Trying to make LA schools less toxic is hit-and-miss; relatively few students receive care they need

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The Peacemakers of Harmony Elementary School in Los Angeles, CA.

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For millions of troubled children across the country, schools have been toxic places. That’s not just because many schools don’t control bullying by students or teachers, but because they enforce arbitrary and discriminatory zero tolerance school discipline policies, such as suspensions for “willful defiance”. Many also ignore the kids who sit in the back of the room and don’t engage – the ones called “lazy” or “unmotivated” – and who are likely to drop out of school.

In the Los Angeles Unified School District (LAUSD), which banned suspensions for willful defiance last May, the CBITS program (pronounced SEE-bits), aims to find and help troubled students before their reactions to their own trauma trigger a punitive response from their school environment, including a teacher or principal.

Gabriella Garcia’s son attended Harmony Elementary School during the 2012-2013 school year. The school has 730 children in kindergarten through fifth grade. She says without CBITS, she would have lost custody of him and her other two children. “But for some reason,” she says, “I let him (her son) take that test.”

“That test” is a questionnaire given to some of the fifth-grade students at the school, which is located in a mostly Hispanic neighborhood south of downtown Los Angeles.

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Every semester, Lauren Maher, a psychiatric social worker, gives all the children in Harmony’s fifth grade a brightly colored flyer to take home. It asks the parent to give permission for her or his child to fill out a questionnaire about events the child may have experienced in, or away from, school. “Has anyone close to you died?” “Have you yourself been slapped, punched, or hit by someone?” “Have you had trouble concentrating (for example, losing track of a story on television, forgetting what you read, not paying attention in class)?” are three of the 45 questions.

Garcia’s son was one of a small group of students whose answers on the questionnaire, as well as his grades and behavior, were showing signs that he was suffering trauma. He joined one of the two groups, each with eight students that met once a week for 10 weeks at the school. In the group, the students don’t

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Dr. Jeffrey Brenner: “I believe ACE scores should become a vital sign, as important as height, weight, and blood pressure.”

This video looks at the relationship between ACEs and hospital emergency rooms.

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Dr. Jeffrey Brenner is founder and executive director of the Camden Coalition of Healthcare Providers, and a 2013 MacArthur Foundation genius award winner. He did groundbreaking work in Camden, N.J., by using data to identify people who were hospital emergency room “frequent fliers”. He found that between their trips to the ER, little or nothing was done to help them improve their health. So, he began putting basic services in place to help these people. His work was written up in a New Yorker article — The Hot Spotters, by Dr. Atul Gawande — in  2011.

That article sent a shock of electricity through me — not only because it was so well written, but because Brenner was on to a solution for markedly reducing health care costs. However, it seemed to me that there was a piece missing —  if Brenner knew about the CDC’s Adverse Childhood Experiences Study, he (and other physicians) might be able to identify the people who suffer most in our society more quickly.

Today, an essay Brenner wrote about how the medical community has neglected the ACE Study, even though its findings were published in 1998, appeared on Philly.com’s The Field Clinic blog. It’s well worth a read. Here’s part of it:  

For nearly 15 years we’ve had the secret to delivering better care at lower cost in America.  The information has sat, hidden away in the medical literature, and barely mentioned among physicians.  It’s a remarkable story of bias. The neglect of this information by the medical community tells you a lot about our failings as a profession and the poor training we receive.  It’s also a powerful commentary on the values of our society and the biases built into our society’s view of health and healthcare.

In the 1990’s, a physician at Kaiser Permanente in California, Dr. Vincent Felitti, conducted a mail survey with 17,000 middle class patients.  He asked them questions about traumatic events that might have happened to them as children.  Incredibly, over 70% of people receiving the survey responded, and they gave permission to connect their survey answers to their medical records.

….In the work that I do in the City of Camden building interventions for high-cost complex

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San Francisco’s El Dorado Elementary uses trauma-informed & restorative practices; suspensions drop 89%

El Dorado Elementary School Principal Silvia Cordero announces one of the winners of the weekly student-of-the-week award.

El Dorado Elementary School Principal Silvia Cordero announces one of the winners of the weekly student-of-the-week award.

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For one young student – let’s call him Martin — the 2012-2013 school year at El Dorado Elementary in the Visitacion Valley neighborhood of San Francisco was a tough one, recalls Joyce Dorado, director of UCSF HEARTS — Healthy Environments and Response to Trauma in Schools.

“He was hurting himself in the classroom, kicking the teacher, just blowing out of class many times a week.” There was good reason. The five-year-old was exposed to chronic violence and suffered traumatic losses. His explosions were normal reactions to events that overwhelmed him.

This year, Martin’s doing better. That’s because he spent months working with a HEARTS therapist, and that therapist worked with his teachers and other school staff to create a more safe and supportive learning environment. Still, on days when he feels extremely anxious, Martin sometimes asks to visit the school’s Wellness Center, a small, bright room stocked with comforting places to sit, headphones to listen to music, and soft and squishy toys.

“If a student starts to lose it, the teacher can give the kid a pass to go to the Wellness Center,” says Dorado. “The kid signs in, circles emotions on a ‘feelings’ chart (to help the person who staffs the center understand how to help the child). The staff member starts a timer. The kid gets five to 10 minutes. The kid can sit on the couch with a blanket, listen to music, squeeze rubber balls to relieve tension and anger, or talk to the staff member. Kids who use the room calm down so that they can go back to class. It’s not a punishment room. It’s not a time-out room. It’s not an in-school suspension room. It’s a room where you feel better going out than when you went in.”

One day this year, as school staff members are meeting in the Wellness Center, Martin bursts in. “I need to borrow something,” he tells them. “Somebody needs my help.”

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Georgia juvenile court judge galvanizes statewide child trauma initiatives

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Douglas County (GA) Juvenile Court Judge Peggy Walker and “Dalton”

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Douglas County Juvenile Court Judge Peggy Walker is an activist judge for the children of Georgia – the children she loves who do not get what they need for healthy, successful lives.  She’s seen how the children are failed when they come back to court again and again. Now she’s doing something about it.  When she takes over later this year as the president of the National Council of Juvenile and Family Court Judges, she’ll have a national platform to promote changes in polices and practices to prevent and treat childhood trauma.  For now, she is spreading the word around the state of Georgia through conferences in four different regions, with the first one held January 10 at the Carter Center in Atlanta.

Woven into Judge Walker’s Georgia Summit on Complex Trauma keynote address to more than 400 participants —  including judges, their staffs, child and family services professionals, and advocates — was a description of a painful case from her work as a judge.  She began her presentation on what science tells us to do for children who have experienced complex trauma with a photo of herself (shown above) holding “Dalton.” He was the first drug-free child in the court’s family drug treatment program; his mother “Tonya” was a participant (both names are pseudonyms).

During the 10 years that “Tonya” had been in and out of her court, Judge Walker did not know her story. When she found out, she learned that  “Tonya’s” mother was alcoholic, emotionally abusive, and manipulative.  At age seven, “Tonya” was raped by a 50-year-old neighbor who was later incarcerated but freed after three years.  She tried drug treatment in

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At Reedley (CA) High School, suspensions drop 40%, expulsions 80% in two years with PBIS, restorative justice; but going the distance might require more tools

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In 2009, when the Kings Canyon Unified School District in California’s rural Central Valley offered its 19 schools the opportunity to adopt a system that would reduce school suspensions and expulsions, Reedley High School jumped at the chance.

Today, Reedley is in its fourth year of changing a zero-tolerance policy that has failed this school and community miserably, just as every zero-tolerance policy across the country has. The school, which has 1,900 students, is feeling its way out of those draconian days by integrating PBIS — Positive Behavioral Interventions and Support — and entering into a unique partnership with the West Coast Mennonite Central Committee and the local police department to implement a successful restorative justice program.

This approach is already having remarkable effect. The school saw a 40% drop in suspensions from the 2010-2011 to the 2012-2013 school year — from 401 to 249 suspensions involving 198 and 80 students, respectively. Expulsions went from 94 in 2010-2011 to 20 last year. But this year’s trends indicate that impressive decline may have stalled out.

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Want to reduce mental illness? Address trauma. Want to save the world? Address trauma.

Our Earth and and moon.

Our Earth and moon

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Different explanations have been given for the increased number of people suffering from mental illness. Some have claimed the increase is the result of ever-expanding diagnostic criteria and syndromes that risk medicalizing normal emotional reactions. Others argue the increase is the result of the pharmaceutical industry financially courting the medical establishment as well as using advertisements to attract potential users of their medications. While both these arguments seem correct, they nevertheless fail to address that an increasing number of people regularly experience despair and anguish and are struggling to make a meaningful life, if not keep themselves psychologically, socially, and financially afloat.

I would like to suggest an additional explanation for the increase in mental illness: The upsurge is the result of the collective failure to alleviate conditions that contribute to trauma-related stress. I also believe the mental health field has stood in the way of people overcoming mental illness and returning to growth-centered lives. In particular, models of mental illness as chronic, genetic-based disorders gives us the sense that we are reaching the origins of our suffering — that is to say, the genes we inherited — when in actuality, we risk denying the traumatizing conditions in which many of us grew up or continue to live. Although a diagnosis and medications may provide temporary relief, they may also cause Americans to evade making the challenging changes that are necessary for moving into an emotionally sustainable future.

Childhood abuse and other emotional damaging experiences are so prevalent today that trauma-focused psychiatrist Bessel van der Kolk claimed the single most important health problem facing Americans is our exposure to what are increasingly referred to as “adverse childhood experiences,” which have been rigorously

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Want your ACE score? Now there’s an app for that!

ACE icon Ever wonder why you, your relatives or friends can’t stop smoking, over-eating, drinking, doing meth or other drugs? Why you’re a workaholic, a rage-aholic or shopaholic? Why you’ve shed marriages like a snake sheds skins? Or why you have trouble keeping a job or making friends?

Maybe it has something to do with your — or their — ACE score.

Many people who learn about the CDC’s Adverse Childhood Experiences Study (ACE Study) and take a 10-question survey based on its findings say two things: “Now my life makes sense,” and “Why didn’t someone tell me about this years ago?”

The ACE Study uncovered a stunning link between childhood trauma and the adult onset of chronic disease, social and emotional problems.

The study’s researchers – Drs. Robert Anda and Vincent Felitti — measured 10 types of childhood

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Survey shows 1 in 5 Iowans have 3 or more adverse childhood experiences

iowaacesIowa’s 2012 ACE survey found that 55 percent of Iowans have at least one adverse childhood experience, while one in five of the state’s residents have an ACE score of 3 or higher.

In the Iowa study, there was more emotional abuse than physical and sexual abuse, while adult substance abuse was higher than other household dysfunctions.iowaprevalence

This survey echoed the original CDC ACE Study in that as the number of types of adverse childhood experiences increase, the risk of chronic health problems — such as diabetes, depression, heart disease and cancer — increases. So does violence, becoming a victim of violence, and missing work days.

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There’s no such thing as a bad kid in these Spokane, WA, trauma-informed elementary schools

WTilesWhat’s a trauma-informed school? It’s a place where this happens:

There’s this third-grade kid. Let’s call him Sam. He’s got ODD (oppositional defiant disorder…a misnomer for normal behavior a child exhibits when he’s living with chronic trauma).

Nine-year-old Sam (not his real name) is very smart. But sometimes he balked, dug his heels in deep,

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Terrifying children into a life of asthma

Credit: Cellular Image/Flickr

Credit: Cellular Image/Flickr

Sometimes the clearest indicator of a family’s dysfunction is, unfortunately, illness in its children. Like the proverbial canaries in the coal mine, it’s the children who are most susceptible to the toxicity of family addiction and dysfunction. Hurt people hurt people, and literally scare the life out of little kids.

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