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July 2017

Consider This… Things to Consider in July 2017 from RTSC:

The Adverse Childhood Experiences (ACE) Study: A Hidden Public Health CrisisJanie Crecco, MA, MSEd, Training and Support Specialist, RTSC

It has been almost 20 years since Vincent J. Felitti, MD and Robert Anda, MD wrote an article in the American Journal of Preventive Medicine titled ”The relationship of adult health status to childhood abuse and household dysfunction.”[1] What started out as an interesting obesity study has toppled our long-held ideas about long term health outcomes and the etiology of challenging behaviors in children and adults. According to the CDC’s website on the ACE Study[2], the original ACE Study was conducted at Kaiser Permanente from 1995 to 1997 with two waves of data collection. Over 17,000 Health Maintenance Organization members from Southern California receiving physical exams completed confidential surveys regarding their childhood experiences and current health status and behaviors. The CDC continues ongoing surveillance of ACEs by assessing the medical status of the study participants via periodic updates of morbidity and mortality data.

 

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Girlhood Interrupted: The Erasure of Black Girls’ Childhood
This groundbreaking study by the Georgetown Law Center on Poverty and Inequality provides first-time data showing that adults view Black girls as less innocent and more adult-like than their white peers, especially in the age range of 5–14. It represents a key step in addressing the disparate treatment of Black girls in public systems, including education, juvenile justice, and child welfare. The report introduces the concept of adultification as it has been applied to Black children, in that Black girls act more like adults than children and are treated as if they are willfully engaging in behaviors typically expected of Black women rather than exhibiting developmentally appropriate, albeit immature, decision making.


The Evolution of Hope
This is the Casey Family Programs’ 2017 signature report, which showcases two communities — Gainesville, Florida, and Johnson County, Kentucky — that collectively brought together different resources, perspectives and supports to improve safety for children and families and reduce the need for foster care. This report features videos, stories and graphics that highlight the challenges these communities faced and the unique solutions they crafted to overcome them.


Why Is It So Hard to Stop Suspending Kindergarteners?
This article from The Hechinger Report, discusses how Philadelphia has banned suspensions of kindergarteners and hopes to do the same for first and second grade students soon. Other districts around the country and even entire states, such as Connecticut, are also banning suspensions and expulsions in the early grades, a practice that research shows disproportionately affects black and Hispanic boys, can be irreversibly damaging, and neglects to take into account other crucial issues impacting a child, such as trauma at home.


When Schools Meet Trauma With Understanding, Not Discipline
Kids in New Orleans screen positive for post-traumatic stress disorder at more than three times the national rate, yet most of the charter schools in the city adhere to strict, no excuses discipline codes. Crocker College Prep is now one of five New Orleans charter schools in a collective to become more trauma-informed. That means Crocker aims to account for the social, emotional and behavioral needs of all students, and their lives outside of school. Three or four staff members might tag team to help one troubled student on any given day. That kind of effort takes a lot of time and energy. 


Twelve Seconds of Gunfire
This heart-breaking story from The Washington Post recounts the horrifying experience of Ava Olsen, a 7 year-old first grader in Townville, South Carolina who was witness to a shooting by Jesse Osborne, a 14 year-old former student at the school. The ways in which several little students react to the trauma of the school shooting, and the confounding life of the shooter himself, leaves the reader pondering how one child’s actions can create so much pain in others. 


How Using Paint, Pen on Paper or Song to Revisit Trauma Helps Us Put It In the Past
The medical model has played a key role in the treatment of trauma – perhaps, as psychiatrist Bessel Van der Kolk says in his book, The Body Keeps the Score, because drugs for “fixing” trauma are profitable and major medical journals rarely publish studies of non-medical treatments, which they class as “alternative” therapies. The problem is that medication cannot strike at the root of the trauma and so cannot free the individual from the loop of reliving it. Recent evidence suggests that creative arts can play a key role in helping individuals recover from trauma.


Leaving No Kid Behind: The Need For More Child Psychiatrists
This article, co-authored by Nancy Rappaport, associate professor of psychiatry at Harvard Medical School and a child psychiatrist at the Cambridge Health Alliance, discusses the fact that few children and adolescents get the behavioral health care they need, and schools too often become the de facto front line for explosive children who might have behavioral problems for a host of complicated reasons, including the possible toxic combination of ADHD and trauma. Researchers have found that children who exhibit aggressive or problematic behaviors wind up being over-medicated, while the real problems — poverty, family discord, poor nutrition or systematic discrimination — are left untreated.


Connecticut DCF’s New Strategy: Treating Children and Families In Their Own Homes
Family-Based Recovery, or FBR, is an example of Connecticut’s DCF dramatic reversal in philosophy and practices, after years of a policy approach based largely on removing children thought to be at risk and placing them in congregate care facilities. Working with researchers from Yale University and Johns Hopkins, they developed a program that addresses both substance abuse recovery and ways to foster healthy child development. Measures show that parents’ levels of depression decrease the longer they are in FBR, and that the decline in substance use is more significant than for all other available substance abuse treatment programs. The crucial measure: When the family is discharged, 85 percent of the children were still living with their parent.


Useful Tools and Resources


2017 Kids Count Data Book:  State Trends in Child Well-Being
This resource from the Annie E. Casey Foundation is the book you need to use for important current trends. This edition highlights notable progress but also areas of concern. Parental employment and wages are up, and a record number of children have health insurance. Teenagers are more likely to graduate high school and less likely to abuse drugs and alcohol. But child poverty rates remain high and more families live in neighborhoods with a high concentration of poverty. Despite modest gains in academic performance, far too many children are below grade level in reading and math. Even where we see improvements, deep racial and ethnic disparities remain.


Movie Review: “My Life as a Zucchini”
An animated short film released in 2016 that is 68 minutes in length and deals with childhood trauma. Available for purchase for under $5.


Growing up LGBT in America: Human Rights Commission Youth Survey Report Key Findings
This groundbreaking research among more than 10,000 LGBT-identified youth ages 13-17 provides a stark picture of the difficulties they face, yet the youths remain optimistic and firmly believe things will get better.


A Trauma-Informed Toolkit for Providers in the Field of Intellectual & Developmental Disabilities
Knowing that a behavior may be manifested by an individual due to a trauma history leads to potentially different interventions then a Functional Behavioral Analysis can typically provide. In fact, the behavior may not serve a purpose or function at all; it may be an anxious response devoid of purpose, but requiring understanding. Critical elements needed in planning for people with a trauma history are delineated. A sample “trauma-informed” support plan is included to provide guidance in this area.


Foster, Juvenile Justice, and Crossover Youth
Young people involved in the child welfare and/or juvenile justice systems often face significant challenges as they transition to college and career. This resource, which draws upon national, state, and local research and data, provides snapshots of the education and workforce outcomes of these populations and explores the challenges they face.


Support for Parents Who Adopt from Foster Care
Subsidies, services, and training available to help parents and children throughout the adoption process compiled by AdoptUSKids.


Take Action In Schools
To help parents and teachers communicate better, the Graduate School of Education at Harvard has developed a short list of questions parents, caregivers, and SESPs can ask principals and teachers. By asking these questions, you can help school staff think about what they’re doing now to help students – and also what they can do differently. 

The Adverse Childhood Experiences (ACEs) Study: A Hidden Public Health Crisis on July 18, 2017 12:30PM EDT
ACEs have a tremendous impact on future violence — both victimization and perpetration, and can create lifelong health issues and lost opportunity. Learning and academic performance can be significantly compromised. Janie Crecco, MA, MSEd, a Training and Support Specialist at the Federation for Children with Special Needs, will explain what the ACE study is and how the research around the study’s findings continues to expand our knowledge of challenging behaviors in both children and adults. Visit our Archived Webinars page

For more on this topic, please read our RTSC Feature Article: The Adverse Childhood Experiences (ACE) Study: A Hidden Public Health Crisis below


 

Featured Article Continued… 

The Adverse Childhood Experiences (ACE) Study: A Hidden Public Health Crisis  

Janie Crecco, MA, MSEd, Training and Support Specialist, RTSC

It has been almost 20 years since Vincent J. Felitti, MD and Robert Anda, MD wrote an article in the American Journal of Preventive Medicine titled ”The relationship of adult health status to childhood abuse and household dysfunction.”[1] What started out as an interesting obesity study has toppled our long-held ideas about long term health outcomes and the etiology of challenging behaviors in children and adults. According to the CDC’s website on the ACE Study[2], the original ACE Study was conducted at Kaiser Permanente from 1995 to 1997 with two waves of data collection. Over 17,000 Health Maintenance Organization members from Southern California receiving physical exams completed confidential surveys regarding their childhood experiences and current health status and behaviors. The CDC continues ongoing surveillance of ACEs by assessing the medical status of the study participants via periodic updates of morbidity and mortality data.
 
The results of the study shed a new light not only on the insoluble issues around obesity but many other health outcomes as well. In a nutshell, the HMO members were asked 10 question about their adverse experiences as young children including three types of abuse — sexual, verbal and physical; five types of family dysfunction — a parent who’s mentally ill or alcoholic, a mother who’s a domestic violence victim, a family member who’s been incarcerated, or the loss of a parent through divorce or abandonment. Dr. Felitti later added emotional and physical neglect, for a total of 10 types of adverse childhood experiences, or ACEs.
 
The most jaw-dropping finding of the study was how common ACEs are: almost two-thirds of study participants reported at least one ACE, and more than one in five reported three or more ACEs. The ACE score, a total sum of the different categories of ACEs, is used to assess cumulative childhood stress. Study findings repeatedly reveal a graded dose-response relationship (a graded dose-response means that as the dose of the stressor increases the intensity of the outcome also increases) between ACEs and negative health and well-being outcomes across the life course.[3]
 
As the number of ACEs increases so does the risk for the following:6

  • Alcoholism and alcohol abuse
    •Chronic obstructive pulmonary disease
    •Depression
    •Fetal death
    •Health-related quality of life
    •Illicit drug use
    •Ischemic heart disease
    •Liver disease
    •Poor work performance
    •Financial stress
    •Risk for intimate partner violence
    •Multiple sexual partners
    •Sexually transmitted diseases
    •Smoking
    •Suicide attempts
    •Unintended pregnancies
    •Early initiation of smoking
    •Early initiation of sexual activity
    •Adolescent pregnancy
    •Risk for sexual violence
    •Poor academic achievement

This list is not exhaustive. As research continues on the subject of developmental trauma, including neuroscience which gives us an opportunity to measure changes to the developing neurology, the more we are able to understand the enormity of this public health crisis. The newest ACE Study questions include exposure to such events as: witnessing violence other than a mother being abused; experiencing discrimination based on race or ethnicity; feeling unsafe in your neighborhood or not trusting your neighbors, bullying, and ever in foster care.
  
The ages-old theories about challenging behaviors being willful, deliberate, manipulative, and able to be changed by using punitive discipline are being tossed to the wind. Developing neurology, it seems, is extremely vulnerable to adverse experiences and not easily reparable. Hence, the new education laws are beginning to focus on social-emotional learning, school climate, trauma sensitive schools, safe and supportive environments, and skill-building rather than consequences. In essence, a major paradigm shift.

Do you know your own ACE Score? Answer the original 10 questions — each “yes” equals 1 ACE.  And realize that 20% of you have had three or more adverse experiences that have impacted the way you react emotionally, academically, and even physiologically. http://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean

 

[1] Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, et al.
The relationship of adult health status to childhood abuse and household dysfunction. American
Journal of Preventive Medicine. 1998; 14:245-258.

[2] https://www.cdc.gov/violenceprevention/acestudy/about.html     

[3] op. cit.
 
For more on this topic, please register for our July 20th Webinar: View our Archived Webinars page


*Disclaimer: While every effort is made to ensure that the contents of Consider This… is accurate, the Federation for Children with Special Needs makes no representations or warranties in relation to the accuracy or completeness of the information found within the enclosed articles. The contents within this transmission are provided in good faith, and nothing included in it should be taken to constitute or imply professional advice, an endorsement or a formal recommendation.