Building Strong Kids: Understanding Adverse Childhood Experiences and Promoting Resilience

1. Strong Communities Raise Strong Kids An Introduction to the Adverse Childhood Experiences Study

2. “The solution of all adult problems tomorrow depends in large measure upon the way our children grow up today.” - Margaret Mead, Anthropologist

3. What Are ACEs?Adverse Childhood Experiences • Sometimes referred to as toxic stress or childhood trauma ACEs are experiences in childhood that are unhappy, unpleasant, or hurtful

4. What Are ACEs?Adverse Childhood Experiences Trauma or Adverse Childhood Experiences: • Events that can impact a child’s sense of safety and alter how they view themselves and the world around them. • These are physical and emotional responses to events or experiences that threaten the life or physical safety of the child. • These might be events that overwhelm a child’s capacity to cope and elicit feelings of terror, powerlessness, and out-of-control physiological arousal.

5. What are Adverse Childhood Experiences (ACEs)? Growing up (prior to age 18) in a household with: Recurrent physical abuse Recurrent emotional abuse Sexual abuse Emotional or physical neglect

6. Growing up (prior to age 18) in a household with (cont): An alcohol or drug abuser An incarcerated household member Someone who is chronically depressed, suicidal, institutionalized or mentally ill A mother who is being treated violently One or no parents

7. Your ACE Score If you are interested in finding out your own ACE score, please visit: acestoohigh.com Taking the test or even talking about the test can be traumatic for some people, please be prepared to talk to a friend or professional about any negative feelings or thoughts you might experience

11. Family Centered Practice, June 8, 2007 Regional Child Abuse Prevention Councils 2011

12. Evidence Suggests: Many chronic diseases and developmental delays or disabilities in adults are determined decades earlier by experiences in childhood – Video for brain science

13. Behavior is Predictable All behavior has meaning - both good behavior and bad behavior We need to look closely at what preceded the behavior - What happened first that is causing this behavior?

14. The Brain and Instinctual Reactions Different parts of the brain control: • Vital functions (heart rate, breathing, temperature, and balance) • Emotions and behavior • Development of language, thought, and imagination • Fight, flight or freeze responses

15. The Brain and Instinctual Reactions For our brains, survival is the #1 job: • We don’t think, we just react • When other parts of our brain are not activated, we revert to basic instincts which are to attack, flee, or freeze • This is the “hot brain” • Anger = Fight (Increase blood pressure and heart rate, release stress hormones) • Fear = Flight (instinctive response to avoid harm, blood & oxygen rushes to muscles and organs) • Hopelessness = Freeze (body shuts down, functions slow, experience of pain is less, normal brain development shuts down)

16. Behaviors of Traumatized Children as a Safety Response Behaviors are: • Meant to protect the child from unsafe situations • Triggered when the child feels that their safety is at risk (real or perceived) • Their reality is REAL • Triggers don’t have to make sense to you • Triggers are deeply rooted in the brain and happen with little or no thought • Triggers are everywhere…we don’t know every piece of a child’s history

17. When a child is in a “hot brain” reaction, they are immune to rationalizing, arguments, consequences, losing privileges, restraints, punishment, or discipline. • These actions only pit us in a power struggle that both the adults and children lose. • Much of what we try to do in the name of behavior management actually reinforces the child’s need for protection and drives them further away from the very people who could help them.

19. Early Brain Development • Nurturing, responsive, and individualized interactions from birth build healthy brain structure. • Healthy brain architecture is the necessary foundation required for optimal future learning, behavior, and health.

20. Our Challenge We can and must “immunize” kids against the effects of ACEs. We can and must reduce the numbers of ACEs for all children!

21. ACEs Often Last a Lifetime . . . But They Don’t Have To • Healing can occur • The cycle can be broken • Safe, stable, and nurturing relationships heal adults and children.

22. It Starts With You! • Identify and understand the importance of protective factors • Utilize protective factors in your own life • Empower others by educating and encouraging them to use protective factors

23. Protective Factors • Are conditions that increase health and well being • Are critical for everyone regardless of age, sex, ethnicity, racial heritage, economic status, special needs, or the dynamics of the family unit • Are buffers that provide support and coping strategies

24. Protective Factors that Strengthen Families and Communities • Nurturing and Positive Relationships • Knowledge of Parenting and Child Development • Parental Resilience • Social Connections • Concrete Support in Times of Need

26. #1 = Nurturing and Positive Relationships…… are the key to mentally healthy children and adolescents

27. Safe, Stable, Nurturing Relationships SAFE = free from harm, fear, anger, yelling, harsh punishment, and aggression STABLE = a high degree of consistency and routine with easy transitions NURTURING = compassionate, caring, loving, and responsive caregiver(s)

28. Building Nurturing and Attachment Observe, attend, and listen to children Provide safe and stable environments Model caring behaviors Respond to children’s needs Use positive discipline Notice and reinforce children’s strengths

29. Begin with yourself • Take care of your own mental health • Develop healthy coping devices (regular exercise, reading, listening to music, etc.) • Seek out healthy family/friends for support • Use community supports (counseling, substance abuse treatment, self-help programs, etc.)

30. Teach the Seven C’s You didn’t CAUSE it You can’t CURE it You can’t CONTROL it You can help take CARE of yourself By COMMUNICATING your feelings, Making healthy CHOICES, and CELEBRATING being yourself

31. To Get InvolvedContact Marcia Stanton, Child Abuse Prevention Coordinator, Phoenix Children’s Hospital mstanto@phoenixchildrens.com Mary Warren, New Parent Resource Coordinator, Prevent Child Abuse Arizona maryw@pcaaz.org

32. Parenting Resources • 1-877-705-KIDS (5437) Birth to Five Parenting Questions Helpline • 1-800-4-A-CHILD (422-4453) Crisis Line for emotional needs and information about child abuse and neglect. Also go to www.childhelp.org • www.azpbs.org/strongkids • www.apa.org/books • www.pbs.org/parents/childdevelopment • www.cdc.gov/parents

33. Information & Resources • ACE Study findings and information - www.acestudy.org or www.cdc.gov • National Scientific Council on the Developing Child at Harvard University - www.developingchild.net • Academy of Pediatrics - www.brightfutures.aap.org

34. More Information & Resources National Center for Trauma-Informed Care – www.mentalhealth.samhsa.gov/nctic National Child Traumatic Stress Network – www.nctsnet.org Center for the Study of Social Policy -Information on Strengthening Families and Protective Factors – www.cssp.org Center for Injury Prevention and Control – www.cdc.gov/violenceprevention

35. Videos and resources for this PowerPoint: • ACE Resources used in this presentation: • http://www.acestudy.org/the-ace-score.html • http://vetoviolence.cdc.gov/apps/phl/resource_center_infographic.html • http://www.cdc.gov/violenceprevention/acestudy/ace_graphics.html • https://acestoohigh.com/aces-101/ • https://vimeo.com/139998006 • http://developingchild.harvard.edu/resources three-core-concepts-in-early-development/ • http://removedfilm.myshopify.com/pages/watch

36. Case Study: You have a 4 year old boy named Eric in your care at Happy Valley Child Care Center. Eric lives with foster parents who both work fulltime jobs, so he is at child care from 6am to 6pm. Eric has told you that his mom is in jail and he misses her. Eric has a difficult time with transitioning from one activity to the next, hides food in his cubby, and has temper tantrums when it’s naptime. He often withdraws from activities, especially if they are chaotic or noisy. At the age of 4, what ACE’s could Eric have already experienced? What could the child care center be doing to support Eric?

37. Growing up (prior to age 18) in a household with (cont): Recurrent physical abuse Recurrent emotional abuse Sexual abuse Emotional neglect Physical neglect An alcohol or drug abuser An incarcerated household member Someone who is chronically depressed, suicidal, institutionalized or mentally ill A mother who is being treated violently One or no parents