adverse childhood experiences (aces): the science of ... · adverse childhood experiences (aces):...

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

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

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)

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.

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)

Under Perceived Threat, the Brain Downshifts

When stress builds our brains literally downshift.

FIGHT

FLIGHT

FREEZE

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

Trauma: Stress-Response

Toxic Stress: Acute vs. Chronic

ACEs Study

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

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).

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)

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


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.


Cumulative ACES Increase Risk for Poor

Outcomes

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.

“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)

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

“ 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)

“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)

The Needed Perspective Shift

“What’s wrong with you?”

“What happened to you & how can I help?”

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.

Characteristics of the

Individual

Characteristics of the Traumatic

Event


Environment

Factors Influencing the TraumaResponse

traumasensitiveschools.org/wp-content/uploads/2013/06/Helping-Traumatized-Children-Learn.pdf page 108


Individual


Event

Characteristics of the Environment




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


Individual


Event




• 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)


Traumatic Event


Individual


Event




• 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


Environment

Safety, Connection and

Assurance of Well Being

Personal Agency,

Social Skills and

Academics

Emotional and

Behavioral Regulation

Three Pillars of Trauma Informed Care

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

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.

“What is predictable is preventable.”

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.

https://www.childtrends.org/publications/prevalence-adverse-childhood-experiences-nationally-state-race-ethnicity/

http://indiana.edu/%7Epbisin/pdf/Safe_and_Sound.pdf

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