Adverse Childhood Experiences (ACEs) and trauma have a profound impact on a child's physical, mental, and emotional well-being. The most recent census reported that 13.3% of residents in Osceola County, Florida, fall within the poverty level (U.S. Census Bureau QuickFacts: Osceola County, Florida, n.d.). Low-income families are at higher risk of experiencing ACEs and trauma, which can lead to lifelong health consequences, that perpetuate cycles of poverty.
Raising awareness and providing access to services that mitigate ACEs within early childhood can help caregivers and families create healthier environments and more promising futures for children. This program will help to provide education programs and social support for families and children from infancy to kindergarten. This multi-component program aims to implement trauma-informed resilience-based public health interventions that will work to help parents and caregivers recognize and respond positively to personal ACEs while improving early childhood outcomes and preventing the occurrence of ACEs in their children.
A multi-disciplinary team, consistent of licensed educators, public health and medical professionals, and individuals in the target population, will work together to create sustainable interventions. Proposing a public health approach that addresses ACEs and trauma in early childhood and engages with communities is essential to breaking these intergenerational cycles and promoting resilience within this target population.
Public Health Framework
A public health framework is used to guide this proposed program. The Trauma-Informed Philanthropy Guide emphasizes that taking a public health approach is needed to generate system-level changes in response to public health issues, such as ACEs and trauma (Scattergood Foundation, 2016). Integrating this approach will help to think outside the scope of disease, and address root causes that can improve long-term outcomes. This can be accomplished by implementing primary, secondary and tertiary levels of prevention.
This program will utilize a cross-sector model to deliver services that advocate for children with ACEs using both primary and secondary levels of prevention, focusing on the pillars of early childhood and education within the population. On the primary level of prevention, universal precautions will be taken as educators will receive formal training on ACEs and learn how to incorporate age-appropriate activities and curriculum within the classrooms that promote healthier spaces, resiliency and mindfulness. Caregivers will also be provided with education on ACEs. At the secondary level of prevention, Family Connection Coordinators will connect caregivers of at-risk children to resources for ACE screenings, as well as safe spaces, counseling and social support (protective factors) to combat childhood adversity. A trauma-informed lens will be used to guarantee that all children and families are approached and interacted with care and compassion. These prevention strategies address social determinants of age and conditions where children learn and play, and the social issues of poverty and education.
Level(s) of the Social Ecological Model
The social ecological model (SEM) is a framework that recognizes the intricate convergence of factors that mold outcomes of health on individual, relationship, community, and societal levels. This model is used to examine and better understand public health issues, and can be applied to investigate adverse childhood experiences (ACEs) and trauma (CDC, n.d.). According to the CDC, using the SEM in health interventions is more likely to create sustainable efforts in prevention and achieve impact on population health (CDC, n.d.). Social determinants of health can be addressed by all levels of the SEM, as each level has degrees of influence on an individual. In regards to ACEs, the individual level of the model identifies biological factors that increase the likelihood of experiencing ACEs, such as age and education (CDC, n.d.). Program interventions include integrating age-appropriate cognition and behavior practices within early childhood classrooms. Practicing these types of therapies can help in reducing symptoms that result from experiencing trauma by promoting healthy attitudes and enforcing protective factors.
The relationship level explores how close relationships may increase the risk of experiencing trauma (CDC, n.d.). Family members and friends often have influence on an individual’s behaviors and can either be an advocate for resiliency or perpetuate trauma. Interventions implemented in this program that address this level include home visits, social support and counseling groups, as well as implementing family connection coordinators. These strategies help focus on strengthening social support networks while combating feelings of isolation due to ACEs, and encourage nurturing connections and communication between families.
The community level of the SEM focuses on how an individual interacts with school, work and other community settings (CDC, n.d.). Program interventions will aim to create safe and healthy environments where positive social relationships can be cultivated. The overall program initiative is to implement trauma-informed care in early childhood schools and classrooms, to lessen the impact of trauma on learning and behavior, while creating a safe and supportive learning environment for young children.
Implementing these trauma-informed approaches could produce multiple-level impact. For example, building an equipped workforce of educators in early childcare will help to improve overall relationships between students and teachers, as these teachers will be able to respond to the needs of students that have experienced trauma. Subsequently, the overall mental health and well-being of the children can improve, impacting the individual level of the model by reducing adverse symptoms of ACEs.
Trauma-Informed Principles
The trauma-informed principles that will be used to structure and navigate this program include safety, trustworthiness, peer support and collaboration (Substance Abuse and Mental Health Services Administration (SAMHSA), 2014). Safety planning and the use of restorative approaches will help ensure the safety of all children and families that are being served. Safety of the children will be prioritized by all early childcare educators, the family connection coordinators, and all other program staff. Classrooms and community settings will create environments for program participants to feel physically, emotionally and psychologically safe at all times, addressing each child’s individual sense of safety (SAMHSA, 2014).
All operations of the program will be conducted with honesty and transparency to build and maintain trust with all children and families that participate in program services (SAMHSA, 2014). Creating safe spaces for children within the classroom and for families within the community will be a permeating culture of this program. Program leaders will work to foster healthy and nurturing relationships with the children, by advocating for them and welcoming open communication. Additionally, caregivers will be provided with the opportunities to share feedback on their experiences with family connection coordinators.
Peer support will help drive this intervention. The purpose of this program is to build trust, ensure safety, encourage collaboration, and promote hope for children that have experienced trauma (SAMHSA, 2014). Although this age may not have the emotional or cognitive ability to express their individual experiences and share their stories, the individuals interacting and engaging with them will be trained in recognizing and responding to their needs with age-appropriate reflection practices, and fostering recovery and healing (SAMHSA, 2014).
Collaboration between the community and program staff will allow meaningful relationships to be formed, in which everyone plays a role in decision-making that will promote healing, either through program direction or program impact. The program will focus on engaging with community-based participation research so that the needs of the community are being addressed. As mentioned, all staff will be trained in trauma-informed approaches for individuals, the community and the health of the public.
Several domains will be deployed within the operations of the trauma-informed principles, and the program will be framed using core tenets for trauma-informed grant-making and funding (Scattergood Foundation, 2018). Safe physical environments will de-escalate and calm, and provide spaces for self-care for everyone. Anyone who receives services from this program will be involved in all aspects of the program, and encouraged to feel empowered. Collaboration and communication will take place across multiple sectors trained in trauma-informed care and evidence-based services to address needs of children. Ongoing training on all forms of trauma, ACEs and social support, will support professional development while ensuring that all staff are sensitive to and considerate of all backgrounds. These domains should address grant funders responsiveness to community needs (Scattergood Foundation, 2018).
References:
CDC. (n.d.). Fast Facts: Preventing Adverse Childhood Experiences |Violence Prevention|Injury Center|CDC. (n.d.). https://www.cdc.gov/violencepr...n/aces/fastfact.html
CDC. (n.d.). The Social-Ecological Model: A Framework for Prevention | Violence Prevention | Injury Center. https://www.cdc.gov/violencepr...ecologicalmodel.html
Scattergood Foundation. (2016). Trauma-informed philanthropy: A funder’s resource guide for supporting trauma-informed practice in the Delaware Valley. Volume1. https://philanthropynetwork.or...raumaGUIDE_Final.pdf
Scattergood Foundation (2018). Trauma-informed philanthropy: Leveraging resources and relationships to advance trauma-informed practice and move from knowledge to action. Volume 2. https://cdn.inst-fs-iad-prod.i...7b88-076d-4cb0-9694- 62a87aceff65/Trauma2-web%20(1).pdf?token=eyJhbGciOiJIUzUxMiIsInR5cCI6IkpXVCIsImtpZCI6ImNkbiJ9. eyJyZXNvdXJjZSI6Ii9jMjQyN2I4OC0wNzZkLTRjYjAtOTY5NC02MmE4N2FjZWZm NjUvVHJhdW1hMi13ZWIlMjAoMSkucGRmIiwidGVuYW50IjoiY2FudmFzIiwidXNlcl 9pZCI6IjEwMTYwMDAwMDAxMTUxNzAyIiwiaWF0IjoxNjQ3NTEzMTQ2LCJleHA iOjE2NDc1OTk1NDZ9.8hF2U210_5JU42bvWBPLv8ia1waft53bcykz3Zp3QNGRjYCsr tzCPvpxI1yWcG- 6E1n2wutU3GSWL63HWzfLzA&download=1&content_type=application%2Fpdf
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: https://store.samhsa.gov/sites.../priv/sma14-4884.pdf
U.S. Census Bureau QuickFacts: Osceola County, Florida. (n.d.). Census Bureau QuickFacts. https://www.census.gov/quickfa...ntyflorida/IPE120221
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