I sent this last night. Let me know what you think!
Jill Lepore’s article “Baby Doe” in the Feb. 1, 2016 issue, was a very well-written look at the Massachusetts Department of Children and Families. I’m sorry to see that this system is still swinging between the same two tracks of family preservation or child removal, when the trend in helping children who are traumatized takes a very different approach.
Lepore touched on that new trend with her descriptions of Minding the Baby program, but seemed to indicate it was an outlier, and that programs like it were few and far between.
There’s no doubt that the U.S. child welfare system as a whole is still stuck in the pendulum swing between family preservation and child removal, as Lepore points out. However, Minding the Baby is just one of hundreds of organizations and agencies across the U.S. that are integrating a new understanding of human development to take a very different approach to addressing and preventing child abuse.
That new understanding of human development has emerged over the last 25 years. It includes the merging of five major areas of research: the epidemiology of childhood adversity, including the CDC-Kaiser Permanent Adverse Childhood Experiences Study, whose more than 70 publications show a clear link between childhood adversity and the adult onset of chronic disease, violence and being a victim of violence (29 states have done ACE surveys with similar results); the neurobiology of toxic stress, which explains how children’s brain function and structure is damaged by toxic stress caused by childhood adversity; the long-term biomedical and epigenetic consequences of toxic stress, which you can find in hundreds of research publications that show how childhood stress damages organ systems to show up decades later as disease, and can be passed on from parents to children by a number of mechanisms; and resilience research, which is showing that intervention and prevention can heal body and mind.
Many communities — cities, counties, states — are using this new understanding of human development in two ways to take a very different approach from the traditional one of child preservation or removal.
First, they’re working across the sectors of education, social services and healthcare to develop ways to intervene early, at the first signs of trauma, so that families don’t have to disintegrate so such a degree that children are damaged, tortured or killed before they receive help. These communities recognize that the current approach just traumatizes already traumatized people — parents and children alike. Furthermore, the traditional system doesn’t address types of childhood adversity — such as divorce, living with a family member who’s an alcoholic or abusing other drugs, or living with a family member who’s depressed or has some other mental illness — that research clearly shows does as much damage as physical and sexual abuse.
Second, these communities and organizations are taking a two-generation approach. Most of the time, if a child is showing signs of trauma, that’s a good indication that the parents (and grandparents) are also traumatized, and need help. So, wrap-around services are provided for all members of the family, from therapy to employment services, from housing to drug counseling.
The examples of organizations and communities taking this approach include dozens of Safe Babies courts, many Head Start organizations, pediatricians who are taking parents’ ACEs histories and providing those with high ACE scores wrap-around services through Healthy Steps, healthcare clinics that integrate Medical-Legal Partnership, trauma-informed schools, Child First, home visiting programs such as Nurse Family Partnership that are using the NEAR@Home toolkit, and several child welfare systems that are participating in the Chadwick Center for Children & Families’ Trauma-Informed Systems Dissemination and Implementation Project.
Many of these organizations have produced research that clearly shows that children and families benefit from this type of intervention. One year after participating in Safe Babies courts, 99% of children suffer no further abuse. Kids who participate in Child First showed a 42% decrease in aggressive behaviors, while 64% of mothers had a decrease in depression or other mental health problems.
Although some pediatricians are looking at kids’ ACE scores, the scores are more useful for adults — in medical practice to understand coping mechanisms (smoking, drinking, doing drugs to ward off depression, anxiety, etc.) for childhood adversity that get in the way of being healthy, in education to help teachers and staff understand how they can be triggered by kids’ behaviors that are symptom of trauma, and for parents to understand how their childhood adversity has affected their life course, so that they don’t pass their ACE scores on to their children.
For more information about this unified science of human development and how it’s being used, go to ACEs 101.
Jane Stevens
Health, science and technology journalist
Founder, publisher, ACEsTooHigh.com
Member, National Association of Science Writers, Journalism and Women Symposium, Online Journalism Association
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