2022 Roadshow

The NSW Department of Education early childhood education and care roadshow was held online throughout May 2022. View the sessions from the roadshow that were recorded below.

Hear about allergy/anaphylaxis management in early childhood education and care services from the NSW Anaphylaxis Education Program (NSWAEP)

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.

Gain knowledge and understanding of the impact of developmental trauma from the Australian Childhood Foundation.

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.

Hear from BeYou on communicating with families, including advice on how to have challenging conversations.

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. 

Explore ECEC and Health perspectives on the issues affecting child development today, and what educators and families can do to support children overcome any developmental delays.

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. 

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