CA Senate unanimously approves ACEs reduction resolution

California Dome & Senate SealOn August 18, the California Senate unanimously approved Concurrent Resolution (ACR) No. 155 to encourage statewide policies to reduce children’s exposure to adverse childhood experiences. As reported on ACEs Too High, the resolution is modeled after a Wisconsin resolution that encourages state policy decision-making to consider the impact of early childhood adversity on the long-term health and well being of its citizens. Since the resolution does not require California Gov. Jerry Brown’s signature, the Senate’s approval is the final step in the process.

The resolution echoes the language of a Wisconsin bill passed earlier this year—the state’s policies should “consider the principles of brain development, the intimate connection between mental and physical health, the concepts of toxic stress, adverse childhood experiences, buffering relationships, and the roles of early intervention and investment in children…”

New programs or mandates are not included in the resolutions, but both provide an important framework for state level decision-making that is informed by the findings of the CDC’s Adverse Childhood Experiences (ACE) Study. The two state resolutions are natural extensions of already robust ACEs-related and trauma-informed programs and policies in those states.

The principal sponsor of the California resolution was Assembly Member Raul Bocanegra (D-Pacoima) who spoke on behalf of the resolution on the Assembly floor and was joined by Rob Bonta (D-Oakland) and Reginald B. Jones-Sawyer, Sr. (D-Los Angeles). Bonta said that “sadly and tragically” almost every youth in the City of Oakland has been touched by violence and that life expectancy is negatively impacted by conditions in vulnerable communities. Jones-Sawyer said that conditions that result in urban PTSD are “unnoticed and unaddressed.”  To see these short speeches, click here http://calchannel.granicus.com…d=7&clip_id=2332 and scroll down to ACR 155. The video also shows the adding of 68 members as coauthors.

During the weeks after the Assembly passage and before the Senate action, advocates led by the Center for Youth Wellness built support for the resolution.  Senator Holly Mitchell (D-Los Angeles), chair of the California Legislative Black Caucus, was the floor

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Patrick Kennedy builds connections among diverse sectors to change healthcare

(l to r) Patrick Kennedy, Bill Emmet, Kennedy Forum executive director, and Mike Thompson

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Former U.S. Congressman Patrick Kennedy is building a “Community of Mental Health,” by making connections that are needed for mental health to be fully integrated into our understanding of overall health. To achieve this goal, the son of U.S. Senator Edward M. Kennedy has created the Kennedy Forum—so named to evoke the memory of President John F. Kennedy and employ the family name to inspire, motivate, and unite advocates and policymakers around a shared vision of what healthcare should be. The Kennedy Forum is focused on the development, implementation, and dissemination of mental health and addiction policy and standards—with the first order of business being the implementation of the new mental health and addiction parity law.

The Kennedy Forum is providing this leadership by convening people with diverse interests and perspectives in a variety of formats including one-on-one meetings, national summits, locally focused seminars and forums being held venues as diverse as Chicago and Cape Cod. The goal of the Forum is to help shape the service delivery and payment system of the future—one that encourages prevention, early intervention, and coordinated care for all who need it.

Patrick Kennedy (center) addresses gathering at the Kennedy compound in Hyannis Port, MA

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The premier meeting of the Kennedy Forum was held at the Kennedy Library in Boston in the fall of 2013 (the second such meeting will be held in June 2015). Earlier this summer, a series of small gatherings took place at the Kennedy compound in Hyannis Port, on Cape Cod in Massachusetts. A meeting is scheduled for November 13 in Chicago to address local issues. Part of that meeting will address prevention and early intervention in mental health, including the traumatic impact of community violence on the city’s children.

Arthur Evans

Arthur Evans at Philadelphia “I Will Listen” event

The gatherings at the the family home on Cape Cod brought together leaders from a variety of fields to share experiences and expertise and learn from each other, often for the first time. Here are several examples of participants who illustrate different perspectives on improving health in the broadest sense of the word:

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Massachusetts “Safe and Supportive Schools” provisions signed into law, boosts trauma-informed school movement

Massachusetts Gov. Deval Patrick

Massachusetts Gov. Deval Patrick

Massachusetts Governor Deval Patrick today signed into law provisions to create conditions for “safe and supportive schools” intended to improve education outcomes for children statewide, and giving momentum to the state’s trauma-informed schools movement. They were included in The Reduction of Gun Violence bill (No. 4376). This groundbreaking advance was achieved when advocates seized the opportunity to add behavioral health in the schools to the options under consideration as state officials searched for ways to strengthen one of the nation’s more restrictive gun laws in the aftermath of the tragic shooting of schoolchildren in Newtown, CT.

House Speaker Robert DeLeo saw the connection between reducing gun violence and school achievement and was instrumental in the bill’s passage. When the original sponsor of a Safe and Support Schools Act, Katherine Clark, left the state legislature for the U.S. House of Representatives, some advocates were concerned the void would not be filled. Their fears were assuaged when Rep. Ruth Balser of Newton and Sen. Sal DiDomenico of Boston became lead sponsors.

The schools act supporters were jubilant that the legislation they labored on for years was incorporated in the gun violence bill now signed into law, and expressed deep relief and excitement about the achievement. They also said the hard work of statewide implementation now begins.

The law requires the state education department to develop a framework for safe and supportive schools, first developed by a task force established by the legislature in 2008, that provides a foundation to help schools create a learning environment in which all students can flourish. The framework is based on a public health approach that includes fostering the emotional wellbeing of all students, preventive services and supports, and intensive services for those with significant needs.

Within the framework, schools are encouraged, but not mandated, to develop action plans that will be incorporated into the already required School Improvement Plans. The law also provides a self-assessment tool to help in the creation of the plans.

Under the leadership of the Trauma and Learning Policy Initiative (TLPI), a coalition of the Massachusetts Advocates for Children and Harvard Law School, the “Safe and Supportive Schools Coalition” was formed to move the legislation

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To prevent childhood trauma, pediatricians screen children and their parents…and sometimes, just parents…for childhood trauma

TabithaLawson

Tabitha Lawson and her two happy children

When parents bring their four-month-olds to a well-baby checkup at the Children’s Clinic in Portland, OR, Drs. Teri Petersen, R.J. Gillespie and their 15 other partners ask the parents about their adverse childhood experiences (ACEs).

When parents bring a child who’s bouncing off the walls and having nightmares to the Bayview Child Health Center in San Francisco, Dr. Nadine Burke Harris doesn’t ask: “What’s wrong with this child?” Instead, she asks, “What happened to this child?” and calculates the child’s ACE score.

In rural northern Michigan, a teacher tells a parent that her “problem” child has ADHD and needs drugs. The parent brings the child to see Dr. Tina Marie Hahn, who experienced more childhood trauma than most people. Instead of writing a prescription, Hahn has a heart-to-heart conversation with the parent and the child about what’s happening in their lives that might be leading to the behavior, and figures out the child’s ACE score.

What’s an ACE score? Think of it as a cholesterol score for childhood trauma.

Why is it important? Because childhood trauma can cause the adult onset of chronic disease (including cancer, heart disease and diabetes), mental illness, violence, becoming a victim of violence, divorce, broken bones, obesity, teen and unwanted pregnancies, and work absences.

The CDC’s Adverse Childhood Experiences Study (ACE Study) measured 10 types of childhood adversity: sexual, physical and verbal abuse, and

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What’s missing in climate change discussion? The certainty of trauma…and building resilience

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This spring, a group of more than 160 mental health professionals, resilience-building specialists and mindfulness teachers officially launched the International Transformational Resilience Coalition. Their goal is a challenging one: to raise awareness of how climate change traumatizes communities around the world. The group’s mission is to not only educate the mental health field about this threat, but to also provide preventive solutions before disaster strikes.

The initiative was first envisioned by Bob Doppelt, executive director of The Resource Innovation Group, an BobDoppelt2Oregon-based nonprofit that works across the U.S. to develop new approaches to social-ecological problems, including climate change. Doppelt said that efforts to mitigate climate change have focused on external aspects like fixing and improving infrastructure and developing new forecasting models.

“And throughout all of that work,” he said, “it dawned on me that we were missing what is likely to be the most important issue facing us, and that is the human response to climate change.”

Doppelt said he’d seen this firsthand after Hurricane Sandy devastated communities in southeast Florida, a region where The Resource Innovation Group played a key role in helping the government address climate change readiness. Trained as a counseling psychologist, Doppelt decided that it was essential to develop programs for teaching people how to become resilient as they faced the acute trauma and chronic stress brought on by climate change.

A year-and-a-half ago, The Resource Innovation Group launched its own program to teach mindfulness skills to individuals, organizations and community leaders across the country. The premise is that everyone will need coping techniques as climate change disrupts communities in both profound and subtle ways.

Yet, resiliency is a word that Doppelt uses carefully. “We came up with the term transformational resilience because in many cases the impacts of climate change mean there is no going back to pre-crisis conditions,” he said.

Doppelt also realized that this approach needed an entire network of dedicated mental health and mindfulness professionals – not just one organization like his championing the cause. That’s when he helped organize nearly two dozen founding members, including Dr. Sandra Bloom, co-creator of the Sanctuary Model, and Elaine Miller-Karas, executive director and co-founder, Trauma Resource Institute.

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Are there non-medication alternatives for ADHD treatment?

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[Photo: robert_rex_jackson, Flickr]

The Question: While more than two-thirds of youth diagnosed with attention-deficit hyperactivity use prescription medication to control their symptoms, it’s not uncommon for both parents and children to want a non-drug alternative. The guidelines recommend evidence-based behavior therapy as the primary treatment for pre-school age children; older students are advised to try ADHD medication alone or in combination with behavior therapy. Despite these clear recommendations, clinicians and parents may not know that alternative treatments exist, or how to access them.

The Alternatives: Three types of non-medication interventions have been demonstrated as effective for ADHD.

  • Parental training is designed to help caretakers improve their own communication and discipline practices. The goal is to better manage a child’s behavior by encouraging positive behavior and deterring what might be seen as classic ADHD conduct. Four parent training programs have been shown to reduce disruptive behavior: Triple P; Incredible Years; Parent-Child Interaction Therapy; and, the New Forest Parenting Program.
  • A mental health professional typically delivers psychosocial therapy, counseling a patient and his or her family on a regular basis about how to manage ADHD symptoms. These therapists, however, may not know the latest evidence-based techniques for working with children who have ADHD.
  • Behavioral therapy focuses on teaching children important skills, such as organizing, socializing, and problem solving. Showing parents and teachers how to help manage behavior and symptoms is an essential aspect of behavioral therapy as well. Some of this training may take place in the classroom, depending on the school’s resources, but it can also occur at sites where therapists have been specifically trained in evidence-based ADHD interventions. Two such examples are the Summer Treatment Program at Florida International University’s Center for Children and Families and the Challenging Horizons Program at the Center for Intervention Research in Schools at Ohio University.

These treatment types can overlap. For instance, some therapists use behavioral modification while behavioral therapy programs often have a parent-training component. For more information about the types of treatment and their costs, see this brochure (PDF) produced by the Agency for Healthcare Research and Quality.

A Note on Trauma: None of the behavioral

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Am I really the worst? A day in the life of parenting special needs children

AfamilyThe other day after a particularly lively visit to PetSmart with my husband and our two special needs children, a woman who had been in the store at the same time drove up and said: “You are the worst parents I have ever seen.” She drove off before I could respond, not that I had a witty comeback. To clarify, no animals were hurt (or even handled), nothing was damaged and we did not leave any messes for store employees to clean up. We were probably the loudest family in the store, but that is normal in our world.

I am confident I cannot possibly be the worst parent out there.

My children, who both struggle with multiple disabilities, had a fun outing to the pet store with two parents who love them dearly. Despite their challenges, they are on the honor roll at school, play sports and engage in other extracurricular activities and have received awards for their accomplishments. Of course, it is easy to listen and accept negative comments of someone who sees my life for less than 15 minutes and makes a faulty assessment. I am like every other parent: I worry. I have doubts and fears. I doubt myself. I question if I am doing enough.

Most parents worry about their children, but parents of special needs children need to know the world is a better place because they are in it. We are parents who have been to more medical appointments with our young children than most adults have been to in their whole lives.  Our children often have had multiple diagnoses yet don’t really “fit” any of them. We sometimes feel isolated because our children don’t seem to fit into any group, even the “special needs” ones. We’ve scoured books, magazines and web sites in the hopes of finding something new that might be effective for our children’s needs. We feel exhausted, overwhelmed and incompetent on a daily basis but still get up every morning and try to provide the best for our children. We fight schools, doctors, friends and even family members every day just to get them to understand the basic needs of our children. And after all of that, we have to put a positive spin on some very ugly comments our children hear on a regular basis.

To paraphrase the late Erma Bombeck, God is looking down from heaven and pairing children with appropriate parents. When He chooses parents for a handicapped child, He decides they must be happy so the child can know laughter; they cannot have too much patience or they will drown in a sea of self-pity and despair; they must have a sense of self and independence so they will be able help the child who is in her or his own world function. They must to be a little bit selfish to separate themselves from the child occasionally to survive. They will see clearly ignorance, cruelty and prejudice and be able to rise above it.

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