level is, and today might be a really good example of having too much information or trying to process too much information, which is where that having that recording that you can look at might be a really good thing to look out for and going to that list of resources so you can kind of relax today and go back to revisit things when you feel like you can process things a bit easier. But again, make sure you're using that Q&A opportunity so we can answer any questions that you might have throughout the session. A cognitive factor might be getting a notification that approval and ratings is happening soon, so that can be a really... Assessment and rating, sorry, that can be a really big thing that can trigger you out of that window of tolerance quite quickly. Social interactions can also be a stress factor, so sometimes it might be thinking about having if you are an introvert or an extrovert and sometimes you can be both or sometimes you know exactly where you sit. So, thinking about what protective factors you can do to support yourself as an introvert or an extrovert in different situations. You know, it might be if you are an introvert, for example, and you're with people all day, it might be taking some time in your lunch break to really actually take some deep breaths and finding a quiet spot outside or something, or going for a five minute walk just to kind of clear your head and reset yourself a little bit. And thinking about prosocial, it's thinking about what's happening in your environment with other people. So, if other people are stressed or have got something going on, then that can impact us as well. Particularly if you are empathetic, and, you know, I'm a big empath so I pick up on people's feelings quite quickly and quite a lot and take those to heart. So, thinking about how you can protect yourself in those kind of situations, or what strategies you can put into place to support yourself in those moments. So, stress points can move a staff member out of their window of tolerance, and it's important to be aware, as I mentioned, about your own stresses as these risk factors to our mental health. So, if stresses are not appropriately managed, it can push you out of that window of tolerance and from going okay to the struggling zone, going out of that window of tolerance into a hypo or hyper aroused state. And particularly when we think about those stresses being present on an ongoing basis. So, if you're under a lot of stress a lot of the time, that can really have a big impact on your mental health, so thinking about what you can do to support your mental health and your stress factors. To stay inside our window of tolerance, we need to be able to self regulate our own emotions and manage our responses to stresses in our life that supports our positive mental health, so this is a protective factor. Once you're aware of your stresses, you can begin to identify ways you can help regulate your own emotions and manage stress behaviours. So, if we have a resource called the Planning for Wellbeing: mine, yours, ours booklet, and there's some really good strategies and activities you can do in that book to support identifying what your stress triggers are, and what protective factors you can put into place for yourself. And sometimes it's having conversation with others because others may be able to identify what our stress triggers are when we're still not quite sure about them or our stress responses in particular. So, ideally we want to be engaging in strategies that maintain a positive mental health and wellbeing, and those that can relieve or appropriately manage the stresses present. So, as I mentioned, you know, if a messy environment is creating a negative stress for you, you might want to consider how you can create a space that is more calming and supports your mental health. Sometimes adding a couple of plants can also be a really good mental health support so you've got some greenery in your space, or it could be anything that supports you and everyone's different. So, sometimes it's also about reaching out for extra support. So, you know, if we are thinking about some of the stress triggers and some of those stress responses, reaching out to a trusted colleague or if you have an Employee Assistance Program, sometimes it's good just to have a chat with someone. So, if we're thinking about supporting our mental health like we support our physical health, you know, if we had a niggle or a sore knee, we'd go to a doctor and get that looked at. So, if we've got some niggles, or we're feeling quite stressed, or we're feeling down more than we normally are, reaching out to someone can be a really good tool and protective factor in supporting your mental health. And we know that some things are really out of our control, but what we can do is focus on what we can do to mitigate those stress triggers and stress responses, and reframe and reduce the stresses so that they're manageable and that you can stay within that window of tolerance in that okay or flourishing zone. I feel like that was a really lot of information, and it's probably a good time to think about any questions that you may have. And if you've put some questions in the chat, Paola's gonna pop in and we can have a conversation about some of those questions and think about, you know, supporting you and your role. Paola, welcome back.

Hello, so we've had lots of interaction in the Q&A, and I've answered a couple of questions, but there was a common theme coming through that one point that you made, Karina, about the co
regulation that children need to co
regulate before they're able to self
regulate, that was a bit of a highlight. And also, thinking about as adults does that come forward? So, did you wanna expand a little bit on that? Because I know that adults, we also need to co regulate at some points as well.

Yeah, definitely. And I still feel like I need co regulating quite often when I'm in a stressful situation. And like for children, they might come to you for a hug or they might if we're thinking about children who are really in a big emotional state, how we support them to get out of that emotional state. So, you know, thinking about sportscasting what's happening in the situation, "I can see that you are feeling really angry about the fact that so and so has taken your bucket," for example, which is we're thinking about the sandpit that happens all the time and how we can support and talk children through that, but also how we can give children some strategies around identifying what they're feeling and how they can utilise those feelings to come to a good, what's the word, outcome really if we think about it. I think for us, it's thinking about how we are self
regulating ourselves. So, it might be, as I mentioned, reaching out to a colleague, or my husband is probably my biggest co regulator if something's going on. You know, I'll call him and we'll have a talk about it. So, thinking about who those people are in your community, whether it's personal, professional that you can go to when you are feeling unregulated and thinking about if that's what works for you or even thinking about doing some deep breathing exercise, so that can be a thing that regulates us as well is taking a deep breath or going out in nature is a big one as well. And thinking about what works for us, and that's where that reflection really comes into play and thinking about what works for us and because we're all different and we're all what works for one might not work for another. Did I answer that? I'm not sure if I did.

I think you answered that really well, and actually that's brought, that's like the perfect segue to the next question. So, someone was mentioning that they used a diary or they use journaling to actually write down what's either the situation or how they've reacted and how they've felt at that particular time. And then, reading back on it and seeing and learning from those experiences, so that's just one strategy that works for one particular person. But I guess the thing Karina, your point of making sure that what works for one doesn't necessarily work for everybody, so it's having that reflective space, which is really important as an individual to understand, "Well, what's going to work for me?" And I guess personally I think possibly trial and error is going be a good thing because I have tried journaling and I have tried keeping a diary, but I'm not consistent, so then that gives me more guilt for not actually keeping up with my diary. So, that doesn't necessarily work for me, but that doesn't mean that it's not a good strategy. So, yeah, if do, and we are actually getting requests for any other strategies that you may have, and I don't want to put you on the spot, but if you've got anything that you can think of, possibly like now is a good idea to mention some.

Can I jump in there if that's okay?

Please do. (laughs)

I think the whole notion, and I may not give you any particular strategies because I think they are very individual. And Paola, as you've mentioned, you know, trialing some and seeing if they work for you and accepting the fact that maybe they don't. I'm a list writer, but I'm not a journaler if that makes sense, like I love to write a list when I'm feeling overwhelmed. I write a list of all the things I'd like to do and the list then doesn't, it may seem long, but when you read back, it doesn't seem so overwhelming. But the whole notion of self regulation and co regulation, I think as adults and as educators, we really assign those to children and we rarely think about it from our own perspective, but we tend to self regulate and co regulate without even knowing how or why we are doing it. So, it's about taking a step back when you're feeling overwhelmed, and then you're not all of a sudden, "What did I do? What did I do then? Who did I reach out to? Did I self
regulate? Did I have a strategy to self regulate, or did I actually talk to a colleague or a family member to co regulate to help to get some help for that?" So, I think that's what's really important as well. And all of this first part of the session is looking at the stress that comes from all of the professional boundaries and difficult conversations section that we are going to talk about in the second section. So, I think it was really important to unpack all of that first. So, thank you.
Absolutely, and I know that we are short on time, so one last question because this one's specific to Karina. Someone's requesting your particular, you mentioned that you take on others' emotional wellbeing and being that empath, and so do you have any particular strategies that you find useful in, I guess, protecting yourself. And again, I'm guessing that that's taken practice over the years, yeah?

Yeah, definitely. And it's probably something that I still work on because I still find myself resorting back to that thing. And especially when working in a busy early learning community, you know, it was really hard to do that because I'd walk in and I'd know someone was really cranky or something was going on and I'd automatically kind of think, "Oh, you know, have I done something to upset them?" And it wasn't actually anything to do with that, it was more about just things that were happening in their life and they weren't able to kind of identify what was happening. So, some things that I found works really well for me is kind of doing that deep breathing and actually really noticing what I'm feeling at the time. So, thinking about, "Okay, is this my feeling, or is this coming from somewhere else?" And thinking about reframing that, so if I'm noticing that I'm picking up on someone else's emotion, I can go, "Okay, well, this isn't from me and I can't necessarily fix this, but I can sit with this for a minute and hold the space for that person and maybe co
regulate with them and we can co regulate ourselves out of that kind of that feeling." And sometimes it works, sometimes it doesn't, sometimes I just need to kind of separate myself from the space, which is quite hard when you're in a busy learning community, that can be quite tricky. But yeah, it's just thinking about what works for you, and I think the awareness is the most important thing. So, once I became aware that that was something that I did, I could go, "Okay, that's part of me and this is I just need to be aware of it." Does that, I think, does that answer the question and help?

Definitely.

Might help somebody out there.

Yeah, absolutely, and I think just to add one more little point that it takes practice. And you know, it's not going be perfect the first time you try and have that mindful space, but the more you practice these little things, the easier it will become for you and it won't feel so foreign after a little while, but yeah, the awareness I think is the best step. So, I will let you get on with your presentation. We do have lots of other questions coming through, so I will do my best to answer those as you continue with your presentation, and I will see you back here towards the end with more questions.

Beautiful, thanks, Paola. And we are going to have a bit more time at the end of the session to answer some more questions. So, if you do pop, as we mentioned, do keep popping those questions into that chat. So, we're now going to take a bit of a wellbeing break because we've just covered a lot of information. (laughs) It's a lot, and some people might if you're a slow processor and a considered processor, then you might want to take a bit of time just to kind of step away from the computer and process some of the information that you have been exposed to today, and think about how you're going to process that and take a few minutes to write a couple of points, or something like that, or just take a breath. So, this is an opportunity to do some, again, do some movement. Movement can be a really good regulator and good wellbeing practice. Do some stretches, go to the bathroom, grab some water or grab a snack if that's what time it is for you. But we are going to practice a bit of mindfulness beforehand. If you want to go and do that wellbeing and take a bit longer, you can absolutely. But if you would like to stay for a couple of minutes and we can do a bit of a mindfulness exercise, then you're more than welcome to do that. So, I'm not a mindfulness coach or practitioner, but the more I explore mindfulness, the easier it becomes, and the more I'm aware of what's happening, and aware of how important it is as a self regulation tool. So, when you are ready, you might like to get comfortable, notice where you are. So, notice how your body is touching a surface, you might want to notice the temperature, might want to notice how your feet are touching the floor, how you're grounded. We're all in a virtual space at the moment, but that doesn't mean that we're not people who are present in this space. Take a deep breath. Take a deep breath in, and let it out. Inhale, exhale. Inhale, exhale. You may like to close your eyes if you're comfortable, or you can keep them open, it's up to you, you're in a safe space. Take another breath. And as you breathe, notice what can you hear? What sounds can you notice? Maybe my voice, there might be other sounds in your environment that you can hear. Take a moment just to notice what sounds are around you. Inhale, exhale. You might want to think about what you can smell. What smells are in your environment? There might be some cooking smells, some lunch smells depending on what time of the day it is for you. Somebody might be walking past with a coffee and that's what you can smell. Just take a moment to notice what you can smell. This can also be a bit unpleasant, sometimes we have unpleasant smells around us. If you're working in an infant and toddler space, sometimes those smells not so great. And when you're open, you might want to open your eyes when you're ready, open your eyes and think about what can you see around you? What can you see in your environment that's a round shape? A circle, for example. What can you see that's a circle? Think about what you can see in your environment that is green. Notice, again, what your body is touching. And when you're ready, you might like to go to the bathroom and step outside and have a stretch, take a couple of deep breaths, and enter into the space again, or go and grab a drink of water. And we're going to go get back into the session in about, on a different time zone I'm thinking

In about two minutes.

About two minutes. Two minutes. (laughs)

Two minutes. Let's go with two minutes.

Two minutes, perfect.

Okay, doesn't two minutes feel like a long time when I'm just staring at myself on camera? It felt like a very long two minutes. How's that for a stressor for myself?

Indeed, I know.

You could just move to the next slide, Karina, that'll be great.

I can.

Thank you. All right, so that first half of the session hopefully has set the scene for you and made you contemplate all of the things that you need to think about for this second session, second half of the session. Okay, so now we're going to start moving on and talking about our professional boundaries when it comes to communicating with families. So, communicating with families is definitely a part of what we do on a daily basis. If you were just to sit back and think about how often you do communicate with families, you'd probably be actually gobsmacked that you do it so often, but it's really important to actually contemplate the why you communicate with families because there's a lot of various whys. You're communicating about fees, you're communicating to say hello and goodbye, you're giving information about the child's day. And within there, there may be some times where you'll have difficult conversations. And obviously, we're going to go into that soon. So, one of the things that we need to remember when we're communicating with families is that if a family comes to us with concerns about their child, we need to think about whether we are the best person to discuss the issue, or do they need more specialised support? So, this is where our professional boundaries come in. We can be that source of support for a family up until a certain point, after that it may be someone else that needs to step in whether that be a colleague that has more specialised information or knowledge on the area, or a member of your leadership team, or whether it's someone external to your service. So, you have to think about your professional boundaries and your role with within those conversations that you'll be having with families. So, if someone requires external support, we need to have strategies in place that will assist them with making decisions about possible referral options, so this is where your preparedness comes into it. So, what have you got prepared should a family come and have a discussion with you about something that's going on, either for their child, for themselves, or for their family? So, would you know who to turn to should you need to refer on for that family? And please remember, it's not always families that will come and talk to you about something that's impacting them, we may need to consider that we have a colleague sharing challenges they are having, or a parent carer sharing their own personal challenges that does not necessarily have anything to do with the child. So, when you think about in the last two years, we know that many people have been under financial stress, you know, due to COVID with reduced work hours or job loss, and there have been many impacts from the isolation faced during lockdowns. So, there's no doubt that you've had conversations, you know, you've had families come to you with these challenging and difficult conversations. So, please remember that providing support doesn't mean you need to be a mental health professional or to find a solution to the problem yourself, but educators are in a unique position to notice and support children who might be showing signs of mental health issues. Again, it's really important to remember that it's not your role to diagnose, label, or treat mental health issues or conditions, but you can provide support or referrals in collaboration with families and colleagues. And again, I'll hint at that preparedness, Are you prepared should someone come to you that has a difficult or challenging situation, would you know where to refer that person onto if you are not the person able to provide the support? So, in doing that, let's think about your policies and procedures. Have you got policies and procedures in place at your service that provide guidance about how to maintain professional boundaries? So, it'd be really important to unpack this further with your team and plan how you establish and communicate your boundaries to families. Where do you have that written down? Do you have a spiel that you would say verbally when you know you're not the person that's best able to provide that support? So, we at Be You we have a really good In Focus webinar, and it's now a recording so, because it happened last year, I believe, don't quote me on that, I lose track of time, but I believe it was a 2021 webinar, and all of our webinars are recorded and they are put onto our website. We will put the link in a follow
up email to you for this as well, but it's called Professional Boundaries and Difficult Conversations. So, with each of our webinars, there's an accompanying document that gives you a variety of reflective questions that are great to work through as a team. So, it'll get you to look at your professional boundaries, it'll also get you to look at what you do during difficult conversations, and what your strategies are. So, it'll be great for you to have a look at that document as well. All right, if we move onto the next slide, thanks, Karina. So, now we're going to have a look at difficult conversations, which we've all had them and we will continue to have them, there's no doubt about it. So, there are two questions on the screen for you to have a look at, but leading into these, there may be things that you want to consider first. So, you might first want to consider what do you actually classify as a difficult conversation because we all may look at that differently as well. Is a difficult conversation one that you would have because a parent hasn't paid their fees? Is it a difficult conversation when you're noticing that a child is not meeting their developmental milestones? Do you consider those as difficult conversations? But why do you deem them difficult? So, I think that's what's really important for you to unpack as an individual and also as a team because, again, if we're going to support each other, if you don't find something a difficult conversation, but someone else does, you may be that colleague that supports and steps up and is able to help someone with a difficult conversation. We can actually think that conversations are difficult when we are not able to predict the emotional responses from the person we are having the conversation with. So, when you're going into a conversation with someone and you go, "I'm not quite sure how they're going to react when I say this," that in itself is a stressor for us, so we have to think about that from how it's going to affect us. And sometimes for us, it's a case of not feeling prepared emotionally or even mentally for the potential pathway that a conversation may take. So, again, I'd get you to consider that when your preparing for a difficult conversation. So, it's really helpful to be as prepared as much as you can, and to make sure that you're considering all of the aspects that may have an impact on the other person's response. So, things like the timing of the conversation, the environment that you have the conversation in, and your own feelings. And it's really important to ensure we give the other person that's part of this conversation the opportunity to share their point of view. We want the person that we're having a conversation with to feel validated and not feel that they're being told off. So, you know, we've talked a lot about what's happened in the last few years with COVID and then there's been mandated vaccines, there's been absences and changes to childcare subsidy. So, there'll be difficult conversations such as this that you've had over a period of a couple of years, but then no doubt that you can reflect and think about other difficult conversations that you've had. So, if I think about difficult conversations that I've had when I was an educator, I've had to arrange some difficult conversations and some of the concerns I've had are the uncertainty about the emotional response I might receive from the person that I'm having that conversation with, that can make me feel quite anxious leaning into the conversation. I also sometimes have to think about the history I've had with that person and the previous experiences or some previous experiences with that person or the situation in general. So, if I've had to have a conversation with someone else about the similar situation, and I may then reflect on how that went and assume that this one will go the same way, so I'll have an assumption about the response I may get. And the other thing that I have sometimes have felt concerned about is that I might feel that I'm caught off guard, and vulnerable, and unprepared if the conversation takes a turn a different way to what I've planned for it to happen. So, it's really good to, you know, preparedness is really important. So, there's a lovely quote that's mentioned in our Inquire module of the Early Support Professional Learning Domain. So, when discussing having a difficult conversation with a family, this quote says, "Start the conversation by asking the family to tell you what their child is like at home." So, that's a great way to get the family's perspective and to make them feel safe, like they're being heard and that their opinion matters. So, that's really important, so and that means that you're having a two way conversation and that's collaborative, it's not you just going in saying what you need to say without that person able to share their experiences. So, as I said, it's important that we prepare ourselves for difficult conversations so that we can manage our response appropriately when the situation arises. And it's often the unpredictability of the situation that brings a lot of discomfort, and that in itself will trigger stress behaviours. So, if we go back to what we were talking about before the break as stress behaviours, you know, will we freeze, will we feel the urge to fight for our point of view, or will we just end the conversation because we feel like we need to run away? So, think about all of that when you're communicating with families around those difficult topics. So, when we're engaging in these difficult topics and having these conversations with families, it's really important to consider our role and our professional boundaries, as I discussed earlier. So, remember again, remember to consider, "Am I the appropriate person to be having this conversation? Is engaging in this conversation within the professional boundaries of my role?" And think about your role in your service, is there someone else that's in a leadership role that could be having those conversations or should you be referring out to support that person with the difficult topic at hand? In some instances, you might engage in active listening and provide support, but remember you are not counsellors. So, for example, for me, within my role as a Be You consultant, I can sometimes find myself in a sensitive conversation which requires professional support. So, I have to say, "I hear what you're saying and that's really tough, but I'm not a counsellor." I would then provide information on appropriate support options or resources that might support that person. If it's a colleague I'm working with and they talk to me about something that's going on, I may refer them to their Employee Assistance Program. So, again, I'm gonna highlight the preparedness, what have you got at hand should a difficult conversation take a turn when you know that you are not the person that is best placed to be able to talk about it and to provide that support, what are your referral pathways? So, some ideas to consider to be prepared should you need to have a difficult conversation are so to ensure you build and maintain relationships with others. So, that's really important because when trust and respect is already established and you can already effectively communicate, this will support you should there be a need to have a difficult conversation. It'll flow a lot easier because you've got the trust, you've got the respect, and you communicate with that person regularly and openly. Ensure you regularly check in with yourself, we've talked about that, we've talked about your stresses. So, know where you may be sitting on the Mental Health Continuum at that particular stage and maintain your own wellbeing. If you feel like you're struggling before you have started a difficult conversation, take some time for yourself first so that you feel okay when you go into this conversation. And identify what emotions are connected to this situation that could be triggered for you. So, determine the right way to have this conversation with each individual. We all have different communication styles, so have a think about when you need to adjust your communication style to make the other person feel comfortable. So, we may need to have that balance between the way you like to communicate and the way the other person likes to communicate for everyone to feel that they are being heard within the space. So, be prepared with some resources or tools that you can refer to or share with the other person. If you're the one initiating the conversation, go in prepared, go in able to share some information, and share some tools and resources. You might wanna consider writing down, visualising or writing down the purpose of the conversation, what you want to accomplish from it, and what would an ideal outcome would be, but remain flexible in that because your ideal outcome may not be the outcome that you get. Stay updated with your policies and procedures so that you know what your centre's practices are, what your service's practices are, and that you don't stray outside of those. You might want to practice or role play the conversation with a trusted person because that's a great opportunity to practice key communication skills, such as the information sharing, your non verbal communication, and your body language, your empathy, and your active listening skills. Non verbal communication and body language are really important in these times as well. So, you may and then within that, you need to, it's really important to consider and address other communication barriers that might impact the conversation. So, again, I've talked about these already, but the timing of the conversation, think about when a family's coming in at the end of the day, they're running late, the centre's just about closed and you want to have a conversation about something that's going on with their child, that may not be the most appropriate time. The environment that you have the conversation in, so we want to think about privacy and confidentiality, any distractions that are around us. Do we have different agendas? Is what I want to talk about is the family even on the same page? And we also need to consider differences in cultural backgrounds, our personal values, and beliefs as well. These are really important. So, after I've talked about all this, have a think about some of the strategies you already use to communicate with families and to prepare for those difficult conversations. Are there any others now that you'd like to consider or anything that you're thinking about that would be something new that you'd bring in? So, when we are prepared for these conversations, and when we are prepared for any communication we have with families, we are better at communicating. And when we communicate effectively, we build a shared understanding and a partnership with that other person, which is really important. So, in early learning services, strong relationships and partnerships with families and colleagues supports positive outcomes for children, and overall this leads to us having a mentally healthy community. Over to you, Karina, thank you.

Thanks, Karin. I was so enthralled by what you're saying there because it's you spoke about it all so well, so thank you.

Yeah.

And yeah, and it's sometimes really hard, and I'm going to talk about next is about the Stop, Reflect, Act Model because sometimes we are unable to prepare for a difficult conversation. So, we've talked about when we need to have a difficult conversation or a challenging conversation with somebody, but sometimes an everyday conversation can take an unexpected turn or somebody may approach you with a conversation that is really challenging and it can come from a colleague or a family or an external, you know, you're talking to someone external. And I noticed somebody put in about the accidental counsellor kind of thing, and I think it's really important, and that's why we did start the session with thinking about our stress responses and looking after ourselves because if we are aware what our stress responses are, then we can really think about how we can protect ourselves if conversations like that come up. And the Stop, Reflect, Act Framework is a really good one when we are in a situation where a difficult conversation happens, and we're not expecting it, and we're not prepared for it, and it can be really hard to do that. So, a lot of the time in an early learning community, we may be the first person that a parent sees or a family member sees after something really quite traumatic or scary has happened or sad or stressful, and sometimes we are the first person that they see and they want to share what's happened with them or, for example, you know, a family member, something happens with a family member and they call us because we are looking after the children, they need to let us know that something's happened and they may be running late or because of this, this terrible situation that's happened, and it can be really hard to deal with that at the time. And we probably can all think of a situation where we've been in that position where somebody's come to us with something and we have to kind of think about how we're going to respond, and also put those protective factors in for ourselves as well as be that person for that person. And that's where it's really important to think about what we do in that situation. So, if we think about stop as a pause, as a stop, as a break because sometimes we need to think about where we are at the time. So, if a parent's come in and it's a busy reception area and there's lots of families, or there's lots of people around, or there's a courier driver coming in because we know that things happen all the time in those busy learning communities. We may want to think about where we are, and having that conversation in a different space if that's a more appropriate thing to do. So, we might pause and we might stop and we might go, "Why don't we talk about this in a different space?" Because then it also gives us the time to gather our thoughts and go, "Okay, what do I need to do to protect myself? And what do I need to do in this situation?" So, that's where the reflect comes in as well. Consider your thoughts, your feelings, and your professional boundaries. Am I the right person to be having this conversation or do I need to get somebody else to complete this conversation or find someone for this person to share this information with. For example, if we know that there's somebody in our local community who would be a better person to take this conversation and to support this person in this situation. So, yeah, thinking about your own, but everyone's physical and emotional safety. So, sometimes situations may actually be a dangerous situation. It may be something that is happening that we need to stop immediately and go to those supports, and we're gonna talk about activating supports in a minute, but kind of yeah, thinking about what we're going to do and how we're going to respond. What do we need to know in order to respond in this situation and to this particular conversation or situation? And what else might we need before we decide to act? So, is there some more information that we need to gather? Is there someone else that we need to bring into the conversation? What do we need to do in order to have a successful outcome in this situation or conversation? And then we can act, so we may not act straight away, we may act in the moment after we've kind of taken that pause and that reflection time, but we also may say, "I need to consider this for a little bit and act a little bit later." So, you know, it might be that we need to find out some more information and get back to that person. For example, if it is a family who's said something and needs some support, we may need a bit of time to gather that support so that we can give it to that family member to get the support that they need. So, this is where we're going to be purposeful and intentional in taking every step that we are taking at this point in time. And it's important to know that we don't need to completely solve an issue or even have the answers to questions immediately, we can take time to stop, to pause, reflect, and to get more information to get the right supports for that situation. You know, I've been an early childhood teacher since I was quite young, I was in high school and started cleaning and relieving. So, in that time, I've supported families in all sorts of different situations and all sorts of different ways. And each time is different and each time you need to access a different type of support or mechanism. You know, it might be a death in the family that you need to support somehow and figure out what the correct supports are for that family. Or it might be being a listening ear, but thinking about what those next steps would be because, again, we need to put in those protective factors for ourselves and remember our professional boundaries. So, sometimes that can be a really fine line to walk, what are our professional boundaries and where we sit in that situation. And sometimes that can be really blurred, but it's really important that's where that reflective practice and that awareness of what we're doing and what we are able to do is really important. It's also really important to think about being aware of our own signs of stress and distress, and so that we can assist in recognising this in others and supporting them. So, sometimes it might be someone else we can see having a difficult conversation who may need some support, and sometimes just being in that peripheral kind of space so that you are there as a support person, but you're not necessarily involved in this situation, you're just there holding the space for those people so that they can feel safe within that conversation. So, sometimes you need a backup person and that might be a situation, a thing that you think about, I'm going off on a bit of a tangent here, when you are preparing for a difficult conversation is thinking about do you need someone to be in the background to kind of think about supporting you in a space kind of way? Yeah, and so thinking about and being aware of, as I said, those stress behaviours and how you, whether you're a fight, or a fight, or a freeze person, what you can do to kind of support yourself. And it might say, "I need a moment to breathe and take that in," or it may be saying, "I really think that we might need to get some further support for you in this situation." So, thinking about sometimes offering practical support is within your professional boundaries and ask if there's something that you can do. So, it may be kind of thinking about just, yeah, creating that safe space or if it is a family that's going through something, can you arrange to have the child in for an extra couple of days or if that's something that you can support, that might be what the family needs in that moment and at that time, so what you can do, you might want to do, but also you might not be able to. You know, thinking about encouraging self
care as a protective factor for mental health, so for yourself and for that person that you're having that conversation with, who's brought something to you. Promote help
seeking, so that's one of the big things that we do talk about at Be You is thinking about help
seeking is something we want to promote. It's okay to ask for help, it's okay to seek support. What are the options? Whether it's, as we've mentioned before, a colleague, or an Employee Assistance Program, or if it's a general practitioner that you need to refer a family to and support them in finding a GP or a child health professional, pediatrician, I don't know why that word disappeared for a minute there, but is there a pediatrician that you know supports people in a really great way that may help that family in that situation? Another really important thing to remember is to follow up and follow through. So, if somebody has had a tricky conversation with you and a challenging conversation, and you've dealt with it really well or maybe not, you've had some reflective time, it's really important to check in with that person a bit later on and to see what's happened so that you can support them and making sure that they are following through themselves in that situation and going to the GP. Sometimes we might notice a family, you know, if there's a parent with a new baby and you're noticing some signs of postnatal depression, you're not sure how to support that family so you might recommend them going to see a GP and you might just have a chat to one of the other people in your team say, "I'm just observing this family because I think there's some stuff going on and I just want to make sure that they're okay," so thinking about how you can do that. It's also important to check in with yourself, take some time to notice how you are, and give your own feelings some space. So, if you are an empath like me, you might find yourself kind of thinking about things and overthinking things later on. So, how are you going to support yourself in that time? And that's where you might reach out to a professional yourself, and if you do have an Employee Assistance Program that you can access, that's a perfect time if you're struggling with the fact that you've had a challenging conversation then seek that professional help and download them that way, yeah, and enact your self care plan. So, you know, what protective factors can you utilise in order to support that space? So, all of these conversations can help create and maintain a culture of care throughout your learning community. Sometimes families don't have anywhere else, their learning community is their place, so sometimes it's hard for them because they don't know where to go and who to support, so that's where we may provide that knowledge. So, the image on the screen

Sorry, Karina, just going to jump in.

Yes.

We are running out of time. So, yeah. (laughs)

Okay, well, sorry.

That's okay, just want to make sure we get everything in for everyone.

Yes, indeed. And it is something that's so important so I do tend to kind of go over things quite a bit, so thanks Karin for the time check. So, the image in the screen is from the Emerging Minds Toolkit, so the Community Trauma Toolkit. So, if you haven't explored that toolkit at all, and you think that that might be really helpful to you, we will add that to the list of resources that's going out after the session. And it's all about thinking about how we're activating support. So, thinking about what type of information we're going to give and thinking about where we sit in that situation. So, sometimes educators are the experts in child development, and knowing the children in the context of the education setting, and parents are the experts in knowing their child and their child in their home setting. So, having those conversations are really important if we are thinking about activating those supports. So, if we're thinking about what supports we might be thinking and referring to, or what supports might be necessary, we might think about the low kind of sharing information support. So, having conversations might sit in that space or keeping an eye on families might be in that space. And we've got the moderate kind of sharing tools and tips, so that's where we may develop a directory of people that we can refer people to like a GP, as I mentioned, GPs. We may have some child development fact sheets, which you can also find on the Be You website that may support families depending on what's going on. So, if transitions are happening then you'll find some transition fact sheets. So, thinking about what you can give to families that will support them and what's happening in their situation and space. And also, and then we've got persistence, so that's where we're thinking about connecting to specialist support. So, who we might refer families to because they're needing that extra additional support in that situation. And that might be one of the actions that you create a document that outlines supports within your local community to access if things are happening for families in this situation that you find yourself in. I think I've summed that all up quite quickly. But, as I said, we'll put some more support resources in that sheet that we send out after the session. So, I think we are coming back to you, Karin, around our reflections and next steps, yeah.

Yeah.

Thanks, Karina.

No worries.

And I do apologise for having to rush you on a little bit, I'm very conscious of time and I know people have busy days and other things to fit in, so I wanted to ensure that we got through everything. Okay, so we've got our reflect, review, and next steps slide up there. So, it's really important at the end of every session that you attend, that you do reflect on everything that was discussed, review what you would like to consider because not all of it is going to make sense in your place and space, and then consider what you want to implement and how to plan your next steps. So, questions for you to take away are things like were there any strategies you identified throughout what we've discussed today which could be used? Are you now considering anything differently that you might do that you weren't doing before? And do you now have some new tools for your toolbox of communicating with families and your professional boundaries and preparing for difficult conversations? So, consider sharing your strategies with your colleagues and ask them to share theirs if comfortable because it's really good to have that shared understanding of what other people do as well. Because this will support growing a community of care and from there we're better able to support, not just ourselves, but we're better able to support each other. So, staff wellbeing and self care when things become professionally challenging are really important considerations, so discuss possible strategies to support these within your teams. What do you do to support each other within your team? What are your strategies? What do you do if you're feeling overwhelmed? Who do you turn to? Can you take a break? All of those things. So, Be You have some great tools and resources that you can use to document those things. And you may want to use one or more of those tools to put plans into action after today's session. But, as we said, we'll put those in our follow up email to you. So, we have some great interactive PDFs that you can actually write in. Okay, I'm going to ask Paola to come back up on the screen now, and you've got 33 seconds

Oh, thanks. (laughs) to and...

Let me see if I can squeeze it all in. I do have two important ones

Yeah. That I want to touch on. We had some great specific, I guess, situations or examples that were shared through the Q&A. I guess, and I'm just going to jump in and go back to the points that both Karina and Karin made in the fact of being prepared, like thinking about the things prior, you know, when your window of tolerance is quite big and you're able to put things into place and those conversations that take the turn and become difficult when you were least expecting it. If you've had these thoughts prior to having these difficult conversations, sometimes those become easier to cope with in that crisis moment, I guess, for lack of a better term like now when I've got like 33 seconds to answer these questions. But I think the other point too is, and I'm not sure if we mentioned it, but having the documentation to support your conversation. So, another tool that Be You does have on the website is the BETLS Tool, so if you're seeing these behaviors of a particular concern for an individual, and you've documented them over a period of time, those conversations become a little bit easier to have because you have the documentation over a period of time, so it's not something that you are approaching a parent with with a one off situation, it's that ongoing repetitive nature of the behavior that it has become a concern and the reason why you are wanting to have these difficult conversations. Again, quickly, other other people were able to put some really good strategies that they use and preparing for those conversations and making a specific time that's mutually convenient for both parties to have these difficult conversations. And I will jump over to you, and you mentioned, a couple of people mentioned the Employee Assistance Program. So, if you've got any more information around that and just want to unpack that a little bit more because some people aren't understanding what an EAP, or as better known as an Employee Assistance Program is, or how they can access that. So, over to you.

Okay, well, we can't actually recommend specific ones, it'll be something that you would discuss with your leadership team to see what you can access. So, there's a lot of Employee Assistance Programs out there and early learning services. There's a couple that are really highly recommended for early learning services, but that's not our job, unfortunately, to be able to share those with you. So, have a chat.

They do come at a cost though, Karin, don't they?

Yes, that's what I was about to say, they're not free.

Thank you.

So, they do come at a cost to the organisation. So, and depending on what you access for your employees, the cost varies. So, by paying into an Employee Assistance Program, your employees then get some free sessions to chat to a counsellor, but the organisation itself would pay for that. And so, you would need to have a look at your budget to see if you could afford to do that. And so, that's why it's worthwhile having a look at the various options that are out there because the cost will vary depending on what you take up as well.
Thank you, sometimes it may be that your learning community is part of a bigger organisation. So, for example, a lot of councils or bigger organisations may have an EAP program, and it might just be talking to leadership about whether or not that's the case that you can access that through the wider community. So, thinking about it might not be no one in your part of the organisation, but the bigger overall umbrella organisation may have an EAP program that you can access.
And I guess just to add on one last little point before we wrap it up is if you can't afford an Employee Assistance Program, if you can't be part of one, thinking about what local services you have within your learning community, and that does take time and it does take a little bit of effort to become aware of who around you in your local community can be those support, those external supports, and those external professionals that you can reach out to in those times. So

I'm a big advocate of community mapping to find out what is in your

Community mapping.

Yeah, how's that for a term?

That's a great term, I like that. All right, that's it for me that I can fit into my little section, and we've gone over time so I will hand over to you, thank you.

[Karin] Thanks Paola.

Thanks, Paola. Yeah, it's there's so much more like I think we could have probably done a lot more, a lot more time, but yeah, it's one of those things that it's kind of hard figuring out what we can do and what's most important. So, but your next step also may be to think about how you can connect with Be You, so whether that's registering as an individual, registering your learning community, following our social media channels. So, we have Facebook, we have LinkedIn, we have Twitter, we also, as I mentioned, have a YouTube channel that you might wanna have a look at. So, thinking about how you can connect and continue your learning because we are putting things on those channels quite often. But most of all, we really want to thank you for joining us today. We know that your time is valuable, and we really appreciate the fact that you've taken time out of your busy schedules to join us for today's session. So, thank you so much, and yeah, we look forward to supporting you and your work in the future.

Thank you, everyone. Have a great rest of your day.

My name is Cate Denning. I'm the manager of the Brighter Beginnings Team here at the Department of Education. I'd like to acknowledge that wherever we are coming from, we are on Aboriginal lands, and I'd like to pay my respects to Elders past, present, and emerging, and to extend that respect to all of our Aboriginal participants joining us today. I'd like to also acknowledge that next Thursday is National Sorry Day, which will be followed by reconciliation week, which runs from the 27th of May to the 3rd of June. This year's theme is, be brave, make change, and I would really like to acknowledge and thank everyone present for your work, supporting our first nations littlest learners to continue to learn and thrive. Just some housekeeping before we get started. So the microphone video and chat functions are disabled during this presentation, but you will be able to ask questions through the Q&A button down the bottom. There's also an option to vote if your questions already there, and we'll go through those questions as part of the session today. We'll also be using Menti during this session, so if you'd like to participate in any of the interactive components, please make sure that you have your phone with you, that you can scan the code when it comes up, otherwise, a web browser that you can pop in the details. Just also a note that this session is being recorded. So in terms of our agenda, in the spirit of partnership and collaboration, we really wanted to bring together the ECE in health perspectives today, to get a better picture of the state of child development. The 2021 Australian early development census results were released in April, and they do show a decline in developmental outcomes for children. This is the first decline that we've seen in 13 years. But what does this really mean in practical terms? What are the changes that we are seeing on the ground as ECE and health professionals and how can we respond at both a systemic and individual child level? We're really keen to explore those issues today. We also will be hearing from two very special guests, both of whom are Australian early child development experts in their respective fields. The first is Dr. Elizabeth Murphy, who's a senior clinical advisor with the Child and Family Health as part of New South Wales Ministry of Health. She's also the director of Child Youth and Family Health Services for the North Sydney local health district. Dr. Murphy will take us through how living through the unprecedented experiences that we've had over the last couple of years, can really impact children, in particular related to toxic stress and indirect effects of parental stress on their development. We'll also hear about some practical advice on effective tools and interventions in the ECE and home settings that we can use. Our second guest is Dr. Cathrine Neilsen Hewett, who is the director of the early years and director of pedagogical leadership at Early Start at the University of Wollongong. Dr. Neilsen Hewett will take a closer look at the relevance of the AEDC results in informing pedagogy and practice in ECE settings, and we'll also hear about the importance of educators in a systemic response to support child development, as well as the crucial role they play in shifting children's directions. Also I'd like to introduce my colleague Mady Maplethorpe, who'll be helping to co host some of today's sessions. After we've heard from our speakers, we'll also have time for Q&A. Next slide, thank you. So why are we here discussing child development? Well, firstly, I would like to really thank you for the incredible work that you do as educators and the crucial role you play in children's development every single day. As early childhood professionals, you influence many children, nurture their curiosity and love of learning, and really contribute to a critical time in their lives. It's important now to acknowledge the current circumstances, which we find ourselves living through, many of which are extremely challenging. There is no one in New South Wales or the world who has not been affected by the events of the last two or three years. COVID has, and still is having a significant impact on all of our lives. We've experienced prolonged lockdowns, parents working from home, disruption in ECE, loss of income, illness, and in some circumstances, the tragic loss of loved ones. Cost of living stress is also putting additional pressures on many families, and that can affect their ability to provide a stimulating home environment. Many communities have also been devastated by the recent floods, and some are still recovering from the impacts of the black summer bushfires. Now more than ever there is an increase in the level of stress families are experiencing, which can affect children's development. Next slide, thank you. The effects of these recent events on child development are starting to become evident. The decline in the AEDC results is concerning, showing an increase in the number of children who are starting school developmentally off track. Our health colleagues have also reported a decline in the number of developmental checks, which are attended after a child's first year of life. This results in fewer opportunities to identify and address any potential developmental delays through early interventions, especially if children don't participate in early childhood education. The children most affected by these circumstances are those that are at risk or already experiencing vulnerability and disadvantage. And they are potentially those who are harder to engage through our usual processes. We also know from emerging research that pandemic born children have been exposed to increased stress in the womb and more new mothers experience postnatal depression and anxiety. This could potentially affect the children engaging in early childhood education services over the next few years. As a system, we need to better understand the experiences that educators have on the ground, so we can better support the sector, and the families and children you work with in a meaningful way. We take a closer look at the AEDC data for New South Wales over the last 13 years. You'll see that unfortunately, much of the progress that we've made has been wiped out. The main purpose of the AEDC is to inform policy makers and government of the developmental outcomes for children when they start school. And we will be undertaking further analysis of the 2021 data to better understand what it tells us. The AEDC measure, although important in informing, shaping policies and interventions, in the early years, does occur quite late, meaning missed opportunities to put in place early interventions and supports which can make a marked difference in a child's development. We do need earlier data points that are contextual and can be acted upon including through effective partnerships between ECE, health professionals and families. Now I'm going to hand over to Mady to take us through why this is so important.

Thank you, Cate. Yes, well, we know through the first 2,000 days framework developed by our colleagues in health, and Elizabeth will talk more about this in a minute. But the period from conception to school is the most important in shaping future outcomes for a person. This is when the 90% of the brain develops, and it can determine where the school performance involvement, where the criminal justice system or adolescent pregnancy. It has an impact on health outcomes, including obesity, addiction, mental health, premature aging, heart disease, and diabetes in your age, and we're painting a very gray picture here, but it is backed by data. So through Brighter Beginnings, next slide, please. Thanks. We take a holistic approach at understanding children and families' needs, and building a more effective system to support them. We work with our colleagues in New South Wales government from the Department of Customer Service, New South Wales Health, Communities and Justice, and very closely with our colleague in Aboriginal affairs and multicultural New South Wales, as well as regional New South Wales. And we know it's important for families to understand the importance of the first 2,000 days. So that's one of our key objectives, as well as to have universal access to education, health, community and government services. We know it is easier for some than others, and so we want to make this experience as smooth as possible. We also know that some families require more intense and targeted interventions and supporting them is also an important part in Brighter Beginnings. Some of you may have been online and may remember the launch of Brighter Beginnings in October 2020. And we also had a presentation, we did the presentation last year in May at this roadshow. Well, since then, we've been busy delivering projects and setting strong foundations for further collaboration. We designed and implemented the Start Strong preschool program that continues to deliver, sorry, free preschool program that continues to deliver non preschool for children in community and mobile preschool. We created the ECE finder with the Department of Customer Service and continue to collaborate on the digital school non enrollment link with the digital birth certificate. We're working with the Department of Communities and Justice to reduce non free barriers to ECE for families who are facing complex disadvantage in five LGA. That's Walgett, Coonamble, Kempsey, Fairfield and Cessnock. We've also partnered with United Way Australia to deliver books to children in 25 LGAs through the Dolly Parton's Imagination Library, a program that will continue over the next four years. And we've got lots of active projects for ongoing delivery and we'll be hearing more about this in future as well. However, the most important achievement of Brighter Beginnings is championing and building an ecosystem that values each one of its members and builds on their strengths for the benefit of our children. We know supporting child development is a fundamental objective of educators and child and family health professionals. And there is opportunity for us to work more closely together to support this objective, to create a system of families and professionals being supported and empowered in their crucial roles to raise healthy, happy children. We will hear very soon from our expert presenters, but first we can already see that there are some... Sorry, I didn't realize. Yeah, I will see your comments. I'm sorry I was not very loud. But definitely keep your comments and questions coming through and we will respond to them either on online or we will flag them for discussion in our segment at the end. Over to you Cate to introduce our presenters.

Thank you, Mady. As Mady mentioned, we're now onto our expert presenters. Associate professor Elizabeth Murphy is the senior clinical advisor for child and family health at the New South Wales Ministry of Health and the director for Child Youth and Family Health Services at the North Sydney local health district. Dr. Murphy has overseen the implementation of several early intervention programs, including the Out of Home Care pathways program. Sorry, I've just lost my notes. The New South Wales wide screening programs for hearing known as SWISH (Statewide Infant Screening Hearing) and vision, which is known as StEPS. The Aboriginal maternal infant family, infant health strategy and the promotion of health checks for improve child development and health as part of the New South Wales personal health record. She is a past recipient of the Royal Australasian College of Physicians medal, and has recently been recognized as one of the top 50 public sector women. And in 2020, she was also nominated as a finalist for public servant of the year. Thank you, Dr. Murphy. We really appreciate you joining us and very much looking forward to your presentation.

Thanks so much. I'm just... Can't tell you how thrilled I am to be given this opportunity to speak with you all today. Early childhood professionals are such key partners to us in health. And so, let's discuss that over these next 25 minutes. I'd like to begin by acknowledging that we are meeting on many different Aboriginal lands today and pay my respects to elders past, present and emerging, and any Aboriginal people who might be joining us today. So I am wanting to move the slide. Yes, we've achieved it. This is, my toxic stress levels can now go down. Thank you. So three things that we're going to talk about today. So first of all, why are the first 2,000 days of life important? And what impacts on brain development during this period? And then we're going to talk about what interventions are available for optimal brain development, and then focus finally, in particular, on your role, the role of early childhood professionals in supporting the first Now, why are the first Because that's when 90% of the brain's growth occurs. And the brain, we are realizing more and more, is the orchestrator of everything that we will need in life to live, love and to learn. And I wanted to begin by saying that early childhood education is the reason why we in health chose to go for the importance of the first 2,000 days, not the first 1,000 days. You might see in particular, in medical literature, where they will talk about the importance of the first 1,000 days. But we thought it was critical to include that really important piece of evidence of the, in particular, the year of preschool before school entry. And so we saw everything that was part of 2,000 days, the ability for the brain to the resilient brain plasticity. And so the early childhood education sector is, I say is a really important component of why we have a framework of the first 2,000 days. And why 2,000 days? Well, essentially if we live for 30,000 days, which is the average life expectancy at the moment, then the first 2,000 days of that 30,000 days will set what is going to happen as the outcomes for that child as they grow. So think of that investment of 2,000 for 30,000 days. And we define that as from conception to school entry. And why is it important? Because a score of a child at 22 months is an accurate predictor of educational outcomes of 26 years. In fact, this particular study, which is a longitudinal study over 30 years in the UK, consolidates that at four years of age predicting an educational outcome of 26 years. But even at 22 months, there was that indicator. Closer to home in Australia, we have got linked data that shows that NAPLAN results can be predicted by the AEDC result that is done when a child is five. So what's happening with us in health, with you in early education is going to be critical, in particular, in this focus for the child's educational outcomes. Now, some of the things that we will be talking about today could be confronting. Because of course, I know that we have all got a childhood, our own background. We are also maybe responsible for other children being in the role of parents or aunts or friends or grandparents. And I would just like to emphasize that every research and literature that I quote from today is public health research that none of this represents individual advice. That I'll be talking about risk, and risk is never destiny, it is just one part of the tapestry. And one of the things that we have found out in this research is that there's always the amazing human capacity for resilience. And that that is always an amazing part of our humanity. But what you and I are working for are those children that may be more vulnerable and that we need to support more. And just to reemphasize that this is all new evidence. Now, some of it is building on evidence that has been there for many decades, but the consolidation of this is all fairly new. And in particular, I would say over the last Now, I'm not going to concentrate a lot on the emerging evidence. There are other presentations that you can access with regard to that. But I would just like to do that in the context of an ABCDE and just briefly go through each of those aspects. Now, antenatal care that period from conception to nine months in the womb is absolutely critical for the child's future physical health for their psychosocial health and for their future health broadly. But I'm only going to talk about three aspects, in particular focusing on what happens in the womb that can affect learning, three things in particular. The first is going to term. Completing 40 weeks of pregnancy, rather than having an early planned cesarean section is critical for that child to have the best opportunity and not have any learning problems. And the reason why that's important is because now in New South Wales, we have 50% of earlier births due to a social reason. So I'm not talking about a clinical reason in either the mother or the baby where that pregnancy needs to stop and we need to get the baby out a little earlier than the 40 weeks. What I'm talking about is where there is a social indication of choice rather than a clinical reason. And that baby has an elective seizure or a planned earlier birth. This is part of work called Every Week Counts. And it shows that in that final part there with regard to learning difficulties at school entry, that the risk is still there even with one week earlier than the 40 week full term of that child having learning problems. And this is linked data from the weeks that that child is born compared with the AEDC. And the reason why, is a third of the weight of the brain grows in the last five weeks of pregnancy in the womb is the ideal place. And so doing anything to disrupt that is going have an impact and in particular for this talk, on learning. The second is to talk about alcohol in pregnancy. There is no safe level of alcohol to be drunk in pregnancy. And yet we know that one in two women in Australia drink when they are pregnant and one in four continue to drink when they're pregnant. You have a look at the slide on the right. The purple circle represents the cause of developmental disability in the Western world caused by fetal alcohol spectrum disorder, compared to all of the others, autism, cerebral palsy, Down syndrome, tourette's it's much greater. And yet that is one that is a hundred percent preventable, that people need to know, and to be confident that that is the correct advice with regard to drinking in pregnancy. And the third that affects learning in pregnancy is stress, maternal stress. And now we've got some good studies that show that if a mother has mild to moderate stress in pregnancy, that that can affect that child's neuro development or executive function, which impacts on how a child learns. So those things are all happening before the baby is born. Now, next part I want to talk to you about is the architecture of the brain. And just to very simply explain that a child is born with trillions of neurons. And so I like to show this image of night star in the sky. And if you look at all those stars and think of them not being connected. And at birth, only 50 trillion are connected. In the first year's connections increase to a thousand trillion, and they are actually happening as a result of the experiences that that baby has. So the experiences determine which pathways are formed and which are stronger pathways and which are not formed. And so you have a very strong role in actually determining the neural pathways that a child is developing. Whether they're going to be wiring channels of love and consistency and affection or disorder or anger. And of course the home is absolutely critical for that as well. And if you just look at this head circumference graph that we've drawn to the right, the difference in the size of a brain at birth compared to it one year, and look how steep that curve is. Recognizing that brain is growing as a result of the experience, that's what's wiring those channels. And indeed the Romanian orphanage study showed us that if there is no stimulation, if there's extreme neglect, if you have a look at the cat's pet scan on the right, you'll see that there isn't even brain architecture there, that there is nothing formed. The other thing that we understand now is that we've got critical window periods of when systems are being formed for life, language skills, emotional control, communication skills, and you can see most of those are waning by the time that a child arrives at school at the age of five. And there's another slide that consolidates that if you have a look at five years, higher cognitive function is reaching its peak, that red line, at about that time, so critical role. And where are the children? They're with you in early childhood education. Next, very briefly, I just wanna talk about childhood experience and in particular, the impact of traumatic events. This is one study that is called the ACE study, Adverse Childhood Experience study. And that is where you get a score out of 10 as to what's happened in your life. Whether you have one of the three forms of abuse, two forms of neglect or five household challenges. And if you have a score of six or more, then the prediction is actually that you will die 20 years earlier than those who have a score of zero. However, an eighth of the population have four or more ACEs, it's common. But at a high ACE score is setting a child up in flight and fright, and that's the kind of child that you will understand has great difficulty in learning or reaching their optimal potential. Special mention with regard to domestic violence. And that that is a kind of flight and fright that can affect the child even from when they're in the womb. And certainly that is the child that you would recognize in early childhood education. And then finally epigenetics. That ability for you to shape what kind of genetic material is being turned on or turned off based on what's happening in the experience, in the childcare, child early education environment that you're establishing. So that's just a very quick rush through with regard to the evidence. Now let's look at the interventions. And it's very exciting to think about the interventions because we have things that we know will work now because we understand the mechanism. So we understand the anatomy, we understand what's happening with brain architecture. We understand the biology, we understand chemistry, we can measure stress levels in children. We can picture DNA, we can understand epigenetics. And a great example of us turning things around that I like to use as a comparison is with regard to AIDS. When AIDS first happened, we didn't understand what was happening and almost everybody who had AIDS died from AIDS. But as we understood that it was actually caused by one virus, an electron virus, and we were able to get medication. Now, anybody who develops that disease actually lives with that disease. And so similarly, I think I'm very excited about the fact that we understand the mechanism of the first 2,000 days, that this will have an impact for life. And therefore we have a critical role to play, none more important than yours. So what are some of the interventions. I'm going to go through each one of these so that we look at what they could be. And the first is attachment. Now, attachment has actually been around for a long time and Bowlby first talked about this in the 1950s. But I think the importance of attachment is only coming to the forward now. And this is my Bonnie, my strong attachment figure, that's me and her in mutual gaze. And the reason why I talk about attachment is because she is without a doubt, the most destructive, naughty dog that I have ever had in my life. And yet I have this strong attachment and keep loving her despite that. And I think that's what we want for every child. Isn't it? That they have one person who has this strong attachment who will keep loving them no matter what. And in fact, we've been using attachment a lot, just a simple touch in medicine. These are babies that are prem babies, who are in Scandinavian countries, have received what's called kangaroo care, touching of human skin from the minute they're born. And these babies with things affecting their lungs are leaving hospital earlier than babies who don't have that strong skin to skin attachment. We go onto the brain, it's all about serve and return. How do we get those neural pathways firing to get the best results and just form those strong pathways? And that interaction between the baby. Now, regrettably, we have an impact now with screens that are interrupting that switching on of a baby's brain with people thinking that it's stimulating a baby, but in fact it's not, because the whole point is that interaction. That's how those neural pathways are being formed. And there's a wonderful Ted Talk done by a seven year old, Molly Wright, who talks about how important interaction is. And she talks about the importance of a game of peek
a
boo. So I would recommend that Ted Talk to you. And I would also recommend another Ted Talk written by Nadine Burke Harris, who's talking about that adverse childhood experience study. And that is something that I think is really important for you to think about in those children that are highly wired in your early education experience. Because what we know about now is toxic stress, where if we all need a little bit of stress and babies and children need that too, brief increase in heart rate, mild elevation in stress hormone come back to normal. We can even have times in life like COVID, bushfires, floods, where they'll be serious, but a stress response. But if that's buffered by a supportive relationship, that makes that stress tolerable. It's where there's toxic stress, prolonged activation of the stress responsive system in the absence of protective relationships, where that's damaging to that child's development. And I think that we need to consider, in early childhood education, that for some children at some time, you may be the role of that supportive relationship. You may be the person that carries that child through, that lessens the toxic stress that may be impact on that child at that time. We do know that resilience can be built. And I think that that is actually a critical role for early childhood education. If that you might be the opportunity to build that child's resilience. You may be the opportunity to have changed the fulcrum from a negative outcome to a positive outcome, making it easier for that child to learn and to love and to relate later in life. So a critical role that you may be that intervention. And a lot of people are picking up this. And I was privileged to go to a conference in Scotland called ACE Aware Scotland. They want the whole of Scotland to be aware of this study. And one presentation that I thought was pretty, it was very relevant for our talk today, is one that was a primary school intervention. And this principal did many things, but one of the things that he did was he assumed that every child was arriving stressed and began the day with a 30 minute mindfulness exercise for the whole school, including the teachers. And often the teachers had a traumatic background and they, as a result of this, took this school from one of the least well performing to the top school. And the only intervention was beginning a calming, a mindfulness exercise to address that traumatic stress from an area of enormous disadvantage. So just to think about some of the things that we can do in the community and to build our better lives, we need to build better brains and the critical role that you have in that. I'm also quite excited about this because I think that the community response to COVID has demonstrated that we are prepared to do things for others, as well as ourself. The number of people who took up the interventions, harsh interventions, that were required for us to control COVID was exemplary. And so I'm wondering if we can harness that for us to be able to use that for the importance of the first 2,000 days. Now, the third part is in particular, focusing on your particular role. Not that it hasn't been all the way through with regard to Brighter Beginnings and the first 2,000 days of life. And the first thing, I think, is knowledge expertise. You understand early childhood brain development. And what we do know is that the general public don't, they actually think that a child's world is idealized and distinct from an adults, not actually that what the adults doing in interacting with that child is forming brain pathways. They think that words are necessary to start anything with regard to development. Whereas children are using words at the age of two, which and we know by then their outcome is forged. They don't understand that a child could feel sad or happy that they have a mental state that is independent. They think that's ridiculous. But in fact that you can detect how a child is that day. And also they think that play would be something that a child would be able to work out, that it can be child led. So I think all of these things are really important for you to, I suppose, make sure that you have a role not just in with the children, but with their parents, recognizing that most adults don't know about early childhood brain development or what's happening in those early years. I think the other thing is how to respond to a difficult child. Are they suffering from toxic stress? So rather than thinking, what's wrong with that child? Thinking what's happened to that child and trying to look at what story may be behind that behavior, whether that behavior might be normal if they are developmentally vulnerable. So they might be four, but acting like a two year old. And if you think about our AEDC results, then it's quite alarming that even before, we had 20% of children arriving with two or more developmentally vulnerabilities and 10, sorry, So that is a concern because we know that that brain plasticity is in the early years. And so we are hoping that you will embrace our developmental surveillance tool, Learn The Signs, Act Early. It's one that came from the CDC in the US, and it was actually designed for early education professionals. It wasn't designed for health. It was designed for you. And it's a wonderful tool that's in our personal health record, which documents for parents to complete where their child should be with regard to their milestones. And if they're not, to act early, to go and to see a health professional who can do a further test to get a greater idea as to how that child's development is going. We have a wonderful resource called love, talk, sing, read, play, because people say, how do you promote your child's development? And we say, it's not hard, you just love, talk, sing, read, play. And this is a flip chart and it's because a lot of parents don't and carers don't know what to do to promote their child's development. And if you have a look at this graph, you can see that the time for brain plasticity and the ability to change is in those early years. And whilst we can do improvements later on, you can see it's just so much harder and requires so much more effort. So in conclusion, you have a critical role in attachment, in brain development, in creating a safe environment for childhood experience, in working to promote Brighter Beginnings in partnership, you actually are forging epigenetics you are forging that epigenetic pre potential of that child. And remembering that that score at just 22 months is an accurate predictor. And whilst you think about what's happening in the womb, we know now can also affect the grandchild. I was also thinking that the work that you are doing now with children will also be affecting the next generation because that child will be the parent and you'll have a critical role in what kind of parent they are. Thank you.
Thank you so much, Dr. Murphy. That was an incredibly fascinating presentation. So much information to unpack there. We have questions coming in already. I'd really encourage you all to keep adding to those questions. We're going to move onto a Menti to start, and we are really interested in understanding from your perspective what your key priorities and challenges are in relation to child development. You can either scan that QR code with your phone, or you can jump onto the website and pop in that code, but we are very interested in understanding that and we'll come back to those at the end of the session. I'll give you just a couple of moments to get organized and then I will introduce our next speaker. Okay. Hopefully that's given you enough time to get onto the survey. Very happy for you to continue to add to that as we go through our next presentation. So I'd like to introduce associate professor, Cathrine Neilsen
Hewett, who is the academic director of the early years at University of Wollongong. Dr. Neilsen
Hewett has demonstrated leadership and scholarship in translational research with a strong track record in supporting professional development initiatives in the early childhood education sector. She has co led six large scale early start research projects across three Australian states in over 500 ECEC services with more than 3,500 children. Her current research projects focus on quality early childhood environments and workforce development, integrated early childhood service platforms, approaches to assessment along with children's self regulation and wellbeing. Thank you so much Dr. Neilsen Hewett, really appreciate you being here and very excited to have you.

Thanks so much Mady, sorry. I'm just having a share screen problem. Sorry about that. Wonderful. Can you actually all see that?

We can.

Wonderful. Thank you so much. It's always technology as as Elizabeth celebrated her technology as well. So thank you so much. I'm always, one of my favorite parts of the job is the time that I actually get to spend with educators and really talk about some of your practices. But before I begin today, I would like to just acknowledge the traditional owners on the many lands at which we are meeting, I'm here at the University of Wollongong. So I would like to acknowledge the Wodi Wodi people of the Dharawal nation, and really just acknowledge their continuing connection to land and waters and cultures, and pay my respects to elders past, present and emerging. So I get real luxury here today because I get to build upon the last two incredible informative presentations. But in doing this, I do wanna begin by reexamining the value of the AEDC data and how we can use the AEDC data as educators in terms of supporting children. Now, I think it's helpful to think about the AEDC as a report card. So while it's often positioned as a measure of children's development, I think it's really helpful to think about the AEDC as a measure of how well we are doing as a society, and the way that we set up our children for success. And when I'm saying success, I'm talking about readiness for life. So how ready are children to lead a fully engaged life? Now, if we look at the tri annual collection of AEDC data, since its inception in 2009, we can see that it's shown fairly limited improvements across the five domains. And in fact, in our last measure, we've seen rising vulnerabilities amongst that recent cohort of children. Now, the graph that you see here on your screen captures the percentage of children across Australia who have been deemed to be developmentally vulnerable. So as you know, the AEDC data shows that children are either on track or they're at risk. So these children are facing some challenges in their development or they're vulnerable. So these children are facing significant challenges in their development. And in 2021, just over one in five children started school developmentally vulnerable on one or more domains. And just over 11% of children were developmentally vulnerable on two or more domains. So these were the children who are experiencing significant developmental challenges. Now we also know that the vulnerability is not equally shared across our population. So we see higher rates of vulnerability amongst Aboriginal and Torres Strait Islander children. We see higher rates of vulnerability amongst children from socioeconomically disadvantaged areas. And we also see increasing vulnerability with increasing remoteness. So children residing in very remote regions of Australia are much more likely to be developmentally vulnerable on a number of domains compared to those children who are living in metropolitan areas. Now, fast forward 10 years, and our poor performing or vulnerable five year olds, continue to perform badly on international assessments of cognitive performance. So the PISA program, and that's a Program for International Student Assessment, has shown that Australian children have experienced a steady decline in performance, both in real and relative terms. And probably what is most significant, it's not captured in this graph. Is the gap between performance of children from advantaged versus disadvantaged backgrounds. And the performance gap is greater in the Australian context and much more prominent than other OECD countries. And we see these patterns very similar to the decline that we're seeing in NAPLAN, particularly in relation to the performance outcomes for children from disadvantaged backgrounds. So collectively the PISA data, the AEDC data, the NAPLAN data all says to us, that gaps in skills emerge early even before children enter formal schooling. And many children who are raised in disadvantaged communities or in environments start behind and they stay behind and it creates an achievement gap that is very costly or challenging for us to close. So why do we need to prioritize the first 2,000 days? And Elizabeth in her presentation provided a very strong argument for why the first 2,000 days is so critical. And the research is convincing. The first 2,000 days of a child's life has a disproportionate influence over their life trajectories. We know as educators that the first five years of a child's life are, really lay a really important foundation for children's learning and development. It affects what happens within the early childhood context. It affects what happens in school, but it also affects what happens later in life. And as Mady highlighted in her presentation at the beginning, many of those health and wellbeing problems that we're seeing amongst adults, so mental health issues, familial violence, poor literacy, unemployment, all have origins in pathways that begin much earlier in our lives. Now we only need to look to neuroscience, as Elizabeth talked about, to be convinced around the potential for impact. So in those first five years, the rapidity of brain development is at its peak. Children learn more quickly during those early years than at any other time in their life. And while our genes create the blueprint, it's really how we turn out. Depends so much on the quality of the environments to which we're exposed, but also the quality of the relationships within these environments. So as educators, we play a very key role in the architectural team that literally shapes or sculpts children's brains. And as Elizabeth shared with us, children do best when they are brought up in a context that is characterized by rich and responsive relationships. And what eventuates for those children is they develop brains that are comprised of rich neural networks that are primed for learning. The flip side is if children miss out on this or worse still they grow up in what James Garbarino terms as socially toxic environments. Then they end up with brains that are wired for survival. This increases their vulnerability, and it decreases their capacity to learn. Now the development of significance of those first five years is really reflected in a lot of national and state policies and practices. So it underpinned the development of the New South Wales first underpins a lot of the work around Brighter Beginnings. And it was probably one of the key factors that underpins COAG's 2009, national early development reforms, which saw the introduction of our national quality standards, it saw the implementation of the early years framework. And this is something to celebrate. So not many countries have a national approach to early childhood education, standards and curriculum. However, when we look at investment in the early years at a national level, we've certainly seen some increase. So back in 2007, the government was spending about 3 billion, increased to 9 billion. But when we look at our investment compared to other OECD nations, Australia continues to fare pretty poorly. So we spent about 0.5% of our GDP on prior to school education, the average four OECD countries is 0.8. And if we look at countries like Iceland and Sweden, that are known for great outcomes across all levels of education, they spend 1%. So twice what we do. So if we look at economic models of investment in Australia, we continue to preference the school system, which is completely out of step with what the research is telling us. And while there's certainly been an increase in the recognition for the value of active participation in early childhood, we continue to prioritize the year before school. And again, when we compare our data across OECD comparative countries, we're lagging behind when it comes to three year old enrollments. And probably more concerning, which may in part account for some of the differences in terms of AEDC data, the participation gap between children from socioeconomically advantaged and disadvantaged groups is broader in Australia compared to other OECD nations. So the picture that we are left with is this, almost 45%. So one in two children are starting school experiencing delays in their learning and development. And while the recent decrease in the percentage of children on track certainly provides some insight into the early effects of COVID on children and families, the reality is even before COVID, too many Australian children were starting school without the skills necessary to succeed socially and academically. So my question for all of us moving forward is, what are we not getting right? And what do we need to do better? As a society, as a collective. As educators I think we need to ask ourselves how can we best support our youngest citizens to thrive? And what can we do to mitigate the negative impact of familial stress that Elizabeth talked about. From a systemic perspective, I think we need to think about is how can we optimize the potential that a universal early childhood education system plays for all children, not just those children from disadvantaged backgrounds, but for all children. Now, every child is unique, and in order to best support children, we really need to understand their developmental journey. So what happened before? Now, the AECD data tells us where children are at. But for us to make a difference we need to understand that journey. And so I want us to pause for a moment and reflect on children's journeys over the past two and a half years. And in doing that, I'd like to introduce you to Damien. Damien is five, and he lives on the far south coast of New South Wales. Now Damien was evacuated from his home for the first time, at the beginning of December, 2019. And then he was evacuated another two times in January. And during that time, he was required to camp in the grounds of his local high school. So this was the height of the New South Wales bushfires. And while his family didn't lose his house, his favorite early childhood teacher lost everything. And she was actually forced to flee her home with only the clothes that she had on. Now Damien continued to attend his early childhood service when it reopened, but many of his friends that he typically played with weren't attending at that time. So in February, when things started to settle, although many of his friends were still in temporary accommodation, COVID
19 began to emerge from China. And then in March, 2020, people started getting sick in Australia. And then all of a sudden his friends were being kept home. So his mum and dad ran a local restaurant, but many people weren't coming in. So they decided to close their doors for a while and they kept Damien at home. Both of his parents seemed pretty cranky, and he heard his mum crying a lot at night. Now, Damien has two older siblings and his mum spent a lot of time supporting them in homeschooling and helping them with their school work. The upside was that he got to spend a lot more time with his dad saying he was kicking the ball around in the backyard, but he missed seeing his teachers. He missed talking and playing with his friends. He missed doing art and he missed singing songs. And he really wanted to visit his grandparents. But his mom and dad said he wasn't allowed in case they made them sick and they died. Now since 2020, Damien's families experienced ongoing financial stresses. The restaurant closed down. Dad had to find another job in another town and this means that he's rarely home. His experienced significant disruptive connections with families of friends, particularly those living overseas and his attendance in preschool since returning has been pretty inconsistent. Now, the 2021 AEDC cohort of children are particularly unique. They have lived through a pandemic. And this means we need to reposition our perception around vulnerability. We're now witnessing children exhibiting signs of vulnerability where previously they didn't exist at all. And I'm speaking to organizations and educators on a weekly basis, and we're seeing really high levels of stress and anxiety amongst children and adults. And we're seeing increases in the number of children who are exhibiting really big behaviors. Now, if we revisit Elizabeth's discussion around ACEs, COVID has created a population level impact. So every child starting school in 22, every child who walks through your door this year has experienced at least one adverse childhood experience. And while for some families, the pandemic actually enabled them to spend more time connecting with children. I got to spend dinners, having dinners with my children, where normally I'm running around doing soccer training and other things. But for some families COVID has caused disruption to relationships, it's disrupted early learning participation. It's resulted in high levels of stress, fear, and uncertainty. So this is the context in mind. And I wanna shift our focus for the remainder of the talk to the ECE context and the role of the ECE system in supporting young children's development. So, and in looking at this, I want you to imagine the ECE system as a lever, and as a lever for lifting children's development, and for ensuring children feel safe, they feel secure and they feel valued. And to ensure that every child has the opportunity to learn, to create and to engage. Now, we know from decades of research, both in Australia and internationally, there's a very strong association between attending early childhood education and care and a range of child outcomes. And we know that high quality early childhood programs can have a profound impact on children and their communities. So at an individual level, we see attendance at early childhood education being linked with things like improved literacy and numeracy, better physical health and psychological wellbeing. They're more engaged with school. They have better social skills. They have enhanced self regulation. And we also see improved communication and general knowledge. And from an educational perspective, this means improved school readiness, enhanced academic achievement. Our children are more likely to finish high school, but the societal benefits are significant. And there have been several rigorous longitudinal studies that have looked at the long term outcomes of participation in early childhood programs. And in each case, the majority of the returns are to society, not just the individual child. So while children who participate do have better education, they have better jobs and they have better lives, in terms of dollars spent and dollars returned, it's society, that's the big winner, when it comes to the impact of early childhood education. All of these benefits, however, are conditional on quality. You know this, you know it makes a difference. And expanding access to early childhood programs without attending to the quality is not going to deliver the kind of good outcomes for children as measured by the AEDC and nor is it going to result in the long term productivity benefits that are needed for a functional society. So the real innovation of our early childhood education system is in its power and its potential to shift children's trajectories. And while an early year system is probably, ours is really when we look at it structurally, it's probably one of the most comprehensive in the world. We have a strong universal systems. We have targeted supports that are making a real difference for children and families. Yet the AEDC data tells me we still haven't got it quite right. And if we're going to improve the experiences of children and families in the first five years, then we need to be working differently. So if we're going to invest in our future and invest in children like Damien, then we really need to reflect on the quality of the experience the child is receiving and what aspects of our system we need to prioritize in order to affect real shifts. So four parts of our system that I think are most pressing includes really looking deeply at participation of children, how we're supporting our workforce in terms of workforce development, our prioritization of evidence based practices within educational environments, and finally how we support families and the home learning environment. So I wanna unpack some of this for you. When it comes to early childhood impact, access matters. And what we see is many of government policies, both in Australia and internationally are really motivated by increased participation. And this is certainly supported by research. One of the main variables from the OECD Starting Strong report, showed that one of the strongest predictors of performance at 15 was the number of years, a child participated in early childhood education. Longitudinal work that's happened in the UK and the US and some of the work that we've been doing here at UOW provides a very strong evidence base for the extended developmental achievement benefits for children who attend early childhood of two years over one. So the graph that I'm sharing with you here captures the impact of the Abbott pre K model that was introduced in New Jersey. And what this looked at, they were interested in, they provided free preschool to children who were living in New Jersey, who lived in the most disadvantaged areas within that community. And what they were looking at is what impact that could have on children's learning trajectories. And they're also particularly interested in seeing if those impacts could be achieved in one year versus two years. And this data clearly points to the overwhelming benefits of two years of attendance at prior to school, educational context versus one year. The graph that I've got here captures the relative benefits and the value of early education relative to school and higher education. And as well as, it also shows a differentiated role that ECE plays across the different cohorts of children. Now, early childhood education matters for everyone. However, the findings have been particularly strong for children in vulnerable circumstances. Every child needs effective early childhood support. It's not that some children need more than others. But what we do know is that children from disadvantaged environments often come from families who lack education or they just might not have the social or economic resources that are needed to provide the rich early developmental stimulation that's so helpful for children's success at school and in careers and in life. And it's for these children that early childhood education plays a particularly unique role in how we contribute to their developmental trajectory. I do just wanna say something briefly about our measures of participation. At the moment in Australia, our best measure of participation is enrollment. And the challenge here is that there's a distinct disconnect between enrollment and actual attendance or participation. And in Australia we typically see lower rates of participation amongst children who would benefit the most from quality early childhood education and the children most at risk of non
attendance are those who come from families who experience multiple disadvantage. So if we are going to improve outcomes at a population level, then we need to get much better at supporting the active participation amongst children who are experiencing disadvantage or whose families or community circumstances render them vulnerable to exclusion. So our first need is increased participation. One year is simply insufficient to produce the enrich developmental outcomes that we're striving for. However, participation is just one piece of the puzzle, and a focus on participation without a focus on quality is insufficient to ensure the positive outcomes that we're wanting for children. And while children from disadvantaged backgrounds stand to benefit the most from quality early educational experience, they are also the children who are most vulnerable to the impact of poor quality. And if we don't get this right, not only are we not closing the gap for these children, there is the potential that we're gonna widen it. So two components of the puzzle that have the greatest impact on quality are workforce development and quality practice. And a rich and responsive and quality ECE system can't exist in the absence of high quality pedagogues. And for me, when it comes to quality, teachers matter, educators matter, in fact you matter the most. So ensuring an effective ECE system means that we really need to ensure our pre service educational context is rigorous and it's discerning. But we also need to make sure that we are very effective in supporting practicing teachers. And we can do that through high quality and contextually responsive professional development that not only reflects research understandings of how children learn best, but responds to the contextual needs of the services where you are working. What are the needs of the children that you're supporting? What are the needs of the families? And while there's certainly been an increase in interest, both at a state and federal level about improving the quality and quantity of Australian research, I really want to see a much stronger link between this research and educational or early childhood policy and how that translates to practice. So closely connected to workforce development is our commitment to quality practice. Curriculum frameworks like our Australian early years learning framework can really play a pivotal role in ensuring the quality of what's happening within our services and our own research that we've done here at UOW. We've developed a pretty clear understanding of the pedagogies needed to foster really strong developmental outcomes. And so this is things like a commitment to both relational, intentional pedagogies, where children's thinking and curiosity and engagement is extended through the active involvement of the pedagog. We wanna see equal value to both social and emotional learning, as well as opportunities for cognitive experiences. And I also wanna highlight the need for effective use of assessment tools that support our understanding of children's development. And this needs to come much earlier in children's developmental journey as Cate highlighted. And we also need to think about the establishment of clear individualized learning goals that are not only shared with children, but they're communicated to families. So the last piece of the puzzle that I really want to touch on today is the home learning environment. And affecting change for children, means the need for stronger engagement with families and the home learning environment. And we know that as much as 50% of the variance in children's developmental outcomes can be attributed to the quality of the parent child relationship as well as the quality of the parenting and the quality of the learn home learning environment to which children are exposed. Now as early childhood educators, we often talk about teachers and parents as being partners in children's educational journey. But yet this is probably one aspect of our practice that has been the most challenging to achieve. And parental partnership is critical in increasing our knowledge about children, but it's also important for supporting that rich and extended learning experiences in the home environment. And I think one of the real gifts, so I talked about the wins and losses of COVID, and I think one of the real gifts of COVID to the early childhood education system was the reframing and the re
prioritization of the home learning environment and our impact, but it also highlighted a number of challenges for us moving forward. And so it's thinking really about how do we increase parental awareness and engagement? And how do we negotiate the realities of time constraints and work commitments? But we also need to think about how we can best respond to the increasing diversity amongst parents. And this speaks to engaging parents from different cultural backgrounds, but also those who themselves have really fraught historical relationships with education. So what is our call to action moving forward? What do we need to do to help children like Damien? And like Elizabeth said, I think we really need to commit to ongoing advocacy. And this is about making recent understandings of development in the early years, public knowledge. We also need to ensure our approach to workforce development. And that's both pre and in service training is rigorous and it's discerning. And at a systems level, we need to continue to provide support for practicing educators. And that includes providing support that responds to the current needs of children. So for our current cohort, it might mean that we need to reprioritize the social emotional components of our curriculum, to ensure children feel safe and secure and ready to learn. And I think we also need to continue to prioritize and strengthen connections between health and education. And that's really captured within that first 2,000 days framework. And that change is really going to rely on collaboration and connections and shared commitment. And finally, I think we need to really continue to champion examples of excellence. So I think there are many of you here today who are making a real difference in children's lives, and these are practices that need to be celebrated and they need to be shared.
Thank you so much. That was such an amazing talk. And I think I'll be going back to the recording of this multiple times, I suspect, to both really pick up everything that you and Dr. Murphy have covered in your presentations. It was incredibly comprehensive. And I really hope that our participants have got a lot out of that. So before we get into the Q&A component of our agenda, we'd like to do another Menti and it really picks up on something Cathrine that you just touched on around collaboration between education and health and how we can really make sure that we understand what is happening locally. It's something that through Brighter Beginnings, we really want to explore further and try and really build on some of that great collaboration that's already happening between our early childhood education services and our health professionals. So we do have another Menti for people to participate in. The first question will just be a yes or no question. If you would be interested and willing to share your learnings and experience with our team, we would be really welcome to you putting in your service name and we would love to be able to contact you in the future to talk through some of that experience. So I'll give you a couple of moments just to fill out that, and then we will kick the Q&A component.
Thanks Cate. And our colleagues have put up the link in the chat as well. So if you have missed scanning the code, you can refer to the chat and pick up from there. We have question for both Elizabeth and Cathrine. You both talked about the importance of ECE and our health professionals working together. What would that look like at system level but also at the service level? Where have you seen it work well? And what are the key elements of that?
I'm happy to go first. One practical great example that we've got in health is the steps vision screening. We used to do that at school, and it was way too late for us to be able to improve children's vision. And so we looked at whether we would be able to do that when children were in preschool and doing it in the early childhood education settings. And very graciously that has been allowed, our step screeners go to child care facilities and do the screen. We have 80% of children who are screened and those children with vision problems then have reversible conditions that we can make a difference to. And really there's not anything else in the world that's like it. So that's a fantastic example of a partnership that is there with very obvious effects now. It'll be lovely to expand that to development that we both share this one tool and the signs act early, and that we have partnerships with education and health in better flow. I noted in the chat that some colleagues have said that they have identified children with developmental problems and they haven't been acknowledged by health. And we have work to do if that's happening, I'd hope that wouldn't be happening with regard to child and family health professionals, but can't speak more broadly with regard to others. We are intending to work more with general practice because you are the experts in childhood development, and so if you are concerned, we need to be concerned and act on it. So it's an example of something that's worked well. And an example of something where I'd like greater partnership between health and education which would have stunning outcomes and great benefits.

Thanks. I'm just gonna add to that. And I think if we're really going to make a difference, we need to prioritize collective responsibility. And it's really around what... And asking the question, what does cross sector participation look like? And I think you cannot underestimate the value of relationships and connections, and it's about having that right person in the role. But also I think it's around adopting a contextual lens. So some people on today might be coming from regional areas and rural areas. And I think what works within a metropolitan area doesn't necessarily extend to what's happening in regional and remote areas in terms of providing those strong connections. I know some of the work that we did during COVID, which was looking at service integration and connections and partnerships between early childhood services and health services. One of the things that really worked for children and for educators and for health was that key worker model. So having someone who actually understands the needs of the children and has connections with health. So I don't think, like I really want to prioritize the importance of relationships, but I also want to highlight the significance of elevating voices and really around valuing. And I think Elizabeth talked to this, and it's about valuing the voice of the early childhood professional as part of this. And it's, you know children, you see them all the time, so some of the practices that we've seen work really well around speech pathology and OT is where there's that partnership. And the educator actually might attend the assessment with the child and with the practitioner because you know children so well, you're seeing them every day and you're seeing the impact of their skills in terms of their practices. But I think moving forward, it really is that shared agenda and shared language. So I like the idea that Elizabeth said about having common platforms that we both use. Because I think different languages and different priorities can be real barriers to meaningful connections.

That's wonderful. Thank you. Next, we're going look at the first Menti result. And Karen if you could put up the screen with the results, we're just going to have a look at what people have entered and maybe we can build them on some of that. So there's a lot of secure attachments. There's a lot of, I looked at... They they're still coming through, that's great. We saw something earlier on secure attachment. Now, Cathrine, I know you are... And self regulation, sorry. Self regulation is actually one that was quite high on the priority list. Are you able to expand a bit more on that? I know you are doing some recent research projects on that, would be great if you could talk today about that.

Yeah, certainly I think, and that's what I really spoke to at the last point around reprioritizing, what we're actually doing in terms of our curriculum. And we need that flexibility to respond to what children's needs are at the moment. And I think one of the real challenges that many of you have captured and what we're experiencing is, challenges around children's social, emotional wellbeing. And this is very much manifested in the challenges that they're experiencing with respect to their self regulation. So being able to have a level of control over their emotions and their behaviors and their cognitive processes in order to be able to engage. And we know, if we think about prioritizations, we know if children aren't able to control their emotions and their behaviors and their thoughts, then it doesn't matter what else you do in that learning environment, they're not able to learn. And so really that is one of our prioritizations at the moment, it's really helping children to identify their own emotions, but also to feel safe and secure in the environments and what underpins that. And as early childhood educators, I think that's what we do very well. We prioritize the importance of relationships and that bi
directionality. So I think that's, moving forward, that's one of our real priorities. It's thinking about the relationships that we form with children, how that underpins their wellbeing. And then we start thinking about what are the skills that we need to support children to have in order to be successful. And if we're thinking about that, absolutely prioritization of self
regulation is critical. I often think about self
regulation as almost being the biological basis of school readiness and life readiness.

Thank you. Now I see also quite a bit on parental support and family support. Elizabeth, do you have a bit more advice? Something else to help educators and our participants today in that report with families. And perhaps we can expand that as a triangle to include some of the health professionals. I know you touched on that earlier, but if there's anything else you'd like to add there.

Thank you Mady for that. And I've been reading with great interest all this fabulous questions in the chat. And I think it's just to emphasize that so many parents don't know as much as you do with regard to early brain development and what's happening with their children, and the responsibility of all of us who do to share that information, now we at the ministry are trying to do that by the first 2,000 days, so that everybody understands the importance of the first 2,000 days. And this partnership with Brighter Beginnings and all the other agencies has just been fantastic, but probably an even more important partnership, is with community. And I've got one example, a great example of Dapto Rotary. I spoke at Rotary and the Dapto group who are celebrating 100 years, really picked this up. If you have a look at their website of Dapto Rotary's website, go to first 2,000 days on the front cover, they have discerned some of the most important literature and talks and presentations, and it's all there on their website. And they're actually doing that for their community. It's parents that need to know all of this information and what can we do to enable them. Because as I mentioned briefly in my talk, they don't understand normal childhood development. And we don't get that opportunity again. The importance of the first 2,000 days is that, and so what can we do so that we can work in better partnership? We're developing some videos to be able to spread this message further. And I mean, basically it's what do you do, your love, talk, sing, read, play. How do I do that for a two month or a two year old? That's the kind of videos that we're trying to develop. And we, as I say, are really pushing Learn The Signs Act Early because we think that that has only just recently been updated by CDC so that it's more current and it's about 75% of children have achieved that milestone by that age, if your child has some, you need to identify and refer. In the questions, there are some great shared experiences from Gilgandra and others about what to do to help with getting that support. So there's a resource within the chat of what to do as well, but we've got, there's always a website. We've got a website at New South Wales health and the Brighter Beginnings website, are great resources for you as well as to what's available to help you with parents.

And I was going to add as well. I know quite a few have of the comments have expressed the need to be educating and sharing this with parents. So Brighter Beginnings is taking a real focus on raising this awareness and understanding of the first 2,000 days. And we're working on a communication strategy. And part of that I think would be for us to give you the resources to share with parents because you are there with them every day. And sometimes it could be a social media post, and sometimes it could be a flyer depending on circumstances. So we'll be in touch through our regular channels that we engage with the ECE sector to find out what works in communicating with families and also to help support you with those resources.

Another wonderful resource is the work that's been happening in Western Australia. And I hate saying about other states' great work, New South Wales, but Bright Tomorrow Start Today, the work that's happened with the Minderoo Foundation is just a fantastic resource. And if you haven't downloaded that app, it's a great one to have on the phone. Remembering we give everybody a, because some of the questions are saying, it needs to start in maternity and we agree. So in the box that's given to every parent in that baby bundle at birth, we have the flip chart for love, talk, sing, read, play. And as I say, that's an excellent resource as to how to promote your child's development, what to do. So perhaps sometimes the problem is that box doesn't get opened until the child starts school. If you could encourage people to have a look at what's there and have a look at that developmental page, 'cause parents can be exhausted. So if we can start that early and it's a beautiful resource.

We heard, and we know health has data on developmental checks slowing down after the first year. And there are some changes in, as you mentioned, Dr. Murphy, in the Learn The Signs Act Early. And so that we changed the wait and see approach, and then take a more proactive approach. We've read on the comments that GPs tend to take more of that laid back approach. What is your advice around that? How can we encourage families to take their children for developmental checks? How can we work a bit better on that so that parents take a more active role in this, in their child development.

Oh, I'm happy to have any advice, we're we are working as hard as we can. I think people don't understand how important development is. And that this is the platform for your child for life. And we try as hard as we can in child and family health. We give everybody a personal health record, a blue book which has the recommended checks, go and get your development done. We are developing reminders tool with DCS for those checks. So just the way you get one several times for your dog, for immunization or whatever, we're looking at raising the importance of development and getting that to create a greater emphasis on people attending to get their developmental checks. But any other ideas anybody would like to share with us, we'd be willing, very happy to hear.

Yeah, I think Mady, I mean the questions that I'm flicking through them madlyas Elizabeth is chatting, I think the questions really speak to the complexity of the situation and I think we need to acknowledge that. And I think some of the work that's happening around the first 2,000 days and what you're doing in Brighter Beginnings, is really around how do we bring this together? And the reality is that the families who are required to walk through the most number of doors are the ones who had the least capacity to do so. So I think some of the work that we need to do is really think about the structural supports that are provided within the system and reducing the number of doors that families need to walk through. And like the early childhood service is often the one space and Elizabeth spoke to that where families actually feel most connected, they feel safe, they feel trusted, they feel known. So sometimes it's about thinking about what is that door that they need to walk through and how we can we bring the services to them in terms of enhancing that engagement. So it's thinking about how can we do this but in a different way.

Anonymous attendees has got a great solution in the questions. Great idea. Imagine a world that's fantastic. Thank you.

I think Cathrine you've completely hit the nail on the head in terms of what we're trying to achieve through Brighter Beginnings around really recognizing how complex it is to raise a child and that there is so much that a parent or carer is responsible for during that first five years of life, that critical period. And we do have to do a lot more in terms of the way in which we think about how we deliver government services, how we sort of design policy really with children and families at the center of that. And particularly those ones who do have increased vulnerability. Mady are there any other ones that we think we haven't already covered?

There are quite a few that we are talking about professional development and investment in the sector and this is also something we're looking to grow through Brighter Beginnings and have a more common approach to doing this, where we involve health colleagues and we look at some of the evidence to develop this professional development. So while the answers just keep rolling it's quite hard to follow, but thank you so much for your engagement. Maybe last thoughts if you want from our amazing experts here, if you want to say anything else, otherwise we will be almost ready to wrap up. We do have a couple of slides left. Karen, if you're okay to share them, we've included a couple of links and we will share the rest as part of the follow up email. But this is the QR code and the link to Brighter Beginnings. If you want to have a look at it, see what's there, the website hasn't been updated in a while, but you can sign up for our newsletter and you'll receive all of this in your inbox. And we have a link to Dr. Murphy's talk on the health website where she speaks in more detail about the evidence that she presented here today so feel free to head there. And we'll share the PowerPoint presentations and the link to this recording will be available on our website.

I just want to reiterate Mady's thanks to our fantastic panelists today. Thank you so much, Elizabeth. Thank you so much, Cathrine. Really appreciate your time and the expertise in a really considered way in which you've presented so much compelling information. I noticed that there are lots of people in the chat who are very interested in receiving the recording. So I suspect that there'll be a few return of viewers like myself to really make sure that we get the most out of what you've shared with us today. Thanks everyone for participating. Thanks for your questions. We really appreciate your engagement. Really hope that you enjoy the rest of the ECE roadshows. I think there's one tomorrow, a couple potentially next week, if I'm not mistaken. But yeah, this is such a great platform for us to engage with you and we really appreciate you taking the time to do so. Thanks so much. Have a great day.

Thanks much.

I will.

Thank you.