Judge Lynn Tepper and a courtroom therapy dog.
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[Editor's note: Judge Lynn Tepper, 6th Judicial Circuit, Florida, wrote this for a newsletter published by the Florida Office of the State Courts Administrator, Office of Court Improvement, and kindly agreed to cross-post it to ACEs Connection. ]
"How do we go from a newborn with its extraordinary potential to the man lying on the street whom we overlook? The answer relates directly and in unexpected ways to difficult problems of medical practice, social functioning, institutionalization, addiction, and public health. The ACE Study is about what we learned exploring the ORIGINS of those problems, and how we came to see that the perceived problem is often someone’s attempted solution to problems about which we keep ourselves unaware."
So began Dr. Vincent Felitti’s plenary presentation at the Annual Education Program of the Florida Conference of Circuit Judges: “The Repressed Role of Adverse Childhood Experiences in Addiction, Disease, and Premature Death: Turning gold into lead." (Click here to see his presentation and his PowerPoint.) Those “problems” and “attempted solutions” fill the divisions of courts and inter-related systems. The original 1998 Adverse Childhood Experiences (ACEs) Study, of which Dr. Felitti, was co-principal investigator with Dr. Robert Anda, of the Centers for Disease Control (CDC), revealed an extraordinary, unexpected relationship between our emotional experiences as children and our physical and mental health as adults. The ACE Study revealed that humans figuratively turn the "gold” of the potential of a newborn into "lead” by converting the childhood traumatic emotional experiences into disease later in life.
During his presentation, Dr. Felitti explained, “Adverse childhood experiences are the main cause of health risk behaviors, and hence of disease, disability, premature death, and healthcare costs. People with an ACE score 6 or higher have a life expectancy almost 20 years shorter than an ACE Score 0.”
What we learned from this presentation as individuals may be revealing to us. In fact, each judge in attendance had the opportunity to complete the 10- question ACE questionnaire electronically and anonymously. As you can see in the table below, none of the responding judges had an ACE Score of 0, and in three of the categories, the judges had higher scores than the respondents from the original study.
CATEGORIES OF ADVERSE CHILDHOOD EXPERIENCES
Abuse, by Category | Original Study | Judges |
Psychological (by parents) | 11% | 15% |
Physical (by parents) | 28% | 17% |
Sexual (anyone) | 22% | 12% |
Neglect, by Category | Original Study | Judges |
Emotional | 15% | 12% |
Physical | 10% | 6% |
Household Dysfunction, by Category | Original Study | Judges |
Alcoholism or drug use in home | 27% | 22% |
Loss of biological parent | 23% | 32% |
Depression or mental illness | 17% | 24% |
Mother treated violently | 13% | 9% |
Imprisoned household member | 5% | 3% |
These scores and the reality that the professional lives of the judges reflect extraordinary accomplishment certainly would be “gold” and not “lead”, despite the childhood traumatic emotional experiences. Key to understanding that outcome are the responses to the two “buffering relationships” questions, which were not part of the original ACE Study, but were administered to circuit judges prior to them attending the conference. One of the insights from the ACE Study was a “primary prevention” approach. Having “buffering relationships" is one of those “primary prevention” approaches that builds resiliency so that the “extraordinary potential” of a newborn is realized, not lost. As the table below illustrates, most of the judges who responded to these questions had strong buffering relationships that mitigated the impact of their ACEs.
Question | Definitely True | Probably True | Not Sure | Probably Not True | Definitely Not True |
When I was a child I had a supportive home environment. | 70% or 162 | 18% or 41 | 4% or 9 | 4% or 10 | 4% or 9 |
When I was a child I had stable, responsive, supportive & caring relationships with adults & caregivers. | 75% or 166 | 18% or 41 | 2% or 4 | 2% or 5 | 3% or 6 |
As judges, what we learned might lead us to an understanding of what lies beneath the behaviors we see in court by litigants, and the risky behaviors that lead parties and defendants into our courts, our jails, our detention centers, and our local mental health and substance abuse facilities. Our take-away? The health risk behaviors linked to ACEs may be viewed by the public and health field as a problem, but may be viewed by a patient, defendant, delinquent, dependent party, and litigant as a solution. That view has a lot to do with why certain problems are so difficult to treat. As Dr. Felitti pointed out, “We’re not treating the problem; we’re attempting to treat someone’s solution.” This has major relevance to treating all addictions and the vast disruptive, chronic, seemingly unresponsive behaviors that cross our thresholds every day. Summarized succinctly by my colleague in the 6thcircuit, Judge Linda Babb, “We have been treating the symptoms” and not looking at the adversity in which that individual spent their childhood.
At the conference, Judge Scott Bernstein (11thcircuit), Chief Judge Jonathan Sjostrom (2ndcircuit), Judge Alicia Latimore (9thcircuit), and I briefly shared our experiences regarding individuals impacted by ACEs in virtually every division of the court and the benefits of being trauma-informed and developing a trauma-informed courthouse and community partners.
Over 75% of the judges who responded to the post-test that was administered believed they may have missed telltale signs of ACEs or trauma in the past; 75% think they might handle “disruptive” parties more effectively moving forward; and 77% think there are things they can change in their courthouse or courtroom as a result of what they learned from Dr. Felitti’s presentation. Ideally, our judicial response will include:
- how we handle and respond to litigants, defendants, and all who appear before us;
- what sentences and dispositions we may impose;
- what types of assessments we may order;
- which bench guides and tools we may utilize to determine “What happened to this person?” instead of “What did this person do wrong?”; and
- embracing the “Big Ten” found within the Family Court Tool Kit: Trauma and Child Development and the constantly updated array of resources and interactive materials on the Florida Courts website.
Dr. Felitti studied the connection between ACEs and health. Unexpectedly, he uncovered for the courts and our community partners a path past our litigants’ “past.” By applying science to what we do every day and responding appropriately to ACEs, we have a chance to change the trajectory of each life we touch. We have an opportunity to change the world if we see it through a trauma lens.
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