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\title{TCI Flash Cards (Seventh Edition)}
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\relax  The TCI System helps Organizations  &  Prevent Crises. De-escalate potential crises, Manage acute Physical behavior, Reduce potential and actual injury to children and staff, Teach children adaptive coping skills, Develop a learning organization.   \\
\relax  Developmental Relationships  &  are characterized by attachment, reciprocity, progressive complexity, and balance of power.   \\
\relax  Theory of Change  &  Identifies roles and tasks as well as desired practice at all levels of the organization that, when implemented create a consistent approach to crisis prevention and management in a nurturing, safe, and predictable environment.   \\
\relax  What are the six domains in TCI?  &  1. Leadership and program support\forcelinebreak 2. Child and family inclusions\forcelinebreak 3. Clinical participation\forcelinebreak 4. Supervision and post-crisis response,\forcelinebreak 5. Training and competency standards, and\forcelinebreak 6. Documentation, incident monitoring, and feedback   \\
\relax  What are the six modules of TCI?  &  1. Crisis Prevention: Creating a Safe Place for Learning\forcelinebreak 2. Crisis as Opportunity\forcelinebreak 3. De-Escalating the Crisis\forcelinebreak 4. Managing the Crisis\forcelinebreak 5. Recovery\forcelinebreak 6. Safety Interventions   \\
\relax  A Trauma-informed organization  &  Supports trauma-informed care through:\forcelinebreak Policies\forcelinebreak Procedures\forcelinebreak Practices   \\
\relax  A Trauma -Informed Organization Ensures that Staff  &  Understand- Understand what trauma is and how it impacts everyone in the system.\forcelinebreak Recognize- Recognize behaviors and patterns that reflect past and present trauma.\forcelinebreak Respond- Respond in ways that avoid re-traumatization   \\
\relax  Developmental Relationships are characterized by  &  Attachment\forcelinebreak Reciprocity\forcelinebreak Progressive Complexity\forcelinebreak Balance of Power   \\
\relax  What is the definition of Crisis?  &  Is an upset in a steady or normal state.   \\
\relax  Reactive Aggression  &  When there is a loss of ability to regulate emotions and emotions instead of reason drive the child's actions.   \\
\relax  Proactive Aggression  &  Is planned and is used to obtain something; reason and the thinking brain dominate not emotions.   \\
\relax  What is the fight, flight, or Freeze response   &  It is the stress response   \\
\relax  What can trigger a stress response?  &  A smell, thought, or perceived danger   \\
\relax  What is the Therapeutic Milieu?  &  The combinations of people, emotions, attitude, and objects that create a sense of safety, respect, belonging, care, and accountability.   \\
\relax  What are the spaces in the Therapeutic Milieu  &  Ideological, Physical, Cultural, Social, Emotional   \\
\relax  What are setting conditions?  &  Anything that makes challenging behavior or traumatic stress responses make or less likely to occur.   \\
\relax  Ideological Space  &  1. Communicates a philosophy of care\forcelinebreak 2. Supports developmentally appropriate practice.\forcelinebreak 3. Provides opportunities for children to participate successfully in activities.\forcelinebreak 4. Involves children, families, and staff members in decisions making.\forcelinebreak 5. Encourages relationship building activities.\forcelinebreak 6. Creates a learning organization.   \\
\relax  Physical Space  &  1. Makes good use of space for personal and public use.\forcelinebreak 2. Is clean, orderly, inviting.\forcelinebreak 3. Feels safe and nurturing.\forcelinebreak 4. Has soft lighting and reasonable calm noise level.\forcelinebreak 5. Is furnished and decorated appropriately for the age group living there.   \\
\relax  Cultural Space  &  1. Develops culturally competence staff\forcelinebreak 2. Accepts and celebrates cultural difference\forcelinebreak 3. Supports family connections and involvement.\forcelinebreak 4. Allows for culturally diverse staff child interactions.   \\
\relax  Social Space  &  1. Values attachments and developmental relationships.\forcelinebreak 2. Balances structure and flexibility to meet individual and group needs.\forcelinebreak 3. Creates opportunities to participate and contribute.\forcelinebreak 4. Has goals, structure, and is designed to help children develop skills.\forcelinebreak 5. Allows for practice of important life skills.   \\
\relax  Emotional Space  &  1. Taken into consideration specific effects of trauma\forcelinebreak 2. Facilitates an atmosphere of safety and acceptance\forcelinebreak 3. Encourages warm and response relationships\forcelinebreak 4. Requires emotionally competent staff\forcelinebreak 5. Allows for development of co regulation and self regulations skills.   \\
\relax  4 Foundations for intentional Use of Self  &  1. Self awareness\forcelinebreak 2. Self Regulation\forcelinebreak 3. Relationship skills and attunement\forcelinebreak 4. Self Care   \\
\relax  Self Awareness  &  1. Knowing our own attitudes, values, and beliefs about children and how they influence our behaviors\forcelinebreak 2. Understanding our own cultural values, fears, and beliefs.\forcelinebreak 3. Understanding how our previous life experiences can influence current behaviors\forcelinebreak 4. Knowing our beliefs about trauma and pain-based behavior   \\
\relax  Self Regulations  &   • Ability to consciously focus attention\forcelinebreak  • Awareness of our own physical and emotional state\forcelinebreak  • Skills to marriage our own emotions and behaviors.\forcelinebreak  • Ability to draw on memory and experience to adapt effectively in the present situation.   \\
\relax  Relationship Skills and Attunement  &  To build developmental relationships, adults need to:\forcelinebreak  • Listen and engage the child\forcelinebreak  • "Tune in" to what the child is saying and feeling\forcelinebreak  • Be aware oftheir own feelings\forcelinebreak  • Respond to the child\forcelinebreak  • Be attuned to how the child is experiencing adults.   \\
\relax  Self-Care  &   • Monitor personal levels of stress\forcelinebreak  • Maintain a healthy lifestyle\forcelinebreak  • Use reflective supervision   \\
\relax  Knowing The Child  &  to help them therapeutically to a child, you need to have a understanding of what is driving the child's emotions and behaviors.   \\
\relax  The Truine Brain Model  &  Pail McLean described three basic brain processing regions. The Survival Brain, The Emotional Brain, The Thinking Brain.   \\
\relax  The Survival Brain  &  Also known as the reptilian brain. It is responsible for survival functions like breathing, heart rate, circulations and most bodily functions that don't require conscious thought.   \\
\relax  The Emotional Brain  &  Also called the limbic system and is for center emotions, emotional behavior, and motivation. This is also amygdala is and is also known as the sentry. Amygdala plays the role to help determine whether or not something is a threat.   \\
\relax  The Thinking Brain  &  This is the neocortex and is responsible for higher functions like reasoning, language, creativity and abstract thought. Children with trauma often perceive things differently or sense danger even when there is not. They struggle with emotional regulation.   \\
\relax  Assessing Behavior  &   • All behavior has meaning\forcelinebreak  • Behavior reflects emotions and needs\forcelinebreak  • Trauma affects children's ability to manage feeling and behaviors.   \\
\relax  A Crisis Occurs When:  &  A child's flight, fight, and freeze response is activated and they are unable to regulate their emotions and behaviors.   \\
\relax  Goals of Crisis Intervention  &  1. Support: provide immediate emotional and environmental support to support to reduce and risk and increase child's sense of safety\forcelinebreak 2. Teach: Help children learn and practice ways to regulate their emotions and behaviors   \\
\relax  Trauma Driven Perception  &  Potential Danger\forcelinebreak Emotional Brain\forcelinebreak Survival Brain\forcelinebreak Panic   \\
\relax  Rational Perception  &  Potential Danger\forcelinebreak Emotional Brain\forcelinebreak Thinking Brian\forcelinebreak Two outcomes "No Danger" "Panic"   \\
\relax  Stress Model of Crisis  &  Baseline\forcelinebreak Triggering Event\forcelinebreak Escalation\forcelinebreak Outburst\forcelinebreak Recovery   \\
\relax  Baseline Behavior  &  Every child has a normal state of functioning and arousal level that is specific to that child.   \\
\relax  Triggering Event  &  Children who are already struggling and have experience high levels of stress as they attempt to cope with everyday challenges are more likely to react negatively or emotionally to frustration or to a challenging situation than those who are not already stressed. The aroused state or increased stress can be caused by different types of setting conditions.   \\
\relax  Escalation phase  &  During this phase the child becomes more and more upset or agitated and less able to manage their emotions as the amygdala sends the danger message to the survival brain and this takes over.   \\
\relax  Outburst Phase  &  During the outburst phase, the child is in survival mode and may explode in a manner that could be dangerous to themselves and others.   \\
\relax  Setting Conditions  &  Anything that makes challenging behavior more or less likely to occur   \\
\relax  Setting Conditions that make pain based behavior to occur:  &   • Physiological Stress\forcelinebreak  • Psychological Stress\forcelinebreak  • Use of drugs or alcohol\forcelinebreak  • Biological or neurological conditions\forcelinebreak  • External pressures such as having a paper due, being unable to understand instructions, or not being able to spend more time at home.   \\
\relax  Recovery Phase Outcome  &  Higher\forcelinebreak No Change\forcelinebreak Lower   \\
\relax  Higher  &  In this outcome the child is damage by the crisis by the way it was handled or ignored.   \\
\relax  No Change  &  In this outcome, the crisis is handled, no one was injured, and every thing went back to "normal". The immediate goal ofcrisis intervention was achieved by reducing the stress and risk of the situation. There was nothing learned by the staff or child.   \\
\relax  Higher Outcome  &  In this outcome, an intervention occurred in a therapeutic manner. The child is supported by the adult and the adult and child have an opportunity to reflect on the incident. There is growth and repair.   \\
\relax  Assessing a Crisis Situation  &  Accurately assessing a potential crisis situation and choosing strategies that will provide the emotional and environmental support the child needs to navigate through the event.   \\
\relax  4 Questions We ask Ourselves in a Crisis Situation  &  1. What am I feeling now?\forcelinebreak 2. What does this child feel, need, expect, or want?\forcelinebreak 3. How is the environment affecting the situation?\forcelinebreak 4. How do I best respond?   \\
\relax  What am I feeling now? How do I want the child to Experience Me in this moment?  &  Adults who are skilled at "use of self" understand themselves, can read the impact they are having on the children, and respond in a way that supports the child's effort to get through the difficult situation, or try something new.   \\
\relax  How does this child feel, need, expect, or want?  &  Staff who understand how the child experience them can us that self-understanding to convey messages that help the child feel supported, safe and cared for. This will help reduce level or stress and help the young person regulate their emotions.   \\
\relax  How is the Environment Affecting the situation?  &  Emotional and Culture Space\forcelinebreak Social Space\forcelinebreak Physical Space\forcelinebreak Ideological Space   \\
\relax  How Do I Respond?  &   • Exercise self-control over feelings the situation may evoke (stay in control)\forcelinebreak  • Engage child and defuse pain-based behavior (provide emotional support)\forcelinebreak  • Manage the environment to neutralize potential triggers (provide environmental support)\forcelinebreak  • Asses impact of the response on the child and the situa-tion(Decrease level of stress)   \\
\relax  Active Listening  &  Helps children express their thoughts and feelings\forcelinebreak Reduce defensiveness and opposition\forcelinebreak Promotes Change\forcelinebreak Communicates we understand and have a desire to help Helps Children learn to self-soothe as we model ways to respond (Co-Regulation)\forcelinebreak Helps children "Talk out rather then act out"   \\
\relax  Nonverbal Techniques  &  Silence\forcelinebreak Facial Expression\forcelinebreak Eye contact\forcelinebreak Tone of Voice   \\
\relax  Encouraging and Eliciting techniques  &  Minimal Encouragement\forcelinebreak Door Openers\forcelinebreak Closed Questions\forcelinebreak Open Questions   \\
\relax  Reflective and Emphatic Response are ways?  &  Connect with the child's Feelings.\forcelinebreak Connect with the Child Experience   \\
\relax  Summarization  &  Sum up feelings and content    \\
\relax  Behavior Support Techniques  &  Redirection and Distractions\forcelinebreak Managing the Environment\forcelinebreak Prompting\forcelinebreak Proximity\forcelinebreak Direct Statements\forcelinebreak Caring Gesture\forcelinebreak Time Away\forcelinebreak Hurdle Help   \\
\relax  Redirection and Distractions  &  this helps the child or group by changing the activity, location, or request and this in turn comes or reduces the stress.   \\
\relax  Proximity  &  nearness, closeness Sometimes the presence of the adult gives the needed support to stay focused.   \\
\relax  Criteria For Using Direct Statements  &   • The Child has a trusting relationships with the adults\forcelinebreak  • The expectation is important enough to risk escalating the situation.\forcelinebreak  • The Child has the ability to meet the expectations and has demonstrated this ability in the past when they were at the same level of arousal.\forcelinebreak  • The child is still in control enough to hear and understand the statement and respond positively to the request\forcelinebreak  • The request is made respectfully and calmly.   \\
\relax  Criteria for Using Time Away  &   • The child has demonstrated an ability to self-regulate\forcelinebreak  • The child is not too highly escalated\forcelinebreak  • The child can go somewhere to relax, be quiet and think\forcelinebreak  • The purpose is to help the child quiet their emotions, not to punish   \\
\relax  Adults can be a source of strength for children by:  &   • Seeing the situations from the child's point of view (empathetic response)\forcelinebreak  • Lending enough support (emotional and environmental) to help bring the situation within the child's ability to manage.\forcelinebreak  • Celebrating the child's efforts and success   \\
\relax  Goals of Emotional First Aid  &   • Provide immediate support to reduce emotional intensity\forcelinebreak  • Identify and resolve the underlying concerns causing distress\forcelinebreak  • Keep the child in the activity   \\
\relax  Strategies for Emotional First Aid  &   • Co-regulate emotions-Be a Calm presence\forcelinebreak  • Maintain the relationship and lines of communication\forcelinebreak  • Plan and anticipate-be a coach   \\
\relax  Pain Based Behaviors  &  Is an expression of the emotional and psychological pain children experience.   \\
\relax  Pain-based behavior takes many self-destructive forms.  &   • When a child has a loss of control\forcelinebreak  • Reminded of a traumatic eventfConsciously or Unconsciously)\forcelinebreak  • Os afraid, feels threatened or overwhelmed.\forcelinebreak  • Frustrated or overwhelmed   \\
\relax  When a child cannot manage the emotion a trigger effect can send them?  &  Into Crisis   \\
\relax  Setting Conditions  &  that may make pain-base behavior more likely to occur.   \\
\relax  Setting conditions examples would be?  &   • Physiological stress (being tired, hungry or sick\forcelinebreak  • Physiological Stress (Trauma effects or possessing a low self concept)\forcelinebreak  • Use of drugs or alcohol\forcelinebreak  • Biological or neurological conditions (Autism, ADHD)\forcelinebreak  • External Pressures (paper due, not understanding, cant understand instructions, not getting to go home.   \\
\relax  Recovery Phase  &  Higher-\forcelinebreak No Change\forcelinebreak Lower   \\
\relax  Four Questions you ask yourself before intervening?  &  1. What ami feeling now?\forcelinebreak 2. What does this child feel, need, expect, or want?\forcelinebreak 3. How is the environment affecting the situation?\forcelinebreak 4. How do I best respond?   \\
\relax  How am I feeling?  &   • What is my self-talk and how is it affecting to my emotions.\forcelinebreak  • How is my body responding (breathless, heart rate)\forcelinebreak  • how do I want the child to experience me in this moment.\forcelinebreak  • Am I able to provide a feeling of safety and trust?\forcelinebreak  • Am I communicating concern and acceptance or irritation and frustration?\forcelinebreak  • How is my worldview influencing me?\forcelinebreak  • How is the young person experiencing my though their worldview?   \\
\relax  What does this child feel, expect, or want? How is the child experiencing me?  &   • What does the child expect from me based on their past experience?\forcelinebreak  • How is the child's worldview affecting their reactions to the situation?\forcelinebreak  • What feelings are driving the child's behavior, fear, anger, frustration? What are they expressing?\forcelinebreak  • What is the child's ability to regulate their emotions?\forcelinebreak  • How is the child experiencing me? Am I am source of strength, and support or stress?\forcelinebreak  • How mightthe child's trauma background and memories be influencing their perceptions?   \\
\relax  How is the environment Affecting the situation?  &  Emotional and Cultural Space\forcelinebreak Social Space\forcelinebreak Physical Space\forcelinebreak Ideological Space\forcelinebreak  • What combination of setting conditions are making a potential trigger to pain-based behavior more likely?\forcelinebreak  • How is the organizational culture and climate impacting the child's behavior and my thinking?\forcelinebreak  • What is the atmosphere and is it contributing to the stress of the child, the group or myself?\forcelinebreak  • How is the physical environment affecting the children and staff?\forcelinebreak  • How are the expectations and activities influencing the child's anxiety level?   \\
\relax  How Do I Best Respond? How Can I use My Relationship to Comfort the Child?  &   • What do I want to Happen?\forcelinebreak  • How do I want the child to experience me and respond to me? If the child is not experiencing me the way I would like, what do 1 need to change?\forcelinebreak  • What response will most likely reduce the child's stress and arousal?\forcelinebreak  • How can I support this child through this crisis?\forcelinebreak  • How can I co-regulate with this child?   \\
\relax  How To Best Respond?  &   • Is my response increasing the stress or decreasing the stress?\forcelinebreak  • Am I in control of my own emotions and behavior?\forcelinebreak  • Am I able to co-regulate with the child?\forcelinebreak  • Can 1 recognize and reinforce the child attempt to cope?   \\
\relax  We Can Avoid or End the Power Struggle By?  &   • Listening and validating feelings\forcelinebreak  • Giving choices and the time to decide what to do next.\forcelinebreak  • Managers the environment (removing overs)\forcelinebreak  • Dropping or changing the expectation   \\
\relax  Nonverbal Messaging  &   • Eye Contact\forcelinebreak  • Body Language\forcelinebreak  • Personal Space\forcelinebreak  • Height and Gender\forcelinebreak  • Sensitivity to Cultural Issues   \\
\relax  Non-Verbal Crisis co-regulation "help me help myself" strategies  &  take a deep breath and exhale slowly\forcelinebreak give the child space and time\forcelinebreak use silence\forcelinebreak if safe, step out of the child's sight\forcelinebreak assume a neutral stance and concerned facial expression   \\
\relax  Elements of a Potentially Violent Situation  &   • The Spark\forcelinebreak  • The Target\forcelinebreak  • The Weapon\forcelinebreak  • Level of stress or motivation   \\
\relax  Remove the Spark By  &   • Never touching an angry and potentially violent child\forcelinebreak  • Avoiding any aggressive moves and provocation statements.\forcelinebreak  • Avoiding the power struggle and counter aggression.\forcelinebreak  • Removing others who might spark the violence.\forcelinebreak  • Body language is critical.   \\
\relax  Remove the Target  &   • Asking the targeted person to leave\forcelinebreak  • If it's you, reminding the child of your relationship or leaving the situation and asking a "neutral" staff to manage the incident.\forcelinebreak  • The target may shift during the episode.   \\
\relax  Avoid the Weapon By  &   • Discreetly removing objects\forcelinebreak  • Maneuvering away from weapons\forcelinebreak  • Staying a safe distance away.   \\
\relax  Decrease the Level of Stress or Motivation By  &   • Using your relationship (Intentional use of self)\forcelinebreak  • Actively listening to identify feelings (reflective responses) and communicate understanding (empathetic responses)\forcelinebreak  • Removing the audience\forcelinebreak  • Using co-regulation strategies (reactive aggression)\forcelinebreak  • Removing the audience\forcelinebreak  • Using co-regulations strategies (reactive aggression) -Offering alternative, non aggressive ways to achieve goals (if motivation)   \\
\relax  Objective of Crisis Co-Regulation  &   • To provide support in a way the reduces stress and risk and increase the child's sense of safety.   \\
\relax  What to think (Seif-Talk)  &   • Ask yourself the four questions\forcelinebreak  • Use positive self-talk   \\
\relax  What to Say (verbal strategies)  &   • Say very little\forcelinebreak  • Speak calmly, assertively, respectfully\forcelinebreak  • Understanding responses\forcelinebreak  • Remember the importance of tone of voice.   \\
\relax  What to Do (When it is over)  &   • It's over when\forcelinebreak  • Prepare to discuss the situation in a LSI   \\
\relax  Effective TCI Implementation Includes  &  1. Immediate Response (Is everything ok?)\forcelinebreak 2. LSI with the Child (how can the young person recover at a higher level?\forcelinebreak 3. Documentation (What happened?)\forcelinebreak 4. Incident Review with Staff (What have I learned from this?)\forcelinebreak 5. Incident Review with Team (how can we all learn from this?)   \\
\relax  The Life Space Interview  &  A verbal process that helps turn crisis events into learning experiences.   \\
\relax  Goals of Life Space Interview  &   • Provide a sense of emotional safety\forcelinebreak  • Help clarify events for the events for the child and adult\forcelinebreak  • Repair and restore the relationship between the adult and child\forcelinebreak  • Help the child learn to regulate emotions\forcelinebreak  • Re-enter the child back into the routine   \\
\relax  Steps to The LSI  &  I- Identify a place and time to talk\forcelinebreak E- Explore child's point of view\forcelinebreak S- Summarize feelings and content\forcelinebreak C- Connect trigger to feelings to behavior\forcelinebreak A-Alternative responses to feelings discussed\forcelinebreak P- Plan developed\Slash{}Practice\forcelinebreak E-Enter child back into routine   \\
\relax  Potential Pain-Based Responses During the LSI  &  Child does not respond\forcelinebreak  • Convey calm support and affirm silence\forcelinebreak  • Ask a focused question\forcelinebreak  • Reschedule LSI\forcelinebreak Child gets off subject\forcelinebreak  • Allow exploration and relate it to incident\forcelinebreak  • Focus on issues at hand\forcelinebreak Adult or Child want to just "fix it"\forcelinebreak  • Don't interrupt child's thought process\forcelinebreak  • Don't develop the plan for the child   \\
\relax  Options to Handle Physical Violence  &  Element- Element one of the elements of a violent situation\forcelinebreak Release- Use releases and maintain a safe distance with a protective stance\forcelinebreak Restrain- Employ physical restraint techniques(If indicated on the Individual Crisis support Plan)\forcelinebreak Leave- Leave the situation and get assistance   \\
\relax  Goals of Physical Intervention  &  To reduce risk   \\
\relax  Goals of Crisis intervention  &  Support provide immediate emotional and environmental support to reduce stress and risk and increase the child's sense of safety.\forcelinebreak Teach: Help Children learn and practice ways to regulate their emotions and behaviors.   \\
\relax  Definition of Physical Restraint  &  Physical Restraint-The use of trained and competent staff members to hold a child in order to contain acute physical behavior   \\
\relax  Physical Restraint Should Only Be Used When:  &  Acute physical behavior- Behavior likely to result in physical injury\forcelinebreak (All three criteria must be met)\forcelinebreak 1. Agency policies state regulations regarding restraint allow it.\forcelinebreak 2. The child's individual crisis support plan prescribes it.\forcelinebreak 3. Our professional dynamic risk assessment indicates it.   \\
\relax  Physical Restraint is NOT used to:  &  Demonstrate Authority\forcelinebreak Enforce Compliance\forcelinebreak Inflict Pain or Harm\forcelinebreak Punish or Discipline   \\
\relax  Basic Principles of Physical Intervention  &  A maximum amount of care with a minimum amount of force and the goal of de-escalating the situation by reducing stimulation.   \\
\relax  Caveat  &   • Participate only if physical and medically able ‘Offer no resistance in the role of the childfunless the trainers instruct you otherwise)\forcelinebreak  • Remove objects that might cause injury\forcelinebreak  • Be appropriately dressed\forcelinebreak  • Practice only the techniques demonstrated   \\
\relax  Personal Consideration and Decision Making  &  What do you think and feel about the possibility of making the decision to use a high-risk intervention?\forcelinebreak What are the possible emotional impacts of the restraint?   \\
\relax  Duty of care  &   • Always act in the best intentions of individuals and others.\forcelinebreak  • Not act or fail to act in a way that results in harm.\forcelinebreak  • Act within one's own competence.\forcelinebreak  • Not take on anything one does not believe they can do safely.   \\
\relax  Duty of Candor  &   • Tell the child and family when something has gone wrong.\forcelinebreak  • Apologize to the child and family.\forcelinebreak  • Offer an appropriate remedy or support to put matters right if possible.\forcelinebreak  • Explain fully to the child and family the short and long term effects of what has happened.   \\
\relax  Making High-Consequence Decisions  &  What skills will you need to make the high-consequence decision to apply a restraint?\forcelinebreak What organizational support and structures need to be in a place for you to make that decisions?   \\
\relax  High- Consequence Decisions Require  &   • Training and competence\forcelinebreak  • Dynamic risk assessment skills\forcelinebreak  • Knowledge of child's medical condition and trauma history\forcelinebreak  • Informed consent\forcelinebreak  • Safety plans and ICSP's\forcelinebreak  • Staff and team debriefing\forcelinebreak  • LSI's between child and staff\forcelinebreak  • Organizational monitoring   \\
\relax  The Letting Go Process  &  States what is expected of the young person\forcelinebreak Is directed by the team leader\forcelinebreak Is supportive of the young person\forcelinebreak Sets the tine for recovery phase   \\
\relax  Restraint should be Avoided or Discontinued When:  &   • Adults cannot control the child safely.\forcelinebreak  • Adult is not in control-too angry\forcelinebreak  • Child is threatening and is cable of harming staff.\forcelinebreak  • Sexual stimulation is the motivation.\forcelinebreak  • It is a public place\forcelinebreak  • Child has a weapon\forcelinebreak  • Child's medical condition prohibits it.\forcelinebreak  • Child has emotional problems risking traumatization ‘Child is on medications that affect their system   \\
\relax  Definitions of Asphyxia  &  Asphyxia: the deprivation of oxygen to living cells\forcelinebreak Positional asphyxia: fatal respiratory arrest in which the ability to breathe is compromised by the positioning of the body in relationship to its immediate surroundings.   \\
\relax  Predisposing Risk Factors Include:  &   • Obesity\forcelinebreak  • Influence of Alcohol or drugs\forcelinebreak  • Prolonged violent physical agitation\forcelinebreak  • Underlying natural disease (Ie. enlarged heart, asthma, high blood pressure, sickle cell trait)\forcelinebreak  • Hot and humid environments\forcelinebreak  • Young person taking certain types of medication\forcelinebreak  • Effect of sever trauma history   \\
\relax  Improper Restraint Techniques  &  Pressure of neck and back\forcelinebreak Incorrect positioning of arms\forcelinebreak Obstructing the mouth or nose\forcelinebreak Abnormal positioning of the body   \\
\relax  Warning signs of Asphyxia  &   • Make sure the restraint position is correct (Child and Staff)\forcelinebreak  • Assure there is no breathing problems\forcelinebreak  • Observe and assess:   \\
\relax  What to monitor during a restaint  &   • Skin Color\forcelinebreak  • Respiration (no breathing issues)\forcelinebreak  • Level of Consciousness (if responsive)\forcelinebreak  • Level of agitation (overexertion)\forcelinebreak  • Range of motion in the extremities   \\
\relax  Recommendations to Reduce Risk of Injury or Death.   &  End the restraint immediately of there are signs of distress   \\
\relax  More Recommendations to Reduce Risk of Injury or Death.  &   • Who, what, when, where?\forcelinebreak  • What were the antecedents?\forcelinebreak  • What action did staff take to de-escalate the situation?   \\
\relax  Documentation  &  • How long did the restraint last?\forcelinebreak  • Was the ICSP followed? Why or why not?\forcelinebreak  • Staff\Slash{}child injuries? Medical attention?\forcelinebreak  • What plan was Developed in the LSI?\forcelinebreak  • When were staff debriefed?\forcelinebreak  • Was follow up needed? When was the family notified?\forcelinebreak  • Statements of witnesses should be included.   \\
\relax  Adults need to know  &   • Safety Concerns including contradictions to restraint ‘Child's triggers to a stress response\forcelinebreak  • Child's High-risk behavior\forcelinebreak  • Strategies for preventing a crisis (setting conditions) ‘Strategies for responding to reduce the child's stress in the triggering escalation, and outburst phases of the crisis.\forcelinebreak  • How to help the child recover and return to normal functioning after crisis.   \\
\relax  Individual crisis support plan (ICSP's)  &   • Include input from the young person, the family, care team, social workers, and medical professionals.\forcelinebreak  • Guide staff on effective strategies for preventing, de escalating, and intervening in potential crisis with individual children.\forcelinebreak  • Reguarly review and revise ICSP's as part of team meetings or post-crisis response.   \\
\relax  Non-verbal crisis communication we should use during a potentially violent situation?  &  Eye Contact\forcelinebreak Body Language\forcelinebreak Personal Space\forcelinebreak Height and Gender\forcelinebreak Sensitivity to cultural issues   \\
\relax  List examples of pain-based behavior  &  overreaction to situations\forcelinebreak impulsive outburst\forcelinebreak trauma re-enactment\forcelinebreak defiance\forcelinebreak inflexibility\forcelinebreak running away through anger or fear\forcelinebreak withdrawal\forcelinebreak self-injury   \\
\hline
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The Library of Unconventional Lives





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TCI Flash Cards (Seventh Edition)






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