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“PACEs

A couple weeks ago I was enjoying breakfast in a popular restaurant when I was captured by a conversation a husband and wife were engaged in with their children just across from me. I happened to be researching studies and locating data related to foster children with my computer on the net. They were discussing and explaining how terrible it would be to have a foster child in their home, essentially demanding that being victimized by abusive and neglectful parents made them demons of evil, hollow minded, bodies without hope or worth caring for, capable only of being housed like animals in a slaughter house. The children appeared convinced these spokespeople were prefrontal neuro-scientists or behavioral medicine experts to say the least.

My first response urged me to simply move from the listening space, finish my breakfast, then leave and forget what I had heard. A compassionate voice softly convinced me to stay. I remained still, then heard another voice say, “Help”, didn’t know what that meant although within’ a few moments I found myself at their table. In a polite voice and a curious tone I introduce myself, “Excuse me, my name is jeff and I overheard you talking about foster children, would you mind me asking a couple simple questions?” Both parents agreed it would be “ok” while the children sat in quiet amazement.

I kindly continued, “Have you ever met a foster child?” They both explained, “No”. Then I asked if they would ever care for foster children. They wife quickly answered with a stern voice, “No”. My heart fell a few inches down my chest. I reluctantly asked, “Could you help me understand why?” The wife announced, “The state doesn’t pay enough.” The husband added, “Those kids are out of control, even medication can’t stop them.” The children sat quietly, staring at my face. With one last question in mind I said, “If you had a choice between adopting an animal or a foster child, which would you choose?” Simultaneously the parents agreed, “An animal”, the children finally smiled at me. The wife added, “Animals are much easier to control”. I thanked them for their time and as I began to turn, I made one last comment, “O, by the way, you all have just met your first foster child”, then I smiled and slowly moved my feet back to finish my research and breakfast. Within a matter of seconds, the parents rushed the children away from their unfinished meals, out the front door, and into a new minivan. They couldn’t leave the parking lot fast enough and scared a few customers as the sped away.

A few days later, after careful reflection, it occurred to me what I had learned that morning. With all our modern science, we still have no real understanding what is happening with a child’s brain on the organic neuro-biological molecular level. Science cannot explain exactly what abuse, neglect, or maltreatment does to neuro-circuits, we know they are damaged. We know the growth patterns are inhibited; however the brain does have an amazing capacity to heal itself, often referred to as resilience or plastisicity. Someday science may have more answers. Until that day, my hope is that more people will begin to practice patience, kindness, understanding, and empathy for foster children. As a culture, we are selfish, self-centered, and quick to label, diagnose, stigmatize, and then medicate powerless and victimized children in our efforts to control their thinking and behavior, ultimately casting them off as hopeless animals while living in the denial of our own character flaws and prioritizing personal comfort levels. Give these children a break and five minutes of your undivided attention. For you, one child may not be the whole world, yet, to one child you may be their whole world.

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Please take a moment to watch/listen to this 2:00 video of the story of a little girl in 1874, Mary Ellen Wilson, and one Social Worker (Etta Wheeler) that changed the course of history for abuse, neglected, and maltreated children in this country.  Here is a link as well if you prefer reading something about the history of Foster Care.    http://en.wikipedia.org/wiki/Mary_Ellen_Wilson

Thankx Tanya and Loren for your recent contributions...lets keep the communication ongoing...!

Well Jeff,

You cannot educate everyone!  There are those that do not want to see or hear, at least not yet, not until it becomes personal.  The one thing that people should keep in mind is that not all children in foster care are/have been abused.  There are many reasons that children enter into the foster care system.  Are there sociopaths in the "system", sure there are. However, it does not appear that the proportion of sociopaths is higher in foster/congregate care than it is in the general public.  It does appear that there are a greater proportion of children in foster/congregate care on psychotropic medications than children of the same ages ranges in the general public.

 

 

Wow interesting !!! I was just thinking about how there is a similarity between animals in shelters and humans in prison .. people love and support no kill shelters where dogs are trained and able to find good forever homes .. they get so much attention and everyone is willing to donate and help save the dogs ... not so much with prisons .. 

“It is said that no one truly knows a nation until one has been inside its jails. A nation should not be judged by how it treats its highest citizens, but its lowest ones.”  Nelson Mandela

January 28, 2014

 

My Dear Colleague Jeff Bergstrom:

 

The interaction you had with the couple in the restaurant in June 2013 was fascinating, scary and probably an honest summary of some of the mis-information and the biased thinking that dominates segments of this country.  I have been told that it is difficult to reason someone out of something that they have not been reasoned into. This may be one of those conversations.  But I wonder where the ideas about children in foster care came from?  It is hard to imagine abuse and neglect being targeted at children - particularly when you have some of your own.  My parents would do anything to improve the status of their children, and I would do the same for mine.  They say that fruit does not fall far from the tree.  I believe this - and I count on it.                      

 

At one time I served as Deputy Health Director for the County of San Diego (1980-96).  Dr. David Chadwick was the physician-leader in the Department of Social Services for foster care and Clinical Director of Center for Child Protection at Children's Hospital.  He was responsible for the medical care aspects of the foster care system until he retired in 1996.  I was running a pilot project for dissemination of the first electronic medical record system developed by the National Center for Health Services Research, which began in 1981.  It was called COSTAR.  Had we been successful, I would have partnered with Dr. Chadwick and built an electronic Health Passport, a multi-site health summary that had previously been crafted in paper.   It is only within the last two years that I became aware of the potential impact of Adverse Childhood Experiences (ACE) on young people - and how these experiences evolve into adulthood.  When we look at adult chronic disease mortality by ethnicity (even when we control for income), we find significant gaps in health status – (both class and race).  

 

Might it be that poverty sets the stage for the sadness, the depression, the hostility, the joblessness, the incarceration, the broken families - all of which are fuel for ACE.  Do the same ACE issues arise in families which are not close to the poverty line. It seems to me that if this work has been examined and various solutions exist, there might be an opportunity to spring into action.  If this work has not been pursued, maybe we can integrate what we know and what we now believe into a model that will provide mentoring to parents (and to family support groups) to provide gradual transition into tighter, more supportive, more accountable social structures. What kinds of conversations (or site visits or pilot projects) do we need to foster with our children, to bring a more focused perspective into their reality?  Maybe the world has already changed and they need to craft their own solutions.  What I do know is this – as an African American man, I felt dismayed and ashamed when it was clear that I belonged in the back of the bus.  And if reading and study and academic performance would empower me to inch my way to the front of the bus - this was the price that I should pay - and I did pay. So now we are examining diabetes, looking for mechanisms we can craft to stimulate behavior change that will help close the health status gap. This means steps related to medication management, monitoring blood sugar levels, stimulating exercise of one kind or another, and promoting fruits and vegetables over chips and salsa. But where is the prevention agenda going to take us – and how can we craft messages that will not be ignored.  This is what cultural competency means!!

 

These are difficult times.  Anyone who has a model worthy of analysis or insight should write me at the email address: simmstech@cox.net. I would appreciate any suggestions you (all) may have.  This is our turn to conduct research, but research driven by the events we see on the ground.  We conducted “house call” site visits into barber shops and churches last year to screen for high blood pressure and diabetes, as part of the Men's Health Project (San Diego Black Health Associates, Inc. - www.sdbha.org).  Many consumers welcomed our presence, particularly as we had made arrangements for immediate follow-up and further testing and then treatment.  We did NOT EXPECT reluctance and non-cooperation from a sub-group who preferred that we should go away.  The clinical trials we are now trying to design get to the crux of grace, self-confidence, resilience, mental clarity and recognizing your own personal rhythm. 

 

Anyway, there are opportunities for new reimbursement models and the health care system will soon be more inclined to compensate with incentives for healthy outcomes.  This shift away from fee-for-service is a natural outcome of a health plan written by insurance companies.

 

This change in provider payments MAY also stimulate the opportunity for us to introduce another vector - the importance of ACE on health and wellness.

 

Be well.

 

Paul B. Simms, MPH, Visiting Scholar

Claremont Graduate University

 

Having adopted our two kids through foster care before we got involved with dog rescue, I've got this insight... those people aren't any more capable of caring for a dog than they would be for a child who came to them with worries, obsessions, and, God forbid, any obvious "defects".

WOW!!! I am amazed at your excellent impulse control.... I could not have been so still listening.... I would have had to leave and would have been ill with a migraine for a day or I may have confronted less graciously .... But I love how you artfully had their engagement and then informed them they had met their first former foster child.... You are a hero!!!

I totally understand the experience of stigma but I guess there is a blank spot in my intellect as to why??? I have never hid that experience with the system but have also paid the stigma price...

My sister has a masters in speech therapy and works for early intervention. She is now a foster parent and was in foster care as I was an emancipated minor... I would have been in foster care too but in therapy.... I literally could not speak to the therapist ... In fact at that time I truly couldn't speak out loud and if forced would cry or laugh inappropriately.. It was assumed I was uncooperative so I was made an emancipated minor when in fact I was terribly traumatized....

Anyway, years later I am a doctor my sister has a masters degree... She has a daughter who's best friend's father is a school social worker. She is more cautious than I with our personal history and asks me for my advice. "Should I tell Camryn's best friend's father I was in foster care?" Me with my utopian world beliefs says "well yes of course, he is a social worker. He must deal with foster children all the time nothing to worry about and something so important to you won't be buried deal inside you.. Of course.. No worries". So Renee tells this man of her foster care placement. I am so hurt by this... The man would no longer let his daughter and my niece play together again??? I simply do not understand but

I still remember the day the cps workers came into our broken down trailer.. They asked me " what did you do to make your parents so mad?"

All I could think is walk away... These folks like every adult on the planet are stupid...

I took my act testing after sleeping under a tree because my parents threw me out ... I couch serfed for a year before it all broke apart while my parents still collected from the gov. And weren't feeding me... I was going to be valedictorian of the same HS my dad flunked out of, I had never kissed let alone touched a boy, I had never been in trouble for anything, I never smoked a cigarette in fact couldn't stand them reminded me of Leo, and I had never drank or used any drug of any kind... I was dumbfounded as to why they would ask me such an absurd ?. I still am dumbfounded...

I asked the family who took my sis in for foster care if they would they were Christians and I thought she would be safe there but she looked like Cindy Crawford at the time and during her time spent there wanting to be loved, she tallied up another ace. I was mortified to learn of this and have felt guilt and horror ever since. They also told me when I'd call not to call because she had a new family now and didn't need me... It was the first time I attempted.....

Anyway I get what you are saying.... I truely do... And for those out there who are social workers please don't be mad at me... I am not down on anyone .. I am just relaying my experience...

I am older now but I still see that time through the same child eyes...

I think in our society we have a blind spot to why people behave the way they do. We like to assume that we are all playing with the same set of rules, but that leaves us blind to those that do not act in ways we can predict. If we can't predict their behavior, there must be something wrong with them. I believe that actions have meaning. I work with survivors of domestic violence and so often I hear survivors say, "You're going to think I'm crazy, but let me tell you what happened..." and then they tell me exactly what happened and how they responded to it, and it makes perfect sense! Action has meaning. I've had an opportunity to mentor foster kids aging out of group homes, and I am amazed by the choices they make. Clearly, in group homes they have had to survive in a way I don't understand. But, again - they tell me what their thought processes are and it makes sense. I think when we talk about how the general public perceives things we have to acknowledge that they can't understand what they don't know. AND, they don't know it. When I see people blaming people caught in systems, like foster care, this looks a lot like victim blaming to me. It's hard to fix systems, especially when we don't know how they work. But, blaming individuals making choices we don't understand is easy. I think we also have a real lack of empathy for children. How can we blame kids for anything? They have no control over their lives!

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