Preventing ACEs!

As a family physician and long time parenting educator, I think this is a simplistic top down solution. It solves the problem from the outside, not the inside. Parents of newborns don't know what they don't know - in fact usually they are pretty confident that they know how to parent... until they struggle- there isn't a big window for taking in new knowledge in their overwhelmed, sleep deprived state. There are other tools we have - that are trauma informed that I believe are more promising. 

- Use home visits for parent support and model attachment tools and teach about development (lots of good studies on this). The key is really training the home support folks in trauma informed practices and cultural practices of the community.

- Work with physicians who care for families - starting with family docs and pediatricians. Help them look for signs of insecure attachment - which, without intervention will get passed down another generation. Include that as a health risk and in the context of the trusted relationship, use the baby to help the parents. Eg. Narrate the baby's feelings, help the family interpret the baby's signal, lift out what happens when the adults are tired, frustrated or disappointed or angry - and help them understand their own brain so that they can be responsive to the baby's needs. (This takes coaching of physicians)

- Use a multi-generation approach. As children enter child care and school, teach them about their brain and use trauma informed tools. Help them develop the social-emotional skills that help them be resilient - and simultaneously create community based parenting groups to offer both support and skills.

I’m reading this book.... I’m getting a little tired of reading but for those of us in places with no education or direction... 

I just know that in Frank Putman’s book, he talks about parental dissociation (and many other researchers discuss this also) and unresolved trauma being the risk factor for problematic child development and that this risk factor passes down generations....it’s not easy to repair this difficulty, but I know what we’ve been doing so far is not working. 

I think this is a good question to ask so thank you. I wish ever peds doc and OB doc and psychiatrist and therapist and educator, etc... in the world would ask this question and also every parent would be asking and involved in finding a workable answer because these are the questions that need to be asked and ways that work that are respectful to families need to be found and started now!!!!! 

I know it seems great if we could just sit people down and teach them about all the ACEs at once and have that be enough to prevent the next generation experiencing ACEs. I think that could be a bit overwhelming for a parent who is struggling as someone pointed out in an earlier comment. Also, if a parent is struggling it may take pretty intensive, long-term support to help them make those huge changes to their lives (ie - find effective treatment for mental health issues or substance abuse) so that they can prevent their children from experiencing ACEs. So I think this is a both-and situation. While it's great to have ACEs education in multiple settings - like a hospital and schools - we also need to ensure we're connecting people more intensive prevention programs even if those programs aren't addressing all the ACEs at once. There are lots of prevention programs for preventing specific ACEs - Nurse-Family Partnership to prevent abuse and neglect; Stewards of Children to prevent child sexual abuse; curricula in high schools focusing on healthy relationships or substance use. While some of these programs - like NFP - are secondary prevention programs in that families or individuals with certain risk factors are targeted for intervention, many of the others are primary prevention programs available to everyone. I think it's very important to know who is doing prevention work in your area, to make connections with those organizations to make sure families are getting information and support specific to their situation, and to support existing prevention efforts so we can hopefully reach a tipping point with ACEs. 

I think we have to move beyond ACEs.   It isn’t enough and connecting parents with what is available isn’t enough either because where I came from, there is little available... and I’ve learned from lived experience that it is dangerous to just blindly accept what we are told by “authorities” like CMH -  “Here do this buccal DNA swab, it will give us the genetic information we need to determine what psychotropic combo will treat and cure your developmental trauma.”   This is the message I hear being given over and over to parents and kids involved in the child welfare systems and that just isn’t working.  I’m not willing to not take it upon myself to learn -  I know I might sound a little gruff and I admit, I’m a little frustrated because I know many kids are falling through the cracks as I type this out... I’m willing to do everything and anything that works .... and then also weed out what doesn’t and keep seeking to know and brainstorm ideas that might help keep kids from falling through the cracks even if it’s just an exercise in my own mind. 

So I’m gonna keep wondering out loud about stuff for example if communities learning about Newborn Behavior/Communication could be useful... it might be something that OB nurses could learn and teach to new parents??? Just a thought    Heck, I did Edinburgh and we didn’t even have safe and effective places to refer severely depressed new moms to in order to help them besides getting psyche drugs and that just isn’t very good treatment in my mind.   I did ASQ-SE and at 6 months you can see kids who were going to have behavioral problems at 15-18 months already if nothing is done with No good place to refer these kids to either (except to get them on an early path to psyche drugs which is medical malpractice to me) so I’m trying to think out loud about ways to give power and control to parents because there is no one else who is going to be able to solve these problems ultimately....