At a March 8 breakfast meeting in Washington, D.C., the featured speakers—U.S. Senator Heidi Heitkamp of North Dakota (left) and Judith Sandalow, Executive Director of the DC Children’s Law Center (CLC)—used the vivid image of children growing up with “black mold climbing the walls,” referring to unsafe physical and emotional environments at home and in communities, exacerbated by poverty but not limited to poor households. Heitkamp described how the science now explains what we already knew—traumatic life experiences alter children’s ability to learn and thrive and now we know why.

Senator Heitkamp’s passion for sharing knowledge about the impact of trauma is fueled by the history and experience of Native Americans in her state and informed the work of her two sisters—a social worker with the University of North Dakota and an advocate for runaway and homeless youth. When she asked one sister what could possibly be worse for a child than sexual abuse, she was told that abandonment could be even more traumatic.

Senator Heitkamp described her experience with the tobacco settlement as Attorney General for the State of North Dakota, calling it one of the greatest public health triumphs in history and then compared the economic and health impacts of tobacco use and trauma-based illnesses. She said that no one is looking at the role of trauma in the current opioid crisis and noted that some communities are experiencing more trauma than returning Iraqi soldiers, an easier and more relatable subset within the larger community. Trauma can result in 20 years of lost life, according to Heitkamp.

Heitkamp identified the need to start early in children’s lives, spread “pockets of innovation,” and get ahead of treating the consequences of trauma. The success of the Menominee tribe of Wisconsin in reducing high school dropout rates was one example. She called for the development of evidence-based practices and said there is a need for approaches similar to the Duluth model for domestic violence prevention and the California model for tobacco cessation. She credited the native North Dakotan Bruce Perry, MD with the “most innovative thinking around” on understanding trauma.

She addressed the intergenerational trauma experienced by Native Americans that results in changes in DNA, noting the consequences and continuation of long-term genocide. The path forward, she says, “is to change outcomes” and “not continue doing what we’ve always done.” Unless poverty and trauma are addressed, there will no longer be a native population, she says.

Senator Heitkamp intends to continue being a “broken record” with her colleagues in the Senate by asking “how about trauma” in major legislation whether education, addiction, or healthcare. She referred the Roundtable on Traumatic Stress in Native American Communities and held up the work of a Johns Hopkins University scientist (Zach Kaminsky) who is working on a blood test to gauge the risk of suicide. She also expressed frustration about the lack of knowledge by some “experts” in fields such as suicide prevention who are not familiar with the science of trauma.

Heitkamp is planning a field hearing in Indian country in her state, a broader symposium, and a Capitol Hill staff briefing on trauma. She encouraged the attendees to do more—increase their advocacy and build awareness among policymakers regardless of the “lane they are in”—education, justice, child welfare, and health care.

Sandalow said that many of the 5,000 DC children served by CLC each year are re-traumatized in court and as well as in school, especially those who are suspended or expelled from school. Her organization and others are advocating for trauma-informed policy changes that do not necessarily mean more money. She used the example of the power of a school principal greeting each child by name as they come to school each day. The organization is supporting a pilot of trauma-informed practices in the District schools to document outcomes. CLC has worked closely with DC City Council Member David Grosso who held a hearing on trauma-informed schools last year.

Photo credit:  Lacey Mason, Children's Law Center