Author: Kerry Jamieson

Sound Solutions for Children’s Mental Health

Kerry Jamieson Latest News, Uncategorized

A generous donation of noise-mitigating wall art from Audimute is going to make all the difference to Center for Child Counseling’s new Child and Family Center offices and play therapy rooms located in the Palm Health Pavilion at St. Mary’s Medical Center.

Children at play are noisy — just ask any parent! Now imagine you work with exuberant children all day long and that your offices share walls and hallways with their playrooms. The din can be pretty disruptive. That was the situation for dozens of therapists at the Center for Child Counseling in our wonderful new offices located in the Palm Health Pavilion on the grounds of St. Mary’s Hospital in West Palm Beach. CfCC’s Child and Family Center moved into the new facilities in January and have been getting settled in but finding a happy sound balance between our playrooms, which can be loud and our offices where we need to do careful reporting and administrative work was a challenge.

Now, we’ve had help solving that problem thanks to an incredibly generous donation from Audimute, a company that specializes in producing eco-friendly, sound-dampening acoustic solutions for residential, commercial, and industrial applications. Audimute donated hundreds of acoustic tiles–8 boxes full, in fact–to us for their walls. Audimute has its headquarters in Cleveland, Ohio, far from our home base. But that was no problem for Audimute…they picked up the shipping costs to deliver the products, too!

When our therapists opened the boxes, they were amazed at the variety and quality of the tiles – all designed to delight children. “Play is a child’s language and toys are their words,” explains CfCC’s CEO, Renée Layman. “That’s why we use play therapy with our clients who can be as young as two years old. Many of these children are suffering the effects of abuse and trauma. Having a bright, cheerful, safe place where they can just have fun and express themselves alongside a skilled therapist goes a long way to help them on their journey to recovery.”

The hundreds of donated tiles instantly brought new life to the organization’s play therapy rooms. “They’re terrific as art and to ensure privacy for our clients,” says Stephanie de la Cruz, the Center’s Director of Clinical Services. “They’ve also transformed our offices into tranquil places we can enjoy.”

Center for Child Counseling wishes to thank Audimute and its Founder and President, Mitch Zlotnik, for their caring and creative commitment to our kids. Your contribution helps make therapy a less daunting experience for children who we believe should always be joyful, playful, and hopeful.

Community Leaders Unite Against Childhood Trauma

Kerry Jamieson Uncategorized

Center for Child Counseling (CfCC), Palm Beach County’s preeminent agency in the field of childhood mental health, brought together leaders from the public and private sectors to jumpstart an action plan to address childhood adversity.

Last week’s 3rd annual “Lead the Fight: ACEs to Action” event represented a milestone in addressing the basic human right of all children in Palm Beach County to lead lives free from trauma and adversity. The County’s leaders in mental health, business, education, law enforcement, healthcare, and the judiciary assembled to tackle the most pressing public health issue facing our communities today: Adverse Childhood Experiences (ACEs), which carry lifelong physical and mental health implications and result in exorbitant costs to taxpayers, financially and in terms of social ills. The event was attended by 289 VIPs from across Palm Beach County and beyond.

Based in Palm Beach County, CfCC offers mental health services to children from birth to 18. The nonprofit agency specializes in helping to heal young children exposed to trauma and has emerged as the local leader in the fight against ACEs. They also work to educate the public about the prevalence and profound negative effects of childhood trauma by conducting an awareness campaign focused on training teachers, healthcare providers, and community leaders to view their interactions with people, especially children, through a more trauma-informed lens. This year’s “Lead the Fight” event was aimed at uniting important stakeholders to tackle ACEs by putting research-based plans into action.

CfCC’s CEO, Renée Layman, describes her commitment: “It’s the most crucial work we can do. We raise the future in our children…how we choose to harm or help them determines the kind of future we can bank on. We know that prevention and early intervention is the key to ensuring healthy childhood development, but we keep failing our children even though most societal issues, including soaring rates of teen depression and suicide, school shootings, substance abuse, incarceration, and domestic and community violence, all have their roots in childhood trauma that was never adequately addressed.” In recent years, research has proved that adverse experiences and trauma effect the physiological development of a young child’s brain and cause a lifetime of issues. “We need to prioritize efforts that get help to children when they first need it; we need to fund these efforts.”

The event’s keynote speaker was Dr. Neil Boris, Medical Director of Circle of Security International and President of the Florida Association for Infant Mental Health, who shared the social consequences of missing the opportunity to intervene and help children as early as possible.

Amber Payne, CfCC’s Director of Community Engagement and Development, presented the findings of a White Paper entitled: “A Public Health Approach to Fighting ACEs in Palm Beach County: Opportunities for Levers of Change and Innovation”. The paper which assesses the County’s readiness to respond to this public health crisis, was underwritten by local health funder Quantum Foundation and provides best-practice solutions to help different sectors identify ways to work with children who are facing adversity.

As Ms. Payne explains: “We know that people with high levels of childhood adversity suffer throughout their lives and die, on average, 20 years younger than those without these experiences. There is hope, however, because research shows that introducing just one positive adult influence in a child’s life can make all the difference to the trajectory of that child’s future path. We want to equip people to promote and provide those buffering relationships to our children.”

CfCC offers training opportunities for those who wish to learn more. As Renée Layman explains. “We want people to know their ACE score and understand the implications of that score. Knowledge is power,” she said. “If you can understand how ACEs have affected you and how they might be affecting your children, you’ll be able to break the intergenerational cycle of abuse and start on the road to healing.”

Learn more about CfCC's Fighting ACEs work or to take the free, anonymous 10-question ACE survey right now.

The Power of Language: ACEs and Trauma

Kerry Jamieson Uncategorized

ACEs and trauma are different. Gain an accurate understanding of adversity, ACEs, trauma, and toxic stress to fully understand how best to fight adverse experiences in childhood.

Language, or the words we choose to describe experiences to ourselves and others, is powerful. Words influence the way we think, and how we choose to think about ACEs and trauma influences our actions. So often, we use the term ACEs and the word trauma interchangeably, but they are different. While this educational series is part of our Fighting ACEs campaign and therefore focused on ACEs, we cannot afford to ignore the full range of childhood adversity, including social inequity, and how children can respond to it in many ways.

Before we get into definitions, it’s important to remember some concepts we’ve discussed before. Every child is unique from the genetic level up. The way they react to trauma can and will vary dramatically. Because their brains are still growing, children are vulnerable to situations that can alter their chemistry and hamper normal brain development. But they also have neural plasticity which makes them adaptable and responsive to healing interventions. Two children (even siblings living in the same home…even twins!) might experience the same traumatic event then process and respond to it very differently. There are no rules for how we can expect a child to react or behave after a traumatic event. Of course, expert therapists trained in childhood mental health, like those at the Center for Child Counseling, can make some predictions based on years of experience and work with a child accordingly.

Certain types of childhood adversity are especially likely to cause trauma reactions in children, such as the sudden loss of a family member or witnessing intense domestic violence. Other events, like divorce or separation result in a wider, less predictable range of responses. Some children are deeply traumatized when their parents divorce; some fare well and may even thrive, especially if the divorce removes a negative influence (such as an abusive, alcoholic father) from the picture thus stabilizing the relationship between mother and child.

General Adversity in Childhood

Let’s consider adversity in general. Adversity describes any number of situations or events that threaten healthy development for a child, both physical and psychological. Adversity can include circumstances like abuse, neglect, domestic and community violence, bullying, extreme poverty, and discrimination. Adversity tends to be a condition that exists for an extended period of time; it is not a one-time event. Adversity is a general living condition that is often, or always, present.

Certain groups of children, including minorities, receive a disproportionate dose of adversity because they belong to a group that has been historically disadvantaged and continues to face the challenge of inequity. Science shows that enduring adversity for long periods can affect the developing brains of children, resulting in lifelong physical and mental health issues. However, adversity is only one half of the equation because it seems that even the most harmful experiences can be balanced out, or even negated, if a strong support system is in place.

ACEs Defined

General adversity is not the same thing as ACEs which are a clearly identified set of adverse situations. ACEs (Adverse Childhood Experiences) is an acronym that emerged after a study originally conducted by Kesier Permanaente and the Centers for Disease Control in the 1990s. This study was the first to identify a strong correlation between certain adverse experiences in childhood and poor physical and mental health outcomes (e.g.: heart disease, diabetes, substance abuse, depression, etc.) later in life. The term ACEs describes a more specific set of adverse experiences outlined by the original study and subsequently added to.

The original study placed adverse experiences into seven specific categories based on 10 questions:

  • physical, sexual, and emotional abuse
  • a mother who was treated violently
  • living with someone who was mentally ill in the household
  • someone who abused alcohol or drugs in the household
  • incarceration of a member of the household

ACEs vs. Trauma

So how do ACEs differ from trauma? Trauma is one possible outcome of prolonged exposure to adversity. We tend to think of a trauma as a sudden, cataclysmic event like a serious car accident or a tornado. While it’s true that those experiences can qualify as ACEs, trauma is also the result of sustained periods of toxic stress over weeks, months, or even years.

The original ACE questionnaire was not definitive. More recent, expanded studies have added questions about peer victimization (bullying, etc.), serious physical illness in the household, especially where the child might become a caregiver, and one-off traumatic events with long-term consequences (a car accident, for example). No survey can cover the full scope of what might be an adverse experience for a child, not only because the variables are endless but also because not every child sees or responds to the same experience as an adverse one. Adversity and ACEs are, to some extent, in the eye of the beholder. What is traumatic is very much about perception. This perception is often unconscious or automatic rather than a considered reaction.

In simple terms, not every child who experiences a traumatic event is traumatized by it.

When a child experiences an adverse situation, let’s use a school shooting as a sad example, in the moment they will feel the associated emotions (terror, panic, helplessness) and the physiological responses (rapid heartbeat, adrenaline surge) as well as the after-effects which may manifest themselves immediately or much later. These manifestations may last far beyond the event itself and can include responses like bedwetting, nightmares, and stomach aches.

The same is true of the intensity of the experience. A child who witnessed the shooting and saw friends harmed or killed versus a child who was in the school during the event and experienced the panic but did not necessarily witness anything, might behave differently. The services they will need will likely differ, too, but again this depends on genetic vulnerabilities, prior experiences that have damaged the stress response system, or the presence of limited healthy gene expression (learn more about gene expression in our post about epigenetics).

PTSD and Toxic Stress

While the event is the same, two aspects may be very different: the physical experiences of the event and the individual’s response to it which can be based on nature (genetic resilience), nurture (coping skills that have been learned) and the support they have received in their lives thus far as well as the support they receive after the event i.e.: the immediate presence of crisis-trained buffers as well as the support of long-term buffers. Of course, one child who experienced the shooting may recover quickly without significant distress, whereas another may develop Post-Traumatic Stress Disorder (PTSD) and benefit from professional help and services – crucially, those provided by a trauma-informed team of caregivers. Swift intervention can certainly help children express and deal with the aftermath of an intense traumatic event, mitigating or buffering against that stress and preventing it from harming their development or well-being.

If trauma is unaddressed and prolonged, it can result in toxic stress which we’ve discussed at length in an earlier post in this series. It is really the effects of toxic stress on the body that can result in lifelong negative outcomes. Toxic stress wears down the body’s natural response systems over time and is the real villain in the story of ACEs, building up insidiously and causing countless potential future ills for the individual and for society.

Knowing Better = Doing Better

As our understanding of adversity, trauma, and ACEs grows, and as awareness grows among sectors who work with children and the general public grows, too, opportunities to intervene will reveal themselves. Some opportunities are already self-evident, however. Knowing that adverse community environments breed ACEs, we can focus on children living in these conditions who are most likely to need therapeutic intervention. We can provide preventative and early intervention services to support these children and avoid retraumatizing them. Sound knowledge can also help us avoid over-diagnosing or over-medicating children who are responding well to their circumstances or demonstrating the resilience that is the antidote to toxic stress

Let’s be specific in our language and avoid jargon and catchphrases which don’t accurately describe the situation. Labels can be vague and dangerous. The more specific we can be with our words and their meanings, while understanding the differences and uniqueness of each individual, the more effective we will be as buffers and healers for our children.

 

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Double Win for Childhood Mental Health in Palm Beach County!

Kerry Jamieson Uncategorized

Center for Child Counseling is ‘two for two’ with local Impact organizations

Center for Child Counseling has been awarded not one, but two grants totaling $200,000 from both the north county and south county women’s giving organizations, Impact the Palm Beaches and Impact 100. The funds will be used to transform the lives of children experiencing adversity and trauma by providing four elementary schools with innovative, research-based prevention and early intervention mental health services and education.

In a first since their inceptions, the southern-based and northern-based chapters of the Impact charitable organizations have both selected us as their 2019 grantees, which means we’ve been recognized as an outstanding nonprofit from one end of the County to the other!

The first award was made by Impact the Palm Beaches, based in West Palm Beach, at an event held on Thursday, January 31st at the FITTEAM Ballpark of the Palm Beaches. This event represented the final stage in a year-long search to identify and support worthy local projects that are innovative and transformational. Center for Child Counseling received top honors, walking away with the $100,000 grant.

The second win came on Wednesday, April 17th when Impact 100, based in Boca Raton, awarded Center for Child Counseling $100,000 at an evening event held at the Lynn University campus.

These grants will be used to support Center for Child Counseling’s school-based mental health programs which offer prevention, early intervention, and direct services. Since the aim of the grants is to transform schools one at a time, the awards will be used to pay for specialized child therapists to provide mental health education and support at four elementary schools which are eager to welcome the program.

The therapists will work with children, families, and their caregivers – helping them manage behaviors, cope with challenges, and regulate emotions that can lead to mental health concerns later in life. This unique model brings a calmer, more positive atmosphere to the whole school and promotes an environment of security that is conducive to learning.

The therapists will also educate and train school staff, teachers, and parents about the impact of ACEs (Adverse Childhood Experiences) and how they can have a lifelong effect on a child’s mental and physical health.

“It’s our goal as local leaders in this field to ensure we have a trauma-informed community,” said CfCC’s CEO Renée Layman. “The women of Impact the Palm Beaches and Impact 100 clearly recognize this need and have supported our research-based model for schools with their wonderful grants. We thank them, and our community’s children thank them.”

Implementation of the project at the four schools is planned to begin immediately.

More about the Center for Child Counseling:
Center for Child Counseling is building the foundation for playful, healthful, and hopeful living for children and families in Palm Beach County. We work to ensure an ACEs-aware and trauma-informed community with a focus on preventing and healing the effects that ACEs (Adverse Childhood Experiences) and toxic stress have on developing children by promoting coping skills, resilience, and healthy family relationships. To learn more about the Center for Child Counseling or its work, visit centerforchildcounseling.org

 

 

More about Impact the Palm Beaches:
Founded in 2015, Impact the Palm Beaches is a unique organization of dynamic women who make transformational change in their local community through collective philanthropy. Impact members each contribute $1,000 annually and award a $100,000 Impact grant. Impact the Palm Beaches serves the northern portion of the county from Lake Worth to Jupiter. To learn more about Impact the Palm Beaches or its work, visit impactthepalmbeaches.org

 

 

More about Impact 100:
Impact 100 Palm Beach County is a women’s charitable organization funding local nonprofit initiatives. It is comprised of a growing number of women (532 members last year) who donate $1,000 annually, pool their funds and vote to award multiple $100,000 grants to local nonprofits in southern Palm Beach County. The organization is a progressive leader in women’s philanthropy, committed to strengthening our community through the collective resources of our members by awarding high-impact grants in five focus areas: Arts & Culture, Education, Environment, Family, and Health & Wellness. To learn more about Impact 100, visit impact100pbc.com

Epigenetics and ACEs

Kerry Jamieson Uncategorized , , , ,

Reading the word “genetics” in the title of an article fills most of us with dread. We won’t understand it. We don’t even remember the basics from school. Genetics is such a complex field of study that it won’t make sense to us. But please read on because the possibility of a connection between genetics–or, more accurately, epigenetics–and Adverse Childhood Experiences (ACEs) could uncover startling revelations about how we should be raising our children.

Let’s start at the beginning. Genetics is a branch of biology concerned with the study of genes, genetic variation, and heredity—or the passing on of traits from parents to their offspring—in living organisms.

For many people, knowledge on the subject is limited to a few simple facts:
1.)  We all have genes that we got from our parents.
2.)  Genes carry our inherited information or genetic code.
3.)  Genes are responsible for characteristics like eye color, height, hair color, etc.
4.)  Genes also account for less tangible traits like whether we will be susceptible to certain diseases, or even if we will be optimistic and resilient, or prone to
alcoholism or depression.

Some of us may remember a little more of what we learned in high school science class, but here are the basics:
•  Human cells can house about 25,000 – 35,000 genes, which are carried on structures called chromosomes.
•  As a human being, you have 23 pairs of chromosomes (46 total) – half from your mother and half from your father. Your genetic makeup is determined
when your father’s sperm fertilizes your mother’s egg at conception to produce the materials needed to make a new, unique individual – you!
•  Each gene on the chromosomes has a function. The DNA (deoxyribonucleic acid) in a gene spells out specific instructions—like a cooking recipe — for
making proteins in the cell.
•  Proteins are the building blocks for everything in the body from bones to muscles to blood. Proteins help our bodies grow, work properly, and stay
healthy.

Genetic processes don’t occur in a vacuum, however. They can be greatly influenced by our environment and experiences which, in turn, can affect our development, decision-making, social-emotional wellness, and behavior. But how much of who we are is due to our genetic code and how much is the result of how and where we were raised and by whom? This is often referred to as the nature versus nurture argument.

Identical Twins and Nature vs. Nurture

Consider the example of genetically identical twins separated at birth and raised in different homes. One child ends up in a chaotic, insecure environment where he suffers ACEs and trauma. The other child grows up surrounded by love and kindness; he is provided with close personal bonds, diverse opportunities, and encouragement. While the nature of the identical twins might be genetically determined to be equal, the nurture component is clearly different. The child raised in the austere, uncertain climate may develop at a slower rate and have greater difficulties in school and life than the nurtured twin. The toxic stress associated with his ACEs has delayed his cognitive and behavioral development, disadvantaging him from birth.

How much of who we turn out to be is the result of genes and how much is the result of our environment is an age-old debate that has not yet been settled. Most scientists accept that both nature and nurture are at play in all human development. There is, however, a growing body of research that suggests a great deal of who we are is up to our genes. Genetics is an incredibly complex (and often misunderstood) field of science and breakthroughs are made every day. Decoding who we are and what kind of lives we will lead is a great mystery, one of the last great frontiers of human exploration and discovery.

The Concept of Epigenetics

Let’s take the concept one step further into the realm of epigenetics. Epigenetics is the study of cellular and physiological phenotypic trait variations that are caused by external or environmental factors that switch genes on and off and affect how cells read genes instead of being caused by changes in the DNA sequence. Huh? That may sound like gobbledygook to most of us, but it simply means that while the field of genetics looks at the expression of the genetic code, epigenetics studies factors that influence the expression of the gene.

Research in the area of epigenetics has concluded that during early life, the environment we live in can affect the way our genes are expressed.
So, environmental factors like security, bonding, and love can alter how our genes switch on and off, or simply operate. Differing genetic expressions can occur without causing any changes (or mutations) to the underlying genes themselves. In essence, the environment we experience, especially when we are young, can affect which of our genes are active (or expressed), and which remain dormant (or unexpressed).

The Intergenerational Transmission of Trauma

This is why we are discussing epigenetics in connection with ACEs. Because, increasingly, research seems to bear out the fact that the toxic stress of ACEs might not only be experienced by an individual but could also be transmitted from one generation to the next at a genetic level. In very simplified terms, it may be possible to pass on trauma to our children and grandchildren, making the implications of ACEs more devastating and far-reaching than we ever imagined.

Some researchers who have studied historic periods of trauma like the American Civil War or the Holocaust now suspect that abuse, neglect, deprivation, and trauma can impair the functioning at some level of future generations who may not even be living in the same adverse circumstances.

Experiments with Mice and Scent

Controlled experiments in mice have allowed researchers to begin to understand the epigenetics of ACEs. A 2013 study found that there was an intergenerational effect of trauma associated with scent. Researchers blew acetophenone – which smells like cherry blossoms – through the cages of adult male mice, zapping their foot with an electric current at the same time. The mice learned to associate the smell of cherry blossom with pain. Shortly afterwards, these males bred with female mice. When their pups smelled the scent of cherry blossom, they became jumpier and more nervous than pups whose fathers hadn’t been conditioned to fear it. To rule out that the pups were somehow learning about the smell from their parents, they were raised by unrelated mice who had never smelt cherry blossom.

The grand-pups of the traumatized males also showed heightened sensitivity to the scent. Neither of the generations showed a greater sensitivity to smells other than cherry blossom, which indicates that the inheritance was specific to that scent.

The science is far from definitive however. Many studies are currently underway and several alternate theories of if and how this is possible are still being debated within scientific circles. One thing is certain: Epigenetics is going to reveal many secrets in the coming years.

Consequences and Hope

The good news is that intergenerational transmission of trauma seems to happen infrequently. The story of human history is rife with trauma. If the transmission of that trauma was inevitable, all of us would be riddled with crippling health issues and developmental delays, and yet most of us are not. Protective factors that seem to mitigate or even prevent transmission in many people are clearly at play. Again, how and why this happens is not fully understood.

Still, the idea that we may be passing on the effects of trauma is a weighty one.

If this is the case, it should change the way we live our lives. Our parents’ and grandparents’ experiences should suddenly take on new relevance to us. Knowing that the consequences of our own actions and experiences could have long-term implications for the lives of our unborn (and yet to be conceived) children should dramatically alter the choices we make. It might even influence how seriously we, as a society, take violence, abuse, trauma, and mental health.

All these possibilities make it more important than ever before that we value and nurture ourselves and protect our mental and emotional wellbeing. ACEs and trauma are not a predetermined route to a disastrous life, they are simply warning markers along the way that encourage us to be self-aware, surround our children and ourselves with buffers, and practice resilience skills and self-care.

“There’s a malleability to the system,” says Brian Dias, researcher at Emory University and the United States’ Yerkes National Primate Research Center, and author of the 2013 controlled epigenetics study in mice. “The die is not cast. For the most part, we are not messed up as a human race, even though trauma abounds in our environment. [I believe that], in at least some cases, healing the effects of trauma in our lifetimes can put a stop to it echoing further down the generations.”

Our goal should be healing the effects of childhood trauma now, so that even the possibility of passing it on to future generations is minimized. As a community, let’s all focus on trying to achieve that.

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Toxic Stress and ACEs

Kerry Jamieson Fighting ACEs PBC, Latest News , , , , , ,

Stress is a strange thing. It’s both a feeling (a sense of being under intense pressure or emotional strain) and a mechanism by which the body’s systems respond to those feelings. We hear opposing statements about stress. Either stress is good for us because it motivates us to succeed, or all the stress in our lives in going to kill us… Which one is true? When it comes to stress, it’s a matter of degree. Yes, a little stress is part of human survival. It focuses us, energizes us, and helps us get things done. On the most primitive levels, feelings of danger trigger our body’s autonomic responses, flooding us with the hormones that once allowed us to flee from predators or enemies, or stand and fight them. Although that dramatic response is seldom needed these days, except in extreme cases of danger or sudden emergency, the stress response mechanism is still in place and vital in the rare instances when we need it. But this powerful system that’s built into every human body can be very dangerous—especially to children—when it’s triggered too frequently.

The body has several reactions to extreme danger or fear:
1.) It can embolden us to stand our ground and fight for our survival (FIGHT)
2.) It can trigger the strength and stamina we need to run away (FLIGHT)
3.) It can cause a state of near inertia in some people, thus the phrase “paralyzed with fear” (FREEZE)

It’s often hard to predict which response we’ll have in any given situation. In many cases, it seems that our body innately chooses for us but, in every case, the presence of danger sets off a series of chemical reactions in the body led by the brain and the endocrine (or glands and hormones) system.

The Immediate Effects of Adrenaline and Cortisol

The presence of danger or even severe unpredictability causes the brain to send a message to the glands to release adrenaline and cortisol. Between them, these two hormones do quite a lot to the body in a very short time:
1.) They increase the heart rate which raises blood pressure
2.) They expand the air passages to the lungs, bringing more oxygen to the body
3.) They rush sugar to the bloodstream
4.) They dilate the pupils of the eyes
5.) They prioritize the sharing of oxygen with muscles to give us power we may not know we had. Think about those news stories where people suddenly display incredible strength to save others, by lifting up a wrecked car to save a child, for example. Thank you, adrenaline!

However, adrenaline and cortisol are emergency measures — the last resort response for extreme situations. You might feel exhausted or quite nauseous after an extreme adrenaline dump, for example. That’s because your body is recovering from the intense activation and takes some time to manage and re-balance all the hormones in the blood. The body is always looking for homeostasis, or balance, where all systems are operating normally. Spikes of adrenaline and cortisol severely disrupt homeostasis and that’s a problem.

It’s true that there are good levels of stress. These are short periods of pressure that push us to complete tasks or focus on something we need to achieve. The stress passes and the body recovers quickly. However, when the stress is prolonged or repeated and there aren’t enough positive resources to counteract their effects, stress becomes dangerous and we call that toxic stress.

ACEs and Hormones

So why all this information on hormones and toxic stress? And how does it all tie back to understanding Adverse Childhood Experiences? Dr. Nadine Burke Harris, a pioneer in ACEs research, explains that adrenaline and cortisol are great if you encounter a bear in the woods. “The problem,” she says, “is what happens when the bear comes home single night?”

Continuous and repeated activation of the fight or flight response can “burn out” the system which is not intended to be in constant use. Adults suffer physical health issues if adrenaline and cortisol are released too frequently into their bodies. High blood pressure, chronic inflammation, high glucose levels, and low bone density are just a few of the numerous side effects which can result in:
• Anxiety
• Depression
• Digestive problems
• Headaches
• Heart disease
• Sleep problems
• Weight gain
• Memory and concentration impairment

The Effects on Children

For children, the situation is even worse. When little human brains and bodies are growing, there is a lot to do. The brain is developing at its fastest rate. Brain growth surges for the first 3 years of life, expands rapidly for the next ten years, then plateaus in the early 20s. But during the formative years, the body is using resources like the energy from food to accomplish countless tasks – building muscle, growing bone, honing the senses, and developing coordination and communication skills. With only a finite number of resources available, the brain allocates them to the most immediate and vital needs. In the case of constant fear and danger, the adrenaline process is triggered again and again at the expense of developing other parts of the brain and body.

Since survival must come first, that’s where all the energy goes, neglecting cognitive development and impeding those sectors of the brain vital for reasoning, self-regulation, and ultimately behavior and learning ability for the rest of a child’s life. In many cases, the lost ground is difficult, if not impossible, to make up.

A Life of Fear

So, imagine a child living in a home with domestic violence. He lives with daily uncertainty and apprehension. He is on constant alert, waiting for the next tragic event. He is always in fear of witnessing or being the victim of abuse. When it occurs, he suffers extreme terror and a sense of helplessness. He lives his life in a constant state of toxic stress. The healthy development we owe all children has, in a sense, been stolen from him.

Effects of Toxic Stress on the Body Systems of a Child

Nervous System:
Toxic stress disrupts the developing brain, including changes to the hippocampus, prefrontal cortex, and amygdala. This raises the risk of cognitive impairment, learning disabilities, hyperactivity, poor self-regulation, inhibited memory and attention span, and anxiety.

Cardiovascular System:
Toxic stress increases a child’s risk of developing high blood pressure later in life because it elevates levels of inflammation that can damage the arteries. This can lead to heart disease, stroke, and other serious heart issues.

Immune System:
Toxic stress raises the risk of infections and autoimmune diseases due to chronic inflammation and other factors. This can impair the normal development of the body’s immune system.

Endocrine System:
Toxic stress can inhibit the functioning of hormones that regulate growth and development. It can also lead to obesity and impede or accelerate the onset of puberty.

This is what toxic stress looks like: It’s the relentless fear, anxiety, uncertainty, and terror that can cripple a child’s developing brain and body.

ACEs are not just experiences, they are events that cause chemical disruption in the body and result in lifelong mental and physical health issues. When a child is traumatized, abused, or neglected, we are changing who they are at a cellular level and causing damage from which it is very difficult to recover.

But hormones are powerful agents for good, too. A few months ago, this blog series focused on resilience and how to be a buffer for a child. Science shows that the presence of just one positive adult influence in a child’s life can help mitigate against the detrimental effects of ACEs. How does that work on a cellular level?

The Science of Kindness
As well as hormones that protect us, we have hormones that keep us close as a society. Human beings are communal creatures and we’ve developed to co-operate and help one another. Our bodies are even programmed to want to do this because it facilitates our survival imperative: we are stronger together than we are alone.

Acts of kindness often bring us a good, warm feeling. That’s not just an emotion, it’s a chemical reaction in the body. Kindness or altruism releases a chemical in our blood called oxytocin which sends positive, self-affirming signals to our brain. It’s often called the happiness drug. Oxytocin, along with dopamine and serotonin, make up what’s called the Happiness Trifecta. They increase the production of neurochemicals that lift your mood.

Kindness, care, support, warmth, compassion, and love all release these amazing chemicals which have positive health effects like lowered blood pressure, which reduces strain on the veins and arteries and can help stave off heart disease. These positive chemicals are fast-acting, too. In fact, chemicals resulting from a kind or loving interaction can positively influence the brain in as little as 3 seconds!

Remember a time when you felt anxious or depressed. Think how good a simple hug from a loved one felt at that time. That’s oxytocin! There’s a reason it’s called the “cuddle hormone”. Think about how uplifting an unexpected compliment can feel. That’s dopamine! The Happiness Trifecta help both the giver and the receiver to raise their levels of good, happy hormones. And its these hormones that counteract and neutralize the effects of adrenaline and cortisol.

Every time you have an interaction with a child that’s focused on giving something positive to them–even if it’s a high-five, a thumbs up or a big smile–that’s medicine that works as an antidote to ACEs. It hardly seems possible that it’s also doing great things for your own body, too.

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ACEs and Divorce

Kerry Jamieson Fighting ACEs PBC, Latest News , , , ,

Between 40 and 50 percent of US marriages end in divorce. Divorce may seem commonplace, even mundane, these days but its prevalence is exactly what makes it such a threat to the healthy mental and physical development of children. While divorce may have become more socially acceptable in recent decades (or even ‘normalized’) the experience for children is almost universally difficult. There is no doubt that the conflict and chronic stress involved in divorce is one of the leading causes of trauma in young children and a very significant ACE (Adverse Childhood Experience).

Even when both parents agree that it’s the best decision, divorce is a confusing, difficult process for adults, let alone children. Divorce introduces new stressors into a child’s life. Whether the separation occurs when they’re three or 13, children worry about what’s happening to their family. Often, children experience feelings of fear, uncertainty, anger, and disappointment. To a child, a divorce can feel like a violation of trust or a broken promise. Most children rely on their homes to be a place of security and safety. Breaking up that home shakes their world to its core. Little brains that are still forming cannot process information in the same way a more reasoning adult can. Children tend to internalize feelings of guilt or self-blame over their parents’ divorce that can affect them for the rest of their lives.

True, there are millions of successful adults who grew up as children of divorce. While ‘pro-marriage’ groups say all divorce has negative impact on children, other studies do seem to indicate that it is preferable for unhappy parents to separate and care individually for their children than for children to be raised in two-parent homes filled with resentment or even rage. A recent British study shows that 82% of children (aged 14 to 22) whose parents divorced  preferred their parents to separate agreeably than to ‘stay for the kids’. Divorce becomes an even more urgent decision when domestic abuse or violence against one or both partners (or the children themselves) is occurring. But there are as many adult children of divorce who are still trying to deal with the emotions and experiences their parents divorce caused them. Some studies indicate that the death of a parent (one of the most significant ACE indicators) may be easier for some children to understand and manage than divorce. In a child’s mind, it is easier to think that a parent died rather than that they left by choice.

Why is divorce such a powerful ACE?

• It introduces intense feelings of uncertainty, often for the first time if it happens very early in a child’s life
• It can cause an environment of chronic stress from anger, bitterness, and fighting
• It may cause economic strain on one of the divorcing parents
• It may separate the child not only from one parent but that parent’s family members who may have been a loving and stable influence
• It may expose a child to a parent’s new partners, which can increase risk of physical or sexual abuse

Of course, resilience levels among children are different. Some children cope and adapt better to divorce than others. Even among siblings experiencing the same divorce environment, the reactions may vary dramatically.

What Are the Warning Signs?

Here are just some of the indicators that your child may be having difficulties coping with your divorce:
• Poor performance or declining grades in school due to inability to focus
• Behavioral problems like attention seeking, “acting out”
• Mood swings or prolonged sadness/depression
• Apathy or loss of interest in places or activities they once enjoyed
• Less interest in spending time with friends
• Unwillingness to cooperate with everyday activities/defiance
• Low self-esteem and withdrawal
• Regressing to younger behaviors in an attempt to return to babyhood, clinginess
• New or increased irrational fears

If you’re dealing with divorce, be aware that even very young children may struggle emotionally. Short-term sadness and anger are normal. If negative emotions and behaviors continue beyond a few months, experts suggest counseling. Organizations like the Center for Child Counseling can provide expert, age-appropriate therapy to help children during and after a divorce. If an ACE like divorce is not addressed adequately, children may be impacted long-term and have a higher likelihood of using drugs and getting involved in criminal behavior later in life.

Adults Recall the Childhood Trauma of Divorce

When adult children of divorce look back on their childhood experiences, many express that it was the stress and conflict that was created by the divorce and not the splitting of parents itself that was so difficult to overcome. Often, children are used as pawns or become weapons in the fight between the separating partners. Asking children to choose between parents is extremely traumatic and brings feelings of anxiety and guilt that can last a lifetime.

Most times, parents go into self-protective, offensive mode and “lawyer up” which, while advised for many reasons, can create an immediately hostile and adversarial environment into which the children are inevitably dragged. The numerous emotions adults feel during a divorce—grief, anger, disappointment, loss of control, fear, loss of status, antagonism, bitterness, sadness, etc.—may also be experienced by children in different ways and for different reasons.…and if adults find it difficult to identify and cope with the emotions being raised, how much harder must it be for a child’s growing brain to process?

Parents who prioritize their children’s needs during a divorce should be viewed as heroes who have managed to look beyond their own emotions and chosen not to put their children at risk for long-term repercussions associated with ACEs.

Minimizing the Impact of the Process

You don’t have to put your own interests/needs last in order to put their children’s interests first. There are different ways to get a divorce. Parents can try to choose a non-adversarial form of divorce, if possible. They can consider mediation or collaborative resolution, if the nature of the divorce allows for it. It’s cheaper and often less traumatic for everyone involved.

Of course, there are as many different kinds of divorce as there are marriages. Some divorces are divisive and going to court may be inevitable. Center for Child Counseling board member and partner at Ward Damon, Eddie Stephens views ACEs from a family court perspective. He sees the trauma in families going through divorce: “There is an incredible amount of dysfunction out there. It is on full display in family courtrooms across the nation. Most professionals are just dealing with symptoms (substance abuse, violence, reckless behaviors), but little is done to address the root cause. In more cases then not, these individuals have suffered through some kind of traumatic experience(s) as a youth. That is the problem that needs to be addressed… not just the symptoms.”

Stephens sees how childhood trauma is transmitted from one generation to the next.

“The goal should be to create a trauma-informed society that appreciates the impact ACEs can have on an individual throughout their lives. If we shifted resources and provided the needed therapy when these kids were young, we would be more likely to stop the generational cycle which would lead to a healthier society. If we don’t embrace that approach as a society, we will continue to spend money on the symptoms while further generations become entrapped in this horrible cycle of dysfunction.”

Try to Have a ‘Grown-Up Divorce’

Children mimic grown-ups’ behavior. They learn what maturity is by watching adults. Parents teach us lessons of sharing, listening, playing fair, and being honest and kind, yet so often these simple rules are broken during a divorce. For a little brain seeking to process these events, it’s all very confusing. Positive or negative world views are being formed at this stage of life and witnessing a mature versus an acrimonious divorce can skew a child’s views on the safety or danger of adult relationships for the rest of their lives.

Mature parents can minimize the impact of their divorce by focusing on some simple guidelines. They may sound like common sense but, in the heat of the moment, practicing these rules can be a challenge. However, it will benefit your child during your divorce and for the rest of their lives.

Communicate:
Wherever possible, communicate decisions about the divorce as a family. Ideally, if all parties are present, the child will understand what is happening and see that both parents still love them. Do not share intimate details of the causes of the divorce; share age-appropriate facts only. Avoid the “blame game” or “he said, she said” story-telling.

Prepare:
Tell your children ahead of time what will be happening and when. Nobody, especially a child, likes to be sidelined by dramatic, unexpected events. Tell your children, as early as possible, about major life events like moving houses, changing schools, etc.

Acknowledge Emotions:
Don’t try to pretend that this decision is the best choice and “better for everybody”. Your child may not feel that way. Empathize with their sadness and fear and allow them to talk about their emotions. Always allow them to talk positively about the other parent.

Prevent Stress:
Try not to expose your child to adult concerns. Ensure they don’t overhear cruel arguments or intimate issues. You need to walk a fine line between keeping them informed and protecting them from age-inappropriate facts, no matter how true.

Provide Structure:
Some of the biggest changes for a child going through a divorce is the loss of significant time with one parent or the other and the constant moving between new living spaces. If you can agree on universal rules that are obeyed at both homes, it will reduce stress for your child. Try to maintain routines and not change/cancel plans at the last minute. This will only add to your child’s anxiety and insecurity.

Keep Loving Buffers in Their Lives:
Your child should never have to choose one parent over the other and that goes for extended family members, too. Your child may be very close to your ex’s siblings (their aunts, uncles, and cousins) and your ex’s parents (their grandparents). These positive influences in their lives can help buffer against the stress of the divorce and minimize the effects of ACEs. Do your best to nurture those relationships and let your child enjoy the stability of still having these good, kind people in their lives.

Use Kind Words:
In the case of biological children you have in common, it helps to remember that your amazing, precious children are 50% your ex. Every bad thing you say about him or her, you’re saying about the children you share, too.

Don’t Force Them to Hide Things From You:
Your children are likely to feel torn or periodically disloyal during and after the divorce. Allow them to share positive thoughts or feelings about your ex. They shouldn’t feel that they have to hide funny stories or happy thoughts about your ex from you. You can find ways to reinforce these in a way that’s both honest and supportive of their feelings:
“I always loved how smart your mom is.”
“You dad always tells the best jokes.”

Love Them Extra:
It goes without saying that during this difficult time you should support your child even more than usual. Smother them with love and encouragement. In the case of an especially hard divorce, you might try to remind yourself that you love your child more than you hate your ex.

There is no reason your divorce should be a childhood trauma that scars your children for life. So many parents manage to get it right and provide two secure, stable and happy homes for their children after their divorce. The ultimate goal is not to “win your divorce” but for your children to have a lifelong positive relationship with both their parents.

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ACEs and Pregnancy

Kerry Jamieson Blog, Fighting ACEs PBC, Latest News, Uncategorized , , , ,

For many women, seeing a positive result on a pregnancy test is a moment of pure joy, the culmination of months (or even years) of hope, and the start of a fulfilling journey to motherhood. But pregnancy isn’t easy, physically or emotionally. It places extraordinary demands on a woman’s body and may cause stress in relationships, introduce financial hardship, and affect self-esteem. It is undoubtedly the most dramatic and permanent life change most women will ever face.

As wonderful as the prospect of bringing a new life into the world may be, it comes with its own unique set of challenges when viewed through a trauma-informed lens. The two lives of a mother and her growing infant are inextricably intertwined, and stress and trauma can have a startling impact on both. While a mother brings her own childhood experiences to her pregnancy, she may also be encountering new ones, and since the baby is exposed to all the hormones and emotions of the mother during its crucial in-utero development, pregnancy is a critical time to discuss Adverse Childhood Experiences (ACEs).

To discuss ACEs and pregnancy fully, we need to understand it from two points of view.
1.) How ACEs have affected the mother’s life, how they may still be affecting her mentally and physically, and how they might interfere with her ability to nurture and care for her child.
2.) How a mother’s ACEs affect her developing baby and what effects the infant might experience in the womb and during its first few years of life.

A Time of Change and Challenge

Some of the issues a prospective new mom might be going through include:
• identity shifts
• fear of inadequacy as a parent
• loss of independence
• delay or loss of personal goals and dreams
• relationship conflicts
• financial uncertainties
• ambivalence about bonding with her baby
• body image difficulties
• hormonal dysregulation
These issues are especially magnified if the pregnancy is unplanned or unwanted.

In addition to all these new feelings and insecurities, finding out that she is pregnant often focuses a mother-to-be's attention on the concept of parenting. This can bring past traumas to the surface, especially if she was a victim of childhood abuse or neglect. Symptoms of depression, anxiety, or post-traumatic stress may return, or surface for the first time, during pregnancy. It's a tumultuous time and one when the consequences of ACE can be clearly seen but also an opportunity to intervene and hopefully prevent the cycle of ACEs from continuing into the next generation.

For example, a recent study using data from the 2010 Nevada Behavioral Risk Factor Surveillance System showed that a history of childhood stressors, such as physical, sexual, and emotional abuse, influenced alcohol use among pregnant women. The research found a dose–response relationship between ACEs and alcohol use during pregnancy. This study contributes to a growing body of research that shows that the factors affecting alcohol use during pregnancy begin long before pregnancy...in fact, they likely begin in the pregnant mother’s own childhood.

Health Risks Associated with High ACE Scores

When adults become parents, the effects that ACEs have had on their own bodies, minds, and behaviors can influence how they experience their pregnancy as well as the physical health of their growing baby.

  • When a pregnant woman is exposed to chronic stress, large amounts of neurohormones are released into her blood stream and can change the developing fetus' own stress response system.
  • Maternal stress hormones can cross the placenta as early as 17 weeks into pregnancy.
  • Women with high ACE scores are more likely to develop gestational diabetes and high blood pressure.
  • They are more likely to deliver prematurely or have a baby that is underweight or requires NICU care.
  • Even when they deliver full-term, their babies are at greater risk for developmental delays.

The good news is that during pregnancy mothers are particularly receptive to ideas on how to positively impact their baby’s life and more open to positive reinforcement about improving their own lives. Pregnancy represents the perfect point to intervene on behalf of both mother and child. Often, just finding out that she is pregnant brings a new sense of hope and determination to a woman. Pregnancy offers the opportunity for her to discuss her own childhood issues, make improvements in her life, and perhaps really confront past traumas for the first time. Pregnant women should be encouraged to openly and honestly ask for support from family and friends. In most cases, once loved ones are aware of past trauma, they respond with concern and compassion, which can be a relief for the mother-to-be and a source of comfort. For some, this may well be the right time to consider counselling or seek professional support, if needed.

Identifying At-Risk Moms

Identifying moms-to-be with high ACE scores is crucial. A simple ACE questionnaire conducted during routine pre-natal care visits can indicate the need for early intervention. This tool can help begin discussion around the concept of ACEs -- that a mom's (and other caregivers') behaviors when the baby is in utero and during its first few years of life can position their baby either for success and wellbeing or for possible lifelong poor health outcomes.

According to a study published earlier this year in the Journal of Women’s Health, when moms-to-be were surveyed at two Kaiser Permanente clinics in Antioch and Richmond, CA, from March through June 2016, clinicians discovered that the women were receptive to filling out an Adverse Childhood Experiences (ACE) survey. The researchers found that the vast majority of the pregnant women — 91 percent of the 375 surveyed— were “very or somewhat comfortable” filling out the ACE survey. Even more, 93 percent, said that they were comfortable talking about the results with their doctors. Simply using the ACE questionnaire as a tool provides an opening for discussion and thus plays a small part in providing a safeguard for the unborn baby and hopefully preventing multigenerational trauma transmission. For the most at-risk women, an intensive course of action might be necessary.

How Can We Protect a Baby in utero When ACE Scores are High?

Providing an at-risk pregnant woman with intensive support and practical resources will benefit her, her baby, and those around her.
The ideal approach would include all or most of the following:

  • Conduct joint counseling sessions with a professional therapist, the mother, the father, and other children in the home. This can be extremely helpful and informative for all involved.
  • Fully integrate behavioral health services with the mother’s medical team to optimize outcomes.
  • Train all medical staff (including pediatricians, midwives, OB-GYN practitioners, and ultrasound technicians) to be trauma-informed.
  • Connect the mother with a nutritionist and other ancillary support services for after she delivers.
  • Encourage the mother to connect with the baby in utero to promote bonding and stimulate mothering instincts.

Center for Child Counseling works extensively to implement some of these best practices. Therapists in our Infant Mental Health Program (funded by the Children's Services Council) provide services throughout Palm Beach County for pregnant women, new mothers, and young children. We also partner with Healthy Mothers, Healthy Babies in their efforts to provide support to all new moms and their babies born in the County.

Research increasingly shows that the connection between a pregnant mother and her unborn baby is even more powerful than previously imagined. While love may be instantaneous and natural for most moms-to-be, it may not be as intuitive for women who have a history of abuse, neglect, or trauma. These mothers can work on building that bond by practicing some loving exercises with their unborn baby.

For example, here are some ideas to help a pregnant woman connect with her growing baby girl:

  • Tell the baby often that she is loved.
  • Share how happy you are that she is a girl.
  • Reassure the baby that you are eagerly waiting to meet her.
  • You are ready to care for her, meet her needs, and protect her.
  • Her birth is welcome. She is good news.
  • Read stories to her, sing to her, and laugh as often as possible.
  • Choose and use silly, loving nicknames for her.
  • Babies seem to respond strongly to music and rocking/swaying. Dance with her.
  • Your voice forms a bond with your baby. Talk to her.

The Role of "Buffers" for Moms and Babies

Since we know that “buffers” are the single greatest weapon in the fight against ACEs, pregnancy is the perfect time to be the buffer for an expectant mom.

Listening, showing genuine concern, and offering love and support is the single greatest gift you can give a mom with a high ACE score.

You might share strengths you see in her. Constantly reassure her that she is a kind, capable, strong woman and that she is going to be a wonderful, giving mom. She does not have to repeat mistakes from her past and can give her baby the gift of a happy childhood, even if she never experienced that herself. Support should come, crucially, from spouses or partners (if they are present), but friends, family members, and neighbors can help, too. Community support is key. Women who connect with no- or low-cost community support programs fare better than those who remain isolated. Mothers-to-be support groups, centering circles, and even children’s reading groups at local libraries are places where pregnant women and new moms can meet and share with one another.

Pregnancy is a time for teamwork at every level. When mothers who have experienced childhood trauma feel supported by the people around them, their risk of pregnancy complications and repeating negative patterns are substantially reduced.

ACEs don’t define who we are or who we will become. Every pregnancy is a brand-new start, a fresh chance to bring a happy, healthy new life into the world. With support, people who have endured ACEs can achieve emotional and physical well-being and be given a better chance to avoid repeating trauma-causing cycles. It is compelling to realize the real difference each of us can make in someone else’s life – simply by choosing to be a kinder, more compassionate, and more giving person.

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ACEs and Minorities

Kerry Jamieson Fighting ACEs PBC, Latest News , , ,

ACEs and Minorities

ACEs can affect anybody, anywhere. Children experiencing adverse situations, and adults who experienced adversity when they were children, come from all walks of life. ACEs are not confined to any particular race, religion, socio-economic background, or nationality. Any child can experience the sustained toxic stress associated with untreated trauma and suffer negative mental and physical health effects.

The original study on Adverse Childhood Experiences conducted by the Centers for Disease Control and insurance giant Kaiser Permanente in the mid-1990s unearthed this fact early in their research. Their study was conducted among 17,000 middle-class Americans living in Southern California. Even though these original participants were not necessarily representative of the average American, approximately half of them had still experienced at least one ACE.

Subsequent US-based ACE studies, including the largest study conducted to date between 2011 and 2014, have consistently shown the same general prevalence of ACEs among American children. This far larger sample group, and the data accumulated from many studies, highlighted some startling differences in who is most likely to suffer from ACEs. Children from minority backgrounds—whether based on race, socio-economic standing, or sexual orientation—were at distinctly higher risk of ACEs and their devastating life-long effects than middle-class white children.

At-Risk Minority Groups

Children of different races and ethnicities across the country do not experience the same exposure to ACEs. In the United States, 61% of black children and 51% of Hispanic children have experienced at least one ACE, compared to 40% of white children. In every part of the country, the lowest rate of ACEs was among Asian children. In most areas, the population most at risk was black children.

Geographic regions also showed different results. Compared to the national average of 1 in 10 children experiencing and ACE score of 3 or more, in 5 states—Arizona, Arkansas, Montana, New Mexico, and Ohio—1 in 7 children had experienced the same.

In Florida, 49% of children between birth and 17 reported no ACEs. 26% reported 1 ACE, 14% reported 2 ACEs and 10% reported 3 or more ACEs. This is generally in line with national averages.

The high occurrence of ACEs among minorities can likely be attributed to the uneven provision of services and opportunities in minority neighborhoods. This inequity is caused by social determinants of health. The World Health Organization describes the social determinants of health as “the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources.” These result in the unfair but avoidable differences in health status seen between different neighborhoods, zip codes, and even states. The social determinants of health are responsible for most health and other social disparities.

ACEs Clusters

ACEs are the result of not only situations children face within their own homes or families but the general circumstances in which they live. Because the impact of ACEs is cumulative, we see high rates in areas where several detrimental situations are occurring simultaneously. For example, a neighborhood where there is a high rate of unemployment, few educational opportunities, a strong gang presence, and high rates of domestic violence is likely to produce children who are suffering from clusters of ACEs. Because of this, ACE studies now look at the cumulative effects of ACEs rather than the individual effects of any one specific ACE.

ACEs caused by the community environments where a child is raised go hand-in-hand with the ACEs occurring in individual homes and within families.

So, ACEs aren’t a racial issue; they’re a societal one. People with low incomes and limited education are also more likely to experience ACEs, as are people who identify as gay, lesbian, bisexual, transgender, or are questioning their gender or sexuality (the LGBTQ community). According to numerous research papers, including one published by the US National Library of medicine/National Institutes of Health, this group has a dramatically higher chance of experiencing childhood trauma, probably the result of lack of understanding among family members, the taboo of discussing these issues in some communities, and the stigma often imposed by society at large.

Helping children in these particular minority groups involves cultural sensitivity and the kind of community education that takes a long time to penetrate established ways of thinking. For many children confronting overwhelming adversity and inequity, buffering relationships are needed. It is essential to address the rejection and hardships they are statistically likely to experience in their lives - with a mental health professional or caring mentor or teacher who understands the impact of these experiences. Success among marginalized groups involves developing strong internal fortitude in children and encouraging them to eventually find accepting, supportive friends, if these relationships are not available at home or school.

It’s clear that minorities, children living in economically challenged neighborhoods, and members of traditionally marginalized groups are in particular need of support in the fight against ACEs.

Solutions

Now that we know that certain groups are more likely to experience ACEs, what can we do? As individuals and communities, we can channel our efforts. A high ACE score does not predestine a child for poor life outcomes, but it does identify that child as vulnerable. Since the fight against ACEs has two primary weapons, namely 1.) building resilience and 2) promoting healthy relationships (the internal and external supports, if you like), we can provide two practical forms of assistance to targeted groups.

Building Internal Coping Skills

To build resilience in children, they need to be taught how to self-regulate and cope. Anybody can help a child to develop these vital skills. Simple techniques like providing encouragement, supporting special interests, and even just taking notice of a child is, in some small way, building self-esteem and promoting independence and strength. Children will copy the actions of adults, especially those they admire. Showing children how to calmly and fairly negotiate, compromise, demonstrate empathy, and look at all sides of an issue can help them establish a new way of thinking. Remember that children mimic both positive and negative behaviors, so it’s important to carefully consider the messages you’re sending with your behaviors and choices.

Providing External Support Systems

Of course, the most at-risk children may need professional assistance to build effective coping skills and resilience. Offering age-appropriate early intervention and mental health care in childcare centers and elementary schools (especially in at-risk neighborhoods) is the obvious place to start. Center for Child Counseling, with support from local funders including Quantum Foundation, has developed a comprehensive model for childcare centers and schools, including trauma-informed education for all caregivers, classroom-based mindfulness activities, and direct services for children identified as needing assistance. The model focuses on transforming the school environment, which in the long-term, impacts all students.

Another approach is to provide supplemental support systems in at-risk neighborhoods. Many highly-respected nonprofits do just this by creating places where children can meet, play, and be in contact with positive, caring role models and mentors. Local organizations like Urban Youth Impact, the YMCA, Compass, and Big Brothers Big Sisters are all examples of nonprofits in Palm Beach County  focused on creating positive relationships that may be absent from the home.

And, as always, every one of us can play a role in the fight against ACEs by advocating for children, encouraging every child we encounter in our lives, and being on the alert for children who may need the support and help of a caring, ACEs-aware adult.

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ACEs: How to Be a Buffer for a Child

Kerry Jamieson Fighting ACEs PBC, Latest News , , , , ,

Research shows that just one positive adult can dramatically improve the outlook for a child suffering from Adverse Childhood Experiences (ACEs). Learn how your simple actions can provide a buffer against toxic stress and change the course of a child's life.

Remember when you were a child. Think back. Remind yourself how vulnerable you were. The world was big; you were little. Was there ever a time when someone protected you? For many of us, it was an older sibling, maybe a big brother, who stepped in, literally, and came between us and a bully or danger. Do you remember how safe that made you feel? How exhilarating it was, in your moment of need, to know that you could rely on help to arrive. When you hurt yourself or had your feelings hurt, you probably ran to a parent who gave you a caring hug and soothed you. Without consciously knowing it, those of us with these sorts of memories were running to a buffer, looking for the concern and protection every single child needs and deserves…but which not every child gets.

For millions of children worldwide, Adverse Childhood Experiences (ACEs) make growing up a challenge at best and a chaotic nightmare at worst. The brain of a child growing up in a home with attentive parents will create a world view where adults as safe, predictable, and a source of love and sustenance. But the brain of a child living in a home plagued by domestic violence or neglect will create a world view where adults are unreliable and a source of fear and pain. Children carry these ideas with them and they color all future relationships. Depending on their experiences and outlook, children can grow to become nurturing, invested adults or mistrustful, suspicious and withholding.

During this blog series, we’ve learned about ACEs, their tragic lifelong consequences for individuals and communities, and how we must urgently address this greatest of all public health crises. Rather than being overwhelmed by the statistics though, let’s focus on hope because healing is possible.

As a society, we now know more about ACEs than ever before. That knowledge empowers us. On a system level in Palm Beach County, we’ve mobilized the community to fight ACEs, but the truly encouraging news is that you don’t need to be an expert to help turn a child’s life around. Of course, severely traumatized children might need the professional help and compassion provided by skilled therapists like those at the Center for Child Counseling, but for many of the others the answer is relatively straight-forward. The answer is you.

As someone who loves and cares for a child, or who interacts with children often, it is vital to be ACEs educated and trauma informed. Simply by reading this educational blog series, you’ve demonstrated an interest in the subject. You’re already equipped to play your small but vital part in the fight.

Adjust Your Approach
Being trauma-informed really means adjusting our thinking and the way we respond and react to a child’s behavior. Instead of asking: “What’s wrong with you?” the focus should be: “What happened to you?” This changes our attitude to consider what the child has experienced rather than the resulting behaviors which may be frustrating. Follow-up questions will help get to the cause of the problem, questions like: “When did this happen?”, “How long has it been going on?” and “Who has been there to help you since this happened?” This way of approaching children helps to avoid re-traumatizing already traumatized people. It creates a safe, non-judgmental place where children feel secure enough to share their experiences and ask for help without fear of punishment or retribution.

Be a Buffer
Supportive, loving caregivers can buffer the effects of toxic environmental stress. There are many ways you can support a child with ACEs. Studies show that a positive, nurturing relationship with even one engaged adult can help a child cope with adversity. Consider how you interact with children—your own and other people’s—and focus on being loving, kind, and genuinely interested in them.

Easy Ways to be a Buffer
In the bestselling novel “The Help” by Kathryn Stockett, a devoted nanny repeatedly tells the young child in her care: “You are kind. You are smart. You are important.” Let that be your mantra when helping a child who has experienced ACEs. Whether you’re a teacher, neighbor, coach, community volunteer, or friend of the family, being a buffer means employing several different approaches aimed at:
• Reducing stress
• Building positive relationship
• Strengthening life skills

Here are some practical, real-world ways you can combat the toxic stress caused by ACEs.

Celebrate:
When we celebrate a child’s achievements and challenges, both big and small, and affirm who they are as individuals, we support the development of their self-identity and remind them of their competence, importance, and lovability. When we acknowledge their birthdays, graduations, or everyday accomplishments like completing their homework, making a new friend, or doing chores, we help children build positive self-esteem. It may be something as simple as a clap, a smile, or a ‘thumbs up’. These simple gestures are expressions of support that can build self-confidence and help a child to thrive.

Comfort = Safety:
Children who have experienced trauma or toxic stress need comfort. Often, they need help to manage their emotions and to calm themselves down. Practicing relaxation, patience, and emotional regulation may help them connect with their feelings. Creating a safe environment is one of the most valuable components in re-establishing a sense of security and stability for a child. Whether the issue seems big or small, offer reassurance and always reinforce your commitment to be there for them. Sometimes it can be difficult to stay calm and supportive when a child exhibits the behaviors associated with toxic stress, but a measured response tells them that you are solid and reliable.

Help Children Collaborate:
Science shows that children who have been exposed to toxic stress may struggle to appreciate others’ perspectives. They may lack a sense of belonging. They may not have the skills or the know-how to reach out. And they may need help controlling their emotions, working through their problems, and gaining independence. Every day there are opportunities to collaborate or work with children towards common goals. With simple examples, you can teach problem solving and basic negotiating techniques to deal with conflict. When children learn to collaborate fairly, they feel like part of a team rather than isolated.

Grow Optimism:
We’ve already learned that a young child’s growing brain has plasticity – it’s still forming neural pathways and those pathways can be altered for the better. Brain science shows that we can actually train our brains to be more optimistic and hopeful about the future by practicing positive self-talk. You can reinforce this kind of positive brain growth in the children you know.

Don’t Just Hear…Listen:
It may sound easy, but listening is a skill we all need to practice. For all children, especially those who have experienced traumatic stress and violence, a patient and receptive adult who listens can help them feel safe and valued. Active listening means paying careful attention to what is being said, rather than simply hearing it. Listening is the foundation of learning and understanding what a child is trying to communicate. It shows care and concern. Listening to a child and teaching them how to listen helps them communicate and see situations from other people’s perspective – a key to empathy. Whether children are sharing happiness, sadness, anger, or fear, having someone truly listen to them matters.

Hold on to Healthy Relationships:
Often, when parents separate or divorce, it becomes a challenge to help kids maintain healthy contact with grandparents, supportive adults, and extended family members. One key to reducing stress is making the effort to maintain contact with these positive influences. It’s never a bad idea to let your children interact with people who truly love them…sometimes it means setting aside personal feelings in the best interest of the child.

Inspire:
To inspire someone means to lift them up with your words. Children need constant encouragement to recognize and reach their full potential. They need help identifying dreams and working towards them. Children who have witnessed violence and experienced traumatic stress can become negative, often have a low sense of self-worth, expect to be unsuccessful, and fail to foresee a positive future. But caring adults can help children reverse these negative responses. You can help inspire a child by identifying their strengths and natural talents and by connecting them to programs that help develop self-confidence.

Those who spend more time with children, like teachers, caregivers and, of course, parents have a greater opportunity to provide the tools that can really have a positive impact. Increasingly, schools, sports clubs and community events aimed at children are including elements of mindfulness training, self-care, and self-regulation activities in their work. But every one of us, even those of us who only have time to give a child a quick high-five, can consider it a privilege that we are contributing to that child’s resilience, health, and wellbeing.

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