Skip to main content
×
×
Home

Change and Recovery: Culturally Appropriate Early Childhood Programmes with Refugee Families and Communities

  • R. G. Signorelli (a1), M. Coello (a2) and S. Momartin (a3)
Abstract

The STARTTerS Early Childhood Programme at the NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS) has been developed in response to the complex refugee experiences of very young children, their families and communities. This biopsychosocial and systemic model is informed by neuroscience, attachment theory and current knowledge of the nature and impact of refugee-specific trauma on very young children and their families. It addresses the complex interactions between, social, cultural and political factors within the trauma and recovery environments, as they influence the clients’ presentations and the choice of interventions with families in cultural transition (FICT).

This paper provides a background to the STARTTerS programme, and reports on the results of a Community Based Participatory Research (CBPR) project with the Karen and Mandaean refugee communities. It explores perceptions and cultural views of signs and symptoms related to early childhood trauma. It also explores help seeking preferences in relation to the recovery, settlement and health needs of families with young children. This research has led to ongoing collaborative and consultative processes with those communities, resulting in the development of services and referral systems, which will build a comprehensive and culturally appropriate early childhood programme.

Copyright
Corresponding author
address for correspondence: R. Signorelli, STARTTS, Clinical Services - Early Childhood, PO Box 203, Fairfield, New South Wales, 2165, Australia. Phone: 02 9794 1900; Fax: 02 9794 1910. E-mail: Rosemary.Signorelli@sswahs.nsw.gov.au
References
Hide All
Abdi, R., Ahari, S. S., Amani, F., Habibzadeh, S., & Yousefi, M. (2012). Community based needs assessment in an urban area: A participatory action research project. BMC Public Health, 12, 161 Mar 7. doi: 10.1186/1471-2458-12-161.
Adamson, J., Warfa, N., & Bhui, K. (2011). A case study of organisational cultural competence in mental healthcare. BMC Health Services Research, 11, 218. doi: 10.1186/1472-6963-11-218.
Arden, J. B., & Linford, L. (2009). Brain-based therapy with children and adolescents: Evidence-based treatment for everyday practice. New Jersey: John Wiley & Sons Inc.
Armin, J., & Shaw, S. J. (2011). The ethical self-fashioning of physicians and health care systems in culturally appropriate health care. Culture, Medicine and Psychiatry, 35 (2), 236261. doi:10.1007/s11013-011-9215-1.
Arnault, D. S. (2009). Cultural determinants of help seeking: A model for research and practice in research and theory for nursing practice. An International Journal, 23 (4), 259279.
Aroche, J., & Coello, M. (1994). Towards a systematic approach for the treatment and rehabilitation of torture and trauma survivors in exile- the experience of STARTTS in Australia. Presented at 4th International conference of centres, institutions and individuals concerned with victims of organised violence. “Caring for and empowering victims of human rights violations”. DAP, Tagaytay City. Philippines. December 5–6 1994.
Azarian, A. G., Lipsitt, L. P., Miller, T. W., & Skriptchenko-Gregorian, V. G. (1999). Toddlers remember quake trauma. Chapter 23. In Williams, L. M. & Banyard, V. L. (Eds.), Trauma & Memory (pp. 299310). Thousand Oaks: Sage Publications.
Bemak, F., Chung, R. C.-Y., & Bornemann, T. H. (1996). Counseling and psychotherapy with refugees. In Pedersen, P. B., Draguns, J. G., Lonner, W. J. & Trimble, J. E. (Eds.), Counseling Across Cultures 4th edition. Chapter 10. London: SAGE Publications.
Berthelsen, D., & Nicholson, J. (2006). Observation of interactions scale. Brisbane: QUT
Blaustein, M. E., & Kinniburgh, K. M. (2010). Treating traumatic stress in children and adolescents - how to foster resilience through attachment, self-regulation, and competency. New York: The Guildford Press.
Brenner, B., Butz, A., Coates, L., Coronado, G., Halstead, S., & Israel, B. A. (2005). Community-based participatory research: Lessons learned from the centres for children's environmental health and disease prevention research. Environmental Health Perspectives, 113 (10), 14631471.
Brisch, K. H. (2012). Treating attachment disorders – 2nd ed. From theory to practice. New York: The Guildford Press.
CDCHU. (2007). Center on the developing child at harvard university. A science-based framework for early childhood policy – using evidence to improve outcomes in learning, behavior, and health for vulnerable children. Retrieved from http://www.developingchild.Harvard.edu.
CDCHU. (2010). Center on the developing child at harvard university. The foundations of lifelong health are built in early childhood. Retrieved from http://www.developingchild.Harvard.edu.
CDCHU. (2011). Center on the developing child at harvard university. Building the brain's “air traffic control” system: how early experiences shape the development of executive function: Working paper no. 11. Retrieved from http://www.developingchild.harvard.edu.
Coello, M. (2014). Details for this reference have been deleted for the purpose of preserving the blind review process.
Cohen, J. A., & Mannarino, A. P. (2010). Psychotherapeutic options for traumatized children. Current Opinion in Paediatrics, Oct. 22 (5), 605609. doi: 10.1097/MOP.0b013e32833e14a2
Collman, G. W., & Srinivasan, S. (2005). Evolving partnerships in community. Environmental Health Perspectives, 113 (12), 1814.
Commanda, L. E., Freeman, W. L., Gibson, N., Macaulay, A. C., McCabe, L., & Robbins, C. M. (1999). Participatory research maximises community and lay involvement. British Medical Journal, 319 (7212), 774.
Cooper, R. (2009). Play focused therapy: Different settings, different approaches. In Stagnitti, K. & Cooper, R. (Eds.), Play as therapy – assessment and therapeutic interventions. London: Jessica Kingsley Publishers.
Cozolino, L. (2006). The neuroscience of human relationships – attachment and the developing social brain. New York: W.W. Norton & Company.
Creighton, A. (2011). Mother-infant musical interaction and emotional communication: A literature review. Australian Journal of Music Therapy, July 22, 37–56.
De Anstiss, H., Ziain, T., Procter, N., Warland, J., & Baghurst, P. (2009). Help-seeking for mental health problems in young refugees: A review of the literature with implications for policy, practice, and research. Transcultural Psychiatry, 46 (4), 584607.
De Gangi, G. (2000). Pediatric disorders of regulation in affect and behavior – a therapist's guide to assessment and treatment. San Diego: Academic Press.
De Gangi, G., & Balzer-Martin, L. A. (2000). Sensorimotor history questionnaire for preschoolers. In DeGangi, G. (Ed.), Pediatric disorders of regulation in affect and behavior – a therapist's guide to assessment and treatment. San Diego: Academic Press.
De Gangi, G., & Poisson, S. (2000). Infant-toddler symptom checklist: Long version. In DeGangi, G. (Ed.), Pediatric disorders of regulation in affect and behavior – a therapist's guide to assessment and treatment. San Diego: Academic Press.
De l’Etoile, S. (2011). Mother-infant musical interaction and emotional communication: A literature review – a commentary on Creighton's article. Australian Journal of Music Therapy, July 22, 56–58.
Edwards, J. (2011). Music therapy and parent-infant bonding. In Edwards, J. (Ed.), Music therapy and parent-infant bonding (pp. 521). Oxford: Oxford University Press.
Edwards, N. (2012). Personal communication, brighter futures group facilitator. Sydney: Brighter Futures, Cumberland, Wesley Mission.
Eines, J., & Mantovani, A. (1980). Teoria del Juego Dramatico. Madrid: Servicio de Publicaciones del Ministeria de Educacion.
Ellis, B. H., Lincoln, A. K., Charney, M. E., Ford-Paz, R., Benson, M., & Strunin, L. (2010). Mental health service utilization of somali adolescents: Religion, community, and school as gateways to healing. Transcultural Psychiatry, Nov. 47, 789811. doi: 10.1177/1363461510379933.
Fitzgerald, M. H., Yang, T., Hay, S. H., Mitchell, P., Ing, V., Ya, T. H., . . . McNamara, J. (1997). Collaborative research; the bridge that can carry you over. In Ferguson, B. & Barnes, D. (Eds.), Perspectives on transcultural mental health. Culture and mental health – current issues in transcultural mental health. Parramatta: Transcultural Mental Health Centre.
Greenspan, S. I. (2004). Greenspan social-emotional growth chart – a screening questionnaire for infants and young children. Bloomington: Pearson.
Greenspan, S. I. (2011). Overview and recommendations. Interdisciplinary council on development and learning disorders (ICDL) (2000). Clinical practice guidelines-refining the standards of care for infants, children, and families with special needs (pp. 1354). Bethesda: ICDL.
Guzder, J., & Rousseau, C. (2010). Child and community mental health in cultural perspective. Transcultural Psychiatry November, 47 (5), 683685.
Harkness, S., & Super, C. M. (2009). Parenting across cultures. SGI quarterly a buddhist forum for peace, culture and education. Retrieved from http://www.sgiquarterly.org/feature2009Jan-2.html.
Herman, J. (1997). Trauma and recovery – the aftermath of violence – from domestic abuse to political terror. New York: Basic Books.
Hinton, D. E., & Lewis-Fernandez, R. (2010). Idioms of distress among trauma survivors: subtypes and clinical utility. Culture Medicine, and Psychiatry, vol. 34, Issue 2, June (pp. 209–218). doi 10.1007/s11013-010-9175-x.
Hsu, E., Davies, C. A., & Hansen, D. J. (2004). Understanding mental health needs of southeast asian refugees: historical, cultural, and contextual challenges. Faculty publications, department of psychology. Paper 86. Retrieved from http://digitalcommons.unl.edu/spcychfacpub/86.
Idemudia, E. S. (2004). Mental health and psychotherapy “Through” the eyes of culture: Lessons for African psychotherapy. TRANS Internet-Zeitschrift für Kulturwissenschaften. no. 15/2003. Retrieved from www.inst.at/trans/15Nr/02_7/idemudis15.htm.
Interdisciplinary Council on Developmental and Learning Disorders. (2000). Clinical practice guidelines-refining the standards of care for infants, children, and families with special needs. Bethesda: ICDL.
Israel, B. A., Coombe, C. M., & McGranaghan, R. J. (2009). Community based participatory research: A partnership approach for public health. Michigan: University of Michigan School of Public Health.
Karen Buddhist Dhamma Dhutta Foundation. (2011). The karen people, culture, faith and history. Retrieved from www.Karen.org.au/docs/Karen_people_booklet.
Keller, H., Voelker, S., & Yovsi, R. D. (2005). Conceptions of parenting in different cultural communities: The case of West African Nso and Northern German women. Social Development, 14, 1, 2005.
Kim, J. (2011). Korean immigrant mothers’ perspectives: The meanings of a Korean heritage language school for their children's American early schooling experiences in Early Childhood Education Journal 39.2 (June 2011): pp. 133141. doi 10.1007/s11013-010-9170-2, Springer Science+Business Media, LLC 2010.
Knatterud-Hubinger, N., Mendenhall, T., Narr, D., Solheim, C., & Velasquez, J. (2011). Mano a mano: Improving health in impoverished bolivian communities through community-based participatory research. Families, Systems & Health, 29 (4), 303.
Kramer, E. J., Kwong, K., Lee, E., & Chung, H. (2002). Cultural factors influencing the mental health of Asian Americans. Western Journal of Medicine, Sep. 176 (4), 227231.
Lewis-Fernandez, R., Gorritz, M., Raggio, G. A., Pelaez, C., Chen, H., & Guarnaccia, P. J. (2010). Association of trauma-related disorders and dissociation with four idioms of distress among latino psychiatric outpatients. Culture Medicine and Psychiatry, June 34 (2), 219243. doi 10.1007/s11013-010-9177-8.
Ludy-Dobson, C. R., & Perry, B. D. (2010). The role of healthy relational interactions in buffering the impact of childhood trauma. In Gil, E. (Ed.), Working with children to heal interpersonal trauma: The power of play, chapter 3. New York: The Guildford Press.
McArdle, F., & Spina, N. (2007). Children of refugee families as artists: Bridging the past, present and future. Australian Journal of Early Childhood, 32 (4), 50.
McCubbin, H. I., Thompson, E. A., Thompson, A. I., McCubbin, M. A., & Kaston, A. J. (1993). Culture, ethnicity, and the family: Critical factors in childhood chronic illnesses and disabilities. Pediatrics, 91 (5), 10631070.
Mehraby, N. (2012). Lost in translation: Idioms of distress. Psychotherapy in Australia, 18 (3), 5556.
Mehraby, N., Signorelli, R., & Coello, M. (2014). Details for this reference have been deleted for the purpose of preserving the blind review process.
Moffic, H. S. (2005). Thirteen ways to achieve cultural incompetence. Behavioral Health Management, 25 (6), 20.
National Scientific Council on the Developing Child (NSCDC). (2004). Children's emotional development is built into the architecture of their brains: Working paper no. 2. Retrieved from http://www.developingchild.net. Boston: Harvard University.
Naw, W. W. (2012). Personal communication. Karen bilingual counsellor. Sydney: STARTTS.
Nichter, M. (2010). Idioms of distress revisited. Culture Medicine and Psychiatry, June 34 (2), 401416. doi 10.1007/s11013-010-9179-6.
NSCDC. (2005). National scientific council on the developing child. Excessive stress disrupts the architecture of the developing brain: Working paper no. 3. Retrieved from http://www.developingchild.net. Boston: Harvard University.
NSCDC. (2007a). The science of early childhood development. Boston: Harvard University. Retrieved from http://www.developingchild.net.
NSCDC. (2007b). The timing and quality of early experiences combine to shape brain architecture: Working paper 5. Boston: Harvard University. Retrieved from http://www.developingchild.net.
NSCDC (2008). Mental health problems in early childhood can impair learning and behavior for life: Working paper 6. Boston: Harvard University. Retrieved from http://www.developingchild.net.
NSCDC. (2010). Early experiences can alter gene expression and affect long-term development: Working paper no. 10. Boston: Harvard University. Retrieved from http://www.developingchild.net.
O’Fallon, L. R., & Dearry, A. (2002). Community-based participatory research as a tool to advance environmental health sciences. Environmental Health Perspectives, 110 (2), 155159.
Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body – a sensorimotor approach to psychotherapy. New York: WW Norton & Company.
Pedersen, D., Kienzler, H., & Gamarra, J. (2010). Llaki and nakary: Idioms of distress and suffering among the highland quechua in the peruvian andes. Culture, Medicine and Psychiatry, 34 (2), 279300. doi 10.1007/s11013-010-9173-z.
Perry, B. (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatized children: The neurosequential model of therapeutics. In Webb, N. B. (ed.), Working with traumatized youth in child welfare, (Chapter 3). New York: The Guilford Press.
Perry, B., Pollard, R. A., Blakley, T. L., Baker, W. L., & Vigilante, D. (1995). Childhood trauma, the neurobiology of adaptation, and “use-dependent” development of the brain: How “states” become “traits”. Infant Mental Health Journal, 16 (4), 271291.
Porges, S. W. (2011). The polyvagal theory – neurophysiological foundations of emotions, attachment, communication, self-regulation. W.W. Norton & Company.
Powell, B., Cooper, G., Hoffman, K., & Marvin, B. (2014). The circle of security interventions – enhancing attachment in early parent-child relationships. New York: The Guildford Press.
Queensland University of Technology. (2009). Murdoch Children's Research Institute, & Playgroup Queensland Sing and Grow Programme. Parent Survey – Commencement.
Reebye, P. N., Ross, S. E., Jamieson, K., & Clark, J. M. (2013). A literature review of child-parent/caregiver attachment theory and cross-cultural practices influencing attachment. Research report Retrieved from http://www.attachmentacrosscultures.org/research.
Satar, J. (2012). Personal communication. Director. Sydney: Sabian-Mandaean Association.
Schaffer, E. (2011). Personal communication, Sydney: Families in Cultural Transition (FICT) team, STARTTS.
Schore, A. N. (2001). The effects of early relational trauma on right brain development, affect regulation, & infant mental health. Infant Mental Health Journal, 22 (1–2), 201269.
Schore, A. N. (2003a). Affect dysregulation and disorders of the self. New York: W.W. Norton & Company.
Schore, A. N. (2003b). Affect regulation and the repair of the self. New York: W.W. Norton & Company.
Siegel, D. (2009). Healing trauma: The central role of integration in working with the mind, brain and human relationships. One day workshop. Sydney: STARTTS.
Siegel, D. J., & Bryson, T. P. (2011). The whole-brain child – 12 revolutionary strategies to nurture your child's developing mind. New York: Delacorte Press.
Signorelli, R. (2011a). The music of healing: Part I: Safety, stress management, containment and self-regulation. Sydney: STARTTS. Retrieved from http://mandaladesign.com.au/startts/autumn2011/story4.htm.
Signorelli, R. (2011b). The music of healing: Part II: The place of music in recovery and developmental models. Sydney: STARTTS. Retrieved from http://mandaladesign.com.au/startts/winter2011/story2.htm.
Signorelli, R. (2011C). Personal observation of clients. Sydney: STARTTS.
Signorelli, R. (2012). The dance of lullabies - integrative sensori-motor music therapy with refugee infants and their parents. Presentation at STARTTS Clinical Evening Masterclass, Sydney: Psychevisual. Retrieved from http://www.psychevisual.com/Video_by_Rosemary_Signorelli_on_the_dance_of_lullabies_integrating_music_therapy_sensori_motor_and_play_activities_in_working_with_refugee_and_asylum_seeker_infants_and_their_parents.html.
Signorelli, R. (2013a). Challenges in cross-cultural early childhood work with refugees. Interface: Considerations of Difference, Psychotherapy in Australia, 20 (1), 5657.
Signorelli, R. (2013b). A pilot research project: To explore the perceptions of the Sydney karen and mandaean refugee communities of the impact of refugee and resettlement trauma on their 0–5 year olds, and to explore those communities’ help-seeking preferences, for the children and caregivers. Thesis for Masters of Counselling and Applied Psychotherapy course. Unpublished. Sydney: Jansen Newman Institute.
Signorelli, R. (2014). Personal observation. Sydney: STARTTS.
Signorelli, R., & Coello, M. (2011). STARTTerS collaborative early childhood services for refugee families – drumming, dancing and the wobbly wall. Paper presented at the Early Childhood Intervention Australia (ECIA) - NSW Chapter) Conference Proceedings 2011. Retrieved from http://www.startts.org.au/media/STARTTerS-ECIA-Drumming-Dancing-and-the-Wobbly-Wall-Signorelli-Coello.pdf.
Signorelli, R., & Coello, M. (2014a). STARTTerS screening tool. Trial version 4, unpublished. Sydney: STARTTS.
Signorelli, R., & Coello, M. (2014b). Review of STARTTerS programme – in progress. Sydney: STARTTS.
Signorelli, R., & Coello, M. (2015). Incidence and importance of post-traumatic signs in 0–5 year olds from refugee backgrounds, as seen through western and non-western cultural lenses. Paper presented at The Forum of Australian Services for Survivors of Torture and Trauma (FASST) conference. Hunter Valley. Uploading of video to Psychevisual website pending.
STARTTS. (2011). Working effectively with refugee children – workshop training notes. Sydney: STARTTS.
Tronick, E. (2007). The neurobehavioral and social-emotional development of infants and children. New York: WW Norton & Company.
Tunnecliffe, L. (1996). Children affected by trauma – a guide for parents, teachers, ambulance, rescue and emergency medical personnel. Western Australia: Lesley Tunneciffe with Bayside Books.
Ussher, J., Rae, M., Rhyder-Obid, M., Perz, J., Newman, P., & Wong, W. K. T. (2011). Reproductive and sexual health needs of culturally and linguistically diverse (CALD) communities in Western Sydney. Sydney, Australia: School of Psychology, University of Western Sydney.
Van Der Kolk, B. (2005). Editorial introduction: Child abuse & victimization in Psychiatric Annals 2005, pp. 374–378. Retrieved from www.traumacentral.net/TC_Bessel_van_der_Kolk.htm.
Van Der Kolk, B. (2010). Developmental trauma disorder – towards a rational diagnosis for children with complex trauma histories. Retrieved from www.traumacentral.net/TC_Bessel_van_der_Kolk.htm .
Van Der Kolk, B., & Saporta, J. (1991). The biological response to psychic trauma: Mechanisms and treatment of intrusion and numbing. Anxiety Research (UK), 4 (3), 199212. doi: 10.1080/08917779108248774
Viswanathan, M., Ammerman, A., Eng, E., Garlehner, G., Lohr, K. N., Griffith, D., . . . Rhodes, S. (2004). Community-based participatory research: Assessing the evidence: Summary. In AHRQ Evidence Report Summaries. Rockville (MD) Agency for Healthcare Research and Quality (US): 1998–2005. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK11852/.
Warner, E., Cook, A., Westcott, A., & Koomar, J. (2011). SMART – sensory motor arousal regulation treatment – a manual for therapists working with children and adolescents: A “bottom up” approach to treatment of complex trauma. Boston: The Trauma Center at Justice Resource Institute (JRI).
Yahya, Y. (2013). Personal communication. Bicultural staff member and community member Sydney: STARTTS.
Zu, D. (2012). Personal communication. Karen bilingual counsellor and community leader. Sydney. STARTTS.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Children Australia
  • ISSN: 1035-0772
  • EISSN: 2049-7776
  • URL: /core/journals/children-australia
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed