Balancing Adverse Childhood Experiences with HOPE

Full Report by Robert Sege, MD, PhD; Christina Bethell, PhD, MBA, MPH; Jeff Linkenbach, EdD; Jennifer A. Jones, MSW; Bart Klika, PhD; Peter J. Pecora, PhD

All of us, from parents to politicians, realize that the future of our country rests with our children. With the huge changes in society from agricultural to industrial to post‐industrial, there have been tremendous changes in the environments in which children live and grow. What have we learned that will help us, as a society, best position them to learn and grow?

There has been a great deal of focus, rightly so, on the impact of childhood adversity on healthy child development. At the same time, mounting evidence suggests that we can create the conditions that allow children to experience the safety, stability, and nurturance necessary for healthy development. This report, produced in partnership with Casey Family Programs, illuminates the importance of HOPE – Health Outcomes of Positive Experiences – a framework that studies and promotes positive child and family well‐being (Sege and Brown, 2017).

We present newly‐released, compelling data that reinforce the need and opportunity to support families and communities in the cultivation of relationships and environments that promote healthy childhood development. This approach, which adds to the growing body of work on the Science of Thriving, seeks to foster strong families and promote the prevention, mitigation, and healing from adversity. This report contains information derived from four recent population surveys to:

Findings

1. The 2011‐12 National Survey of Children’s Health (NSCH) demonstrates those aspects of a nurturing environment that contribute to the development of psychological resilience in children, including prevention of many of the effects of adversity.

2. Data from the 2015 Wisconsin Behavioral Risk Factor Survey (BRFS) suggests that positive childhood experiences promote adult health, even among adults who reported adverse childhood experiences.

3. Population surveys released for this report by the CDC Essentials for Childhood Program (EfC) and Prevent Child Abuse America (PCAA) demonstrate the social and political support for a positive approach to parenting. This support and these practices have been linked to reductions in certain adverse experiences – in particular, reductions in child neglect and physical abuse.

Conclusion

This report presents evidence for HOPE (Health Outcomes of Positive Experiences) based on newly‐released, compelling data that reinforce the need to promote positive experiences for children and families in order to foster healthy childhood development despite the adversity common to so many families. These data, when looked at through the Transformational Cycle of the Science of the Positive (Linkenbach, 2016):

1. Establish a spirit of hope and optimism that positive experiences have lasting impact on human development and functioning, without ignoring well‐documented concerns related to toxic environments;

2. Demonstrate, through science, the powerful contribution of positive relationships and experiences to the development of healthy children and adults;

3. Describe actions related to current social norms regarding parenting practices, particularly those associated with healthy child development. These actions are based on data that suggest that American adults are willing to intervene personally to prevent child abuse and neglect; and

4. Reflect upon the positive returns on investment that our society can expect as we make changes in policies, practices and future research to support positive childhood environments that foster the healthy development of children.

Positive experiences and supportive relationships provide the buffering that allows children to withstand, or recover, from adverse experiences. Nurturing care and attention in infancy profoundly influence brain development and form the foundation of human development. Four broad categories of positive childhood experiences that encourage health, functioning, and quality of life outcomes have been identified: nurturing and supportive relationships; safe, stable, protective, and equitable environments in which to develop, play, and learn; constructive social engagement and connectedness; and social and emotional competencies. When children are nurtured and free from harm, they are able to gain mastery across domains that establish the basis for future learning. For example, we can reduce the need to place children in foster care if there are policies in place that address income and housing needs, treat mental illness, and support parents as they adopt positive parenting approaches. Family supports can come from many sectors, both formal and informal: friends, family, nonprofit social and human services organizations, child care providers, schools, and the health care, business, faith, and law enforcement communities. Foster parents can help children in their care thrive by extending their responsibility from simply ensuring physical safety to including those parenting approaches that allow children to have positive experiences. Children can succeed in school, even with substantial adversity, when they develop executive functioning skills and use the relational supports that are known to promote resilience. Parents and families can manage their own stress better when they embrace nurturing communication and interaction styles. The implications for a better understanding of the factors that allow children and families to thrive are potentially game-changing.