By Jeremy Loudenback

Recent federal legislation put forward by Sens. Dick Durbin (D-IL), Al Franken (D-MN) and Heidi Heitkamp (D-ND) proposes to address the issue of childhood trauma through the creation of a federal trauma task force.

The Trauma-Informed Care for Children and Families Act would gather federal officials and members of tribal agencies to create a set of best practices and training to help create a better way to identify and support children and families that have experienced trauma.

In North Dakota, the home state for co-sponsor Heitkamp, advocates are hoping that the bill can have an impact on addressing the needs of Native American children who disproportionately enter the state’s foster care system. According to one report, Native American youth deal with post-traumatic stress disorder at a rate of 22 percent, three times the national average and at the same level as Iraq and Afghanistan war veterans.

At PATH North Dakota, a non-profit child and family services agency, a trauma-informed approach means helping Native American children address historical trauma, as well as contemporary adverse experiences faced by children in foster care.

Jodi Duttenhefer and Heather Simonich, operations directors at PATH, recently talked with The Chronicle of Social Change about the new legislation, the importance of collecting data on the adverse childhood experiences of youth in its treatment foster care program and how the tribal community at Standing Rock is thinking about child trauma.

The Chronicle of Social Change: What would the proposed legislation mean for children in the child welfare system?

Heather Simonich: The importance of a task force like this is helping us sustain many of the efforts that the system is currently making to adopt a trauma-informed perspective in their work. For example, we have a lot of work going on in the state of North Dakota to provide education and information to child and family service providers about trauma and its impact on children’s development and how it shows up in their behavior at home and in school, and strategies for professionals to intervene in a way that acknowledges trauma as part of [children’s] struggles. This legislation would just help bring a greater focus to that issue and help sustain current efforts to really infuse that understanding into all of our systems. It’s my deep belief that it’s going to take all of our systems working together to help support these children to reach their full potential and be as resilient as possible. It’s impossible to ignore the profound findings from neurobiologists with regards to early adversity and long-term health consequences.

CSC: How do you think about dealing with the burden of historical trauma for Native American children? Can you talk about what a trauma-informed approach looks like for Native American children in the child welfare system?

Jodi Duttenhefer: When you go around and talk to children and acknowledge that they’re the expert when it comes to their historical trauma, you bring them to the tables, drawing on their expertise and their knowledge. We want to use it for what they need us for, not us coming in and saying, “This is what I think we’re going to do.” It’s also having them share what that historical trauma looks like for them. Does it need to be at the forefront of their experience or does it need to be on the backburner to deal with some of the other issues they have? It’s important to bring everyone together and have that conversation together.

HS: It’s important to appreciate and try to find culturally sensitive interventions—and what that means to them given the variation in tribes—and not making assumptions. The way you work with one Native American community doesn’t mean you work with all tribes that way.

In the child welfare system, it’s helping kids know what’s coming next. Strategies that help kids understand what’s coming next and predictability are helping them feel safe. Anytime we’re sharing control with kids and families, we’re helping kids feel safe, kids that haven’t had a lot of control in their lives. It also helps to ask [Native children] what would help them feel safe. Often it’s feeling connected. So for our Native kids that aren’t placed with Native families, how do we support the foster parents and help the kids stay connected to their Native communities and culture in a way that the child is interested in and comfortable with? Helping kids feel connected at the end of the day is about helping kids feel safe.

CSC: Heather, you recently had a chance to talk about trauma at Standing Rock Reservation. What did you learn from that experience?

HS: I was recently invited to talk to the community at the Standing Rock reservation. A couple women from Standing Rock heard me speak at a conference about trauma-informed schools and invited me to talk to the community. I talked to the community members about the impact of trauma on children and their ability to learn at school and in the community. I was nervous about it beforehand, but we sat together in a circle, and it was a really warm welcome.

My biggest goal was to invite people to a conversation, to uplift people, not shame or blame but to say today’s a new day. All we can do with what we know about trauma is to help people move forward and talk about parenting strategies.

What I sensed is that there is great appreciation of our understanding and acknowledging and appreciating historical trauma. They’re also pretty focused and made it pretty clear to me that this is not a helpful place for the conversation to stay. It’s important to move the conversation forward, to start talking about the trauma that is in the community right now and start creating safer neighborhoods for children today.

CSC: How long has PATH been collecting the number of adverse childhood experiences (ACEs) of children in its care? How has that changed the perception of children in care?

JD: We really started collecting ACEs data from every youth who was entering our treatment foster care program in January 2016. We had some assumptions that we thought the kids coming into our care had probably experienced quite a few ACEs, but when we actually looked at the data, it was staggering. We didn’t expect it to be an average of six. Because when you look at the ACE Study and life down the road, our kids are right there. These are the kids that are going to suffering chronic health issues if we don’t do something now and intervene now. (ACEs Science 101.)

[Sharing ACEs data] has been a black-and-white way to present the needs of the children to foster parents and community partners. When they [foster parents] realize that the kids aren’t just choosing these behaviors just to be rotten in the home, that the behaviors are actually a symptom of what they’ve experienced, and a foster parent understands that, it’s almost like they change and want to become more involved in their treatment and help them get better. And more focused on treatment, rather than just about discipline and control. There’s so much more understanding from foster parents now. At the end of the day, what this really does is build compassion, patience and understanding to support these children. Our foster parents have also become advocates for our youth. They become the teachers and the mentor.

Along with implementing the ACEs data collection, we also do a trauma screen for kids that come in. One is for older group of kids and the other one is for ages eight and younger. It looks at what kind of behaviors the kids are exhibiting, what the symptoms look like. What was really striking is the growing number of [younger kids] that we’re serving in treatment foster care and how severely trauma is impacting their behavior and what they’re displaying. So that was probably the biggest shock, seeing the data for the younger group and their symptoms.

HS: [With the trauma screening] we also saw higher rates of psychological abuse and understood that 80 percent of our kids come from homes where there’s an addiction problem, which tells us something as administrators about the training that we need to provide our staff and programming that might be helpful when that many kids come from an environment where addiction has been part of their story.

But the answer can never be about just be about an ACE score, in terms of screening. Because an ACE score indicates risk for negative health outcomes. You might have a kid with an ACE score of 8 who is incredibly resilient and functions really, really well. It’s really important for systems to understand how exposure to traumatic events is impacting each particular child. The thing about trauma and childhood is that it shows up so differently in every kid, depending on developmental stage, temperament, previous traumatic experiences, adequate support or caregivers. Knowing that really helps us support the foster parents in understanding how it’s showing up in the kids who are in their homes.

This interview has been edited and condensed for clarity.

Jeremy Loudenback is the child trauma editor for The Chronicle of Social Change.