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Creating a trauma-informed early childhood workforce in Los Angeles County: understanding the self-reported impact of a TIC training program

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Creating a trauma-informed early childhood workforce in Los Angeles County: understanding the self-reported impact of a TIC training program

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Content CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR
Creating a Trauma-Informed Early Childhood Workforce in Los Angeles County:
Understanding the Self-Reported Impact of a TIC Training Program
by
Jessica Reynaga, MSW
Rossier School of Education
University of Southern California
A dissertation submitted to the faculty
in partial fulfillment of the requirements for the degree of
Doctor of Education
Au gust 2020
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR

© Copyright by Jessica Reynaga 2020
All Rights Reserved

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR

The Committee for Jessica Reynaga certifies the approval of this Dissertation

Dr. Erika Patall
Dr. Reneé Smith-Maddox
Dr. Briana Hinga, Committee Chair

Rossier School of Education
University of Southern California
2020

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR

Abstract
Utilizing a critical approach to trauma, coupled with a theoretical framework supported
by the Transtheoretical Model of Change, this study aims to understand the self-reported impact
of a trauma-informed training program on early childhood educators (ECEs) in Los Angeles
County. The purpose of this study was to gain insight into the perceived changes in attitudes and
beliefs, attributions and practices of ECEs after having completed a trauma-informed care (TIC)
training program. Three focus groups of ECEs that completed the TIC training were convened to
provide insight into these research questions. A qualitative approach to inquiry, grounded in a
formative evaluation framework, was utilized to collect and analyze data in this study. A
combination of ATLAS.ti software and manual coding techniques were used to code, organize
and synthesize the data collected. Findings from this study indicate that training participants
gained new understandings of childhood trauma, became more curious about the cause of
challenging behaviors, and began using TIC strategies after completing the training. This study
provides insight into the early change experiences of ECEs that have undergone a TIC training
program and begins to highlight effective components of a TIC training curriculum.
Keywords: trauma, dysregulated child behavior, early childhood educator, trauma-
informed care

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Acknowledgements
This manuscript would not have been possible without the love and support of Denise
Nichole Reynaga, Annette Sylvia Gutierrez, Neva Wallach, Darlyn Silvestre, and Louis Enrique
Urrutia. Each of these individuals has "up-close and personal" knowledge of the struggles and
joys of this accomplishment, and I would not have been able to continue successfully without
their endless cheerleading and pep talks! I owe you each a lifetime of gratitude - thank you.
This manuscript is also a product of all the strong mujeres that I have encountered along
my journey: Mrs. Debra Connell, Monica Ann Leon, Karen Barnes, Dr. Terri Mendoza, Maricela
Rios-Faust and so many more! Thank you for everything you have taught me, I carry your
words with me everywhere I go. I also want to thank my mom, Yolanda Reynaga, my dad, Raul
Reynaga, and my grams, Refugia Rodriguez, for always believing in me and my ability to do
more. This doctorate is a result of all your hard work and sacrifice – I would not be at this point
in my life without your love and support – thank you.
I also want to thank my three amazing committee members: my wonderful Chair, Dr.
Briana Hinga, my macro-social work inspiration, Dr. Reneé Smith-Maddox, and my educational
psychology inspiration, Dr. Erika Patall. Each of you has been an integral part of my educational
journey – your work, both in the classroom and out, motivates me to do the work I do, and has
grounded my skillset in foundational theories upon which I will always base my practice.
Without your guidance and critical feedback, I would not have been able to complete this
research study – thank you.
Lastly, I want to acknowledge God’s loving presence that is always with me, guiding my
path.

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Table of Contents
Abstract .......................................................................................................................................... iv
Acknowledgements ......................................................................................................................... v
Table of Contents ........................................................................................................................... vi
List of Tables ................................................................................................................................. xi
List of Figures ............................................................................................................................... xii
Chapter One: Overview of the Study .............................................................................................. 1
Background of the Problem ............................................................................................................ 4
Trauma-Informed Interventions .......................................................................................... 5
Statement of the Problem ................................................................................................................ 7
Purpose of the Study ....................................................................................................................... 8
Significance of the Study ................................................................................................................ 9
Organization of the Study ............................................................................................................. 10
Key Terms ..................................................................................................................................... 11
Chapter Two: Literature Review .................................................................................................. 12
A Critical Approach to Trauma .................................................................................................... 14
Towards a Critical Trauma Theory ................................................................................... 15
Developmental trauma. ......................................................................................... 18
Historical attitudes, beliefs and approaches to child-rearing in the U.S. ............ 20
The Trauma-Informed Care (TIC) Theoretical Model ..................................................... 23
Emergency child care bridge program. ................................................................. 25
Bridge TIC training program................................................................................ 26
Trauma-informed care in early care and education. ............................................. 30
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The early childhood workforce in California. ...................................................... 31
The Goal of Training: Behavior Change ...................................................................................... 32
Transtheoretical Model of Change (TTM) ....................................................................... 33
TTM and TIC training for ECE professionals. ..................................................... 35
Attribution theory. ................................................................................................. 36
Conceptual Framework ................................................................................................................. 38
Summary ....................................................................................................................................... 39
Chapter Three: Methodology ........................................................................................................ 41
Qualitative Inquiry ........................................................................................................................ 41
An Evaluative Study ......................................................................................................... 41
Setting and Participants ................................................................................................................ 42
Research Setting................................................................................................................ 44
Participant Characteristics ................................................................................................ 44
Data Collection and Instruments/Protocols .................................................................................. 45
Focus Groups .................................................................................................................... 45
Data Management and Analysis ................................................................................................... 47
Data Coding Process ......................................................................................................... 48
Limitations and Delimitations ...................................................................................................... 49
Credibility and Trustworthiness .................................................................................................... 50
Positionality .................................................................................................................................. 51
Ethics ............................................................................................................................................ 52
Summary ....................................................................................................................................... 53
Chapter Four: Findings ................................................................................................................. 54
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Perceived Changes in ECE Attitudes and Beliefs ........................................................................ 54
Finding 1: ECEs Move from No/Limited Understanding to a New Understanding of
Trauma and a Belief that Others Benefit from TIC Training. .......................................... 54
Descriptions of ECEs initial understanding of childhood trauma via recollection.
............................................................................................................................... 55
Moving to a new understanding of trauma and a new belief. ............................... 60
New understanding of trauma. .............................................................................. 60
Belief that others would benefit from the TIC training. ........................................ 63
Perceived Changes in Attributions ............................................................................................... 66
Finding 2: ECEs Move from Assigning Specific Attributions to Being Curious About
Child Behavior. ................................................................................................................. 66
Analysis of ECE initial attributions via recollection. ........................................... 66
Developmental causes as attributions for challenging behavior. ......................... 66
Poor parenting skills as attributions for challenging behavior ............................ 68
Negative child dispositions as attributions for challenging behavior. ................. 70
ECEs move to a place of curiosity regarding challenging child behavior. ........... 71
Perceived Changes in ECE Practices ............................................................................................ 76
Finding 3: ECEs Report Using TIC Strategies with Children in Their Care After Training
........................................................................................................................................... 76
Analysis of ECEs initial practices via recollection. .............................................. 76
Child-focused responses. ...................................................................................... 76
ECE-focused responses. ........................................................................................ 80
ECEs report using TIC strategies. ......................................................................... 81
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Partnering with other primary caregivers. ........................................................... 82
Building a secure attachment with children. ........................................................ 83
Additional TIC strategies reportedly utilized by ECEs. ....................................... 83
Summary ....................................................................................................................................... 87
Chapter Five: Discussion of Findings ........................................................................................... 88
Discussion of Findings .................................................................................................................. 89
Finding 1: ECEs Move from No/Limited Understanding to a New Understanding of
Childhood Trauma and a Belief that Others Benefit from TIC Training ......................... 90
Finding 2: ECEs Move from Assigning Specific Attributions to Being Curious About
Child Behavior .................................................................................................................. 91
Finding 3: ECEs Report Using TIC Strategies with Children in Their Care After Training
........................................................................................................................................... 93
Limitations .................................................................................................................................... 93
Implications for Practice ............................................................................................................... 94
Incorporating Pre-existing ECE Attributions into Future Training Efforts ...................... 95
Teaching ECEs When to Utilize Specific TIC Strategies ................................................. 96
The Importance of Emphasizing the TIC “Catchphrase” ................................................. 96
Measuring Curriculum Efficacy ....................................................................................... 97
Recommendations for Research ................................................................................................... 98
A Representative Sample .................................................................................................. 98
Measuring Self-Efficacy ................................................................................................... 98
Utilization of Pre-/Post-Tests ............................................................................................ 99
Observation of Participants ............................................................................................... 99
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Conclusion .................................................................................................................................. 100
References ................................................................................................................................... 102
Appendix A ................................................................................................................................. 115
Appendix B ................................................................................................................................. 117
Appendix C ................................................................................................................................. 118
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List of Tables
Table 1: Bridge TIC Training Content 29
Table 2: Participant Demographics 44
Table 3: Background Knowledge of TIC in ECE Settings Before Attending Training 45
Table 4: Amount of Formal TIC Training ECE Have Received 45
Table 5: Focus Group Details 46
Table 6: Description of ECEs That Report No Understanding of Childhood Trauma 56
Table 7: Description of ECEs That Report Limited Understanding of Childhood Trauma 58 – 59
Table 8: Review of Finding 1 65
Table 9: Review of Finding 2 75
Table 10: Additional TIC Strategies Used by ECEs 84 – 85
Table 11: Review of Finding 3 86

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List of Figures
Figure 1: Conceptual Framework 39

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Chapter One: Overview of the Study
A growing number of children in the United States are experiencing the harmful effects
of trauma. The term trauma has been defined in various ways; however, key commonalities
across definitions exist, namely the experience of a negative stressor followed by negative
consequences experienced by the individual (Cummings, Addante, Swindell, & Meadan, 2017;
Huang et al., 2014; La Greca et al., 2008; Sweeney, Filson, Kennedy, Collinson, & Gillard,
2018). Differences in definitions of the term "trauma" often arise when referring to the traumatic
experiences of different populations. For example, some definitions of trauma have been crafted
with the traumatic experiences of adults in mind, as opposed to definitions that are more
inclusive of the trauma experienced by children. This study will utilize the definition of trauma
provided by Georgetown University's Center for Early Childhood Mental Health Consultation,
which defines trauma as the following:
“Trauma is the unique individual experience of an event or enduring conditions in which
the individual’s ability to integrate [their] emotional experience is overwhelmed, and the
individual experiences (either objectively or subjectively) a threat to [their] life, bodily
integrity, or that of a caregiver or family” ("Defining Trauma", 2019).
This definition of trauma emphasizes the subjective nature of traumatic experiences, which is
vital to consider when thinking about the multitude of ways in which children are exposed to
trauma in the United States.
According to The National Survey of Children’s Exposure to Violence, 67.5% of children
in the United States have been exposed (either directly or indirectly) to at least one act of
violence that can be considered traumatic, including physical abuse, sexual abuse, maltreatment
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or witnessing violence (Finkelhor, Turner, Shattuck, & Hamby, 2015). In addition to the
experience of violence, trauma can be caused through other means such as natural disasters, life-
threatening illness, and migration experiences; however, this is by no means an exhaustive list
(La Greca et al., 2008, “Trauma Types”, 2019). In light of the high rates of exposure, early
childhood educators (ECEs) are increasingly challenged in their ability to meet the needs of
those children exposed to trauma ("Building a Comprehensive State Policy Strategy to Prevent
Expulsion from Early Learning Settings", 2017; Cummings et al,. 2017; Duran et al., 2009; Ko et
al., 2008).
Within the past two decades, advancements in the areas of neuroscience and child
development have provided substantial research on the impact of trauma, highlighting evidence
of the harmful effects trauma has on early childhood development (Brunzell, Stokes, & Waters,
2016; Elana, 2000; Perry, 2009). These scientific advancements counter a dominant narrative
that was, and to a large extent still is, pervasive in the United States – a narrative which assumes
children are "too young" to remember experiences of trauma and, therefore, are immune to early
traumatic events (Buss, Warren, & Horton, 2015). It is now understood that children who have
experienced a traumatic event also experience disruptions in healthy cognitive and physiological
development. The experience of trauma impairs neural pathways that control behavioral
responses to stress, and as a result, children that have experienced trauma often display
dysregulated behavior and find it difficult to develop secure attachments (Brunzell, Stokes, &
Waters, 2016; Elana, 2000; Perry, 2009). Dysregulated child behavior is often understood in two
ways: hyper-aroused or hypo-aroused states (Perry, 2009). Hyper-aroused behaviors include:
biting, kicking, screaming, running away from adults, inability to focus on tasks at hand, and
sensory preferences that cause a child to seek out intense amounts of stimulation in various ways
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(Perry, 2009). Examples of hypo-aroused states in a child include withdrawn, or avoidant
behavior, and these children also have sensory preferences; however, they tend to prefer
experiences that provide lower amounts of stimulation, such as a quiet space rather than a noisy
classroom (Perry, 2009). These states, which are often experienced by adults as challenging
child behaviors, make children already exposed to trauma more sensitive to stimuli in their
environment, thereby, eliciting additional stress responses to situations that may not be
distressing to a child without a history of trauma (Grasso, Ford, & Briggs-Gowan, 2013). This
understanding of child behavior is now informing how adults are working with children in ways
that were not previously occurring a decade or so ago (Buss et al., 2015, La Greca et al., 2008;
Sweeney et al., 2018).
While trauma does negatively impact development, current research also highlights the
plasticity of a young child's brain, making the use of early childhood interventions particularly
effective in mediating trauma's adverse effects (Brunzell et al., 2016; Elana, 2000; Perry, 2009).
Research also exists highlighting that one of the most potent mediators of trauma exposure in a
child's life is the presence of a secure attachment with a primary caregiver (La Greca et al., 2008;
Perry, 2009). A secure attachment is understood to be a relationship that is consistently attuned
and responsive to the child’s needs (Holmes, Levy, Smith, Pinne, & Neese, 2015; Lieberman,
2004). In light of these developments, there is growing interest among policymakers and ECEs
in support of trauma-informed interventions targeted at children ages zero to five and, as a result,
trauma-informed programs are growing in popularity (Bartlett et al., 2015; Conners-Burrow et
al., 2013; Donisch, Bray, & Gewirtz, 2015; Jankowski, Schifferdecker, Butcher, Foster-Johnson,
& Barnett, 2019; Kerns et al., 2015; Kramer, Sigel, Conners-Burrow, Savary, & Tempel, 2013).

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Background of the Problem
Across the country, approximately two million adults (mostly women) are caring for and
educating nearly 10 million children ages zero to five (Whitebook, McLean, Austin, & Edwards,
2018). Despite the instrumental role these ECEs play in the development of young children, this
profession has been historically undervalued, both in terms of wages and the educational
qualifications necessary for this profession (Elevating the voices of children: The state of early
care and education in Los Angeles County, 2017; Whitebook et al., 2018). In 2016, a review of
state minimum qualification requirements coded into child care licensing regulations found that
requirements across the country remained low and were not in line with current research-based
best practices in the field of child development (Whitebook et al., 2018). This identified need for
professional development, coupled with the fact that more ECEs report encountering an increase
in the number of young children displaying challenging behavior, is resulting in these children
being removed or expelled from early childhood education settings at alarming rates ("Building a
Comprehensive State Policy Strategy to Prevent Expulsion from Early Learning Settings", 2017;
Cummings et al., 2017; Duran et al., 2009; Ko et al., 2008).
One study conducted by Walter Gilliam across 40 states found that the rate of expulsion
for children in early care and education programs such as pre-kindergarten, Head Start and
various child care settings, was triple the expulsion rates for children in K – 12 settings, with a
national rate of 6.7 children expelled for every 1,000 children (Gilliam, 2005). Several studies
highlight that this rate is even higher when looking at settings that work with children under the
age of three in particular. Studies in Colorado, Massachusetts and Michigan show that children
under the age of three are being expelled at a rate of 27.4 children per 1,000, while a Chicago
study found that 42 percent of this age range were expelled due to challenging behaviors. These
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studies also highlight racial and gender disparities among young children being expelled, with
male children of color experiencing the highest rates of expulsion in ECE settings ("Building a
Comprehensive State Policy Strategy to Prevent Expulsion from Early Learning Settings", 2017;
Gilliam, 2005).
While expulsion appears to be a popular disciplinary tactic, there is no evidence to support
the assumption that expelling children from educational settings has a remedying effect on
challenging child behavior. Rather, quite the opposite has been found true. Research shows that
exclusionary discipline practices (those that include out-of-school strategies such as suspension
and expulsion) erode a sense of trust and safety and can negatively affect children into their adult
lives (McCarter, 2017). Children that are expelled from educational settings are more likely to
experience failures in school (low grades, high school drop-out) and more likely to become
involved in the juvenile justice system – a phenomenon commonly known as the school-to-
prison-pipeline (STPP) (McCarter, 2017; Wolf & Kupchik, 2016). When exclusionary practices
are utilized, children that have experienced trauma are re-victimized rather than being offered
early interventions that work to mitigate the impact of a child's original trauma experience.
Trauma-Informed Interventions
In light of scientific advancements that explain the impact of trauma on early childhood
development, coupled with a growing amount of research demonstrating the negative impacts
exclusionary discipline practices have on children - educators, mental health practitioners, and
policymakers across the U.S. are investing time and money into the creation of trauma-informed
programs (Bartlett et al., 2015; Conners-Burrow et al., 2013; Donisch et al., 2015; Jankowski et
al., 2019; Kramer et al., 2013). These programs, commonly referred to as trauma-informed
strategies or trauma-informed care (TIC) initiatives, occur at various organizational and system
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levels, as well as across and between fields (Donisch et al., 2015; Hanson & Lang, 2015; Ko et
al., 2008). A TIC approach to serving children, families and individuals is one that realizes the
widespread prevalence of trauma in U.S. communities, recognizes when behaviors may be a
result of trauma, and responds in ways that seek to resist re-traumatization of the individuals
being served (Fallot & Harris, 2008; Substance Abuse & Health Services Administration, n.d.).
Trauma-informed systems operate under the assumption that all people, from clients to staff,
have experienced trauma, and therefore "thoroughly incorporate an understanding of trauma,
including its consequences and the conditions that enhance healing, in all aspects of service
delivery," (Hales, Kusmaul, & Nochajski, 2017; Harris & Fallot, 2001, p. 6). This approach to
trauma goes beyond the traditional client-provider relationship, wherein a helping professional
provides a direct service, or a specific intervention, to a client seeking services (Harris & Fallot,
2001; Sweeney et al., 2018). A trauma-informed approach requires the implementation of
organizational policies and strategies that do not necessarily include the pathologizing of an
individual, which is a shift in perspective from the traditional mental health, social service and
child welfare models (Hales, Kusmaul, & Nochajski, 2017; Harris & Fallot, 2001; Sweeney et
al., 2018). A popular catchphrase that encompasses this shift is rather than asking, “What is
wrong with you?”, a trauma-informed response asks, “What happened to you?” (Sweeney et al.,
2018). These phrases represent the paradigm shift at the heart of TIC which promotes curiosity
around past trauma experiences as a way to approach helping an individual, rather than
automatically identifying a deficit, which necessitates a specific intervention.
Similar to the shift in perspective required on an individual level when applying a TIC
approach, the implementation of trauma-informed approaches on a systems-level can also be
experienced as paradigm-shifting. As a result, a core component of any TIC strategy includes
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education and training for staff working with children, families and individuals that are
reasonably expected to have experienced trauma (Fallot & Harris, 2008). As the interest in
utilizing TIC strategies in early care and education settings increases, it is crucial to ensure that
TIC training for ECE professionals is effective in achieving its ultimate goal of facilitating
behavior change to include TIC specific strategies.
Statement of the Problem
Despite the growing popularity of TIC training programs, there is a lack of research
exploring the impact of these trainings on the attitudes, beliefs and practices of ECE
professionals as they relate to how trauma impacts a child’s behavior. In the U.S., a growing
number of TIC training initiatives in the child welfare field are beginning to yield evaluative
research as it relates to program outcomes; however, the same cannot be said for research in the
ECE field (Bartlett et al., 2015; Conners-Burrow et al., 2013; Kerns et al., 2015; Kramer, Sigel,
Conners-Burrow, Savary, & Tempel, 2013). The different functions of these roles (child welfare
vs. ECE) result in different relationships with the children in their care and, therefore, require the
implementation of different TIC strategies. Therefore, it is essential to understand the impact of
TIC training programs in ECE settings, with ECE professionals.
Based on research in the areas of human behavior and motivation, it is widely accepted
that before behavior can change, individual attitudes and beliefs must first change in ways that
ultimately increase an individual’s motivation to act in a new way (Cerasoli, Nicklin, & Ford,
2014; Norcross, Krebs, & Prochaska, 2011; Ryan & Deci, 2000). Without initial changes in
attitudes and beliefs, there would be little preliminary evidence to suggest that, as a result of
attending the training, ECE professionals would change their practices to include more trauma-
informed strategies in the future.
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Similarly, just as there is a lack of research into the impact TIC training has on the attitudes and
beliefs of ECE professionals, there is also a lack of research into the ways ECE practices are
changed by TIC training programs. As the ultimate goal of training is to change behavior, it is
also important to begin assessing whether or not ECE professional practices have changed
following participation in TIC training.
Purpose of the Study
As a result of limited research on this topic, the purpose of this study is to understand the
self-reported impact of a TIC training program on the attitudes, beliefs and practices of ECE
professionals in Los Angeles County. The Emergency Child Care Bridge Program for Foster
Children, commonly referred to as the Bridge Program, is a statewide effort in California to
place foster children ages 0 - 5 in trauma-informed, early care and education settings. In addition
to providing emergency child care to foster children ages 0-5, the program seeks to create a
trauma-informed ECE workforce by providing free TIC training and coaching services to ECE
professionals ("Emergency Child Care Bridge Program for Foster Children (Bridge Program",
2019). The Bridge TIC Training curriculum that is offered to ECE professionals in Los Angeles
County and was informed by the aforementioned scientific advancements in child development
and neuroscience that pertain to the traumatic experiences of children. The Bridge curriculum
was developed and adapted from three similar TIC curriculums that are also rooted in these
recent scientific advancements and whose main topics include: (1) how traumatic stress impacts
child development; (2) normal stress behaviors of young children; and (3) strategies to support
these children (Child welfare trauma training toolkit: Trainer’s guide, 2013; “Child Care Bridge
Program Trauma Training Series”, 2018; "Understanding the Impact of Trauma & Identifying
Strategies to Promote Healing ", 2019). As the Bridge training content is aligned with current
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research in child development and neuroscience, and was informed by three similar TIC trainings
for ECE settings, it is considered to be representative of other TIC trainings for ECE
professionals working with children ages 0 – 5 that are currently in existence. With this said,
this study seeks to understand the self-reported impact of the Bridge TIC Training program on
the attitudes, beliefs and practices of ECE professionals in Los Angeles County that have
completed all six modules of the Bridge TIC Training program. The specific research questions
that guide this exploration are:
1. How do ECEs perceive changes in their attitudes and beliefs as they relate to how trauma
impacts a child’s behavior after having completed the Bridge TIC Training Program?
a. How do ECEs perceive changes in the attributions they place on challenging child
behavior after having completed the Bridge TIC Training Program?
2. How do ECEs perceive changes in their practices with the children in their care that
display challenging behaviors after having participated in the Bridge TIC Training
Program?
Significance of the Study
Findings from this study will provide formative insight into the impact the Bridge TIC
Training program is having on the attitudes, beliefs and practices of ECE professionals in Los
Angeles County that have completed all six TIC training modules. This insight is important as it
may lead to revisions of the training curriculum, or Bridge Program generally, in ways that can
make the program more efficacious. Additionally, the broad reach of this program is, in itself, a
compelling reason to understand the efficaciousness of the program. As of December 2019, over
1,800 ECE professionals received training in Los Angeles County utilizing the Bridge TIC
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Training curriculum, with an average of anywhere between 100 to 200 new ECEs trained each
month ("TIC Bridge LA County Data Report: January 2020", 2020).
Furthermore, findings from this study may also provide insight into similar TIC
initiatives in other ECE settings. Understanding the experiences of ECEs attending a TIC
training may allow future TIC curriculums to be designed more effectively for these
professionals, possibly resulting in shorter curriculums and reducing the amount of staff time
needed to attend effective trainings.
Lastly, the findings from this study are significant because, as previously mentioned, TIC
approaches in the ECE field create an opportunity to replace widely used punitive responses to
dysregulated/challenging child behavior, often leading to the expulsion of children from ECE
settings. This change in response may also potentially lead to a decrease in the number of youth
entering the school-to-prison-pipeline, resulting in a more equitable education system for all
youth (Ko et al., 2008).
Organization of the Study
The following chapters describe why and how this study is being conducted. Chapter Two
provides a literature review discussing the main concepts and theories examined in this study and
introduces the theoretical and conceptual frameworks that provide a rationale for this
study. Chapter Three will review the research methodology and tools that were utilized for data
collection purposes. Chapter Four provides an analysis of the key findings and Chapter Five
presents a discussion surrounding these findings.

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Key Terms
Trauma: “the unique individual experience of an event or enduring conditions in which the
individual’s ability to integrate [their] emotional experience is overwhelmed, and the
individual experiences (either objectively or subjectively) a threat to [their] life, bodily
integrity, or that of a caregiver or family” ("Defining Trauma", 2019)
Dysregulated Child Behavior: behavior that occurs in response to stress that
overwhelms an individual's capacity to cope; in children, this results in children
displaying either hyper-aroused or hypo-aroused states (Perry, 2009)
Early Childhood Educator: professionals that care for children ages zero to five in various
settings including center-based child care, family child care homes, and early head start
programs (Whitebook, McLean, Austin, & Edwards, 2018)
Trauma-Informed Care: strategies to serving children, families and individuals that “realizes
the widespread impact of trauma and understands potential paths for recovery; recognizes
the signs and symptoms of trauma in clients, families, staff, and others involved with the
system; and responds by fully integrating knowledge about trauma into policies,
procedures, and practices, and seeks to actively resist re-traumatization’’ (Fallot &
Harris, 2008; Substance Abuse & Health Services Administration, 2014. p.9)

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Chapter Two: Literature Review
This study explores the self-reported impact of a TIC training program on the attitudes,
beliefs and practices of ECE professionals in Los Angeles County as they relate to how trauma
impacts a child's behavior. In order to understand this impact, this chapter provides a review of
relevant literature surrounding this topic, beginning with a review of Critical Trauma Theory
(CTT), which presents a view of trauma aligned with the trauma-informed approach promoted by
the Bridge Program. According to CTT, traditional trauma theory was borne out of traumatic
experiences specific to Western soldiers and is, therefore, limited in scope, creating a dominant
narrative that largely excludes the traumatic experiences of non-White, marginalized
communities (Craps, 2013; Matthies-boon, 2018; Stevens & Stevens, 2009; Traverso &
Broderick, 2010). CTT challenges this dominant narrative, and instead promotes a complex
understanding of trauma which intentionally includes the experiences of marginalized groups of
people, including the traumatic experiences of children, now referred to as developmental trauma
(Craps, 2013; Matthies-boon, 2018; Stevens & Stevens, 2009; Traverso & Broderick, 2010; van
der Kolk, 2005). Given that the concept of developmental trauma is central to the Bridge
Program, a review of the literature surrounding the evolution of developmental trauma will also
be discussed (van der Kolk, 2005).
Once an understanding of trauma is established through the use of CTT and
developmental trauma theory, a review of the Bridge Program itself will be provided, including a
review of the Trauma-Informed Care (TIC) Theoretical Model, as this model informed the
design of the Bridge Program. As previously stated, the TIC Theoretical Model is a relatively
recent approach to trauma that is aligned with a critical approach to trauma – recognizing the
widespread prevalence and impact of trauma in U.S. communities and promoting the
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 13

development of systems-level responses to trauma (Hales, Kusmaul, & Nochajski, 2017; Harris
& Fallot, 2001). Furthermore, a brief review of the literature surrounding existing TIC efforts
with ECE professionals, in particular, will also be covered in this chapter.
After having reviewed literature specific to trauma, a review of literature relevant to the
process of behavior change will be conducted. The Transtheoretical Model of Change (TTM)
provides a theoretical framework from which to understand the process of behavior change,
beginning with changes in attitudes and beliefs and culminating with sustained behavior change
(Brug et al., 2005; Corden & Somerton, 2004; Moore, 2005; Norcross, Krebs, & Prochaska,
2011). The TTM provides a rationale for the importance of this study and why it is necessary to
understand changes in ECE attitudes and beliefs as integral parts of the change process, which
ultimately support the use of TIC strategies in ECE settings. The TTM presents five distinct
'stages of change' a person is believed to go through as they attempt to change their behavior.
The TTM also presents 10 'processes of change' which are activities or strategies that can be
utilized in various stages of change to facilitate progress from one stage to another (Brug et al.,
2005; Corden & Somerton, 2004a; Moore, 2005; Norcross, Krebs, & Prochaska, 2011a).
While utilizing the TTM as a framework for behavior change, the motivational construct
of attributions will also be explored. Attributions are the causes people assign to events, either
within themselves, or others, in the absence of actual evidence (Weiner, 2010). Educator
attributions are particularly important, as they can directly impact an educator's motivation to
perform a task, and in some cases, predict how an educator will respond to a particular
phenomenon (Georgiou, Christou, Stavrinides, & Panaoura, 2002; Hart & DiPerna, 2017;
Johansen, Little, & Akin-Little, 2011). As a result, ECE attributions as they relate to children
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 14

displaying challenging behavior will also be explored in this study, and as such, a brief review of
the literature surrounding educator attributions will also be conducted in this chapter.
A Critical Approach to Trauma
In order to understand how the Bridge TIC training program impacts the attitudes and
beliefs of ECE professionals (as they relate to the effect trauma has on a child's behavior), it is
essential first to understand a historical view of trauma that may have informed pre-existing ECE
professional attitudes and beliefs around trauma. In order to achieve this common
understanding, this study utilizes an emerging critical approach to trauma known as Critical
Trauma Theory (CTT) (Craps, 2013; Matthies-boon, 2018; Stevens & Stevens, 2009; Traverso &
Broderick, 2010).
According to the Frankfurt School of Social Theory and Critical Philosophy, social
research should be approached through a critical lens that combines philosophical approaches
and social science in order to advocate for the liberation of people from oppressive
circumstances (Waluchow, 2009). This critical approach to social science research is known as
Critical Theory, and for a theory to be considered "critical" it must be explanatory, practical and
normative. A critical theory must explain what is wrong with the current social reality by
highlighting the oppressive experiences of people and it must be practical in that the theory also
must identify the mechanisms in place (structures, policies or practices) that create not only the
oppressive conditions in question, but also have the power to change the current reality to one of
liberation. Lastly, a theory is said to be normative if there are well-accepted standards by which
criticism can be levied (Waluchow, 2009). Examples of existing critical theories are Critical
Race Theory (Solórzano & Yosso, 2002) and Feminist Critical Theories (Rhode et al., n.d.) – to
name a select few.
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 15

Towards a Critical Trauma Theory
In the past two decades, in conjunction with the recent developments in trauma studies
and the high prevalence of trauma in U.S. communities, some scholars have begun to advocate
for the formal development of a Critical Trauma Theory (CTT) (Craps, 2013; Matthies-boon,
2018; Stevens & Stevens, 2009; Traverso & Broderick, 2010). When viewing trauma studies
through a critical lens, these scholars explain that the concept of trauma has developed from a
Western European lens which primarily understands trauma to be occurrences that are out of the
norm, overwhelming, time-limited (as opposed to continuous) and either result in life-threatening
injuries, or hold the potential of causing life-threatening injuries (Craps, 2013; Matthies-boon,
2018; Stevens & Stevens, 2009; Traverso & Broderick, 2010). The earliest recorded experiences
of trauma in the U.S. were among civilians that experienced large accidents in factories or
railroads during the Industrial Revolution (1760 – 1840) and soldiers in the American Civil War
(1861 – 1865). The concept of trauma continued to grow alongside the growth of U.S. military
actions and during the first World War (1914 – 1918), and with the advent of new and higher-
powered military machinery, the term "shell shock" was one of the first used to explain the
physical symptoms of trauma experienced by soldiers (Huang et al., 2014; Ringel & Brandell,
2011). As a result of these wartime experiences by soldiers, the U.S. Department of Veteran
Affairs first developed the concept of Posttraumatic Stress Disorder (PTSD), and in 1980 the
Diagnostic and Statistical Manual of Mental Disorders (DSM) (an instrument used by mental
health clinicians to formally assess and diagnose clients) included a definition of PTSD for the
first time. This definition centered around the experience of a catastrophic stressor outside the
range of typical human experience (Pai, Suris, & North, 2017; Substance Abuse & Health
Services Administration, n.d.). According to CTT, the introduction of PTSD into the lexicon of
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 16

trauma theory had a significant impact on the development of trauma interventions and how
traumatic experiences were conceptualized.
Given the historical origins of trauma, proponents of CTT criticize the dominant narrative
that has emerged around trauma as one that has been informed by the experiences of Western
soldiers. This narrowly defined conceptualization limits the experiences of trauma to a dominant
(White) culture, which is not inclusive of the type of traumatic experiences that are common to
members of a non-dominant culture, thereby creating marginalized groups based on their trauma
experiences (Craps, 2013; Matthies-boon, 2018). Evidence of this critique is seen in the way
Posttraumatic Stress Disorder is defined and operationalized in the DSM (Dell'Osso & Carmassi,
2011; Pai et al., 2017). As previously mentioned, in 1980, the DSM-III first included a
definition of PTSD and since that time, changes in the way PTSD is understood and measured
have continued to evolve in subsequent versions of the DSM (namely the DSM-IV (1994) and
the DSM-V (2013)).
The changes to the criteria for a PTSD diagnosis in the DSM-V were substantial – the
most important of which center around criterion A, which requires exposure of a traumatic event
and then qualifies which experiences can be considered "traumatic" (Pai et al., 2017). The
DSM-V definition of trauma necessitates a prior experience of "actual or threatened death,
serious injury, or sexual violence" that is either (a) directly experienced; (b) witnessed in person;
(c) experienced indirectly by learning of a traumatic event that happened to a family member or
close friend; however, the criteria of actual or threatened death must be by a violent or accidental
event; and (d) "repeated or extreme exposure to aversive details" of traumatic events – this
exposure cannot be through electronic media and is primarily considered to apply to first
responder professionals such as police officers or those that "[collect] human remains"
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 17

(American Psychiatric Association, 2013). In order to be diagnosed with PTSD, criterion A
must be met, therefore, despite the symptoms an individual may be experiencing, if the cause of
their symptoms does not fall within the above criteria, the individual's experience is not
considered traumatic and does not warrant a formal PTSD diagnosis (Pai et al., 2017). This
understanding of trauma necessitates exposure to a stimulus that posed an actual or perceived
threat of death and, therefore, excludes trauma caused by other means such an insecure
attachment in childhood or continuous exposure to community violence which may not present
actual or perceived threats to life, yet still have adverse long-term effects on an individual.
Continued development in the area of trauma studies remain critical of the dominant
trauma narrative for not being inclusive of traumatic experiences that may not necessarily result
in psychopathology or a formal diagnosis, but still have a considerable impact on an individual
and communities. Some of these conceptualizations include: historical trauma, identity trauma
and continuous trauma – all of which result in varying levels of traumatic stress and warrant
serious societal attention (Eagle & Kaminer, 2013). The term historical trauma refers to the
experiences of large groups of people from similar backgrounds whose livelihoods were, and still
may be, under attack – often to the point of near genocide – such as the experience of Jewish
people in the Holocaust, indigenous peoples of North America, and the enslavement of African
Americans across the globe (Eagle & Kaminer, 2013). The term identity trauma refers to
individuals whose identity characteristics, such as sex and gender, lead to persecution and
discrimination or the fear of persecution and discrimination (Eagle & Kaminer, 2013).
Continuous trauma is a term that describes trauma that cannot be relegated to "an event of the
past" – rather it is continuously present; however, because it cannot be separated from the current
time, it does not meet criterion A of PTSD (Eagle & Kaminer, 2013).
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 18

Supporters of a Critical Trauma Theory argue that the dominant narrative around trauma,
which centralizes PTSD, legitimizes who can and who cannot be impacted by trauma and, by
doing so, fails to acknowledge the traumatic experiences of those who do not meet this criteria
(Bracken, 2002; Eagle & Kaminer, 2013; Matthies-boon, 2018; Stevens & Stevens, 2009).
Failure to acknowledge the traumatic experiences of non-dominant cultures results in
interventions that are developed without marginalized groups in mind and services being
rendered without intentional thought to how these services might affect people that are not
generally understood (by Western standards) to have experienced trauma (Buss, Warren, &
Horton, 2015; La Greca et al., 2008).
One group in particular that has been impacted by this limited conceptualization of
trauma is children. To address this gap, the concept of developmental trauma was established,
which is a concept directly related to the advancements in child development and neuroscience,
foundational to the Bridge training for ECE professionals (La Greca et al., 2008; van der Kolk,
2005). Because of the central role this concept plays in the Bridge TIC training and similar TIC
trainings for ECE settings in general, a brief review of this concept will also be provided.
Developmental trauma. The term 'developmental trauma' is grounded in the emerging
mental health specialty known as Infant Mental Health – an area of research and practice that had
largely been ignored until the last decade or so. First proposed by Bessel van der Kolk (2005),
Developmental Trauma Disorder values the caregiver-child relationship as a necessary process
by which a child learns how to regulate themselves and make sense of the world around them
(van der Kolk, 2005). Developmental trauma not only creates space for the traumatic
experiences of a young child or infant, but it also recognizes that a child exposed to the stress or
trauma of a primary caregiver can also have negative impacts on the child's development and, by
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 19

extension, their behavior (van der Kolk, 2005). According to van der Kolk, the current
understanding of PTSD is not developmentally sensitive to the traumatic experiences of children
and the impact these early trauma experiences have on development.
Furthermore, van der Kolk supports the notion that when professionals are limited in their
understanding of the specific needs of children, they are necessarily limited in the kind of
interventions that are appropriate for this population. When professionals are unaware of the
needs of children exposed to trauma, these professionals tend to label children as defiant or
oppositional which can lead to rejecting the child, an unwillingness to work with a "difficult"
child, and in some cases may even result in punitive responses to behavior that unknowingly re-
victimize the child (McNeill, Friedman, & Chavez, 2015; van der Kolk, 2005; Wiest-Stevenson
& Lee, 2016). This rejection is problematic because it affects the ability of the professional to
form a healthy, secure attachment with the child - which has also been shown to be an important
mediator of the negative impacts of trauma on children (Holmes, Levy, Smith, Pinne, & Neese,
2015; La Greca et al., 2008; Lieberman, 2004; Perry, 2009).
Not only has the dominant narrative around trauma limited the credibility of childhood
trauma by mental health practitioners whose practice is primarily centered around the kind of
formal diagnostic criteria cited in the DSM, but it has also seeped into the consciousness of the
larger society and helped to promulgate a long-held erroneous belief that children were immune
to the effects of trauma; a view that discounts the traumatic experiences of children entirely
(Buss et al., 2015). This long-held societal view of children and trauma is not surprising, given
the history of childrearing in the United States, which can also be understood as devaluing the
voices and experiences of children (Forehand & McKinney, 1993; Hicks-Pass, 2009). It is
difficult to untangle early conceptualizations of childhood trauma from early childrearing
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 20

practices and beliefs in general; therefore, because the two are so closely related, a brief history
of childrearing in the U.S. will now be explored.
Historical attitudes, beliefs and approaches to child-rearing in the U.S. In the 1600s
and 1700s, popular beliefs around the nature of children were attributed to the religious beliefs of
Puritan settlers whose interpretation of Christian values led parents to use strict forms of
discipline with children who disobeyed their parents as a way of preventing condemnation by
God and promoting their salvation from Hell (Forehand & McKinney, 1993). Strict disciplinary
practices, including the use of corporal punishment – a practice that relied on physical
punishment such as spanking and paddling – were widely used in the United States during this
time (Hicks-Pass, 2009).
By the 1820s and 1830s, attitudes began to shift as parents wanted to support their child's
independence and, therefore, parenting became less authoritative. Some parents took on a
"laissez-faire" approach to parenting, which meant they were more permissive of children's
behavior and began holding the notion that the fewer responsibilities a child had, the better off
they would be as an adult (Caron, 2018). During this time of changing attitudes, the first laws
protecting children in the United States were passed, including laws protecting children in the
workplace. In the 1900s, amidst the growth of specialties such as biology and psychology, there
was even more debate around appropriate ways to raise children. At this time, there were still
those who favored corporal punishment and strict disciplinary practices, while, on the other side
of the spectrum, there were those who argued that strict models of discipline were harmful to the
physical and psychological development of a child. By 1912, the U.S. Children's Bureau was
formed – a federal agency created to protect children from child abuse. At this point, while there
was rising societal awareness of the detrimental effects that abuse, or traumatic events, could
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 21

have on a child, at the same time, corporal punishment as a means of school discipline was
gaining in popularity; by the 1970s, almost all schools in the U.S. utilized corporal punishment
with the children in their care. Despite this initial popularity, in the two decades following this
time, corporal punishment began to decline as a standard practice in schools, and as of 2018,
only 19 states still allowed for the use of this disciplinary practice in schools (Caron, 2018).
As the popularity of corporal punishment in schools began to fade, a new approach to
child discipline grew in popularity in the 1980s and 1990s – zero-tolerance policies. Zero-
tolerance policies "deliver a predetermined set of consequences, often punitive, without
consideration of offense severity, mitigating circumstances, or context," to students (McCarter,
2017, p. 54). At this time in U.S. history, priority was placed on eliminating violence and drugs
in schools, and as a result, the Gun Free Schools Act of 1995 was passed, which was the first
piece of legislation to mandate zero-tolerance policies for students who brought weapons to
school campuses. Funding for schools was dependent upon the adoption of these zero-tolerance
policies. After the passage of the Gun Free Schools Act, zero-tolerance policies began to
increase in popularity and eventually evolved to include behaviors outside of bringing a weapon
to school such as drug offenses, violence of varying degrees and other seemingly minor offenses,
such as an array of "disruptive" classroom behaviors (Wolf & Kupchik, 2016).
Zero-tolerance policies emphasize personal accountability – attributing the cause of
behavior to student choice, operating under the belief that students are always able to control
their behavior and are merely choosing to "act up." Zero-tolerance policies utilize punitive
punishments, which are often synonymous with exclusionary discipline practices that address
behavioral problems by keeping students out of their regular classroom environment. Strategies
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 22

for zero tolerance approaches include in-school-suspension (ISS), out-of-school suspension
(OSS) and expulsion (McCarter, 2017).
Research shows that exclusionary discipline practices negatively affect students into their
adult lives. These students are more likely to experience failures in school (low grades, high
school drop-out) and more likely to become involved in the juvenile justice system (Wolf &
Kupchik, 2016). According to the American Psychological Association's Zero-Tolerance Task
Force that convened in 2006, after zero-tolerance policies were implemented, rather than having
the intended positive effect on student behavior, the number of behavior problems and drop-outs
increased in schools across the country (McCarter, 2017). Research suggests that this inverse
reaction may be attributed to the fact that punitive policies such as those found in zero-tolerance
schools erode a sense of trust and community on campuses, which then can lead to more
misconduct (Wolf & Kupchik, 2016). Rather than applying a critical approach to trauma, which
allows for the possibility that a child may be displaying challenging behaviors as a result of
experiencing a traumatic event, parents and educators alike continue to respond to challenging
behaviors with practices that re-victimize children that have experienced trauma.
A review of the historical attitudes and beliefs that have surrounded childrearing in the
U.S. provides further insight into the preexisting attitudes and beliefs that may also be present for
ECEs attending the Bridge TIC training. It is important to note that these historical attitudes and
beliefs are at odds with a critical approach to trauma, including developmental trauma, which is
central to the Bridge TIC training. A review of this literature has been necessary as it
acknowledges the possibility that the content of the Bridge TIC training may be at odds with
existing ECE attitudes, beliefs, and practices regarding childcare. In order to gain an
understanding of the Bridge TIC training content, it is necessary to review how the Bridge
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 23

Program was designed. This review will be accomplished by next reviewing the TIC Theoretical
Model, which is aligned with a critical approach to trauma and informed the development of the
Bridge TIC training program.
The Trauma-Informed Care (TIC) Theoretical Model
As previously noted, trauma-informed care (TIC) is a concept still burgeoning in the
lexicon of many helping professionals in the United States. TIC is a systems-level approach to
trauma used to design and inform service systems that align with a critical approach to trauma
(Harris & Fallot, 2001). The Substance Abuse and Mental Health Services Administration
(SAMHSA), a subset of the U.S. Department of Health and Human Services, describes TIC as:
“A program, organization, or system that is trauma-informed realizes the widespread
impact of trauma and understands potential paths for recovery; recognizes the signs and
symptoms of trauma in clients, families, staff, and others involved with the system; and
responds by fully integrating knowledge about trauma into policies, procedures, and
practices, and seeks to actively resist re-traumatization.’’ (Huang et al., 2014. p.9).
An important distinction also noted by SAMHSA, is that TIC is inclusive of, but distinct from,
trauma-specific clinical interventions utilized in traditional client-therapist relationships (Huang
et al., 2014).
A primary premise of TIC is that trauma is pervasive in our communities – a fact that is
often traced back to two foundational studies: the Adverse Childhood Experiences Study (ACEs)
(1995 - 1996) and the Women, Co-Occurring Disorders and Violence Study (WCDVS) (1998 –
2003) (Felitti et al., 1998; Mazelis et al., 2005). Not only did the Adverse Childhood
Experiences (ACE) study highlight a relationship between early traumatic experiences and a
myriad of negative health outcomes later in life (including early morbidity), the large study (n =
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 24

17,000) conducted by the U.S. Centers for Disease Control and Prevention (CDC) and Kaiser
Permanente, found that as many as 64% of adults reported experiencing at least one ACE (Felitti
et al., 1998). This study has been replicated numerous times, and data from the 2016 National
Survey of Children's Health found that the number of children in the U.S. under the age of 17
that have experienced at least one ACE varies across states, ranging from 38.1% to 55.9% of
children. The percentage of children experiencing at least two or more ACES varies from 15%
to 30.6% in some states (Bethell, Davis, Gombojav, Stumbo, & Powers, 2017). Current data also
highlights the disparity among those experiencing ACES in the United States. Although ACEs
occur across all demographics, they are disproportionally experienced by people of color and
people living at or below the federal poverty line, with the most adversely affected being African
American children where over 60% have experienced at least one ACE (Bethell et al., 2017;
Crouch, Probst, Radcliff, Bennett, & McKinney, 2019).
Additionally, the WCDVS found that millions of women in the U.S. suffer from the co-
occurrence of substance abuse, mental health disorders and trauma (i.e., physical and sexual
violence), however, before this study, interventions were tailored to address these issues in
isolation, rather than attending to the intersecting nature of these traumatic experiences (Mazelis
et al., 2005). The WCDVS was implemented across multiple sites and found that interventions
that addressed the multiple issues at play, and were therefore responsive to complex forms of
trauma, were more effective than those that only addressed substance abuse or mental health
issues in isolation (Morrissey et al., 2005).
The extreme prevalence of trauma and its impact in U.S. communities has become a
major public health concern and is a primary reason why a TIC theoretical model has been
developed (CDC, 2010; Hales, Kusmaul, & Nochajski, 2017). The TIC theoretical model asserts
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 25

that because of this prevalence, and the fact that those impacted by trauma commonly seek out
health and human services, there exists a need for these systems of care to be trauma-informed
(Hales, Kusmaul, & Nochajski, 2017; Harris & Fallot, 2001; Jennings, n.d.; Substance Abuse &
Health Services Administration, n.d.). Trauma-informed organizations operate under the
assumption that both clients and staff have experienced trauma, and therefore an understanding
of trauma and its effects must be reflected in all aspects of service delivery (Hales, Kusmaul, &
Nochajski, 2017; Harris & Fallot, 2001). Research also highlights that when trauma-specific
interventions are implemented in systems and organizations that are not also trauma-informed,
they will likely begin to trend toward less efficacious outcomes and can end up ineffective
altogether (Fallot & Harris, 2008; Hales et al., 2017). Because TIC offers a system-wide
response to trauma that is different from traditional responses to trauma that center around
individual deficits and interventions, TIC approaches are often understood to be paradigm-
shifting.
The Bridge TIC program was borne out of a recognition that systems-level approaches to
trauma are needed in the ECE field ("Emergency Child Care Bridge Program for Foster Children
(Bridge Program)", 2019). Rather than focusing on interventions that support the needs of
individual children, the Bridge TIC program aims to build the capacity of the ECE workforce in
California to identify and appropriately respond to children in their care that have been impacted
by trauma.
Emergency child care bridge program. In January of 2018, CA Senate Bill 89, the
Emergency Child Care Bridge Program for Foster Children (Bridge Program) was approved by
the California legislature. Senate Bill 89 made it possible for resource parents (formerly known
as 'foster parents/families') to utilize time-limited emergency child care vouchers. These
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 26

emergency vouchers allow resource parents to immediately access child care - meeting a need
that has been identified as a barrier to fostering children ages 0 - 5 ("Emergency Child Care
Bridge Program for Foster Children (Bridge Program)", 2019). As a result of this legislation, it
was anticipated that an increasing number of foster children would enter early care and education
settings across Los Angeles County, presenting an additional need to prepare ECE professionals
to work with these foster children. Foster children have been exposed to at least one traumatic
event: removal from their primary caregiver ("Emergency Child Care Bridge Program for Foster
Children (Bridge Program", 2019).
To address this need, SB 89 provided for the creation of trauma-informed care training
and coaching for ECEs serving children through the Bridge program. Participation in the Bridge
TIC training program is voluntary and provided to ECEs at no cost.
Bridge TIC training program. As previously mentioned, TIC trainings for those
working with children 0 – 5 have become popular and are becoming more widely used. The
Bridge TIC training program that is currently being studied was informed by and adapted from
three similar TIC curriculums that are also rooted in recent scientific advancements in the fields
of child development and neuroscience. Used as a foundational guide for the LA County Bridge
TIC Training, the Child Care Bridge Program Trauma Training Series, developed by the Child
Development Institute (CDI), largely informed the curriculum being studied. Additionally,
aspects of the Child Welfare Trauma Training developed by the National Child Traumatic Stress
Network (NCTSN); and the Trauma-Informed Care Training and Coaching series developed by
the California Child Care Resource and Referral Network and the California Department of
Social Services also informed the Bridge TIC Training curriculum in this study (Child welfare
trauma training toolkit: Trainer’s guide, 2013; “Child Care Bridge Program Trauma Training
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 27

Series”, 2018; "Understanding the Impact of Trauma & Identifying Strategies to Promote
Healing, "2019).
The Child Development Institute (CDI) is an organization local to Los Angeles County
that specializes in child development and has been serving the San Fernando Valley region for
over 25 years ('About Us', 2019). The CDI 'Child Care Bridge Program Trauma Training Series'
consists of five, four and a half-hour long training modules, intended for a Bridge TIC trainer,
rather than an ECE professional. The content provided by this training included: child
development and trauma, developing a trauma-informed lens, strategies to strengthen families,
create supportive ECE settings, reflective practice and self-care strategies ("Child Care Bridge
Program Trauma Training Series", 2018). In order to ensure the accessibility of information,
modifications to the initial training were made to account for a limited amount of training time
for ECE professionals and the varying literacy levels among ECEs to prevent cognitive overload
and promote maximum retention of key concepts.
The NCTSN was established by Congress in 2000 and is a “collaboration of academic
and community-based service centers whose mission is to raise the standard of care and increase
access to services for traumatized children and their families across the United States,” (Child
welfare trauma training toolkit: Trainer’s guide, 2013). The NCTSN is considered a national
leader in the area of childhood trauma (Child welfare trauma training toolkit: Trainer’s guide,
2013; Donisch et al., 2015; Hanson & Lang, 2015; Ko et al., 2008). The NCTSN training was
developed for a child welfare worker audience and is made up of fourteen modules containing
similar information on trauma, child development, the impact of trauma on child development
and the importance of self-care as the CDI training. When tailoring the Bridge TIC curriculum
for an ECE professional audience, the NCTSN curriculum was referenced to ensure alignment
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 28

with national standards. Concepts from this curriculum relevant for an ECE audience were
included, while the information in the NCTSN curriculum specific to the child welfare
profession was excluded from the Bridge TIC training.
Lastly, the “Trauma-Informed Care Training and Coaching” series developed by the
California Child Care Resource and Referral Network and the California Department of Social
Services was also referenced when creating the Bridge training. The “Trauma-Informed Care
Training and Coaching” series is made up of two, day-long modules also created for a trainer
audience, as opposed to an ECE, audience. It was similarly found that the information provided
in this training overlapped well with the information in the previous two trainings and certain
relevant portions of this curriculum specific to working with foster youth were also added to the
final Bridge TIC training currently being studied ("Understanding the Impact of Trauma &
Identifying Strategies to Promote Healing ", 2019).
As a result of comparing and referencing all three curriculums and tailoring the
information to the needs of an ECE audience, the final Bridge TIC curriculum utilized in Los
Angeles County with ECE professionals is made up of six, two-hour-long modules that include
all relevant concepts mentioned in the previous three curriculums. In light of the diverse
educational backgrounds of ECEs in Los Angeles County, it was essential to ensure the content
covered in the Bridge program was accessible for this audience - both in terms of literacy levels
and the amount of time demanded by the training (Elevating the voices of children: The state of
early care and education in Los Angeles County, 2017). Table 1 describes the key topics
covered and learning objectives for each Bridge TIC training module.

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 29

Table 1
Bridge TIC Training Content
Module Title Key Topics Covered Learning Objectives
1 How Trauma
Impacts
Development,
Part 1
Trauma-Informed Care Define trauma

How Trauma Impacts
Development: Brain &
Regulatory System
Name two ways trauma can impact
development

2 How Trauma
Impacts
Development,
Part 2
How Trauma Impacts
Development: Stress
Response, Sensory &
Attachment
Describe the impact of stress on the body

Adverse Childhood
Experiences
Describe the relationship between
trauma “triggers” and the five senses

Explain the difference between a secure
and insecure attachment

3 Identifying
Childhood
Trauma
Identifying Trauma at
Different Ages
Explain the difference between explicit
and implicit memories

Creating a Safe
Environment for Children
List two examples of how trauma can
affect children’s behavior

Describe one way to create safety for
children

4 Responding
to Childhood
Trauma
Understanding Children’s
Behavior
List two possible messages children
communicate with their behavior

Strategies to Build Healthy
Attachments with Children
Name two strategies for engaging with a
child

Trauma Specific Strategies Name two trauma-specific strategies you
can use with a child

5 Strengthening
Families
What to Know About a
Bridge Child
List two risk factors for a Bridge Child

Five Ways to Strengthen
Families
Name two ways to strengthen families
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 30

How to Refer a Child for
Services
Provide a simple explanation of the
referral process for specialized child
services

6 Self-Care for
Providers
Secondary Trauma Describe the relationship between
secondary trauma and self-care

Self-care List two ideas for reducing stress

Reflective Practice Explain how to use reflective practice
with children and families

Trauma-informed care in early care and education. As previously discussed,
children exposed to trauma bring these experiences with them into the classroom and likely
display dysregulated behaviors that are interpreted by ECE professionals as challenging,
behavioral problems (Wiest-Stevenson & Lee, 2016). Without proper teacher training on these
topics, school systems, including early care and education settings, are not prepared to treat or
identify trauma in the children they serve. As a result, students displaying disruptive behavior
are often misdiagnosed with disorders such as oppositional defiant disorder and attention deficit
disorder, or they are disciplined with punitive measures such as out-of-school disciplinary tactics
(Wiest-Stevenson & Lee, 2016).
In order to promote an understanding of child behavior that is inclusive of traumatic
childhood experiences, educators must first have an awareness of how trauma can impact a
child's development. However, despite the critical developmental role ECEs play in the lives of
children, there exists a flawed perception that the younger a child, the less skilled the work -
resulting in lower levels of preparation and training for ECE professionals working with children
exposed to trauma (Whitebook & Mclean, 2017; Whitebook, McLean, Austin, & Edwards,
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 31

2018). A more in-depth look at the existing characteristics of the ECE workforce in California
will now be reviewed.
The early childhood workforce in California. Despite a general lack of information
about the ECE profession, there are a few key characteristics common to the early care and
education field. From what is known, the ECE field in California is linguistically and culturally
diverse, yet not gender diverse – the majority of ECEs are female, which is true of the profession
nationally (Whitebook et al., 2018). Among ECEs in LA County, there are three general
categories of professionals based on the type of ECE setting: (1) Child Care Centers (Center); (2)
Family Child Care Homes (FCC); (3) and License Exempt Providers (LEP). Centers are
licensed child care businesses that operate at a location that is solely for child care business
purposes, unlike FCCs, which are licensed child care businesses that operate from a family home
setting. LEPs are providers that are not licensed and often are family members of the children
needing care ("Elevating the voices of children: The state of early care and education in Los
Angeles County”, 2017).
The prevailing attitudes around the early childhood workforce tend to undervalue this
profession, resulting in low wages earned by the ECEs in Los Angeles County ("Elevating the
voices of children: The state of early care and education in Los Angeles County”, 2017). In
2017, across the county, center-based staff made an average of $14.75 per hour, while FCC staff
made an average of $11.73 an hour, which is less than half the average hourly wage of
kindergarten teachers in California. As previously mentioned, ECEs also come from diverse
educational backgrounds. Based on a recent study completed by First 5 LA of providers that
attended professional development programs, FCC staff had lower education levels (overall) than
Center-based staff with 17% of FCC providers having an associate's degree, 13% having a
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 32

bachelor's degree and six percent having an advanced degree ("Elevating the voices of children:
The state of early care and education in Los Angeles County”, 2017). Additionally, half of Los
Angeles County ECEs do not possess a college degree. It should also be noted that California
does not have a teaching credential for ECEs, but instead has a child development permit, which
63% of the ECE field in Los Angeles County currently have (Elevating the voices of children:
The state of early care and education in Los Angeles County, 2017).
Because professional requirements for ECEs have not kept up with the aforementioned
advancements in child development and neuroscience, and considering the preexisting attitudes
and beliefs that may also be at odds with the critical approach to trauma promoted by the Bridge
TIC training, it is essential to understand how ECE attitudes, beliefs and practices may have
changed as a result of attending the Bridge TIC training. In order to understand this process of
change, a more in-depth look at the literature explaining behavior change will now be
undertaken.
The Goal of Training: Behavior Change
According to the philosopher Paulo Freire, the primary goal of education is behavior
change (Freire, 1970). Freire explains that education does not exist simply to dispel information,
but rather to create a transformation within the learner (and the teacher) that leads to a liberation
of consciousness and praxis. This view of education is in line with one desired outcome of the
Bridge Program, which is to create a trauma-informed early childhood workforce. As previously
noted, the Transtheoretical Model of Change provides a framework by which to understand how
people change their behavior and, in doing so, also provides a rationale as to why changes in
ECE attitudes and beliefs are a central focus of this study (Norcross et al., 2011).

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 33

Transtheoretical Model of Change (TTM)
The TTM is a model of behavior change first developed by Prochaska and DiClemente
(1982) that is rooted in social learning theory and addresses human motivation and the cognitive
aspects of learning (Corden & Somerton, 2004). The TTM was first utilized to understand the
process of individuals attempting to change various health-related behaviors such as smoking,
alcohol/drug use, or lack of exercise (Moore, 2005). Throughout the years, this model has been
utilized to understand and enhance behavior change across a wide range of behaviors, including
achieving the goals of a psychotherapeutic relationship (Norcross, Krebs, & Prochaska, 2011b).
The TTM is made up of five distinct stages of change: pre-contemplation, contemplation,
preparation, action, and maintenance. Precontemplation is the stage where there is no intention
to change behavior; this can result from being completely unaware that there is a behavior that
needs to change or due to being under-aware of the problem's severity. Contemplation is the
stage where an individual has acknowledged that a problem exists and begins to consider
changing their behavior, but no commitment to change has occurred. In the preparation stage,
an individual both creates an intention to change and begins taking small steps toward their goal,
but has not fully committed to changing their behavior. An example of this is a person that
wants to stop smoking – this individual has an intention to stop smoking and is cutting back on
the number of cigarettes smoked each day, but has not yet wholly quit smoking. Once in the
action stage, individuals are fully committed and motivated to change their behavior and, as
such, are actively changing their behavior to match the desired new behavior. Lastly, the
maintenance stage is the point at which an individual works to prevent relapse and supports the
automation of the new, desired behavior. Some versions of the TTM also include a sixth stage of
behavior: relapse, to account for the point at which an individual may return to their undesired
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 34

behavior, at which point they would begin the process of behavior change again (Corden &
Somerton, 2004a; Krebs, Norcross, Nicholson, & Prochaska, 2018).
Included in the TTM are ten processes of change which are activities that facilitate
change and include:
"(1) experiential consciousness-raising (increasing awareness); (2) dramatic relief
(emotional arousal); (3) environmental reevaluation (social reappraisal); (4) social
liberation (environmental opportunities); (5) self-reevaluation (self-reappraisal); (6)
behavioral–stimulus control (reengineering); (7) helping relationships (supporting); (8)
counterconditioning (substituting); (9) reinforcement management (rewarding); and (10)
self-liberation (committing)” (Moore, 2005, p. 397).
Prochaska and DiClemente have identified the ten processes of change as the primary
activity categories that bring about behavior change and have been linked to concepts common to
theories of human behavior and motivation. The ten processes can be understood to represent
three larger categories, the orders of which are thought to correspond to the order of the stages of
change: (1) strategies that improve motivation; (2) strategies that support the development of
new cognitive skills; and (3) strategies that involve relational supports (Corden & Somerton,
2004). Compared to the stages of change, which are widely accepted as being appropriately
representative of how behavior change occurs, the processes of change have received more
criticism because they are considered (by some) to be the most important aspects of the theory as
they facilitate the change process (Brug et al., 2005; Littell & Girvin, 2002). Although the TTM
has been studied numerous times by both the original authors and others utilizing the model,
strong evidence does not exist supporting the utilization of specific processes of change relative
to particular stages of change (Corden & Somerton, 2004; Norcross et al., 2011). Rather, authors
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 35

of the TTM state that, generally, activities which improve motivation on a cognitive level such
as changes in attitudes and beliefs, are better suited for individuals in the pre-contemplation and
contemplation stages, whereas behavioral interventions and supports tend to be more useful in
the action and maintenance stages (Brug, J.; Conner, M.; Harre, N.; Kremers, S. ; McKellar, S.;
Whitelaw, 2005; Corden & Somerton, 2004; Krebs et al., 2018; Norcross et al., 2011).
TTM and TIC training for ECE professionals. Utilizing the TTM as a theoretical
framework for understanding the processes of behavior change, the focus of this research study
is to understand the self-reported impact, or change process, that ECEs experience after having
completed the Bridge TIC training program. According to the TTM, before behavior change is
expected to happen, a shift in attitudes and beliefs should occur first. Given that TIC strategies
in ECE settings are a relatively new phenomenon, coupled with the prevalent, preexisting
attitudes and beliefs adults can carry about children (which in many ways are at odds with TIC
approaches), it is important to gain an understanding of the changes that may occur at the level of
ECE attitudes and beliefs, before anticipating actual changes in ECE practice (Harris & Fallot,
2001; Whitebook et al., 2018).
The attitudes and beliefs of ECEs that relate to causal explanations of a child’s behavior
are known as ‘attributions,' and they are an important factor impacting teachers' motivations and,
by extension, their classroom practices (Kulinna, 2007; Medway et al., 1979; Wang & Hall,
2018). Because attributions can impact ECE professionals’ motivations to implement trauma-
informed strategies with children in their care, they can be viewed as predictors of behavior
change and, for this reason, play a central role in understanding the impact of the Bridge TIC
training program on the attitudes and beliefs of ECE professionals as they relate to how trauma
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 36

impacts a child’s behavior. For this reason, a brief review of attribution theory in education
settings will now be undertaken (Wang & Hall, 2018; Weiner, 2010).
Attribution theory. Attribution theory began with the work of Fritz Heider (1958), a
social psychologist who first proposed the idea that people naturally attempt to make sense of the
world around them by acting as "naïve scientists" and attributing causes to behaviors or
occurrences in the absence of empirical evidence (Pasher, 2013). Later, the work of Bernard
Weiner (1985) largely informed attribution theory, as he expanded on early conceptualizations of
the theory by identifying underlying causal dimensions by which people base their attributional
judgments – dimensions that impact actions and emotions taken by the individual making the
attribution (Wang & Hall, 2018; Weiner, 1985). A full review of attribution theory is beyond the
scope of this study; however, a review into the causal dimensions within attribution theory is
relevant to the purpose of this study.
The three causal dimensions described by Weiner are: (1) locus of causality; (2) stability;
and (3) controllability. According to Weiner, determining the 'locus of causality' is to determine
whether a phenomenon is occurring internally or externally to an individual. For example,
attributions with an internal locus of causality would identify the person's own ability and effort
as a reason for why a particular phenomenon occurred or did not occur. In contrast, an external
locus of causality would identify environmental factors as the reason something occurred or did
not. 'Stability' refers to whether a phenomenon is changeable or fixed (permanent) in nature, and
'controllability' refers to whether or not a phenomenon can be controlled by an individual (Wang
& Hall, 2018; Weiner, 1985). Attributions are made both intrapersonally, based on one’s own
actions and performance, and interpersonally, based on the actions or performance of others.
Based on how an individual categorizes a phenomenon relative to these dimensions, their
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 37

motivations and behavior will also be impacted (Wang & Hall, 2018; Weiner, 1985). Research
demonstrates that when an attribution is made that a phenomenon has occurred as a result of
something external to an individual, is understood to be fixed in nature (unchangeable), and is
outside of their control, their motivation to persist at a particular task is low. Whereas, when an
individual attributes the cause of an occurrence to something internal to themselves, changeable
and within their control, their motivation to persist is strong (Wang & Hall, 2018; Weiner, 2010).
Attribution theory and educator behavior. A large body of research exists which has
focused on the attributions made by educators in educational contexts. These studies highlight
the relationship between teacher attributions and their subsequent behavior with students in their
care. In a classroom setting, attribution theory is seen when educators attempt to make sense of
student performance and behavior; this sense-making then determines what response to take
when implementing educational as well as classroom management strategies (Grieve, 2009;
Johansen, Little, & Akin-Little, 2011; Wang & Hull, 2018). One study by Johansen, Little and
Akin-Little (2011), found that when educators perceive behavior to be less controllable by
students, a more positive, pro-social response was elicited in educators; conversely, when student
behavior was perceived as intentional and under the control of the student, a more negative and
often punitive response was elicited. Furthermore, this study found that when educators attribute
student behavior to an external cause, such as parenting style – they were more likely to believe
that improving student behavior was out of their control, and therefore more likely to seek
assistance from service providers out of the classroom or even school setting, rather than change
their own teaching strategies to support the student (Johansen, Little & Akin-Little, 2011).
These types of attributions are problematic because it allows an educator to hold the belief that
the management of student behavior is out of their control, thereby leaving little incentive for
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 38

these educators to utilize strategies that promote positive behavioral skills in students, such as
TIC strategies.
Without having the necessary understanding of how trauma impacts child development
and behavior, ECE professionals working with children that have experienced trauma run the
risk of attributing challenging child behavior to something external to themselves (internal to the
child), a fixed character disposition (i.e. "this is just a difficult child," "a bad child," etc.), and
something out of their control. These attributions can then impact the ECE professional's
motivation to work with a child in supportive ways, rather than punitive (McNeill, Friedman, &
Chavez, 2015; van der Kolk, 2005; Wiest-Stevenson & Lee, 2016). When an understanding of
trauma-informed practices for children is had, ECE professionals may leave the training with
attitudes and beliefs that attribute dysregulated/challenging child behavior to an internal trauma
response of the child, view the behavior as changeable, and as something they can influence or
control. Based on the previously discussed attribution research in educational settings, this
combination of attributions is likely to motivate ECEs to use TIC practices with children in their
care. Because of the important role attributions play in predicting the practices used by ECE
professionals, they will be examined in this study as a way to assess changes in the attitudes and
beliefs of ECE professionals that have completed the Bridge TIC training program.
Conceptual Framework
The conceptual framework for this study is grounded in a critical approach to trauma that
is understood through the application of Critical Trauma Theory (CTT), developmental trauma
theory and the Trauma-Informed Care Theoretical Model (Craps, 2013; Harris & Fallot, 2001;
Matthies-boon, 2018; van der Kolk, 2005). The intersection of these theories and the ECE field
creates a new opportunity for changes to occur as they relate to how ECE professionals perceive
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 39

and ultimately respond to children that have experienced trauma and, as a result, may display
challenging behavior. The Transtheoretical Model of Change (TTM) provides a framework from
which to understand this change process and is, therefore, also at the heart of this study. Figure 1
provides a visual representation of this conceptual framework.
Figure 1.
Conceptual Framework

Summary
This chapter has reviewed theories that collectively present a theoretical and conceptual
framework that supports the purpose of, and provides a rationale for, the study at hand. The
cornerstone of this study's approach is rooted in an emerging critical approach to trauma, which
questions a dominant narrative that has developed in the United States regarding which
experiences are categorized as "traumatic" (Craps, 2013; Harris & Fallot, 2001; Matthies-boon,
2018). Stemming from an understanding of trauma borne out of White, U.S. soldiers' wartime
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 40

experiences, proponents of a critical approach to trauma argue that this dominant narrative is
incomplete and discredits the traumatic experiences of anyone who does not fit this
demographic, including children (Craps, 2013; Harris & Fallot, 2001; Matthies-boon, 2018; van
der Kolk, 2005).
The literature reviewed in this chapter provided insight into long-held attitudes and
beliefs around child-rearing in the United States, of which a central belief was the idea that
young children were immune to the impacts of trauma (Buss, Warren & Horton, 2015). As a
result of advancements in child development and neurobiology, this antiquated belief has been
debunked and now trauma-informed initiatives in ECE settings are growing in popularity
(Brunzell et al., 2016; Elana, 2000; Perry, 2009, van der Kolk, 2005). The creation of the
Emergency Child Care Bridge Program for Foster Children was also reviewed, as was the
development of the Bridge TIC Training curriculum itself. The TTM provided insight into the
process of behavior change and provides a framework from which to understand the impact of
the Bridge TIC training program on the attitudes, beliefs and practices of ECE professionals as
they relate to how trauma impacts a child's behavior. The next chapter will describe how this
theoretical framework is used to design and analyze the research methods utilized in this study.

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 41

Chapter Three: Methodology
The previous chapter provided an in-depth look at the theories that are central to this
study. This chapter will review the proposed methodological strategies used to carry out this
study. The purpose of this study is to understand the self-reported impact of the Bridge TIC
training program on the attitudes, beliefs and practices of ECE professionals as they relate to
how trauma impacts a child's behavior. Participants in this study were ECEs that completed all
six modules of the Los Angeles County Bridge TIC training program. As a predictor of behavior
change, the motivational construct of attributions were also explored in this qualitative method of
inquiry.
Qualitative Inquiry
Qualitative research methods are used to understand how people experience the world
around them and how they make meaning of phenomena (Merriam & Tisdell, 2016). Qualitative
forms of inquiry generally yield rich data, as the purpose of these studies is to reveal individual
insight into complex topics (Creswell, 2014). Qualitative data is collected by gathering
viewpoints, observing interactions and reviewing artifacts in the hopes of finding common
themes that provide a more in-depth understanding of human experiences (Merriam & Tisdell,
2016). For these reasons, a qualitative approach to research was utilized to understand the
impact of the Bridge TIC training program on the attitudes, beliefs and practices of ECE
professionals.
An Evaluative Study
Evaluation is a form of research that collects evidence, or data, in order to determine the
worth or merit of an entity (Alkin & Vo, 2018; Merriam & Tisdell, 2016). The entity evaluated
in this study is the Los Angeles County Bridge TIC training program for ECE professionals. The
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 42

overall goals of the TIC portion of this program are to create a trauma-informed ECE workforce,
which means that after participating in the Bridge TIC training program, ECE professionals will
implement various TIC strategies with the children in their care. However, at this time, objective
measures to assess changes in ECE practices are not being undertaken in this study. Rather, as
indicators of future behavior change, this study seeks to understand the self-reported impact of
the Bridge TIC training program on the attitudes, beliefs and practices of ECE professionals that
have completed the Bridge TIC training program in Los Angeles County (Brug et al., 2005;
Corden & Somerton, 2004; Moore, 2005; Norcross, Krebs, & Prochaska, 2011). Therefore, the
kind of evaluation utilized in this study is formative in nature (Alkin & Vo, 2018).
At just over 18 months of program implementation, a program of this size is considered
to be in its early stages. Data collected at this point does not provide a summative analysis to
determine definitively whether or not the program is successful, rather, data collection at this
juncture is utilized to indicate whether or not the program is beginning to show signs that
program outcomes will be achieved (Alkin & Vo, 2018). Insights provided by this formative
evaluation may lead to program improvements that will increase program efficacy.
Setting and Participants
A purposeful sampling method, where participants are selected because they possess a
particular skill set or knowledge that is central to the purpose of the research in question, was
utilized in this study (Merriam & Tisdell, 2016). A total of eight Child Care Resource and
Referral (R&R) agencies exist in Los Angeles County, which offer the Bridge TIC trainings to
ECE professionals. In order to be eligible for participation in this study, agencies needed to have
completed at least one round of all six Bridge TIC trainings by December 15, 2019. Three R&R
agencies met these criteria and were subsequently included in this study's population sample. As
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 43

of December 2019, a total of 62 ECE professionals had completed all six modules of the Bridge
TIC training program.
When recruiting participants into the study, the researcher contacted the three R&Rs that
were eligible to participate and requested contact information for all English or Bilingual
(English/Spanish) speaking ECEs that had completed all six of the Bridge TIC training modules
by the specified time frame. Contact information for a total of 39 ECE professionals was
provided to the researcher and after contacting each individual either through phone or email, 15
ECEs agreed to participate in this study. Of the 24 professionals that did not participate in the
focus groups, nine were contacted via phone (voicemail) and then by email, yet no direct contact
was made. Direct contact via phone was achieved with another eight ECE professionals who
expressed interest in attending, yet cited scheduling conflicts; of this group, four were confirmed
to attend a focus group and ended up having last minute conflicts that prevented them from
attending. All but one of these ECEs for whom direct contact was made stated that the timing of
the focus group conflicted with the hours of their child care business. Five of the ECE
professionals contacted were Spanish-only speakers and all indicated that they would be
interested in participating in the focus group had it been conducted in Spanish. Two ECEs
indicated that they were not interested in attending the focus group; no other reason was given.
All individuals contacted were informed of the nature of their participation (focus
groups), the study's purpose, that participation was voluntary, and that all data collected would
be de-identified to protect their anonymity. ECE professionals were also informed that, should
they be able to participate in a focus group, they would receive a $15 VISA gift card for their
time.

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 44

Research Setting
Focus groups for this study took place at three R&R agencies local to Los Angeles
County. Permission to conduct this study and enter these settings was given by administrators at
each R&R site. Focus groups were conducted in conference rooms and participants were asked
to sit in chairs organized in a circle.
Participant Characteristics
Participants in this study were 15 English speaking, or Bilingual English/Spanish
speaking, ECE professionals in Los Angeles County that completed all six modules of the Bridge
TIC training program within the past six months. Demographic information for each participant
is presented in Table 2.
Table 2
Participant Demographics
Participants Participants
Gender

Child Care Setting

Female 14

Center-based 7
Male 1

Family Child Care Home 7
Ethnicity

License-Exempt 1
Asian 2

Black/African American 4

# of Yrs Working in Field

Hispanic/Latinx 8

1-3 years 5
Pakistani 1

10-12 years 3
Age

13-15 years 2
22-30 2

16 years and/or more 5
41-50 7

51-60 4

Over 60 2

Additionally, ECEs were asked two questions regarding their level of familiarity with
TIC in ECE settings. The first question gathered information on the level of background
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 45

knowledge each ECE had about TIC in ECE settings, before attending the Bridge training.
Responses were captured on a Likert scale with options ranging from: No Familiarity (never
heard of TIC before), Slightly Familiar (have heard of the concept, but could not offer a
definition of TIC), Moderately Familiar (have heard of the concept and could offer a definition
of TIC), to Very Familiar (could offer a definition of TIC and provide examples of how to use in
early care and education settings). Responses to this question are represented in Table 3.
Table 3
Background Knowledge of TIC in ECE Settings Before Attending Training

No
Familiarity
Slightly
Familiar
Moderately
Familiar
Very
Familiar
Participants 3 7 3 2

Lastly, participants were also asked about the amount of formal training they had received on the
topic of TIC in ECE settings, before the Bridge TIC training. These responses are reflected in
Table 4; one participant did not respond to this question.
Table 4
Amount of Formal Training ECEs Have Received
None
1
Training
2
Trainings
5
Trainings
Participants 6 1 2 5

Data Collection and Instruments/Protocols
Focus Groups
Focus groups are discussions with a small group of people that share a similar quality (or
qualities) that are central to a particular topic of inquiry (Johnson & Christensen, 2014). As this
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 46

evaluative study is intended to understand the self-reported impact of the Bridge TIC training
program on the attitudes, beliefs and practices of ECE professionals that have completed this
training, the data collection method of conducting several focus groups across Los Angeles
County was chosen for this study. The utilization of focus groups was an efficient way to collect
responses from a larger group of ECEs in a shorter amount of time than conducting individual
interviews. Additionally, the shared experience of having all been trained in the same Bridge
TIC curriculum allowed for topics to be discussed in greater detail as the information reviewed
was familiar to the group.
In total, three focus groups were conducted. Information specific to each focus group,
including the number of participants, duration and the scheduled timeframe, is provided in Table
5.
Table 5
Focus Group Details

# of
Participants Duration
Scheduled
Timeframe
Focus Group 1 5

105 minutes

Saturday,
10am - 11:30am

Focus Group 2 7

120 minutes

Wednesday,
7pm - 8:30pm

Focus Group 3 3

90 minutes

Saturday,
10am - 11:30am

When participants arrived, they were provided with the study information sheet and given
time to review the document. Once all participants stated that they had reviewed the document,
the researcher summarized the document aloud and answered any questions the participants had
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 47

about the purpose of the research study or the methods used. All focus groups were audio-
recorded with the consent of participants.
A semi-structured interview protocol was used for all focus groups (Merriam & Tisdell,
2016). Semi-structured interviews are those in which there is some flexibility in either the order
or the wording of questions, and questions tend to be open-ended (Merriam & Tisdell, 2016). A
semi-structured interview protocol suited this study best as it allowed for flexibility in the way
questions were asked of participants and supported the organic nature of the dialogue that arose
between participants, as is common in focus groups (Johnson & Christensen, 2014). The
interview protocol utilized in this study is located in Appendix A – Focus Group Interview
Protocol.
Once participants completed the focus group, participants were asked to complete a
demographic questionnaire before being given a $15 VISA gift card for their time. The
demographic questionnaire utilized in this study is in Appendix B – Demographic Questionnaire.
Data Management and Analysis
After each focus group, original audio and scanned copies of demographic questionnaires
from the session were uploaded to a password protected file in an electronic file folder local to
the researcher's laptop, onto a password-protected USB device, and uploaded to a cloud-based,
password-protected, storage system. After being scanned electronically, paper copies of all
demographic questionnaires were shredded. Audio files were also uploaded to an online audio
transcription service to transcribe all participant responses. Once initial transcripts were
available, the researcher compared the original audio and transcripts to ensure accuracy and
make any necessary corrections to the transcribed file. During this review of the data,
participants' names were also changed for de-identification purposes. After this process, the
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 48

researcher uploaded finalized transcripts into the qualitative data analysis software, Atlas.TI,
where the researcher conducted the coding process.
Data Coding Process
A constant comparative method was used to organize and analyze data from the focus
group transcripts. Glaser and Strauss (1967) explain that a constant comparative method of
analyzing data is one in which comparisons are continually made between and among units of
data, which allows themes and theories to emerge (as cited in Merriam & Tisdell, 2016). In
order to identify which portions of the data were relevant to compare, a combination of open-
coding and a priori coding was utilized. Open coding is a process first used by a researcher
when analyzing data – the purpose of which is to annotate any piece of data that might be
relevant to the study’s purpose. After this process, a secondary level of coding was undertaken,
known as axial coding, whereby first-round annotations of data were grouped to form formal
categories that emerged from the data (Saldana, 2013).
Based on the research questions, two a priori codes were utilized during the coding
process. A priori codes are codes or categories that exist before hearing from what participants
share; a priori codes are found in the literature central to a study’s purpose and, therefore, can be
reasonably assumed to appear in participant responses (Merriam & Tisdell, 2016). For this
study, the a priori codes that were utilized were “trauma-informed” and "attribute about child
behavior." Based on the literature, the code "trauma-informed" applied to statements that
demonstrated an awareness of how trauma impacts child development and behavior (La Greca et
al., 2008). Additionally, "trauma-informed" was applied to any practices described in the Bridge
TIC training curriculum as trauma-informed strategies to use with a child; these included:
observation, the use of effective praise, creating a safe and welcoming environment,
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 49

identification of child triggers, building a secure attachment with the child, working with parents
and caregivers, and implementing self-care for the ECE professional. The code “attribute about
child behavior” was used any time an ECE named a perceived cause of a child’s behavior (Hart
& DiPerna, 2017). As a result of using both open coding and a priori coding techniques, after
the first set of data was coded, several broader categories began to surface. It quickly became
apparent that all data could be categorized into one of four axial codes: "original
attitudes/beliefs"; "original practices"; "after training attitude/beliefs" and "after training
practices." These overarching categories align with the purpose of this study, which is to
understand the impact of the Bridge TIC training program on the attitudes, beliefs and practices
of ECE professionals that have completed the training program. Additionally, the before and
after nature of these categories aligns with the evaluative approach to qualitative research used in
this study. Understanding whether or not there are self-reported changes in attitudes, beliefs and
practices as a result of completing the Bridge TIC training program provides insight into whether
the program is "on track" to meet the larger goal of creating a trauma-informed ECE workforce
that actively implements TIC strategies with the children in their care.
As the coding process continued, several prominent codes emerged within each broader
axial category.
Limitations and Delimitations
A primary limitation of this study is that ECEs may have provided responses perceived as
being socially desirable and, therefore, did not accurately reflect the actual attitudes and beliefs
of the participants (Maxwell, 2013). The mere nature of a focus group, where individuals are
being asked questions alongside their peers and colleagues, may have increased the likelihood
that the responses given were those believed to have been more socially acceptable. To mediate
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 50

this potential effect, a question was added to the interview protocol that asked ECEs to respond
from the perspective of an ECE professional that has not taken the Bridge TIC training. In this
way, participants were encouraged to provide honest feedback without the fear of having their
response seen as a reflection of them personally.
Another limitation of the study is related to the self-reported nature of data collection. As
the findings are self-reported, no objective evidence exists to corroborate these ECE responses,
such as observational evidence. However, to mediate this limitation, when a participant shared
that there was a change in their behavior as a result of the Bridge TIC training, the researcher
probed deeper to elicit specific details that described the extent of this change in practice. The
level of detail offered provided insight into the magnitude of change; however, this strategy still
does not meet the criteria of objective evidence.
Credibility and Trustworthiness
When analyzing the qualitative data of this study, a criterion of credibility was utilized,
meaning that the data presented accurately represents participant experiences (Merriam &
Tisdell, 2016). In order to ensure the credibility of the data collected and analyzed, rich data
collection, a form of member checking and comparison between groups to check for saturation
of responses was utilized (Maxwell, 2013). The utilization of rich data collection improves the
credibility of a study because it provides a full picture of what occurred (Maxwell, 2013). Rich
data collection was used in this study as focus groups lasted for a significant amount of time
(between 90 minutes to 120 minutes) and full transcripts were utilized in the data analysis
process. Member checking was also completed during the focus group process each time the
researcher summarized statements made during the session to ensure that the researcher was
accurately capturing the sentiment or statement expressed by the participant. Lastly, a
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 51

comparison of identified themes that emerged from individual focus group interviews was
completed to assess for saturation of responses (Maxwell, 2013). By the time of the third focus
group, no new themes emerged from participants.
To further enhance the trustworthiness of the data analysis conducted, the researcher was
intentional about creating an “audit trail” which is evident in the robust description of the data
collection and analysis that has already been provided in this chapter and will continue into
Chapter Four. Furthermore, the rich detail that has been provided assists in the ability of these
research findings to be transferred across similar settings and TIC training programs for ECE
settings (Merriam & Tisdell, 2016).
Positionality
Patel (2015) writes about the relational nature of research and the inevitable impact the
identity of the researcher has on the issue studied (Patel, 2015). In qualitative research, the
researcher is the primary instrument, and as such, it is essential for researchers to consider the
experiences that compel them to pursue particular areas of research, and question their reasoning
behind the types of methods chosen to complete this work. Undergoing such a reflection process
may decrease the likelihood that biased motives are guiding the researcher. In light of this, I will
also undergo this process of reflection.
Two experiences that greatly inform my work, and thereby the work completed in this
research study, are my experiences as a macro-focused social worker and a former high school
educator in both private and public education settings. During my time spent as an educator, I
experienced the challenges of being a first-time teacher, with a limited understanding of broader
socio-economic factors impacting my students. Reflecting on my time as an educator in South
Los Angeles, I too made attributions as to the cause of student behavior that incorrectly assumed
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 52

student behavior was a result of willful defiance; rarely was a student's possible trauma history
taken into account. As research has found to be the case, my original attributions did lead me to
develop a negative concept of some students, which undoubtedly biased my interactions with
these students. After furthering my education and becoming aware of the impact of historical
and developmental trauma, I am now a proponent of trauma-informed care initiatives. However,
as a program developer and implementer, I am also a proponent of funding initiatives that are
expected to create change. Therefore, this study aims to provide formative insight into the
efficacy of the Bridge TIC training program on the attitudes, beliefs and practices of ECE
professionals completing the training series.
Furthermore, it should be noted that the program studied is a program I directly oversee.
In my current role as the Bridge Program Manager at a local Los Angeles non-profit, I am
responsible for the development and implementation of the TIC training and coaching services
that are provided to ECEs across Los Angeles County, through eight partner agencies housing
ten Trauma-Informed Care Advisors. In this role, I do not have direct contact with the ECEs that
receive training. This role is affording me the opportunity to complete this study.
Ethics
In order to ensure that the research methods described in this chapter were conducted
ethically, this research proposal was submitted for review by the Institutional Review Board at
the University (IRB) of Southern California (Patton, 2014). The IRB approved of this study in
October 2019 and categorized this study as 'exempt.' An information sheet for exempt studies
was prepared and given to all study participants (Patton, 2014). A copy of this information sheet
is in Appendix C – Information Sheet for Exempt Research. In line with what was shared with
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 53

participants, participation was voluntary and all identifiable information was de-identified in the
data analysis process (Merriam & Tisdell, 2016).
Summary
This chapter described the approaches to research and methodology utilized in this study.
A review of the setting, population sample, recruitment process, as well as the data collection
process and instruments, have been discussed. Chapter Four will discuss the main findings
yielded by the data collected, and Chapter Five will close with a discussion on these findings.

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 54

Chapter Four: Findings
Based on the data analysis that was conducted for this study, three key findings surfaced
which address the research questions initially posed. Those research questions are:
1) How do ECEs perceive changes in their attitudes and beliefs as they relate to how trauma
impacts a child’s behavior after having completed the Bridge TIC Training Program?
a) How do ECEs perceive changes in the attributions they place on challenging child
behavior after having completed the Bridge TIC Training Program?
2) How do ECEs perceive changes in their practices with the children in their care that
display challenging behaviors after having participated in the Bridge TIC Training
Program?
Due to the evaluative and qualitative nature of this study, research questions were answered
through a combination of descriptive and process-oriented analysis. As a result, this chapter will
begin with a descriptive analysis of participant responses to the first question posed to them,
followed by a richer analysis of key findings.
Perceived Changes in ECE Attitudes and Beliefs
Finding 1: ECEs Move from No/Limited Understanding to a New Understanding of
Trauma and a Belief that Others Benefit from TIC Training.
To understand the process of change that ECEs reported experiencing after completing
the Bridge TIC training program, it was first necessary to gain insight into where ECEs were in
their general understanding of childhood trauma before completing the training. In order to
accomplish this, at the time of each focus group, ECEs were asked to reflect back to before
completing the training and answer the question, “Before you took the Bridge TIC Training,
what was your initial understanding of how trauma impacts a child’s behavior?”.
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 55

Descriptions of ECEs initial understanding of childhood trauma via recollection.
Detailed descriptions of participant responses are presented in Tables 6 and 7; however,
generally, two major themes emerged from the data. Participants either responded that they were
previously unaware/never thought of the impact that trauma had on a child, or they stated that
they had some understanding of trauma's impact on a child. Table 6 describes participants that
verbally stated they had no understanding of the impact of childhood trauma. Table 7 describes
participants that verbally stated that they did have some understanding of the impact of
childhood trauma. Tables 6 and 7 provide additional descriptions of each participant that
responded to the first focus group question; this information includes: (1) ECE age, (2) setting in
which the ECE works, (3) the number of years working in the early care and education field, (4)
familiarity with TIC in ECE settings, as well as (5) the amount of formal training on TIC in ECE
settings participants had before completing the Bridge TIC training. Two ECEs did not respond
to this question at all.

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 56

Table 6
Description of ECEs That Report No Understanding of Childhood Trauma
Participant
(Pseudonym) Age
ECE
Setting
# Years in
ECE
Familiarity
w/ TIC
Amount of
Formal TIC
Training Before
Response to: "Before you took the TIC Bridge Training, what was
your initial understanding of how trauma impacts a child’s
behavior?"
Tai 22 -30 Center 1 - 3 Not at all
Familiar
0 "Before I took the class, I have no idea it will impact the child,
probably more an adult side but not in a child. Like you will say
like, "Wait, it impacts the child?" Or more like adult, like
teenagers and then going up, but never think about [how it] will be
in a child… that it happens to a child.”

Tanya 41 - 50 Center 16+ Slightly
Familiar
0
"Not really. For me, I feel like it start[ed] from the family, the
behavior that's from the family issue… I didn't see [any] trauma."

Amita 41 - 50 Center 13 - 15 Not at all
Familiar
5 or more
trainings
"What I thought is that trauma sometime[s] [is] some kind of
disease. I [was] thinking that's trauma. I don't know what is it - the
trauma."

Clark 51 - 60 FCC 1 - 3 Not at all
Familiar
0 "I had no knowledge of [how trauma impacts a child] at all."

Jasmine 51 -60 FCC 1 - 3 Slightly
Familiar
0 "Before I came to the class ... Yeah, I wasn't aware all those
things. I heard about it because my sister works with victims of
domestic violence. So I kind of knew, but I wasn't sure what it
was about...Trauma. Yeah, I really didn't know. She would tell me
that the children go through a lot and stuff, but I didn't know."
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 57

It is important to note the five ECEs represented in Table 6 who verbally provided focus
group responses indicating they were previously unaware/never thought of trauma's impact on a
child, also stated that they were 'Not Familiar At All'' or "Slightly Familiar" with TIC strategies
before completing the Bridge TIC training. These responses also appeared to align with the
demographic question, which asked about the amount of formal TIC training these professionals
had completed before the Bridge TIC training. All but one ECE (Amita) in this group cited that
they had not received any Formal TIC training beforehand.

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 58

Table 7
Description of ECEs That Report Limited Understanding of Childhood Trauma
Participant
(Pseudonym) Age
ECE
Setting
# of Years
in ECE
Familiarity
w/ TIC
Amount of
Formal TIC
Training Before
Response to: "Before you took the TIC Bridge Training, what was your
initial understanding of how trauma impacts a child’s behavior?"
Victoria 22 - 30 FCC 10 - 12 Moderately
Familiar
1 training "I kind of already also knew what trauma was to a child, but I didn't
realize that there was so much help for these families when they have like
an unexpected kind of like removal from families."

Cathy 41 - 50 FCC 16 + Slightly
Familiar
2 trainings "I knew before this training the impact that trauma had on a child; when
there is violence, drugs, all these problems. But yeah, I knew that I didn’t
have a well detailed understanding of what was a trauma."

Ruth 41 - 50 Center 13 - 15 Slightly
Familiar
5 or more
trainings
"I have kind of [an] idea what trauma is. But sometimes I don't understand
why the children acting like that way they're acting. So sometimes I ask
anybody [for] help, like another teacher or my supervisor."

Valerie 41 - 50 Center 10 - 12 Moderately
Familiar
5 or more
trainings
"I had a pretty good understanding of what trauma was for adults and a
little bit of how it worked with children, but it was more book knowledge.
So I didn't know exactly how it affected infants or toddlers, or four-year-
olds."
Sylvia 41 - 50 FCC 1 - 3 Moderately
Familiar
skipped "I knew that it did affect children due to my past experience and working
in social work."

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFO 59

Table 7 Continued
Description of ECEs That Report Limited Understanding of Childhood Trauma
Participant
(Pseudonym) Age
ECE
Setting
# of Years
in ECE
Familiarity
w/ TIC
Amount of
Formal TIC
Training Before
Response to: "Before you took the TIC Bridge Training, what was your
initial understanding of how trauma impacts a child’s behavior?"
Amanda 41 - 50 Center 10 -12 Slightly
Familiar
0 "I just thought like, trauma happens, and I just didn't think about the
effect. I knew [there] was effect there, but I just thought, we just go on
and we just don't sit there and deal with the trauma. We avoid trauma, we
avoid what we feeling inside…"

Beth 51 -60 LEP,
Center
1 - 3 Slightly
Familiar
0 "I think I wasn't aware completely about trauma just like how we're
saying, 'We know children have trauma. We just don't know each
individual, what the extent of their trauma is.' We don't know what their
triggers are."
Judy Over
60
Center 16+ Very
Familiar
5 or more
trainings
"I do know about some of the things [about childhood trauma] because we
work with children from infant to six… That trauma, the behavior in the
kids, the trauma, I noticed their behavior change. Some of them are shy or
cry a lot, and that's what I mostly... already knew."
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 60

The eight ECEs represented in Table 7 all provided verbal responses indicating that they
had a limited understanding of trauma before taking the Bridge TIC training. One commonality
that arose in this group was that ECE professionals reported having an initial understanding that
trauma does impact a child in some way; however, all but one ECE (Judy) were unable to give
more specific details as to how trauma can impact a child's behaviors than the statements
provided in Table 7. ECE Judy was the only participant that provided descriptions of how
trauma could impact a child's behavior.
Now that a descriptive analysis of ECEs recollections regarding their initial
understanding of how trauma impacts a child has been provided, a more in-depth analysis of the
self-reported change in ECE attitudes and beliefs will now be reviewed.
Moving to a new understanding of trauma and a new belief. When asked about how
ECE attitudes and beliefs about childhood trauma were impacted after completing the TIC
training, ECEs reported: (1) gaining a new understanding of trauma; and (2) a belief that
parents/primary caregivers and all teachers would benefit from the TIC Training.
New understanding of trauma. When asked about how their attitudes and beliefs about
childhood trauma had changed after completing the Bridge TIC training, 12 out of 15 ECEs
(80%) described responses that represent an overall new understanding of trauma. After a
deeper analysis, these ECEs provided responses that fit into the two subcategories of (a) new
understanding of childhood trauma, specifically or (b) new understanding of trauma, generally.
It is important to note that, at times, ECEs provided responses that fit into both categories.
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 61

New understanding of childhood trauma, specifically. Ten ECEs shared statements that
illustrated a new understanding of childhood trauma specifically, after completing the Bridge
TIC training. A quote by participant Valerie illustrates this concept:
Once I started coming to the classes, one of the things that was key for me was when [the
trainer] explain[ed] that trauma, it depends on how the child is feeling it. It’s not what
we think is trauma as adults. So I may think a car accident is traumatic, but to a child
maybe a dog barking really loud in his face is traumatic. So that really shifted my
practice with working with infants and toddlers.
This quote describes an awareness of the subjective nature of trauma and that traumatic
experiences can be different for children and adults, which is covered explicitly in Modules 1
and 2 of the Bridge TIC Training curriculum. ECE Tai also shared a new understanding that
trauma can impact children still in utero; this person shared, “After taking all the six modules, I
understand that [trauma] happens to anybody even the babies not even born [during] pregnancy”
- also a concept covered in Modules 1 and 2 of the training curriculum. Several ECEs expressed
similar sentiments as ECE Victoria who shared:
I feel like I was kind of blind back then. Now I see like, OK, like she said, it's not
just abuse. It's also attention. It's also changes in the environment. Changes in home,
your environment where you live. Maybe [the child] doesn't feel safe and he has to act
this way in order to feel safe…
This quote is aligned with the content covered in Modules 2 and 3 of the Bridge TIC program
and illustrates a newfound awareness that trauma is caused by many different experiences, not
just abuse. ECE Cathy clarified this sentiment further by explaining, "I learned that at times, it's
not just that there is physical abuse, drugs... but also the attention for children." This statement
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 62

speaks to an understanding that a child can experience trauma through a lack of an attuned
attachment by a primary caregiver, a topic central to Module 2 of the Bridge TIC curriculum.
These statements illustrate changes in beliefs about childhood trauma that were experienced by
ECEs who completed the Bridge TIC training. ECE beliefs expanded to include the notion that
trauma does, in fact, impact children, or expanded previously held understandings of childhood
trauma to include more ways that children might experience trauma.
Lastly, reflecting on the impact of completing the Bridge TIC training, ECE Victoria
shared a sentiment that aligned with statements expressed by other ECEs; she stated, "So it kind
of gives us a new meaning to working with difficult children. They're not so difficult, just…
they have a reason to be." This quote reflects an attitudinal shift brought about by the new
information on childhood trauma covered in the Bridge TIC training. Here, Victoria is
describing a change in the way she views "difficult" children, by stating that there is now, in her
eyes, a reason for the child to act this way. This shift in belief is impacting the ECE's attitude
toward working with "difficult" children, as it appears that Victoria is now more motivated to
work with children that are displaying challenging behaviors. This shift in attitude continues to
unfold when looking at the ways ECE attributions around challenging child behavior is reported
to have changed as well.
New understanding of trauma, generally. Four ECEs provided responses that spoke to a
new understanding of trauma generally, not specific to childhood trauma. Three of these ECEs
reported having a new belief that trauma impacts multiple levels of society, including the whole
family and is not relegated only to the experience of foster children - a concept that is the focus
of Module 5. One quote that represents this sentiment is from ECE Jasmine:
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 63

Another thing I want to say is that when they invited me to the class, I thought it was just
for foster children. But I found out that it does not only happen to foster children, it
happens, I will guess, [to] “normal children” and parents, you know at home, and it
helped me a lot. Because I thought, “Well, I don't take care of foster children, do not
have any in my care.” But the regular children, I found out they were going through a
lot.
ECE Judy also mentioned that the Bridge TIC Training made her aware of the fact that men's
behavior was influenced by trauma, which was not something the ECE considered before. Judy
stated, "I never thought of [trauma] like that… And I was like, wow, maybe that's what happened
to my son, but he's more quiet and didn't say. So now I'm more understanding…". After further
probing, this ECE described that before the Bridge TIC training, she would not have attributed
behavior in men to an experience of trauma, but now is more aware of this possibility.
Belief that others would benefit from the TIC training. A new belief that emerged from
the data which was shared by just over half of the participants (eight out of 15 ECEs) was the
belief that parents/primary caregivers and other teachers would benefit and, therefore, should
also receive the Bridge TIC training. Engaging primary caregivers and other helping
professionals that interact with children regularly is a trauma-informed response to childhood
trauma mentioned in Modules 3, 4 and 5 of the Bridge TIC curriculum. Five ECEs stated that
parents/primary caregivers would benefit from TIC training, expressing sentiments similar to this
quote, expressed by ECE Antonia:
But what happens when the parent needs [the training]? This is important, the class,
because it’s working together. I think it’s very important that the parents [have] this
class… get the teacher and the parents. It’s, “Let’s go together… teamwork.”
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 64

Six ECEs stated that other teachers would benefit from the TIC training. ECE Beth expressed
this sentiment by stating:
So I think it would be beneficial to every Headstart, every preschool, as many people that
we can reach and grab to do it and start it and be more sensitive and look for triggers, and
put those trauma lens[es] on and pay attention.
ECE Valerie echoed this sentiment by adding:
I think where to start for us to see more progress, I know when it comes to teachers
mandating the classes really does work, mandating. It does work because then they’re
forced to learn. And I think that would be a very good key.
These responses offered by participants describe how the Bridge TIC training program
impacted ECE attitudes and beliefs. ECEs appear to move from a place of no/limited awareness
of the impacts of childhood trauma as illustrated in Tables 6 and 7, to places where ECEs have a
deeper understanding of the occurrence and the effects of childhood and a belief that TIC in early
care and education settings is worthy of educating others on. In terms of the conceptual
framework guiding this study, it is apparent that as a result of completing the Bridge TIC training
program and engaging with information aligned with a critical approach to trauma, ECE
participants in this study are beginning to move across stages in the TTM Model (Craps, 2013;
Harris & Fallot, 2001; Matthies-boon, 2018; Norcross, Krebs, & Prochaska, 2011; van der Kolk,
2005). Specifically, in this first finding ECE participants are moving from stages of pre-
contemplation, where childhood trauma may not even have been a known, or well-known
concept, to various stages of contemplation as ECEs grew in their understanding of how trauma
can impact a child’s behavior (Norcross, Krebs, & Prochaska, 2011). Table 8 provides a
synthesized review of the information presented in Finding 1.
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Table 8
Review of Finding 1
Research Question 1: Perceived changes in attitudes and beliefs
Benefit from TIC Training
No understanding (5/15 ECEs) Overall new understanding of trauma (12/15 ECEs)
Childhood Trauma (10/15 ECEs)
Limited Understanding (8/15 ECEs) - Trauma DOES affect a child
- 1 ECE able to provide concrete - Trauma can be many things, not just child abuse,
description of childhood trauma but also neglect and insecure attachments
-Trauma can cause challenging behavior
Trauma Generally (4/15 ECEs)
- Trauma impacts everyone, i.e. family, community
- Trauma impacts men
Belief that others would benefit from the training (8/15 ECEs)
Moving to a New Understanding and a New Belief After
Completing Training
Initial Understanding via Recollection
FINDING 1: ECEs Move from No/Limited Understanding to a New Understanding of Trauma and a Belief that Others
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 66

Perceived Changes in Attributions
Finding 2: ECEs Move from Assigning Specific Attributions to Being Curious About Child
Behavior.
Similar to the first finding, in order to understand how ECE attributions might have
changed after experiencing the Bridge TIC training program, it was essential first to have
participants reflect on what they thought about children in their care displaying challenging
behavior before completing the Bridge TIC training program. Those initial attributions will now
be reviewed.
Analysis of ECE initial attributions via recollection. ECEs were asked to
retrospectively answer the following question: "Before you took the training, if you saw a child
displaying what might be considered "challenging" behavior, what would you have thought
about the child and the cause of their behavior?". As a result, all but one ECE cited at least one
of three main beliefs about the causes of a child's behavior. These three causes include: (1)
developmental causes; (2) poor parenting skills; and (3) negative child characteristics. ECEs
were also asked about how their peers who had not received the Bridge TIC training might think
of and respond to challenging child behavior. ECEs were asked to hypothesize about their
untrained peers as a means of collecting responses that ECEs may not have felt comfortable
attributing to themselves. Because of the limited literature on ECE attributions regarding
challenging child behavior, a rich analysis of these three original attribution categories will be
provided.
Developmental causes as attributions for challenging behavior. Eight ECEs
interviewed cited a possible developmental cause for challenging child behavior.
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'Developmental causes' were coded as responses that referred to biological development,
including references to typical and atypical child development. It is important to note that
attributing challenging child behavior to possible developmental causes is aligned with a TIC
approach in ECE settings - this information is covered in Modules 3 and 5 of the Bridge TIC
curriculum.
Typical biological development. Two ECEs cited typical biological causes as the reason
for challenging child behavior. ECE Sylvia stated, “The whole terrible two's, thinking she's just
going through terrible twos and just the temper tantrums and all of that.” While ECE Valerie
shared that before taking the Bridge TIC training she would have thought, “Oh maybe she’s
going through a [developmental] stage or maybe she’s going through a growth spurt.”
Atypical biological development. A code of 'atypical biological development' was given
to responses that included references to developmental delays, "mental issues" and "special
needs." In total, seven ECEs identified atypical development as the cause of challenging child
behavior, with two ECEs attributing these responses to untrained peers. ECE Tanya mentioned a
language delay as a possible cause, stating: "Sometimes [it] can [be] language delays. Because
they don't know how to express themselves so they... want us to pay more attention," and ECE
Valerie shared, "Maybe the child was having a speech problem because sometimes they get very
aggressive when they don't speak fast or something."
Two ECEs referenced the term "mental issues" when reflecting on what they believed
was the cause of challenging child behavior. ECE Clark stated: "I would have thought maybe
that child, I don't know if this is the right word to say, but maybe have some form of mental
issues, that's the way I kind of looked at it…". ECE Judy referenced mental issues as a cause of
challenging behavior by reflecting on what she would have thought about a child displaying
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 68

challenging behaviors before taking the Bridge TIC training; she shared, "What I got out of it?
It's not always when the kids misbehave, we feel like something mental is happening and [the
child] need[s] to go see so-and-so…”. The ECE then went on to reference the Regional Center as
the place to which she would have previously referred these children. Regional Centers are non-
profit, private corporations that contract with the California Department of Developmental
Services (DDS) to serve children and youth under age 18 developmental disabilities
("Developmental Disabilities Resources", 2020).
Lastly, three ECEs described atypical developmental causes of challenging child
behavior more generally. ECE Tai shared, “I would think that a child needed special attentions,
special needs… like Autism, Down Syndrome…”. Two other ECEs referred to the beliefs of
their untrained peers when they mentioned an atypical attribution for challenging child behavior.
ECE Margo stated, “I believe that they would say, ‘These children are hyperactive,’… because
even in the schools, they give them the medicine and do not want to work with them…”.
Poor parenting skills as attributions for challenging behavior. Nine out of 15 ECEs
attributed challenging child behavior to poor parenting skills, which included behaviors such as
spoiling the child, lack of discipline with the child, being a bad example and not communicating
with the child. Most ECEs cited more than one example of poor parenting skills.
Four ECEs reported that challenging child behavior was due to parents spoiling their
child. ECE Amanda stated:
I would think that ... that [the child is] trying to just get their way or they're just spoiled,
their parents just spoiled them rotten, or something, and they just come and they do
temper tantrum because their parents allowed them to. That's how I would think.
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ECE Ruth stated, “I was thinking, maybe like their parents give them whatever they ask, they
give it to them, that's why he's acting that way.” Both statements demonstrate that ECEs are
attributing the cause of challenging child behaviors to parents spoiling their child, which is
viewed negatively by these ECEs.
Another popular attribution regarding poor parenting skills had to do with the idea that children
displayed challenging behaviors because parents were unable to discipline their children. Four
ECEs reported sentiments similar to the following statement shared by ECE Sylvia:
My opinion would have been more on the parent. Wow, are they not teaching [the child]?
They're not working with them? There needs to be a little bit more discipline. And
discipline means to teach, not to spank and all that. But are they not working with that
child … what's going on with the parent?
ECE Judy shared, “Well before I took the training, I would think that there's no guidance in the
home. There's no discipline. And we always quick to blame the parent…”. Additionally, ECE
Beth, when reacting to a scenario where a child was displaying challenging behaviors in public,
this ECE stated, “Probably I would have just rolled my eyes or walked the other way and just
was like, ‘Wow, these parents have no control over their child.’” These remarks highlight the
idea that a lack of parental discipline leads children to display challenging behaviors.
ECE Tanya stated that the cause of challenging child behavior was due to a poor example set by
parents. This ECE shared:
They come from the parents. Because the parent raise[s] the voice at home, and the kids
come [to the daycare] and then they [raise their] voice to another friend. And they say,
“It's okay because my mom yell[s] at me, I can yell at you.”
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Here, Tanya is describing an instance where the child has learned undesirable behaviors from
their parents and, as a result, is bringing those behaviors to the early care and education setting.
Lastly, two ECEs attributed the presence of challenging child behaviors to the poor
communication between the parent and child. One quote that sums up this sentiment is from
ECE Margo; she shared, “The first thing I would do if I see a child who is not behaving, I would
say, this is a child [that] does not speak with their parents. The parents do not speak with the
child.”
Negative child dispositions as attributions for challenging behavior. When asked about
the cause of challenging child behaviors, 11 out of 15 ECEs attributed child behavior to a
negative child disposition; most ECEs provided more than one response that was coded as a
negative child disposition. Responses were first coded as 'child dispositions' any time an ECE
described a child's perceived typical nature, demeanor, or personality trait. After deeper
analysis, it became clear that all the dispositions noted reflected negatively on the child and were
perceived as negative by ECEs, resulting in the final code of "negative child disposition" utilized
for data analysis purposes.
ECEs used a variety of words that were coded as 'negative child dispositions ', these
words include: attention-seeking, bad/naughty, brat/bratty, crazy, difficult, a fighter, hard-
headed, a problem, manipulative, rebellious, spoiled, and strong-willed. An example of an ECE
describing a "bad/naughty" child is reflected in this statement by ECE Amanda: "Okay, they're
acting [like this] because they're just trying to be just bad, just acting out." ECE Tai shared,
"Before I took the class, if a kid's acting up, I was obviously, 'What a naughty kid.' You're acting
pretty weird and crazy. And then probably, that's how they act at home." Then discussing the
perceived cause of challenging child behavior, ECE Sylvia shared,
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Before going through the trauma classes and talking with the foster parent, it was more of
the behavior was seen more as a negative and like [they] said, hard-headed and attention
seeking, manipulative, all of that.
Two more quotes that highlight an ECE attributing child behavior to negative child
dispositions are: “If I hadn’t taken this course, I actually know that I would have said this kid is
naughty, take him” shared by ECE Cathy and, this quote from ECE Ruth who stated,
Before taking the training, I was thinking, “Oh, this child is spoiled, oh why they send
this child to me? Oh, why I have to [have] the child in my classroom? Oh my God…”
So I complain all day long.
These quotes illustrate a connection between an attributed negative child disposition and an ECE
lamenting over having to work with the child.
Some negative characteristics were mentioned more frequently than others. For example,
the terms "bad/naughty" and "spoiled" were each mentioned by four different ECEs. Two
different ECEs mentioned the terms "hard-headed" and "crazy." All other terms previously
noted were used once by individual ECEs.
When asked about the perceived causes of dysregulated child behavior, ECE Victoria
was the only ECE that did not attribute child behavior to any of these three causes. Victoria
stated, "What I would think about the child is, oh, he's having an off day … maybe he's just slept
on the wrong side of the pillow…". As this statement did not directly reference developmental
causes, poor parenting, or a negative child attribution, it was not coded as fitting into any of the
three categories mentioned above.
ECEs move to a place of curiosity regarding challenging child behavior. While a
majority of ECEs recollected attributing challenging child behavior to three specific causes
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before attending the Bridge TIC training, this response notably changed when ECEs discussed
how they would view this behavior after having completed the training. When asked what ECEs
would think about a child displaying challenging behavior now that they have completed the TIC
training, providers no longer mentioned developmental causes, poor parenting, or negative child
dispositions as causes of child behavior. Instead, ECE responses did not attribute child behavior
to one thing in particular; rather, they were more likely to report being curious about what could
be causing the behavior and explicitly wondering if a traumatic experience could be the cause.
ECE Valerie explained how the new information she learned from the Bridge TIC
training changed the attributions she made regarding the causes of challenging child behavior.
She stated:
I thought trauma had to be something really severe, just like it would be for me, but I
never thought of how it would be for a child. Even though I understood, it just wasn't
something that I was aware of. And like her, when I would see [her] behaviors, I would
think, "Maybe there's attachment issues, maybe there's crankiness or they're going
through their two's." I always come up with a different reason as to maybe why [children
behaved this way]. It never occurred to me to think that, "Oh, maybe she had a traumatic
experience when this and this happened." And so it really shifted my thinking.
This quote highlights the fact that after completing the Bride TIC training ECE Valerie now
understands that a traumatic experience could be the cause of a child’s challenging behavior.
Like Valerie’s experience, 12 other ECEs reported moving to a place of curiosity, when being
confronted with a child displaying challenging behavior. ECE Amanda shared, “I look at [the
kids], sometimes … I look at them, I'll be like, ‘What happened?’ I asked them, ‘What happened
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to you?’ I actually use that now.” ECE Clark expressed a statement that captures this curious
approach to child behavior by sharing:
Nowadays, when I see a kid that could be suffering some form of trauma or whatever
case it may be, and I'm looking at [the child’s] behavior changing, it's funny, it's
different, I'll store it in my mind, I think about that little deal that we did in the classroom
... But anyway, I love it when I see a child that looks like they [are] traumatized or they
have “bad behavior”, I started trying to put things together and to come up with some
form of strategy to get more information of why, what and when, and then a solution,
how can I help this child?
ECE Ruth shared a similar sentiment by stating:
Now in my center with them, when I see a little boy or little girl having a tantrum instead
of saying, "Hey, what happened with you?" Or getting angry or whatever, I just go down
and think by myself, "Okay, he's going through something, so I need to see what is
happening." So I ask them, "Okay, what's going on? What happened to you? How can I
help you? What do you like? For example… why [are] you kicking or why [are] you
fighting?”
In both examples, ECEs view challenging child behavior with curiosity - a preliminary thought
that is beginning to lead them toward appropriately actionable strategies with the child. ECE
Amanda reflected on this new curious stance and shared:
Now, I look at the kids and I'd be like, "Wow," I imagine what they might go through at
home or what's going on? Well, why are they responding this way? We don't know what
they're going through and what they're facing in their own home, you know? … We have
to really be observant and really pay attention and not think, “Okay, they're acting
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because they're just trying to be just bad, just acting out.” It could be a situation that we
don't know. Maybe they experienced their mom getting hit on … or maybe they're
dealing with alcohol, some of their parents. Or maybe they're not eating enough, and
they're so hungry and you don't know, you don't know they're dealing with neglect.
Again, this quote reflects a general approach of curiosity on behalf of the ECE - an awareness
that many things might be causing the challenging child behavior. Viewing child behavior
through a lens of curiosity is the epitome of the TIC "catchphrase" which states, "Rather than
asking, 'What's wrong with you, ask what happened to you.'" This approach to working with
children is at the heart of the Bridge program and is reviewed in all six of the Bridge TIC
curriculum modules.
This finding also demonstrates the changes that a critical trauma knowledge base had on
the ECEs participating in this study. Moving away from assigning specific attributions to
challenging child behavior to being curious about the cause of the behavior is not only moving
ECEs into deeper contemplation stages of the TTM, but it also appears to be having the added
effect of preparing ECEs to take strategic and intentional actions with the children in their care.
This preparation stage is also aligned with the stages of change in the TTM (Norcross, Krebs, &
Prochaska, 2011). Table 9 provides a synthesized review of the information presented in Finding
2.

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Table 9
Review of Finding 2
Developmental Causes (8/15 ECEs) ECEs Move to a Place of Curiosity (13/15 ECEs)
(1) Typical Biological Development (2 ECEs)
(2) Atypical Development (7 ECEs)
Poor Parenting Skills (9/15 ECEs)
- Spoiling the child
- Lack of Discipline
- Bad example
- No communication
Negative Child Dispositions (11/15 ECEs)
- i.e. bad/naughty, manipulative,
rebellious, etc.

Moving to a Place of Curiosity After Completing Training Initial Attributions via Recollection
- ECEs are curious about the cause of the challenging child
behavior, rather than making an attributions to one thing in
particular
Research Question 1. a.: Perceived changes in attributions about challenging behavior
FINDING 2: ECEs Move from Assigning Specific Attributions to Being Curious About Child Behavior
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Perceived Changes in ECE Practices
Finding 3: ECEs Report Using TIC Strategies with Children in Their Care After Training
To understand the impact of the Bridge TIC training on ECE practices when responding
to challenging child behaviors, participants were again asked to reflect on their practices before
completing the Bridge TIC training. ECEs provided a range of responses from which a few
commonalities emerged. These retrospective responses will now be reviewed in order to provide
a robust understanding of the Bridge TIC training impact on ECE practices.
Analysis of ECEs initial practices via recollection. ECEs were asked to retrospectively
answer the questions, “Before you took the training, how would you have responded to [a] child
that is showing “challenging” behavior?”. ECE responses were categorized as either child-
focused or ECE-focused and will be analyzed through these groupings.
Child-focused responses. When asked about their practices with children displaying
challenging behavior before completing the Bridge TIC training, ECEs reported responding in
four main ways with the children in their care. ECEs reported being either: (1) directive or
controlling with the child; (2) ignoring the child; (3) not wanting to work with the child; or (4)
referring the child to outside services. The first three responses are not aligned with a trauma-
informed approach in ECE settings; however, the fourth response can be aligned with TIC
practices and is covered in Module 5 of the Bridge TIC training program. ECEs described either
personally engaging in these practices, or attributed these practices to an untrained peer.
Practices attributed to an untrained peer were practices that ECEs also attributed to themselves.
Directing/controlling the child. Five ECEs mentioned responding to challenging child
behavior with directive or controlling practices. ECE Clark stated, “I would have responded to a
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child by trying to be controlling, I think. Trying to make or force the child to do something, do
the opposite of what they actually [were] doing.” ECE Amanda shared, “I would just be like,
you need to have a seat, you need to take a moment. You acting out, that's not nice. You
shouldn't be acting this way. Not hearing them or trying to find out why.” Both statements
illustrate that these ECEs would respond in ways that tried to immediately stop the challenging
behavior, rather than trying to understand the cause of the behavior.
Ignoring the child. Four ECEs stated that when they would see a child acting out, they
would ignore the child. ECE Ruth shared, “Sometimes I just ignore them to be honest. I just
ignore them, say 'Okay, whatever, when you're ready, let me know and we can continue.'" ECE
Beth shared a similar sentiment stating, "I probably would have just, a little bit ignored the
situation, and said, 'When you're done acting up, you can come and see me.'" Both statements
reflect a pre-existing ECE belief that if ignored, a child will soothe themselves and rejoin the
group. ECE Jasmine reinforced this belief by sharing that this idea was passed onto her by
another ECE. They shared:
I heard a provider, and this is a teacher that I heard. "Oh, when a child comes crying, I
just let him or her cry, they'll come around and they're going to come and find me and
they're going to be okay. So just ignore them." I heard it. At that time I thought, "Well, I
guess that's how you handle it." And after training, it's like, "No, that's not how you
handle it."
Not wanting to work with the child. Three ECEs mentioned not wanting to work with the
child as their response to challenging behavior. Two ECEs shared sentiments similar to the
following statement given by ECE Ruth:
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Before taking the training, I was like, “Why is this child acting like this?” So maybe at
home, [there’s] something happening at home. I don't care what happened but, what? I
have the child. So yeah, I was like, “I don't want to have them in my class or whatever.”
ECE Victoria discussed her untrained peers not wanting to work with children displaying
challenging behavior. She shared:
I personally think that maybe that other provider might either kick [the child] out of the
daycare, because I've seen that happen… Most providers, sometimes, who haven't taken
these courses, they think, “Oh no, that's a trouble child. I don't want that at the daycare.
You know, it's gonna affect my other children. It's going to affect my flow. I don't want
that.” So I've seen that happen. And then and then they kick [the child] out. They don't
necessarily ask or talk to the parents. They just like, “Oh, no. You know what? That's a
lot for me. I don't want to deal with it.”
These quotes reflect a reality that is common for children in early care and education settings,
namely the removal of children from these settings.
Referring the child to outside services. Three ECEs reported referring children to outside
services. All three ECEs described referring children with challenging behaviors to a Regional
Center. ECE Margo stated, “When you see a child is not behaving, or who is being aggressive,
wanting to hit, wanting to bite, then you have to try to get help from the Regional Center.” ECE
Judy shared:
Every little thing … [other ECEs] are quick to send [children] to the Regional [Center] to
get tested. Yes. And it's not always that. You are not equipped to see that … And then
they come back and they put them on some kind of medication … and I'm so against that.
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The last quote is referencing the behavior of other untrained peers and appears to be suggesting
that referring a child to the Regional Center should not be the first response undertaken with a
child displaying challenging behavior. ECE Tanya expressed a similar sentiment when
reflecting on how her practices have changed after the Bridge TIC Training, sharing:
When the teacher come[s] and ask[s] me for help. I say, "Okay, we need to identify
where [the child's challenging behavior] is coming from? What is the cause? What is the
effect?” Before we do paperwork to refer them to the Regional office.
This statement also appears to be stating that the ECE is encouraging their staff to ask more
questions about the child’s behavior before referring the child to the Regional Center, which was
the practice before this ECE completed the Bridge TIC training.
Additionally, one of the three ECEs who stated that they would refer a child to the Regional
Center also shared an instance when, before taking the Bridge TIC training, they had reported a
scratch on a child in their care to school officials which resulted in a child welfare investigation
into the family. This ECE shared that, after reflecting on what was learned in the Bridge TIC
training, this response was perhaps too extreme, and instead, learned that she should first talk to
the child and parent to learn more about what happened before reporting an incident like this to
officials. This ECE stated:
Well now with the classes, I think that I had to get more information from the child, ask
the child, know what was the motive … learn more, for me to help her with the
knowledge that we have now. So, I think that’s where I had a little failure, because as we
have learned of trauma, when there is a separation ... I think that the girl wanted more
love, more affection, and that the mother was not giving that attention…
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The last portion of this statement also highlighted this ECE's new understanding of trauma,
which includes the fact that challenging behavior and childhood trauma can be the result of an
insecure attachment and is not always due to abuse or neglect.
Outlier response. One ECE reported responding to challenging child behavior in a way
that was child-focused but did not align with the previous subcategories listed. This ECE shared,
If I were to see a child standing there acting, acting out, what would I do before? I would
probably get the child with me. And I was like, “What's going on? Are we fighting for a
toy?” But not necessarily probably ask about the personal life, because I would probably
just think it's something going on right there, between the two children.
This response is different from the other responses already covered because it is an inquisitive
response, less punitive when compared to the previous responses.
ECE-focused responses. When asked about their practices with children displaying
challenging behavior before completing the Bridge TIC training, ECEs reported responding in
two main ways that relate to internal states of the ECE. ECEs reported either feeling stressed or
not knowing how to respond.
ECE feeling stressed. Four ECEs discussed feeling stressed when responding to a child
displaying challenging behaviors. ECE Antonia shared, "I have a lot of stress and, with the child
especially, because the child sometimes [doesn't] understand what happens … a lot of jumping,
of kicking or something like that. It stresses me." While reflecting on a change in their response
compared to how an untrained peer might respond, ECE Amanda shared:
I notice the difference since I took the classes and how, like I can say my coworkers, how
they deal with the kids, they let it stress them out more and they're always, "Stop this,
stop that," instead of understanding. I let things mull over. I think I've become very calm
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in the workplace as far as it's not getting to me. It's just like she says, it's not stressful
[anymore].
These two quotes reflect a feeling of stress that ECEs feel when responding to challenging child
behavior.
ECE not knowing how to respond. When reflecting on their response to challenging child
behavior before completing the Bridge TIC training, four ECEs discussed not knowing how to
respond. Three of the ECEs attributed this to themselves and one ECE attributed this to an
untrained peer. ECE Ruth shared:
Before I [took] this training, I have kind of an idea what trauma is. But sometimes I don't
understand why the children [are] acting the way they're acting. So sometimes I ask
anybody [for] help like another teacher or my supervisor. “What can I do to help this
kid?” Because I don't really have an idea how I can help them.
ECE Jasmine echoed:
I didn't know how to handle it. And I was like, “Oh, I'm losing sleep over this.” So I
wake up all thinking about it. And so I was like, "... It does affect me too." And so if I'm
affected, I'm not sleeping well, then I have to care for these children that are having
issues. And it's not going to go well.
This last quote connects a relationship between not knowing how to respond and the ECE feeling
stressed when responding to challenging child behavior.
ECEs report using TIC strategies. All 15 ECE focus group participants reported
utilizing at least one TIC strategy that was mentioned in the Bridge training with the children in
their care after completing training. ECEs described a total of eight different TIC strategies.
Two strategies, in particular, were used by more than half of the ECES, including (1) partnering
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with other primary caregivers which is reviewed in Modules 3 and 5 of the Bridge TIC training
and (2) building a secure attachment which is covered in Modules 2, 3, and 4, specifically.
Because of the high prevalence of these two strategies, they will be discussed in greater detail,
whereas the additional six strategies that were mentioned by less than half of ECEs will be
briefly reviewed in Table 10.
Partnering with other primary caregivers. Another foundational tenet of TIC strategies
in ECE settings is the importance of partnering with key figures in a child’s life such as parents,
guardians, resource parents, teachers, etc. to build a comprehensive support network for a child
that is displaying challenging behaviors; this topic is covered explicitly in Module 5 of the
Bridge TIC training program. After completing the Bridge TIC training, 11 ECEs reported
engaging in interactions where they partnered with the primary caregivers of children displaying
challenging behaviors. ECE Sylvia described working with a primary caregiver by sharing,
“Now it's more of ‘Let's work together’. And like I said, bringing the information that we
learned to the foster parent to help that foster parent have support and information. So it's all
about information”. ECE Jasmine stated that after the TIC training, they
… started also having more conversations with the parents and see what was going on.
And so that helped me a lot. That stood out to me too, that you have to build
relationships with these parents, kind of treat them like they're family because they're
always there anyways. So I thought, "Okay, I have to change that." So I started doing that
too.
A last quote that also represents this partnership between ECE and a child’s primary caregiver is
when ECE Margo shared, “And right now, with the classes, I try investigate more and talk with
parents and implement what I've learned with my classes here.”
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Building a secure attachment with children. As previously noted in Chapter 2, a
consistent, attuned and appropriately responsive attachment between a child and a primary
caregiver is a mediator for childhood trauma, and as such is a TIC strategy promoted in the
Bridge TIC training curriculum in Module 2 (Holmes, Levy, Smith, Pinne, & Neese, 2015; La
Greca et al., 2008; Lieberman, 2004; Perry, 2009). When asked about how ECEs would
respond to a child displaying challenging behaviors after having completed the Bridge TIC
training, 10 out of 15 ECEs reported that they now engage in activities that build a secure
attachment with the child. ECE Beth described this by stating, “Then also was the consistency -
to be consistent with the kids, be there all the time, be there. If you're that safe person for them,
be that every day for them.” ECE Jasmine explained:
For me what stuck to me after the training was security for the kids. Make them feel
secure, they can trust me. And when you come to my house, you're going to be okay.
And I always talk to them about that after the training, I just want to make sure that they
feel secure. If they don't feel secure at home, then they can feel secure with me.
And lastly, ECE Margo described how she builds a secure attachment with a child that is
dysregulated when she shared:
Then I try to bring the child closer to me, giving the child affection, teaching them
songs… that he also is a child and who has respect that we have to teach the same values,
that we love them. And that they also love their parents. We try to show that love and
respect.
Additional TIC strategies reportedly utilized by ECEs. As previously mentioned, ECEs
also identified six additional TIC strategies as practices that they now implement with the
children in their care after having completed the Bridge TIC training. Each strategy was
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mentioned by fewer than half of the ECE focus group participants. Table 10 provides details
specific to each of the six additional TIC practices that ECEs engaged in with children in their
care after completing the Bridge TIC training, including the number of ECEs that mentioned
each TIC strategy and participant quotes for each strategy.
Table 10
Additional TIC Strategies Used by ECEs
After Training
Practice
# of ECEs
Mentioning
Practice
ECE Quotes
ECE Engages in
Self-Care
(Module 6)
7
“Oh, taking care of myself. That is a huge one... Because you go, go,
go and you don't think that somebody else's trauma affects you… But it
does take a toll on your system as well, as it does in the family and the
child that has had trauma. And so that's something that I'm more aware
of now. I know what buttons when something's happening in my body,
I know. And I start to question, ‘Okay, why are these buttons being
pushed? This was something so mild, what's going on? What do I need
to do to take care of myself a little better?’ ... That's something that I
really wasn't mindful of before.

“And also self care. Because that's something I did not do before that
training. I always felt like it's a job. I need to take care of them. But I
never thought I have to take care of me too, because I'm not going to be
able to take care of them if I don't take care of me first. Yeah, those
things I changed.”

Observe/ Identify
Child Triggers
(Module 3)
6 “I think now that I have completed the modules and taken the class, it
helps me to be a little bit more sensitive, compassionate, understand
triggers and what's going on… [the child] might have had a trigger in
the car before they got to you.”

"So I think it just helps me be a little bit more sensitive and look out for
different triggers, because they happen throughout the day.”

Personal
Reflection
(Module 6)
1 “And I knew [trauma] already affected, but it made me even more
aware because my own self and the things that I have gone through, it
made me realize, wow, this is why I respond this way to certain things.
It opened my eyes in my own life…”

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Table 10 Continued
Additional TIC Strategies Used by ECEs
After Training
Practice
# of ECEs
Mentioning
Practice
ECE Quotes
Effective Praise
(Module 3)
1 “[The children] need to know they're special. They need to know they're
awesome. They need to hear validation, and good validation. We can't go
overboard with it...but when they deserve it, they should be able to hear it.”

Socio-
emotional
development
(Module 4 &
5)
1 “It's very important to talk about feelings with them. That's really
important because some of them say, "Oh, no, I'm not allowed to be mad."
So they think [being] mad is like hitting or punching or whatever. So we
talked about it, ‘Okay, yeah, it's okay to feel mad or angry sometimes, is
not okay to hurt any anybody else but you can be angry. If you're going to
punch something, here, let me give you a ball or something to hit. It's
okay to feel sad.’ So talking about feelings. It's really important for me.”

Support Child in
Self- Regulation
(All Modules)
1
“For example, on the day that the child acts up, we can provide, we call it
the area for the kid [so they] can calm down because we know that is not
the normal behavior … if the child gets some anger they need a moment by
themselves.”

The data presented in this section reflects the various trauma-informed strategies that
ECEs now report utilizing after having completed the Bridge TIC training. This finding is also
aligned with the stages of change in the TTM. As a result of ECE participants engaging with a
curriculum aligned with a critical approach to trauma, participants reported moving from pre-
contemplation/contemplation stages to action stages, as depicted in the TTM. In these action
stages, ECEs are now utilizing TIC strategies with the children in their care that display
challenging behavior - strategies that were not reportedly utilized before ECEs completed the
Bridge TIC training series (Norcross, Krebs, & Prochaska, 2011). Table 11 provides a
synthesized review of the information presented in Finding 3.

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Table 11
Review of Finding 3
Child-focused Responses (10/15) Partnering with Other Primary Caregivers
(1) Directive/Controlling (5/15 ECEs) (11/15 ECEs)
(2) Ignore Child (4/15 ECEs)
(3) Not Wanting to Work with Child (3/15 ECEs) Building a Secure Attachment with Children
(4) Referring Child to Outside Services (3/15 ECEs) (10/15 ECEs)
(5) Outlier Response (1/15 ECEs)
Additional Strategies
ECE-focused Responses (5/15 ECEs) (1) Self-care (7/15 ECEs)
(1) ECE Feeling Stressed (4/15 ECEs) (2) Observe/Identify Child Triggers (6/15 ECEs)
(2) ECE Not Knowing How to Respond (3/15 ECEs) (3) Personal Reflection (1/15 ECEs)
(4) Effective Praise (1/15 ECEs)
(5) Socio-emotional Development (1/15 ECEs)
(6) Support Child in Self-Regulation (1/15 ECEs)
Research Question 2: Perceived changes in practice with children displaying challenging behaviors
FINDING 3: ECEs Report Using TIC Strategies with Children in Their Care After Training
Initial Practices via Recollection ECE Using TIC Strategies
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 87

Summary
This chapter reviewed the research questions guiding this study and provided three main
findings based on data collection efforts. After hosting focus groups with 15 ECEs in Los
Angeles County, the main findings presented in this chapter reflect the self-reported changes in
attitudes, beliefs and practices that occurred after having completed the Bridge TIC training
program. The first finding presented in this chapter revealed that after ECEs completed the
Bridge TIC training, they reported moving from no/limited understanding of childhood trauma to
a new, fuller, understanding of childhood trauma and a belief that others would benefit from TIC
Training. The second finding was that ECEs moved from assigning specific attributions to
challenging child behavior to a place of curiosity around these behaviors. Lastly, the third
finding presented in this chapter was that after having completed the Bridge TIC training
program, ECEs reported using several TIC strategies with the children in their care. Viewed
holistically, the findings are aligned with the process of change described in the TTM, which is
at the center of the conceptual framework that guides this study. Chapter Five will now provide
a discussion on these findings as well as the limitations of this study, the implications for
practice and the recommendations for future research related to TIC trainings for early childhood
workforces.

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 88

Chapter Five: Discussion of Findings
The purpose of this study was to understand the self-reported impact of the Bridge TIC
training program on the attitudes, beliefs and practices of ECE professionals in Los Angeles
County. Up until this time, there has been a lack of research on the impact of TIC training
programs for ECE professionals; the Los Angeles County Bridge TIC Program provided an
opportunity to assess these local training efforts. The significance of this study is that, with a
potential reach of impacting over 30,000 ECEs in Los Angeles County alone, formatively
assessing for the effectiveness of the Los Angeles County Bridge TIC Program allows for
meaningful program improvements which can enhance the overall efficacy of the program to
create a trauma-informed ECE workforce ("Progress and Potential: A snapshot of Los Angeles
County in California's Early Care and Education Workforce Registry, 2018 Report", 2018).
Enhancing the ability of this profession to respond appropriately to children that exhibit
challenging behavior also has the potential to lower the rates by which children are being
expelled from early education settings, curbing the cascade of negative consequences
experienced by these children explained by such phenomenon as the school-to-prison pipeline
(McCarter, 2017; Wolf & Kupchik, 2016). Additionally, this study may provide insight into
similar TIC training programs in ECE settings, which have become popular initiatives across the
United States (Bartlett et al., 2015; Conners-Burrow et al., 2013; Donisch, Bray, & Gewirtz,
2015; Jankowski, Schifferdecker, Butcher, Foster-Johnson, & Barnett, 2019; Kerns et al., 2015;
Kramer, Sigel, Conners-Burrow, Savary, & Tempel, 2013).
In order to gain an understanding of the self-reported impact of the Bridge TIC training
on ECE professionals, a conceptual framework rooted in critical trauma theories and the
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 89

Transtheoretical Model of Change was utilized. Stemming from this theoretical base, the
following research questions guided this inquiry:
1) How do ECEs perceive changes in their attitudes and beliefs as they relate to how trauma
impacts a child’s behavior after having completed the Bridge TIC Training Program?
a) How do ECEs perceive changes in the attributions they place on challenging child
behavior after having completed the Bridge TIC Training Program?
2) How do ECEs perceive changes in their practices with the children in their care,
displaying challenging behavior, after having participated in the Bridge TIC Training
Program?
To answer these research questions, a qualitative approach to research was applied in
combination with formative evaluation methodologies. Participants in this study were 15 ECEs
local to Los Angeles County that had completed all six modules of the Bridge TIC training
curriculum in the six months before participating in this research study. Data was collected via
ECE participation in focus group discussions.
Discussion of Findings
After thorough data analysis, the research questions in this study are answered through
the three key findings previously presented in Chapter Four. The first finding revealed that, after
having completed the Bridge TIC training program, ECEs reported a new understanding of
trauma and a belief that others would benefit from TIC training. The second finding was that
ECEs moved from assigning specific attributions to challenging child behavior to a place of
curiosity regarding the cause of the behavior. Additionally, it was found that ECEs now
included trauma as a possible cause of challenging child behavior. The final finding was that
after completing the Bridge TIC training program, ECEs reported using TIC strategies with the
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 90

children in their care, which they did not mention using previously. A complete discussion of
these findings will now be undertaken.
Finding 1: ECEs Move from No/Limited Understanding to a New Understanding of
Childhood Trauma and a Belief that Others Benefit from TIC Training
A majority of those interviewed reported that their initial understanding of childhood
trauma was either no understanding or a limited understanding, which is aligned with current
literature citing a need for more professional development on these topics for the ECE field
(Elevating the voices of children: The state of early care and education in Los Angeles County,
2017; Whitebook et al., 2018). The new understandings of trauma by ECEs included several key
insights, including
(1) trauma does, in fact, impact a child;
(2) trauma can be a result of various experiences for a child and is not relegated to
instances of abuse and neglect; and
(3) traumatic experiences can cause children to display challenging behaviors.
Interestingly enough, the first critical insight, namely that trauma does impact a child, directly
contradicts a previously noted, pre-existing, societal belief that children are immune to the
effects of trauma (Buss, Warren, & Horton, 2015). Taken holistically, the new insights gained
from the Bridge TIC training resulted in attitudinal shifts for many of the study's participants, as
ECEs made statements that reflected a change in attitude toward a child displaying challenging
behavior. Based on participant responses, attitudes shifted from places of less compassion and
resistance to working with a child to a place of more compassion and a willingness to work with
a child displaying challenging behavior. These changes in ECEs are aligned with the process of
change described by the Transtheoretical Model of Change (TTM) in the early stages of the
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 91

model - the pre-contemplation and contemplation stages. For example, in the pre-contemplation
stage, an individual is moving from a place of no awareness to awareness. This new awareness
leads an individual to the contemplation stage, where they begin to question and think more
critically about the new information they possess and the implications of that new knowledge.
This critical awareness can lead to additional changes in attitudes and beliefs, as was seen with
the participants in this study (Corden & Somerton, 2004a; Krebs, Norcross, Nicholson, &
Prochaska, 2018). The fact that changes are beginning to occur in these early stages and across
the domains of attitudes and beliefs is a positive indication of efficacy for the Bridge TIC
program.
Finding 2: ECEs Move from Assigning Specific Attributions to Being Curious About Child
Behavior
Another specific indication of changes in attitudes and beliefs is that ECE reported
changes in attributions about children displaying challenging behavior. As noted in Chapter
Two, educator attributions are especially important to understand as they impact the way
educators respond to the children with whom they work (Kulinna, 2007; Medway et al., 1979;
Wang & Hall, 2018). Based on the findings presented in Chapter Four, the initial ECE
attribution that placed the cause of challenging child behavior on negative child dispositions is
aligned with existing literature regarding adult responses when an understanding of
developmental trauma is lacking (McNeill, Friedman, & Chavez, 2015; van der Kolk, 2005;
Wiest-Stevenson & Lee, 2016). Disposition is generally understood to be a fixed trait and,
therefore, a negative child disposition can be experienced as demotivating for ECEs as the ability
to change the challenging behavior is perceived as being out of their control (Johansen, Little &
Akin-Little, 2011). Additionally, it was also found that ECEs in this study attributed challenging
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 92

behavior to poor parenting - another attribution that has been found in the literature to lead
educators to believe that improving child behavior is out of their control. When educators hold
the belief that improving child behavior is out of their control, they become less motivated to
utilize strategies that will help the child change their behavior (Johansen, Little & Akin-Little,
2011). Fortunately, the data presented in the previous chapter indicates a shift away from these
attributions for study participants towards a more curious stance that prompted ECEs first to
question the cause of the behavior, and then identify an appropriate response for a child
displaying challenging behavior.
As attributions are specific kinds of beliefs that impact an individual's motivation to act,
the shift in attributions that was seen by ECEs in this study is also a positive indication that
participants are moving across the stages of change. Rather than attributing challenging child
behavior to a specific cause, such as developmental delays, poor parenting, or negative child
dispositions, ECEs in this study are now able to attribute challenging behavior to a possibly
traumatic experience by asking the question, "What happened to this child?". This shift in
attribution is essential because, in combination with the new knowledge, strategies and resources
provided by the TIC training program, ECEs in this study have also become aware of the things
they can do to support children displaying challenging behavior. According to attribution theory,
this change in attribution where educators now understand that although the behavior is
happening externally, it is changeable and there are effective strategies that they can control the
use of to improve the situation, ECEs should also experience an increase in their motivation to
act and support a child displaying challenging behavior (Grieve, 2009; Johansen, Little, & Akin-
Little, 2011; Wang & Hull, 2018, Weiner, 2010). Based on statements shared by ECEs, it is
evident that these changes in attributions are also moving them from the contemplation stage in
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 93

the TTM, where ECEs are thinking about the child's behavior, to the preparation stage, where
ECEs are beginning to think about the individualized response needed by a specific child
(Corden & Somerton, 2004a; Krebs, Norcross, Nicholson, & Prochaska, 2018). Many ECEs
reported asking questions such as, “Where is this behavior coming from?”, which is preparing
them to identify and utilize an appropriate TIC strategy for the child displaying challenging
behavior.
Finding 3: ECEs Report Using TIC Strategies with Children in Their Care After Training
In line with the TTM, after an individual goes through the stages of pre-contemplation,
contemplation, and preparation, they can reasonably be assumed to be moving to the action
phase where, in addition to changes in attitudes and beliefs, individual behaviors also begin to
change (Corden & Somerton, 2004a; Krebs, Norcross, Nicholson, & Prochaska, 2018).
According to ECEs responses, after completing the Bridge TIC training, ECEs were able to
implement a variety of different TIC strategies that were covered in the training curriculum.
This reported finding speaks directly to the efficacy of the Bridge TIC training program as the
end goal of any training is behavior change. This finding demonstrates that not only was the
Bridge TIC training effective in shifting attitudes and beliefs, but it is also showing early signs of
changing participant behaviors with the children in their care as well.
Limitations
A limitation of this research study was the inability to include a true pre-measurement of
ECEs attitudes, beliefs and practices before the ECEs in this study completed the Bridge TIC
training program. If focus groups or individual interviews could have been completed with
participants before they received TIC training, a more reliable understanding of the impact of the
Bridge TIC program could have been rendered. As the study was conducted, an analysis of the
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 94

program impact has been understood through the retrospective recollection of ECEs describing
their initial attitudes, beliefs and practices compared to their attitudes and beliefs after
completing the training.
Additionally, another limitation of this study is that not all ECEs who completed the
Bridge training by the time this research took place participated in this study. The lack of
participation could have been for several reasons, one of which being that the ECEs who chose
not to participate did not have a favorable experience with the Bridge TIC training curriculum
and were, therefore, unmotivated to participate in this study. In this scenario, only those ECEs
that had a pleasing experience, to begin with, would have participated in this study. For this
reason, the findings in this study are not representative of all ECEs in LA County that have
completed the Bridge TIC training program.
Lastly, a final limitation of this study is that the population used is not a representative
sample of all ECEs in LA County. Not all ECEs actively participate in programming provided
by a local R&R agency. Therefore, there may be an important variable that enables some ECEs
to access R&R resources more frequently than ECEs in LA County who do not actively utilize
the R&R system. A representative sample of ECEs in LA County would include both ECEs that
regularly utilize R&R resources and those that do not.
Implications for Practice
As a result of the study's findings, there are four implications for practice that will now be
reviewed. The first implication for practice is that incorporating pre-existing ECE attributions
around challenging child behavior can be a critical addition to TIC curriculums in early care and
education settings. A second implication for practice is to intentionally include when to apply
specific TIC strategies, as some strategies are intended to be used only after other lower-level
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 95

strategies are attempted first. A third implication for practice is that continuously emphasizing
the TIC "catchphrase," which states, "Rather than asking, 'What's wrong with you, ask what
happened to you," appears to have a prominent effect on ECE attitudes and beliefs. Lastly, a
final implication for practice is that curriculums should be created with some measurement of
efficacy in mind. These implications for practice will now be discussed in greater detail.
Incorporating Pre-existing ECE Attributions into Future Training Efforts
The second finding of this research study sheds light on pre-existing attributions that
were prevalent for the ECEs participating in this study. Identifying these attributions for
participants before the start of the training series would be beneficial as it would allow
curriculum designers and trainers the opportunity to address any unsubstantiated attributions
directly when presenting the trauma-informed information and best practices to early childhood
workforces. Due to the critical role that attributions play in educator motivations and
subsequently, educator behaviors, intentionally including either audience attributions, or popular
ECE attributions generally, into training efforts can itself be an enlightening, consciousness-
raising experience that leads to a change of praxis (Corden & Somerton, 2004; Johansen, Little
& Akin-Little, 2011; Krebs, Norcross, Nicholson, & Prochaska, 2018).
Additionally, discussing attributions in terms of the "fundamental attribution error" which
explains people's general propensity to attribute behavior to dispositional characteristics rather
than circumstances surrounding a phenomenon that are outside an individual's control, may be a
topic worth addressing specifically in the training curricula (Hooper, Erdogan, Keen, Lawton, &
McHugh, 2015). An understanding of the fundamental attribution error and the ways it can
impact educator behavior opens the door for ECEs to reflect on their own biases - a practice that
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 96

is aligned with 'reflective practice,' which is discussed in Module 6 of the current Bridge TIC
training curriculum.
Teaching ECEs When to Utilize Specific TIC Strategies
Three ECEs shared responses where, upon reflection, they stated that after having
completed the Bridge TIC training, they would change their previous behavior and not refer a
child to outside services (such as the Regional Center) as a first response to a child displaying
challenging behavior. This response is interesting because, as previously noted, referring a child
that needs specialized services to an external support system is aligned with a TIC approach in
early care and education settings. The nuance, however, is that a complete understanding of TIC
in ECE settings incorporates an understanding of when to refer a child to these services
appropriately. For example, a trauma-informed approach by an ECE would be the following: the
ECE sees a child displaying challenging behavior, they understand that this behavior may be due
to the child exhibiting a stress response; as a result, the first action taken is for the ECE to
intentionally observe the child to identify any possible environmental triggers that are
dysregulating the child. A response that would not be characterized as trauma-informed would
be for this same provider to automatically assume there is an elevated need that the ECE cannot
meet and refer the child to outside services, without first employing other strategies that might
regulate the child's behavior. Incorporating this nuanced information into a TIC training
program for early care and education settings can help to provide a more comprehensive
understanding of how and when to incorporate various TIC strategies.
The Importance of Emphasizing the TIC “Catchphrase”
As previously mentioned, there is a widespread TIC "catchphrase" that highlights the
shift in perspective from an older way of thinking about child behavior from a deficit point of
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 97

view, to a perspective that incorporates a critical approach to trauma and views behavior as a
result of a child's past experiences. In the Bridge TIC training curriculum that was studied, this
catchphrase was included in every module to allow for ongoing reflection and discussion around
the idea that TIC means being curious and asking an individual, "What happened to you?",
instead of asking, "What's wrong with you?". Broken down even further, this catchphrase
embodies the notion that children are communicating something with their behavior that cannot
be verbalized and that it is the responsibility of a caregiver to do their best to understand and
respond to this need by getting curious. Given the fact that many study participants referenced
this phrase specifically during their focus group responses, and that all participants reported
moving to a place of curiosity after having completed the TIC training, illustrates the importance
of including this catchphrase into a TIC curriculum in a meaningful way.
Measuring Curriculum Efficacy
A final implication for practice for program administrators and funders to consider is the
importance of including measurements of curriculum effectiveness into program proposals and
funding allocations. Although, for some, including measurements of program efficacy is an
automatic component for any new program or curriculum developed, this, unfortunately, is not
always the case. Oftentimes, evaluative measures for training programs are not considered at the
time of funding, which can become a challenge for program administrators once the program has
gone live. Whether additional funds are available to hire an evaluator, or program administrators
need to be creative in the ways they measure program efficacy, it is essential to consider
evaluative measures at the onset of program/curriculum design. This study illustrates one way to
begin assessing formative program efficacy with little to no funds allocated for evaluation
efforts.
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Recommendations for Research
Due to the relatively new utilization of trauma-informed strategies in the realm of early
care and education, more information is needed on the efficacy of such efforts with ECE
professionals (Bartlett et al., 2015; Conners-Burrow et al., 2013; Kerns et al., 2015; Kramer,
Sigel, Conners-Burrow, Savary, & Tempel, 2013). As a result, four recommendations for
practice will now be offered. These recommendations include
(1) research conducted with a representative sample;
(2) measuring the self-efficacy of training participants;
(3) the utilization of pre-/post- test measures with participants; and
(4) observation of participants after having completed the TIC training.
A Representative Sample
Given that the use of TIC in ECE settings is a national trend, any research into the
efficacy of TIC training programs in ECE settings should be representative of the early
childhood workforce, either nationally or regionally (Bartlett et al., 2015; Conners-Burrow et al.,
2013; Donisch, Bray, & Gewirtz, 2015; Jankowski, Schifferdecker, Butcher, Foster-Johnson, &
Barnett, 2019; Kerns et al., 2015; Kramer, Sigel, Conners-Burrow, Savary, & Tempel, 2013).
The use of a representative sample would allow findings to be generalizable across the ECE field
(Merriam & Tisdell, 2016). Generalizable findings would increase the amount of literature on
this topic that others in the early childhood workforce, working on similar efforts, can draw
from.
Measuring Self-Efficacy
Assessing for ECE self-efficacy after having completed a TIC training program is another
important indicator that ECEs may change their behavior. Self-efficacy is the belief that an
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 99

individual has about their behavior, a belief that they will be able to accomplish a given task; this
belief affects the amount of effort put forth and the length of time an individual will persist in
completing a given task (Bandura, 1982). Understanding the self-efficacy of ECE professionals
that have completed TIC training programs is beneficial information for curriculum designers
and trainers to know so that curriculums can be modified to enhance self-efficacy, if necessary.
Utilization of Pre-/Post-Tests
A third recommendation for research is the utilization of a traditional pre-/post – test
design where unique identifiers capture the growth of individual participants. A pre-/post – test
would assess for knowledge gain after each module and then again in a follow-up survey 3 – 6
months after completion of the training. Implementing this type of design would allow for an
objective, quantitative approach to understanding program efficacy that can be considered
reliable (Merriam & Tidsell, 2016).
Observation of Participants
Lastly, a final recommendation is to observe a representative sample of ECEs 3 – 6
months after they have completed the training program to assess for actual change in practice
with the children in their care. As previously noted, the ultimate purpose of a training program is
to create behavior change, not only shifts in attitudes and beliefs (Freire, 1970). By including
participant observation into the research of TIC training program efforts, an objective
determination of whether or not behavior has changed can be reached. Moreover, a second point
of observation can be included at another time interval, for example, one year after training, to
determine whether or not the curriculum was successful in creating sustained behavior change.

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 100

Conclusion
This small study is important for a number of reasons. As a macro-focused social
worker, I have had the privilege of working on several wide-reaching, collective impact, social
justice-oriented training programs, and I understand all too well the value of evaluating the
efficacy of such programs. Oftentimes, when these programs are funded, not much attention, or
resources, are given to evaluative measures that demonstrate effectiveness. This study highlights
the importance of formative evaluations for training programs that are meant to build capacity
within a given workforce and also offers some insights into how this can be conducted with
limited resources and staffing. Programs such as the Bridge Program easily have budgets rising
into the millions and this size of an investment into our communities alone underscores the
importance of program developers and administrators exercising their due diligence in ensuring
these programs are running effectively.
As a blooming educational psychologist, I understand the importance of creating
curriculums that succeed in bringing about behavior change. To build the capacity of one
person, let alone an entire workforce, requires not only the teaching of new content knowledge
and best practices, but it also requires an understanding of the impact that attitudes and beliefs
have on an individual's motivation to act. Without addressing motivational factors, curriculum
designers and program administrators alike would be ignoring an essential part of the learning
process. In a program like the Bridge TIC Program, where pre-existing attitudes and beliefs are
likely to run counter to current science and best practices, it is of the utmost importance to
acknowledge these factors and address them head-on in the hopes of facilitating behavior
change. I hope that the findings of this study will enhance that work.
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 101

By utilizing a conceptual and theoretical framework rooted in a critical approach to
trauma, this study was able to understand the changes that occur when concepts central to critical
trauma theory interact with ECEs that have completed the TIC training. The findings in this
study shed light on how new TIC information can lead to a change of attitudes and beliefs by an
ECE professional with a child in their care. Subsequently, these shifts motivated the ECEs in
this study to respond differently to children displaying challenging behavior by utilizing TIC
strategies - the most basic of which is strengthening the relationship between a caregiver and a
child. For TIC efforts in early care and education settings, in particular, the importance of
effectively building capacity within this workforce is paramount. As previously discussed in
chapter one of this study, when ECEs are ill-equipped to support children displaying challenging
behavior, these children are more likely to be expelled from early care and education settings,
beginning a trajectory that ends in the school-to-prison pipeline. This occurrence, which
disproportionately affects boys of color, is contributing to the mass incarceration of men of color,
causing even more harm to these communities (Ko et al., 2008).
It is my hope that this small study not only improves the Bridge TIC training by adopting
the recommendations above, but that it also is of some use for programs that are similar to the
Los Angeles County Bridge TIC Program. It is crucial, for all the reasons previously discussed,
that these programs continue to be evaluated and improved to ensure optimal efficacy.

CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 102

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Appendix A
Focus Group Protocol

Welcome

Hello my name is Jessica Reynaga and I will be the moderator for today’s focus group. The
purpose of this focus group is to learn about the ways you believe the TIC Bridge Training
program has impacted your attitudes and beliefs as they relate to how trauma can impact
children’s behavior. All of you have been asked to participate because you have completed all
six modules in the TIC Bridge Training program. Your opinions and experiences will help me
learn more about the impact the Bridge Training program has had on you as early childhood
educators. After this focus group, the information you shared will be categorized into themes
and topics before being utilized anonymously in my dissertation for the degree of Doctor of
Education. This focus group will be audio recorded and your personal information will not be
collected or used in connection with the results of this focus group.

I am passing around a consent form. By signing this form, you are agreeing to participate in this
focus group, and your participation in this focus group is voluntary and you may choose to end
participation in this focus group at any time. Please take a moment to read and sign the consent
form.

Before we begin, I would like to go over a few ground rules for the focus group. These are in
place to ensure that all of you feel comfortable sharing your experiences and opinions.
Ground Rules:
1. One Speaker at a Time – Only one person should speak at a time in order to make sure
that we can all hear what everyone is saying.
2. Use Respectful Language – In order to facilitate an open discussion, please avoid any
statements or words that may be offensive to other members of the group.
3. Open Discussion – This is a time for everyone to feel free to express their opinions and
viewpoints. There will be no right or wrong answers.
4. Participation is Important – It is important that everyone’s voice is shared and heard in
order to make this the most productive focus group possible. Please speak up if you have
something to add to the conversation!

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Focus Group Protocol
Semi-Structured Questions:

1. Before you took the Bridge TIC Training, what was your initial understanding of how
trauma impacts a child’s behavior?

2. Now that you have taken the TIC training, what do you understand about how trauma
impacts a child’s behavior?

3. Is there anything in the curriculum that really stood out to you? Can you describe the
impact it had on your attitudes or beliefs about children that have experienced trauma?

4. Before you took the training, if you saw a child displaying what might be considered
“challenging” behavior, what would you have thought about the child and the cause of
their behavior?
a. What would you think about this child now that you have taken the training?

5. Before you took the training, how would you have responded to this child that is showing
“challenging” behavior?
a. How would you respond to this child now?

6. Imagine another child care provider in your similar situation who has not taken this
training. If they were to see a child that was displaying what might be considered
“challenging” behavior how do you think they would react to this child?

7. Since being trained, is there anything you do now with the children in your care that you
didn’t before? Please describe.

8. Is there anything else you want to share with me about your training experience and how
it has impacted your attitudes or beliefs about children displaying dysregulated behavior?

Closing
Thank you for participating in today’s focus group! I will be sharing the information learned
from this session in my dissertation for the degree of Doctor of Education. Your opinions and
experiences will help us understand the perceived impact of the TIC Bridge training on early
childhood educators.

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Appendix B
Demographics
Please list your first name and the initial of your last name. For example, if your name is Jeremy Moore,
please write: Jeremy M.
Participant First Name, Last Initial
Please answer the following questions:
Age Before participating in the TIC Bridge Training program, my
background knowledge of trauma-informed care in early
childhood education settings was:
❒ 21 or less
❒ 22-30 ❒ Not at all familiar (never heard of trauma-informed care
before)
❒ 31-40
❒ 41-50
❒ Slightly familiar (have heard of the concept, but could not
offer a definition of trauma-informed care)
❒ 51-60
❒ Over 60
❒ Moderately familiar (have heard of the concept and could
offer a definition of trauma-informed care)
❒ Very familiar (could offer a definition of trauma-informed
care and provide examples of how to use in early childhood
education settings)

Gender
Not including the Bridge TIC Training program, how much
formal training have you received on trauma-informed care in
early childhood education settings?
❒ Male
❒ Female
❒ Non-Binary
❒ Prefer Not to Say
❒ Prefer to Self-Describe:
_________________
❒ None
❒ 1 training
❒ 2 trainings
❒ 3 trainings
❒ 4 trainings
❒ 5 or more trainings

How would you describe yourself?
Check all that apply.
How many years have you been working in the early childcare
education (child care provider) field?
❒ Native American ❒ None
❒ Asian ❒ 1 – 3 years
❒ Black/African American ❒ 4 – 6 years
❒ Hispanic/Latinx ❒ 7 – 9 years
❒ White/Caucasian ❒ 10 – 12 years
❒ Pacific Islander
❒ Other: _______________
❒ 13 – 15 years
❒ 16 years and/or more
*All information will be de-identified during the data analysis process.
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Appendix C
INFORMATION SHEET FOR EXEMPT RESEARCH

STUDY TITLE: A Paradigm Shift: Understanding the Perceived Impact of a Trauma-Informed
Training Program on the Attitudes and Beliefs of Early Childhood Educators in Los Angeles
County

PRINCIPAL INVESTIGATOR: Jessica Reynaga, MSW

FACULTY ADVISOR: Dr. Briana Hinga, PhD

You are invited to participate in a research study. Your participation is voluntary, and you can
choose to end your participation at any time. This document explains information about this
study. You should ask questions about anything that is unclear to you.

PURPOSE
The purpose of this study is to understand the perceived impact of a trauma-informed care
training program on the attitudes and beliefs of early childhood educators, or childcare providers,
in Los Angeles County. As trauma-informed care strategies in early childhood settings continue
to grow in popularity, this study seeks to gain insight into how the content of these trainings is
being perceived by early childhood educators and identify what impact if any, this training is
having on early childhood educators. You have been invited to participate in this research study
because you have completed all six TIC Bridge Training modules.

PARTICIPANT INVOLVEMENT
Research participants will first be asked to fill out a brief demographic survey and then will be
asked to participate in a 60 - 90 minute focus group with other early childhood educators that
have also completed all six modules of the TIC Bridge Training. Participants will be asked a
series of questions about their perceptions around the TIC Bridge Training. The focus group will
be audio recorded for data analysis purposes.

If you decide to take part, you will be asked to answer questions open and honestly, and to
respect the opinions of others participating in the focus group.

PAYMENT/COMPENSATION FOR PARTICIPATION
You will receive a $15 Visa gift card for your time. You do not have to answer all of the
questions in order to receive the card, however, you will be expected to participate for the entire
length of the focus group in order to receive the gift card. The card will be given to you at the
end of your participation in the focus group.

CONFIDENTIALITY
The members of the research team and the University of Southern California Institutional
Review Board (IRB) may access the data. The IRB reviews and monitors research studies to
protect the rights and welfare of research subjects.
CREATING A TRAUMA-INFORMED EARLY CHILDHOOD WORKFOR 119

When the results of the research are published or discussed in conferences, no identifiable
information will be used.

Audio recordings will be saved on a password protected device and will be transferred to a
password protected hard drive. Audio recordings will go through a process of transcription via a
third-party transcription service that utilizes encryption software and secure servers – no one
other than the transcribers and the researcher will have access to audio files. During the
transcription process, all identifying information, such as names, will be changed to ensure the
de-identification of participants. Survey data will also be de-identified during the data analysis
process. Transcriptions and all survey data will be kept on a password protected hard drive.
After three years, all data files will be destroyed.

Due to the nature of focus groups, your confidentiality cannot be guaranteed. However, in order
to maintain the confidentiality of the group, you are asked not to discuss the content of the group
with anyone not in the group, or to discuss who participated in the focus group.

INVESTIGATOR CONTACT INFORMATION
If you have any questions about this study, please contact Jessica Reynaga, Principal
Investigator, at jreynaga@usc.edu; (323)-717-7826 or Briana Hinga, Faculty Advisor, at
hinga@rossier.usc.edu.

IRB CONTACT INFORMATION
If you have any questions about your rights as a research participant, please contact the
University of Southern California Institutional Review Board at (323) 442-0114 or email
irb@usc.edu.

Abstract (if available)

Abstract Utilizing a critical approach to trauma, coupled with a theoretical framework supported by the Transtheoretical Model of Change, this study aims to understand the self-reported impact of a trauma-informed training program on early childhood educators (ECEs) in Los Angeles County. The purpose of this study was to gain insight into the perceived changes in attitudes and beliefs, attributions and practices of ECEs after having completed a trauma-informed care (TIC) training program. Three focus groups of ECEs that completed the TIC training were convened to provide insight into these research questions. A qualitative approach to inquiry, grounded in a formative evaluation framework, was utilized to collect and analyze data in this study. A combination of ATLAS.ti software and manual coding techniques were used to code, organize and synthesize the data collected. Findings from this study indicate that training participants gained new understandings of childhood trauma, became more curious about the cause of challenging behaviors, and began using TIC strategies after completing the training. This study provides insight into the early change experiences of ECEs that have undergone a TIC training program and begins to highlight effective components of a TIC training curriculum.

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University of Southern California Dissertations and Theses

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Asset Metadata

Creator Reynaga, Jessica (author)

Core Title Creating a trauma-informed early childhood workforce in Los Angeles County: understanding the self-reported impact of a TIC training program

School Rossier School of Education

Degree Doctor of Education

Degree Program Education (Leadership)

Publication Date 08/01/2020

Defense Date 05/14/2020

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag critical trauma theory,developmental trauma disorder,dysregulated child behavior,early childhood educator,OAI-PMH Harvest,trauma,trauma-informed care

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Hinga, Briana (committee chair), Patall, Erika (committee member), Smith-Maddox, Renee (committee member)

Creator Email jessreynaga@gmail.com,jreynaga@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c89-355270

Unique identifier UC11663397

Identifier etd-ReynagaJes-8840.pdf (filename),usctheses-c89-355270 (legacy record id)

Legacy Identifier etd-ReynagaJes-8840.pdf

Dmrecord 355270

Document Type Dissertation

Rights Reynaga, Jessica

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA