Study unearths patterns in ACE scores in San Jose, CA, homeless population

It was around 2010 that Dr. Angela Bymaster was seeing a disturbing pattern in the histories of her adult patients. She already knew that patients who saw her at the Valley Homeless Health Care Program in San Jose, CA, where she worked at the time, were homeless or recently homeless. What was most troubling to Bymaster was knowing that their current precarious existence could have been prevented.

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Dr. Angela Bymaster

“Over and over and over again I was hearing the same stories of abuse in childhood and neglect, incarceration, moving around a lot, a lot of trauma for them as children,” said Bymaster, who as a family physician always took her adult patients’ in depth pediatric histories. She now works for the Washington Neighborhood Health Clinic, a school health clinic in San Jose that’s part of a non-profit School Health Clinics of Santa Clara County.

Bymaster became aware of the landmark CDC/Kaiser Permanente Adverse Childhood Experiences Study in 2007. The study showed a link between 10 types of childhood trauma and adult onset of chronic disease, violence and being a victim of violence, among other outcomes.

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Middle school tackles everybody’s trauma; result is calmer, happier kids, teachers and big drop in suspensions

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John Jimno

During the 2014/2015 school year, things were looking grim at Park Middle School in Antioch, CA. At the time, staff couldn’t corral student disruptions. Teacher morale was plummeting. By the end of February 2015, 192 kids of the 997 students had been suspended — 19.2 percent of the student population.

“I was watching really good people burning out from the [teaching] profession and suspending kids over and over and nothing was changing behavior-wise, and teachers were not happy about it,” says John Jimno, who was in his second year as principal at that time.

So, Jimno and the staff took advantage of a program that Contra Costa County was integrating into its Youth Justice Initiative and, in doing so, joined a national trauma-informed school movement that has seen hundreds of schools across the country essentially replace a “What’s wrong with you?” approach to dealing with kids who are having troubles with asking kids, “What happened to you?”, and then providing them help.

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Early childhood educators learn new ways to spot trauma triggers, build resiliency in preschoolers

Julie Kurtz, co-director, trauma-informed practices in early childhood education, WestEd Center for Child & Family Studies/photo by Laurie Udesky

A hug may be comforting to many children, but for a child who has experienced trauma, it may not feel safe.

That’s an example used by Julie Kurtz, co-director of trauma-informed practices in early childhood education at the WestEd Center for Child & Family Studies (CCFS), as she begins a trauma training session. Her audience, preschool teachers and staff of the San Francisco, CA-based Wu Yee Children’s Services at San Francisco’s Women’s Building, listen attentively.

Kurtz leads them into a description of how a child’s young brain functions, how young children – regardless of whether they have experienced trauma or not — live in their reptile brain.

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A Kaiser pediatrician, wise to ACEs science for years, finally gets to use it

Dr. Suzanne Frank has known about the impact of childhood adversity on young lives for decades. She’s seen the fallout in the faces of young people huddled in beds at a children’s shelter where she worked years ago.

She’s seen it as the regional child abuse services and champion for the Permanente Medical Group.

And she’s seen it in hospital examination rooms where, as a member of the Santa Clara County’s Sexual Assault Response Team, she’s been called in to examine shell-shocked children and teens.

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Peer mentor uses her own ACEs story to teach med residents how to help traumatized patients

O’Nesha Cochran, OHSU peer mentor

When O’Nesha Cochran teaches medical residents about adverse childhood experiences in patients, she doesn’t use a textbook.

Instead, the Oregon Health & Science University peer mentor walks in the room, dressed in what she describes as the “nerdiest-looking outfit” she can find.

And then she tells them her story.

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Montefiore Medical in Bronx screens 12,000+ kids for adverse childhood experiences

Image courtesy of Creative Commons/Flickr/ Family drawing-Meggy

Since 2016, more than 12,000 children have been screened for adverse childhood experiences (ACEs) at Montefiore Medical Center in Bronx, New York, according to Miguelina German, the director of Quality & Research in the Pediatric Behavioral Health Integration Program and project director of Trauma Informed Care at the center.

Parents of infants are asked to fill out ACE scores for themselves and their infants.

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Dozens of Kaiser Permanente pediatricians in Northern California screening three-year-olds for ACEs

kidsSince August 2016, more than 300 three-year-olds who visit Kaiser Permanente’s pediatric clinics in Hayward and San Leandro have been screened for adverse childhood experiences (ACEs), such as living with a family member who is an alcoholic or losing a parent to separation or divorce. But when the idea to screen toddlers and their families for ACEs was first broached at the Kaiser Permanente Hayward Medical Center, the staff were, in a word, “angsty,” says Dr. Paul Espinas, who led the effort.

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Patient’s murder leads to soul searching, shift to ACEs science in UCSF medical clinic

Patient’s murder leads to soul searching, shift to ACEs science in UCSF medical clinic

It was the murder of a beloved patient that led to a seismic shift in the Women’s HIV Program at the University of California, San Francisco: a move toward a model of trauma-informed care. “She was such a soft and gentle person,” said Dr. Edward Machtinger, the medical director of the program, who recalled how utterly devastated he and the entire staff were by her untimely death.

“This murder woke us up,” he said. ”It just made us take a deeper look at what was actually happening in the lives of our patients.” The Women’s HIVprogram, explained Machtinger, was well regarded as a model of care for treating HIV patients – reducing the viral load of HIV in the majority of its patients to undetectable levels.

But the staff was clearly missing something. A closer look at the lives of their patients revealed that 40 percent were using hard drugs – including heroin, methamphetamine and crack cocaine, according to Machtinger. Half of them suffered clinical depression, the majority had isolated themselves due to deep shame associated with having HIV, and many experienced violence.

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Custody in crisis: How family courts put children in danger

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Six years ago, in 2010, an appellate court in Tennessee affirmed a family court ruling that had awarded Darryl Sawyer* primary custody of his six-and-a-half-year-old son, Daniel.

The court ruled in favor of Sawyer despite evidence presented by his ex-wife that alleged he had sexually abused their child.

Three years earlier, Daniel returned from a visit with his father with suspicious bruises on his bottom. His mother, Karen Gill, immediately took the three-year-old boy to his pediatrician.

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