How can big data help improve child maltreatment response and prevention?

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Miranda Sheffield and her daughter

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By Daniel Heimpel

At 18, Miranda Sheffield got the shock of her life when a pregnancy test came up positive.

Sheffield’s first reaction was “devastation, disappointment, depression, tragedy: any- and everything that could be negative.”

She was a track star and a senior at Pomona High School, set in the vast urban tracts surrounding Los Angeles. Unlike anyone else in her family, Sheffield was on her way to college.

Even if she didn’t fully realize it as a pregnant teen in 2004, the prospects for her baby girl were less than optimal. She was single, on public health insurance and had been in foster care for almost half of her quickly fading childhood.

In 2013, Emily Putnam-Hornstein and a team of researchers from the University of Southern California and the University of California-Berkeley released a groundbreaking study that tracked what happens to the children of young mothers who had experienced the child protection system in Los Angeles.

By age five, 40 percent of children with mothers who had been suspected victims of abuse were reported themselves. For sons and daughters of moms who had been confirmed victims, 18 percent would wind up as confirmed victims themselves.

Applying Predictive Analytics to Child Maltreatment Response and Prevention

This is only one facet of a growing body of research that is clearly linking certain data points available when a baby is born with their subsequent involvement with the child protection system.

What is emerging is a new paradigm, where big data can be crunched in a way that helps determine which children are at greater risk of being abused.

For Los Angeles County, which committed itself to an overhaul of its child protection system last year, the idea of applying “predictive analytics” to child maltreatment response and prevention has gained a new currency. Its Blue Ribbon Commission on Child Protection recommended that the county implement a predictive analytics model piloted in Florida that is meant to reduce child fatalities. It also pointed to Putnam-Hornstein’s research, which could be applied to targeting services to families and individuals, like Miranda Sheffield, before a call of abuse is ever made.

The transition team charged with seeing the blue ribbon commission’s recommendations through has taken little substantive action towards launching a

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Arizona ACE Consortium spreads awareness, influences prevention of childhood trauma

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Not long after Marcia Stanton stumbled across the original article from the CDC’s Adverse Childhood Experiences Study, she heard a conference presentation by Dr. Vincent Felitti, one of the study’s co-authors. She invited Felitti to do grand rounds with 100 pediatricians at Phoenix Children’s Hospital, where she works.

“I thought they’d be all over this,” says Stanton, a social worker in the hospital’s Injury Prevention Center, where she coordinates child abuse prevention programs and promotes primary prevention. After all, the study revealed a direct link between 10 types of childhood adversity and the adult onset of chronic disease (cancer, heart disease, diabetes, autoimmune diseases, etc.), mental illness, violence and being a victim of violence. It showed that childhood trauma was very common — two-thirds of adults have experienced at least one type. It showed that if people had experienced one, they usually experienced more. And the study showed the more types of trauma experienced, the higher the risk of chronic disease and mental illness. For example, an ACE score of 4 increased the risk of suicide by 1200 percent and alcoholism by 700 percent.

Felitti had warned her that physicians were typically slow to warm to ACEs research. Not these physicians, she thought.

“After a very compelling one-hour presentation, there were only a couple of questions from the physicians,” she recalls of the 2006 event. “Everyone filed out, and that was the end of it. I was shocked at how little response there was.”

She sighs. “So we put our efforts in other directions.”

Looking back over the last eight years, Stanton reflects on the progress of the Arizona ACE Consortium. “We’re moving ahead,” she says. “But it’s as if we’re in a maze. We hit a wall, bounce back, reverse and go another direction. We’ve learned that we have to go where the interest is.”

In fact, for a grass-roots organization that has no funding and one part-time coordinator (Stanton spends 20% of her part-time 32-hour-a-week job on the project), the Arizona ACE Consortium has a stunning list of accomplishments:

  • Seven train-the-trainer workshops in which 450 people learned about ACEs, the effects of toxic stress and resilience factors, and how to present this information to their communities.
  • Tens of thousands of Arizonans who now know about the ACE Study. The first train-the-trainer workshop group alone—which included 35 people from the state’s 15 regional child abuse prevention councils—did presentations in April 2010 as part of Child Abuse Prevention Month. Those presentations reached 13,000 people.

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State data fuels the ACEs conversation in Iowa

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Most Iowans didn’t learn about the Centers for Disease Control’s ACE Study until early 2011. But in the three years since then, the state has completed two ACE surveys, one of them published, with a third survey underway and a fourth scheduled for 2015. Iowa has hosted three ACEs summits; two statewide summits in 2014 focus on ACEs in early childhood, and education and juvenile justice. And nearly every sector—including health care, education, social services and corrections—is busy answering the question: How do we integrate this knowledge into what we do?

“To this day, I can’t find out who knew to bring him here,” says Suzanne Mineck, president of the Mid Iowa Health Foundation, referring to physician

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One-way mirrors, monitors and a whole lot of training — how Parent-Child Interaction Therapy works

A typical setup for a PICT training, in which a counselor monitors interaction between parent and child.

A typical setup for a PICT training, in which a counselor monitors interaction between parent and child.

By Christie Renick

Carla Francis’ training session is fast-paced.

Francis, a therapist, sits in an observation room with two monitors in front of her; one displays her clients – a grandmotherly woman and a toddler (their names have been changed to protect their identity) — in the playroom next door, and through the other she sees her virtual trainer, psychologist Dawn Blacker, who observes from her office hundreds of miles north at the University of California, Davis.

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Los Angeles bets big on Parent-Child Interaction Therapy to reduce adverse childhood experiences

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By Christie Renick

In June 2014, the Los Angeles County Board of Supervisors began implementing the recommendations made by the Blue Ribbon Commission on Child Protection, which calls for augmented child maltreatment prevention efforts.

While implementation of the commission’s many recommendations is a long-term venture, leaders are hoping that the rollout of a maltreatment prevention initiative may improve child safety in the short-term.

First 5 LA, a taxpayer-supported initiative that provides a variety of services to families with young

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Children’s Resilience Initiative in Walla Walla, WA, draws spotlight to trauma-sensitive school

RRocksbannerIn Walla Walla, Washington, the journey to implement ACEs research has been akin to a wild ride on a transformer roller coaster that arbitrarily changes its careening turns, mountainous ascents, and hair-raising plunges. And sometimes the ride just screeches to a frustrating halt.

The odyssey began in October 2007, when Teri Barila, Walla Walla County Community Network coordinator, heard Dr. Robert Anda, co-investigator

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The Camden story: A physician and a priest plant seeds of repair

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Simultaneously making changes at the organizational level and building alliances across sectors for larger system change, Father Jeff Putthoff, SJ, and Dr. Jeffrey Brenner realized they had to dig deeper — beyond symptoms to root causes — to understand the struggles they were witnessing in Camden, NJ. What they found were ACEs.

Putthoff, a Jesuit priest known locally as “Father Jeff,” is a fireplug of purpose under his casual uniform of cargo shorts and sweatshirt, earbuds slung around his neck, a blue bicycle his preferred mode of transport. He is voluble and passionate on the subject of his city. Since 2000, Father Jeff has directed Hopeworks N’ Camden, an organization that offers in-school and out-of-school youth GED classes and web-site design instruction—skills intended to parlay directly into jobs or college.

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