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Understanding and Responding to Early Childhood Trauma: Systems and Program Approaches . Beth L. Green, Ph.D. green@npcresearch.com www.npcresearch.com March 18, 2009. Informing policy, Improving programs. Presentation Overview. What is Early Childhood Trauma?
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Understanding and Responding to Early Childhood Trauma:Systems and Program Approaches Beth L. Green, Ph.D. green@npcresearch.com www.npcresearch.com March 18, 2009 Informing policy, Improving programs
Presentation Overview • What is Early Childhood Trauma? • Some Effective Programs for Preventing or Reducing the Impact of Early Childhood Trauma? • Development of a “Trauma-Informed” Early Childhood System?
What is Early Childhood Trauma? • Definition: A reaction to a traumatic event or situation that overwhelms a child’s ability to cope, and inhibits him/her from moving forward with life in a normal manner • Multiple causes: Child abuse/neglect, family violence, crisis situations, extreme environmental events, prolonged absence of a supportive caregiving environment, chronic poverty, homelessness, etc. • Vulnerability: Very young children are particularly vulnerable to traumatic & stressful events
Consequences of Early Childhood Traumatic Stress • Impedes Brain Development • Impedes Emotional Development • Impacts Behavior and Physical Health • Effects are Cumulative • Effects are Long-Term
Some Effective Approaches • Prevent maltreatment • Evidenced-based parenting and parent-child attachment programs • Effective mental health and substance abuse treatment for parents • Early identification & treatment among young children (e.g., mental health consultation in child care, pediatric screening) • Evidence-based therapeutic treatments for identified trauma
Example Local Programs Oregon Relief Nurseries • Provide home visitation, therapeutic center-based care, case management, parenting education and support, and respite care • Serve very high risk families with children ages 0-5, including those with involvement in child welfare system • Recent evaluation showed several important outcomes
Improved Parenting Outcomes More stable family functioning Improved quality of parent-child interactions More frequent reading to young children
Improved Family Stability Increased employment Increased income Less frequent ER use
Decreased Involvement with Child Welfare Less time in foster care High rate of reunifications – 100% for RN vs. 64% statewide
Example Local Programs Oregon Healthy Start • Universal screening of first-birth mothers • Intensive home visiting and parent education and support for high risk families • Recent evaluation showed several important outcomes • Improved quality parent-child interactions • Improved frequency of reading to young children • Improved immunization rates • Reduced parenting stress
What is a “Trauma Informed” Early Childhood System? • An preventive system that effectively prevents, identifies, and treats trauma as early as possible • A coordinatedsystem that prevents re-traumatization • A well-trained system in which providers understand issues related to early childhood trauma • An effectivesystem that uses evidence-based approaches and evaluates outcomes
Developing A Trauma-Informed Early Childhood in Multnomah County • 2005: Children’s Relief Nursery (CRN, Portland) • Grant from SAMSHA to be a Community Treatment Site within the National Child Traumatic Stress Network (NCTSN) • National network intended to advance knowledge about effective approaches to childhood trauma • Portland CRN is one of the few nationally focused on the 0-3 population, twofold goals: 1. To provide services to prevent and ameliorate early childhood trauma 2. To begin to develop a “trauma informed” early childhood system
System Development Work Led by The Children’s Relief Nursery
Multnomah County Policy Panel on Early Childhood Trauma • A high-level group of policymakers charged with: • Defining key elements of a Trauma Response System for young children • Committing and developing resources for this system • Identifying an agency or group to lead this effort
Current Status of ECT System • Multnomah County Commission for Children, Families, and Communities responded to an RFP and now is leading this effort (working with NWECI) • A few have committed resources (County, United Way) • Actively seeking further support for this effort