adverse childhood experiences (aces): the science of ... · adverse childhood experiences (aces):...
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Adverse Childhood Experiences (ACEs): The Science of Trauma &
ResilienceMarch 7, 2018
Christy Gauss, MSWIndiana School Mental Health Initiative | Indiana Institute on Disability & Community
Indiana University
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Learning Goals
Definition/types of trauma
Overview of the Adverse Childhood Experiences (ACEs) Study and the prevalence of childhood adversity
Impact of ACEs
3 Pillars of Trauma Informed Care
How to build resiliency
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Troubled Children and Youth
“Troubled kids are distinguished by their
regrettable ability to elicit from others exactly the
opposite of what they really need.”
(L. Tobin)
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What is Trauma?
Exposure to an event that threatens or harms the physical or emotional integrity of the individual or someone close to the individual.
Overwhelms the person’s ability to respond in a healthy way (physically, emotionally, and/or mentally).
Creates significant difficulty in functioning. For our children and youth it can have a significant impact on their social, emotional, and cognitive development, including their ability to self-regulate and learn.
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Types of Trauma
Acute trauma: The response to a one-time event
Complex/developmental trauma: Exposure to multiple traumatic events Often of an invasive and interpersonal nature Wide-ranging Causing long term impactNational Child Traumatic Stress Network
Historical/generational trauma: A constellation of characteristics associated with massive cumulative group trauma across generations. Brave Heart, M.Y.H. (1999)
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Under Perceived Threat, the Brain Downshifts
When stress builds our brains literally downshift.
FIGHT
FLIGHT
FREEZE
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What if this bear walked into this room right now?
How are you feeling?What are you going to do? Flee? Fight? Freeze?Are you listening to the presentation?Critical learning – to many children & youth impacted by trauma, adults and situations can be perceived as “bears” that sometimes are very dangerous
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Trauma: Stress-Response
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Toxic Stress: Acute vs. Chronic
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ACEs Study
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Adverse Childhood Experiences Exposure to . . .
Emotional, Physical, and Sexual Abuse
Emotional or Physical Neglect
Domestic Violence
Caregiver Substance Abuse
Caregiver Mental Illness
Parent Separation or Divorce
Incarceration of a Parent
Death or loss of loved one
Life threatening illness in a caregiver or faced by a child
Bullying/Social Exclusion or Isolation
Community violence
Natural Disasters
Economic Hardship/Poverty
Being a “Young Caregiver”
Microaggressions/micro-inequities
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Adverse Childhood Experiences Indiana Children Birth to 17
54%23%
23%
0 ACES
1 ACES
2+ ACES
2016 National Survey of Children’s Health (NSCH).
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13
Source: Washington State Family Policy Council
Prevalence of ACEs in Students
13 of every 30 students in a classroom experience toxic stress from 3 or more Adverse Childhood Experiences (ACEs)
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National Prevalence
• In the U.S., just under half (45%) of children have experienced at least one or more adverse experiences
• One out of 10 children have had three or more negative experiences placing them in high risk category
• Economic hardship and divorce or separation of a parent or guardian are the most common ACEs reported nationally, and in all states
2016 National Survey of Children’s Health (NSCH).
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National Prevalence
Children of different races and ethnicities do not experience ACEs equally. Nationally, 61 percent of black non-Hispanic children and 51 percent of Hispanic children have experienced at least one ACE, compared with 40 percent of white non-Hispanic children and only 23 percent of Asian
non-Hispanic children.
2016 National Survey of Children’s Health (NSCH).
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Cumulative ACES Increase Risk for Poor
Outcomes
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Trauma & Learning
Stressed brains do not learn the same as brains that feel safe, can emotionally regulate, and feel connection. Simply stated, stressed brains don’t learn the same way.
Because these stressors either go unrecognized or there is a lack of knowledge about their effects on learning and behavior, students dealing with adversity and stress are often identified or mislabeled as having behavior, discipline, and/or learning issues in a school setting.
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“Focusing on academics while struggling with trauma is like trying to
play chess in a hurricane.”
51% of children with 4+ ACE scoreshad learning and behavior problems in school
Compared with only 3% of children with NO ACE score
ACES are the best predictor of poor health and second best predictor of academic failure
(Burke et al, 2011)
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What Trauma Look Like . . .
Physical symptoms like headaches and stomach aches
Dysregulation/Poor control of emotions
Day dreaming or disengagement
Can sit in a classroom & not learn/labeled as learning disabled/Have difficulty retaining information
Inconsistent and/or impulsive behavior
Resisting transition or change
Intense reactions to reminders of their traumatic event
Thinking others are violating their personal space (i.e. “What are you looking at?”
Blowing up when being corrected or told what to do by authority figure
Fighting when criticized or teased by other
Over- or under-reacting to bells, physical contact, doors slamming, sirens, lighting, sudden movements
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“ A study estimating the relative influence of 30 different categories of education, psychological, and social variables
on learning revealed that social and emotional variables exerted the most powerful influence on academic
performance.”
Collaborative for Academic and Social Emotional Learning (CASEL)
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“We tend to view misbehavior as a resistance because we understand where we want children to go. Children view misbehavior as protection because they know where they have been.”
(L.Tobin)
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The Needed Perspective Shift
“What’s wrong with you?”
“What happened to you & how can I help?”
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Resilience: A Definition
The process of adapting well in the face of adversity, trauma, tragedy, threats, or significant
stress. It is the counterbalance of trauma.
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Characteristics of the
Individual
Characteristics of the Traumatic
Event
Characteristics of the
Environment
Factors Influencing the TraumaResponse
traumasensitiveschools.org/wp-content/uploads/2013/06/Helping-Traumatized-Children-Learn.pdf page 108
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Characteristics of the
Individual
Characteristics of the Traumatic
Event
Characteristics of the Environment
Factors Influencing the TraumaResponse
traumasensitiveschools.org/wp-content/uploads/2013/06/Helping-Traumatized-Children-Learn.pdf page 108
Characteristics of the
Individual
• Child’s age and stage of development
• Prior history of trauma
• Intelligence
• Strengths and vulnerabilities of personality style
• Individual’s culturally based understanding of the trauma
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Characteristics of the
Individual
Characteristics of the Traumatic
Event
Characteristics of the Environment
Factors Influencing the TraumaResponse
traumasensitiveschools.org/wp-content/uploads/2013/06/Helping-Traumatized-Children-Learn.pdf page 108
• Frequency, severity, and duration of the event(s)
• Degree of Physical violence and bodily violation
• Level of terror and humiliation involved
• Persistence of the threat
• Physical and psychological proximity to the event (observer v. victim)
Characteristics of the
Traumatic Event
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Characteristics of the
Individual
Characteristics of the Traumatic
Event
Characteristics of the Environment
Factors Influencing the TraumaResponse
traumasensitiveschools.org/wp-content/uploads/2013/06/Helping-Traumatized-Children-Learn.pdf page 108
• Immediate reactions of caregivers, or those close to child
• Type of, quality of, and access to constructive supports
• Attitudes and behaviors of first responders and caregivers
• Degree of safety afforded the victim in the aftermath
• Prevailing community and attitudes and values
• Cultural and political constructions of gender, race and sexual orientation
Characteristics of the
Environment
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Safety, Connection and
Assurance of Well Being
Personal Agency,
Social Skills and
Academics
Emotional and
Behavioral Regulation
Three Pillars of Trauma Informed Care
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Always Empower Never Disempower
Maintain High Expectations
Check Assumptions, Observe and
Question
Be a Relationship Coach
Guided Opportunities for
Helpful Participation
Provide Unconditional Positive Regard
6 Principles of ResiliencyEmotional connection in the #1 factor in changing
the trajectory of ACES
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Belief Systems
Our children and youth’s belief systems about themselves.
Our belief systems about their (stress) behaviors –changes how we are called to respond.
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“What is predictable is preventable.”
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References Burke, N.J., Hellman, J.L., Scott, B.G., Weems, C.F & Carrion, V.C. (June 2011). “The Impact of
Adverse Childhood Experiences on an Urban Pediatric Population,” Child Abuse and Neglect, 35, No. 6
Child Trends.(2016). Adverse Childhood Experiences: National and State-Level Prevalence. Retrieved from https://www.childtrends.org/publications/prevalence-adverse-childhood-experiences-nationally-state-race-ethnicity/
Collaborative for Social, Emotional, & Academic Learning (CASEL). (2003). Safe and Sound: An Educational Leader’s Guide to Evidence-Based Social and Emotional Learning (SEL) Programs. Retrieved http://indiana.edu/~pbisin/pdf/Safe_and_Sound.pdf
Desautels, L. & McKnight, M. (2016). Unwritten the story of a living system: A Pathway to enlivening and transforming education. Deadwood, Oregon: Wyatt-MacKenzie.
Harris, W. W., Lieberman, F. A., & Marans, S. (2007). In the best interests of society. Journal of Child Psychology and Psychiatry, 48(3-4), 392-411.
Medina, J. (2008). Brain rules: 12 principles for surviving and thriving at work, home, and school. Seattle, WA: Pear Press.
Perry, B. D. (2009, November). Understanding the effects of maltreatment on brain development. Washington, D.C.: Child Were Information Gateway (CWIG) (p. 1-16
Trauma and Learning Policy Initiative (2013). Helping Traumatized Children Learn: Creating andadvocating for trauma-sensitive schools. Boston: Massachusetts Advocates for Children.
Wolpow, R., Johnson, M., Hertel, R. & Kincaid, S. (2016). The heart of learning and teaching: Compassion, resiliency, and academic success. Washington State Office of Superintendent of Public Instruction.