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Developmental Adversity, Neurobiology, Trauma-Informed Care and Resilience. ?. Adversity, Health and Well-being Across the Life Span The Biology of Personal, Social and Historical Experience Building Resilience, Healing and Hope. Adversity and Trauma. Adversity-Difficulty, Misfortune
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Developmental Adversity, Neurobiology, Trauma-Informed Care and Resilience ?
Adversity, Health and Well-being Across the Life Span • The Biology of Personal, Social and Historical Experience • Building Resilience, Healing and Hope
Adversity and Trauma Adversity-Difficulty, Misfortune Trauma-Exposure to an Event that: • Threatens/harms the physical or emotional integrity of an individual or someone close to them • Overwhelms our ability to respond • Results in adaptations that create significant difficulty in functioning SaintA
Perinatal adverse circumstances by mother's exposure to childhood physical, emotional, and sexual abuse from the Nurses' Health Study, Roberts et al, JAMA Psychiatry. 2013 May; 70(5): 508–515
Cumulative ACES & Chronic Disease1 Prevalence % 1Felitti et al., (1998) American Journal of Preventive Medicine, 14:245-258.
Cumulative ACES & Mental Health Prevalence % Data from the National Comorbidity Survey-Replication Sample (NCS-R) - Putnam, Harris, Putnam, J Traumatic Stress, 26:435-442, 2013
Cumulative ACES & Impaired Worker Performance1 Percent % Reported 1Anda et al., (2004) The Permanente Journal/Winter 8:30-38.
Subsequent ACEs Work • In 2009, 85% of a homeless population reported at least 1 ACE, 55% reported 4 or more • In 2013 BRFSS,60% of adult Illinois residents and in NCHS, 40% of children Birth-17 had at least 1 ACE • In 2014, Juvenile offenders in Florida had an average composite ACE score of 3.5-4.3 ACE, Larkin, Illinois BRFSS, Child Trends, U of Florida
Chicago Longitudinal Study • 1202 low income, minority participants born 1979-80 • 2/3 had experienced>=1 ACE by age 18 • After controlling for demographic factors and early intervention >=4 ACE had poorer outcomes • Decreased high school graduation • Increased risk of depression and health compromising behaviors • Juvenile arrest and felony charges • Less likely to hold skilled jobs Adverse Childhood Experiences and Adult Well-Being in a Low income, Urban Cohort, Alison Giovanelli et al, Pediatrics 2016
Improving the ACE Scale by Acknowledging Additional Adversities The ACE Scale can be Improved by Adding Additional Adversities
Neurodevelopment and Attachment Sources: Bruce Perry, MD PhD; Daniel Siegel, MD
Alberta Family Wellness Initiative www.albertafmailywellness.org
Stress Positive or Tolerable Toxic Unpredictable Severe Uncontrolled Vulnerability • Predictable • Moderate • Controlled Resilience NMT
Brain Regulates Body through Autonomic Nervous System Thoughts or reactions to memories (am I safe?am I loved?) are transmitted from brain to bodyin less than a second
http://theexplanation.com/epigenetics-junk-genes-responsible-for-regulating-the-genes-themselves/http://theexplanation.com/epigenetics-junk-genes-responsible-for-regulating-the-genes-themselves/
What does it cost to do nothing? Each 2014 First-Time Case of Child Maltreatment Costs U.S. Economy Approximately $1.8 Million in Total Expenditures over their Lifetime1 $1.8 Million per 2014 victim1 Graphic from Pew Issue Brief Jan 2011: Paying Later: High Cost of failing to Invest in Young children. 1Suffer the Little Children: An Assessment of the Economic Costs of Child Maltreatment The Perryman Group, info@perrymangroup.com
Building Resilience from the Bottom Up Reason Relate Regulate NMT
http://coldspringcenter.org/images/paradigm.jpg?crc=3889177909http://coldspringcenter.org/images/paradigm.jpg?crc=3889177909
https://lifeinstructionmanual.wikispaces.com/Bronfenbrenner%27s+Bioecological+Modelhttps://lifeinstructionmanual.wikispaces.com/Bronfenbrenner%27s+Bioecological+Model
SAMHSA’s Concept of a Trauma-Informed Approach ACEs and the Next Generation ACEs and the Next Generation SAMHSA/National Council on Behavioral Health 2013
https://makingmomentsmeaningful.blog/2017/04/13/trauma-informed-care-values-youth-worker-values/https://makingmomentsmeaningful.blog/2017/04/13/trauma-informed-care-values-youth-worker-values/
The Path to Becoming a Trauma Informed Organization https://aifs.gov.au/cfca/sites/default/files/cfca37-fig1.png
Trauma-Informed Organizations Scattergood Foundation Recommendations for Trauma-Informed Organizations
Insuring The Basics Maslow Theory of Human Motivation 1943
Part 2: From the Beginning to the EndNeurodevelopment, Attachment, and Attunement Harvard Center for the Developing Child, http://www.goodnet.org/articles/8-reasons-you-need-at-least-hugs-day-list, http://www.catie.ca/en/practical-guides/emotional-wellness/3/3-4/3-4-1
To Screen or Not To Screen http://www.iowaaces360.org/uploads/1/0/9/2/10925571/6958292_orig.jpg