Any experienced teacher will tell you that every class has a few: children who can’t focus, can’t sit still, who fight at the slightest provocation, or perhaps withdraw completely.
These kids are usually labeled as “bad”, “out of control” or “willful”. But brain research has shown that these kids aren’t intentionally bad. Their brains are shorting out from an overload of toxic stress.
Prompted by results from a large study of Spokane, WA, schoolchildren that showed how childhood trauma is taking more of a toll than many imagined, an innovative project is underway that will test three types of intervention in 900 families that participate in Spokane’s Head Start program.
The study of 2,100 children was done in ten elementary schools in Spokane, WA, in late 2010. The study found not only that trauma is common in kids’ lives – trauma includes divorce, homelessness, witnessing family violence, involvement with child protective services, a family member abusing alcohol
or other drugs, neglect, or mental illness in a family – but it’s also the main reason that children missed school or got into trouble. It’s the second-highest predictor of academic failure, after a child being in special education classes.
And the more stressors a kid had, the study showed, the more likely that child was to have failing grades, poor attendance, severe behavior problems and poor health.
“The 248 kids with three or more adverse childhood experiences had three times the rate of academic failure, five times the rate of severe attendance problems, six times the rate of school behavior problems, and four times the rate of poor health compared with children with no known trauma,” says Christopher Blodgett, director of the Child and Family Research Unit (formerly the Area Health Education Center of Eastern Washington) at Washington State University.
Blodgett has been working on issues of family violence most of his career. About 10 years ago, he says, he began thinking about family violence as a set of public health concerns rather than as a medical issue. That was about the time that people in Washington State began learning about two areas of paradigm-shifting research:
- The Adverse Childhood Experience Study (ACE Study), a joint research project by Dr. Vincent Felitti at Kaiser Permanente in San Diego, and Dr. Robert Anda of the Centers for Disease Control and Prevention, and
- neurobiological research – including studies by Dr. Martin Teicher, director of the Developmental Biopsychiatry Research Program at McLean Hospital; Dr. Bruce McEwen, director of the Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology at Rockefeller University; and Dr. Jack Shonkoff, director of the Center on the Developing Child at Harvard University – that showed how toxic stress damaged the developing brains of children.
The CDC’s ACE Study measured 10 childhood traumas – physical, emotional and sexual abuse; emotional and physical neglect; living with a parent who’s an alcoholic or addicted to other drugs; witnessing the abuse of a mother; a family member in prison or diagnosed with mental illness; and a loss of a parent through divorce or abandonment – in 17,000 people in San Diego. (Of course, there are other possible traumatic events a child can experience – such as severe illness, a catastrophic accident or homelessness – but those were not measured.)
Researchers found a direct link between childhood trauma and adult onset of chronic disease, such as diabetes, heart disease, and some types of cancer. They also found that people with a higher ACE Score – three or more types of childhood trauma – had a significantly higher risk of chronic disease, suicide, drug use, engaging in violence or being a victim of violence.
The 17,000 people who participated in the study were 75 percent white, middle to upper-middle class, 76 percent had attended or graduated from college, and, since they were members of Kaiser through their employers, they had jobs and great health care.
In the last three years, 18 states have done their own ACE Studies, and those who have finished the analysis have found similar results.
The link between childhood trauma and adult onset of chronic disease was the damage that the toxic stress of chronic and severe trauma inflicts on a child’s developing brain. It essentially stunts the growth of some parts of the brain, and results in fried circuits in others. Children with toxic stress live their lives in fight, flight or fright mode – unable to concentrate to learn, responding to the world as a place of constant danger, not trusting adults and unable to develop healthy relationships with peers. Failure, despair, blame, shame and frustration follow, and children transition into adulthood finding comfort by overindulging in food, alcohol, tobacco (nicotine is an anti-depressant), drugs (methamphetamines are anti-depressants), work, high-risk sports, a plethora of sexual partners….anything to pump up feel-good moments to escape bad memories and feelings.
This knowledge “started pushing us toward thinking about how we end up getting to the systems that universally serve children and families and how we can potentially bend the curve on risk and consequences of exposure to trauma,” says Blodgett.
To do that, he decided, communities needed to see local data, especially how trauma was affecting children’s performance in schools. That way, Blodgett believes, he could demonstrate “how central ACEs and resulting risk of trauma are to the basic educational mission.”
So, in the spring of 2010, he and five other researchers obtained some funding from the Spokane County Community Network and the Washington State Family Policy Council. They worked with teachers and administrators to randomly choose 2,100 children from kindergarten through sixth grade in 10 elementary schools. They had asked school staff to identify the traumatic events that they knew the children had been exposed to without having to ask the children. The list included divorced or separated parents, homelessness or a risk of homelessness, witnessing family violence, having been involved with child protective services, a jailed family member, a family member abusing alcohol or other drugs, neglect, mental illness in a family member, exposure to community violence, or death of a parent or caregiver.
“This was a very conservative approach,” says Blodgett, “but it still aligned well with the ACE Study. It showed the pervasive epidemic nature of risk common in all of our communities.”
After controlling for special education status, grade level, race, participation in the free and reduced meals program, teachers, school building and gender, the researchers found that childhood trauma significantly predicts academic risks and chronic health problems. (Report: Adverse Childhood Experience and Developmental Risk in Elementary Schoolchildren Research Brief Final)
“ACE exposure may be the most powerful predictor of risk,” says Blodgett. “This is not something schools can ignore; it’s basic to the academic mission. Schools have a fundamental stake in trying to respond to these problems.”
He hopes the data is helping educators understand that, with one in three or four children exposed to significant adverse childhood experiences, trauma may be impacting their ability to teach children.
Blodgett used the research as an impetus to provide tools for teachers to be able to help traumatized children learn. He and his team obtain a $1-million, 4.5-year grant from the Safe Start Center, funded by the U.S. Department of Justice to test out three types of intervention in 900 families that participate in the local Head Start program:
- One intervention will train Head Start teachers to work with traumatized children.
- A second intervention will train teachers and educate parents about parenting skills and how their own childhood trauma has affected their lives.
- A third will train teachers and focuses on parent-child attachment skills, without delving into trauma history.
This project, which began last Fall, is in the process of recruiting families.
A separate grant from the Bill and Melinda Gates Foundation is testing trauma informed practices in elementary schools using similar practices. [ACEsTooHigh will do a separate story about this project.]
Blodgett has high hopes for how this knowledge of ACEs and the toxic effects of stress on developing children’s brains can change how educational systems handle traumatized children.
“I’ve been working on child maltreatment for 25 years, and I’ve never ever had a set of concepts catch fire with people in the community the way these ideas of ACEs and trauma have,” he says. “This may start making things happen differently. That’s probably a really, really good thing.”