Becky Haas and Marlo Nash, co-authors of this article partnered to achieve a two-part goal. The first, to describe a systems-level need for early childhood, child maltreatment prevention and child welfare systems to integrate in response to the COVID pandemic. The second, to build off of the big picture need for change to offer a concrete, practical example for action centered on ensuring early care and education providers are equipped to recognize and respond to trauma in young children, parents and co-workers in the COVID era and beyond. 

Time to Build an Integrated System of Child and Family Well-Being (Nash) 

Tucked tightly inside our nation’s child welfare system are a myriad of little-known truths. They reveal a gap between what we know from the science of trauma, resiliency, and bio-psycho-social-neuro development and how much that knowledge is consistently applied. 

One of those truths is that there is a hidden early childhood system within child welfare and it is dilapidated. Forty-one percent of the children who enter the child welfare system are ages birth to 4 years. Three out of four cases of child maltreatment are due to neglect. Much of this neglect stems from individual, family and environmental causes that are preventable or can be mitigated. 

The Pair of ACES Tree developed by the Milken Institute School of Public Health, illustrates frequent contributors to child neglect. These are stressors that can often be prevented or mitigated. The individual and family conditions, like maternal depression, substance use disorders or a parent’s own history of maltreatment, are often caused or exacerbated by Adverse Community Environments, such as poverty, discrimination, unemployment or under-employment. For young families, adversities from these two categories of ACEs can hit them like a hurricane wind and knock them down when they are just beginning to build a life for themselves and their young children. For families already weathering life’s storms, the COVID pandemic is another devastating wave. 

The COVID era is the time for policymakers, early childhood, child welfare and family strengthening leaders, advocates and practitioners to band together and construct a new, integrated approach to shoring up our nation’s families with young children. We know that too many young children enter the child welfare system, or are at risk of entering, and that the pandemic is anticipated to increase that number. When young children are in the child welfare system, their distinct developmental needs go unmet, which doubles down on the effects of trauma that they have already experienced, with the potential of lifelong consequences. Babies and toddlers are separated from the parents with whom they will eventually be reunited, even though we know separation disrupts a foundational window of attachment and bonding that occurs at this age and is essential for a lifetime. Young children in the child welfare system do not have adequate access to early care and education (ECE) programs and settings. When they do participate, ECE programs are often not equipped to recognize and respond to the predictable behavior driven by the traumatic experiences the children have had. As a result, too many children are expelled from preschool or have experiences that are further traumatizing. 

With the worry of a pandemic-caused increase in maltreatment, we need to do all that we can to safely keep young children out of the child welfare system and quickly return their family to stability if the gravity of the situation demands that child welfare intervenes. Families, just like homes and communities, need stabilizing structures that keep them secure, stable and functioning optimally. We can construct a “system of child and family well-being” that is trauma-responsive and encompasses measures that create the conditions for strong families, prevent against maltreatment, meet children’s learning and developmental needs, and keep families together when they are accessing from supports, like mental health treatment, substance use treatment, housing and nutrition programs, and skill-building for parenting and household management. 

Here are some key strategies to enact:

• Congress needs to allow any federal COVID-response funds to be used to respond to the social-emotional and developmental needs of children in child care and Head Start settings, and through community and social services. The CARES Act child care funds were appropriated strictly because of the critical role child care plays in the economy. Tragically overlooked was the recognition that the young children, families, and essential personnel in these programs are experiencing overwhelming stress and that supports need to be offered that effectively respond.
• When dealing with shrunken budgets, state governments need to become champions – no, superheroes – for investing in proven approaches and programs that respond to trauma and help re-build foundational building blocks, like employment, nutrition, housing, early care and education settings, and access to health care. Instead, state lawmakers are already cutting programs proven to safely prevent child maltreatment and possible involvement with the child welfare system, prevent separating children from families through foster placements, and ensure connections with siblings, grandparents and other family members when time apart from birth parents becomes necessary. Programs like Family Centered Treatment and Family Finding are critical in the COVID era.
• Public agencies and private organizations need to forge results-focused collaborations guided by shared principles and goals for young children and families, and braid and blend funding and financing to achieve the goals. Just like we quickly, collectively learned how to use Zoom and other technology platforms because they became necessary to continue working, leaders across early childhood, child welfare, mental and behavioral health, employment and basic needs, community and housing stability, equity and civil rights need to quickly learn how to effectively collaborate to achieve A Better Normal for young children and their families.
• Early childhood programs and child welfare providers need to quickly and deeply infuse trauma-responsive approaches that are aligned to the various critical developmental periods of early childhood. Equipping stakeholders of all types – child care providers, Head Start teachers, family court judges and attorneys, child welfare case managers, mental and behavioral health providers – with knowledge and techniques that effectively and systemically respond to trauma and consider young children’s developmental stages are keys to re-stabilizing families and children in the face of any type of disaster or tragic event, including this global pandemic. 

When shaky foundations for families with young children are strengthened and stabilized early on, the costs in emotional and financial measures are reduced, and their trajectory of success is improved for a lifetime. 

Childcare Professionals Reducing the Effects of ACEs (Haas)  

When first learning about trauma-informed care and the Adverse Childhood Experiences (ACEs) study in the summer of 2014, I was working for the local Police Department reducing drug-related and violent crime.  Though I’ve lived in rural Appalachia for decades, I had no idea how deeply this crisis was impacting communities.  From overcrowded prisons, hospitals delivering staggering rates of babies whose mothers are addicted, to finding foster care shortfall solutions, and public-school systems where I first heard phrases like, cradle to prison and school to prison pipeline.  As a mother and grandmother, I wondered who are the children that are born with a predisposition heading them into prison? 

The answer is that there isn’t a predisposition. There are traumatic experiences that literally change brain architecture. Child development experts have taught us that toxic stress derails brain development during a time in a child’s life when this can greatly influence future outcomes. An important antidote is “Healing Centered Child Care.” When childcare professionals understand the impact of overwhelming stress on child development, programming can shift to include “serve and return” activities and helping children learn emotional regulation which are two fundamentals impacted by early childhood adversity.  Too often, early education professionals have not been trained to recognize what might be considered as “willful” behavior in a child, may instead be “survival” behavior.  For this reason, in 2015, I began to develop training content to better equip child care professionals to help traumatized children to learn.  When child care professionals receive training and commit to implement trauma sensitive practices into program settings, these can serve as successful buffers to mitigate the effects of ACEs in a child’s life.  “Research shows that Positive Childhood Experiences (PCEs) buffer against the health effects of adverse ones.  The proactive promotion of positive childhood experiences for children may reduce risk for adult depression, poor mental health and promote adult relational health.” (Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample Associations Across Adverse Childhood Experiences Levels) 

Earlier this summer I was contacted by Dr. Micca Knox, Assistant Executive Director for the Early Childhood Academy (ECA) at the Mississippi Community College Board in Jackson, MS regarding a need to provide training for all statewide childcare leadership on trauma informed care.  The Early Childhood Academy is responsible for maintaining a Resource and Referral Center available to participating colleges and universities in order to deliver professional development for all centers, technical assistance and coaching.  Dr. Knox expressed in her request that “their training needs had shifted amidst COVID-19 and racial tensions in the county.”  As a result, they wanted to be more intentional with meeting the needs of childcare providers by providing training to include the science of ACEs and then practical information on how to better serve adults and children exposed to trauma.  According to Dr. Knox, “In order for our staff, especially our child care center coaches, to be completely responsive to the needs of the community it is vital for us to recognize the impact that trauma has on children and adults.  The impact of COVID-19 and social unrest has affected our state heavily and we recognize that these events may have been traumatic for some and to truly see the impact of the services we provide we knew that our capacity around trauma informed care needed to be expanded upon." 

So, in July, I conducted a three-hour online training, “Healing Centered Childcare” for all the ECA staff, leadership, coaches, Resource and Referral Associates, Business Advisors, Family Engagement Specialists and staff from the Mississippi Early Childhood Inclusion Institute.  This training included best practices from trusted sources such as:  National Child Traumatic Stress Network, Starr Commonwealth, American Academy of Pediatrics, Trust Based Relational Interventions (TBIR) of Texas Christian University, Creating Trauma Sensitive Classrooms and Baby Sparks. 

The three-hour training consisted of two modules with these learning objectives: 

• Module 1
  • Why You Need to Know About Trauma
  • Universal Prevalence of Trauma
  • Understanding the ACEs Study
  • Trauma Effects Brain Development
  • Trauma Can Impact School Performance
  • Traumatized Children Can Learn
• Module 2
• Creating a Healing Centered Culture
• Strategies for Learning
• Addressing Trauma in COVID-19
• Emotional Regulation
• Healing Gestures
• Communicating About Racial Bias
• Discipline and Tornado Behavior
• Additional Resources 

Following the training, Dr. Knox reported on the impact it had on the nearly 90 professionals who attended.   "The training will allow us to better recognize what could be a trauma related behavior in children and how to better respond to it. Additionally, the content has helped prepare us to design and implement new opportunities for early childhood professionals that we coach in child care settings and ultimately develop communities of practice around trauma related support. We want to ensure basic needs of adults and children are met so we that our work can truly shine and be of benefit to all." 

By understanding that ACEs are not destiny and what is predictable, is also preventable, we issue a call to action for city and state childcare leaders to consider following the example of Mississippi.  If you currently are not educating early learning professionals to help traumatized children learn, this is more critical now than ever.  Amidst COVID-19 many children have likely experienced additional trauma during times of isolation and quarantine.  Together, we can begin to dismantle the cradle to prison pipeline by seizing every opportunity to mitigate the effects of ACEs and support children.  

For more information about training/coaching childcare and community partners, contact Becky Haas, Core Team Member of the National Trauma Campaign for the Campaign for Trauma-Informed Policy and Practice by visiting https://BeckyHaas.com or email becky@beckyhaas.com.

 For more information and support in moving forward for integrated systems change, contact Marlo Nash, National Director of Partnership and Policy, Saint Francis Ministries, and Co-Chair of the National Trauma Campaign for the Campaign for Trauma-Informed Policy and Practice at marlo.nash@st-francis.org.