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.

“Immediately when I heard about [the study], it just really struck a chord with me, because it agreed with so much that I had seen – with illness being more severe in people who had significant stresses as children,” she said. “It just connected a lot of dots for me. I was really struck by how severe and frequent I would hear those stories from my homeless patients.”

It was the consistency of hearing stories about her patients’ ACEs that compelled Bymaster to document what her patients experienced as children. Her study, recently published in the Journal of Health Care for the Poor and Underserved, she explained, adds to the growing body of research on ACEs and health outcomes.

To capture data related to her patients’ adverse childhood experiences, Bymaster and her fellow researchers asked 125 patients from the Valley Homeless Health Care Program to respond to the original 10-question ACE survey. In addition, the study included questions about traumatic brain injury (TBI), learning disabilities, post-traumatic stress disorder, and whether their main caregiver had ever changed — all of which, she explained, appeared to be common among her patients.

TBIs in particular really stood out. In Bymaster’s conversations with patients she said she repeatedly heard unusually dramatic stories of head injuries experienced in childhood. “I literally had a patient who said, ‘My dad hit me in the head with a baseball bat when I was 15, because I made him mad.’” Noting that there was a dearth of research at the time looking at the association between homelessness and TBIs, she thought the question was important to include.

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Those who separate immigrant children from parents might as well be beating them with truncheons

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Central American asylum seekers, including a Honduran girl, 2, and her mother, are taken into custody near the U.S.-Mexico border in June in McAllen, Texas.

They all agree. Physicians for Human Rights. American Medical Association. American Academy of Pediatrics. American Psychiatric Association. National Association of Pediatric Nurse Practitioners. 

Separating children from their parents or caregivers hurts children. Between April 19 and May 31, nearly 2,000 children were separated from their parents. As Celeste Fremon reported in WitnessLa,  that number has now passed 2,300 children (and is increasing by more than 60/day), with another 11,000 locked up in everything from large cages to a converted Walmart. 

“To pretend that separated children do not grow up with the shrapnel of this traumatic experience embedded in their minds is to disregard everything we know about child development, the brain, and trauma,” says a petition signed by more than 9,000 mental health professionals and 172 organizations.

Many people who see reports of children separated from their parents might think that, because they’re not crying, that they’ve adjusted. Or, if they are crying, they’ll eventually stop and get over it. 

But here’s the reality: In terms of the effects on children’s brains, those who participate in separating children from their parents and locking them up in detainment centers might as well be beating them with truncheons.

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Tonier Cain Deserves an Evidence-Based Apology

Tonier Cain. Photo: Yi-Chin Lee/USA TODAY NETWORK-Wisconsin

Editor’s note: Over 15 years, Tonier Cain was arrested 83 times, and convicted 66 times. She was addicted to crack. She was a prostitute. She had four children and lost them to child protective services. Remarkably, she didn’t give up hope, and one day, she found someone in the system who knew about trauma and who didn’t give up on her. Cain now advocates for trauma-informed care in prisons and mental health facilities. She gives speeches around the country and the world. Cissy White was fortunate to attend a conference in North Carolina where Cain gave a presentation. This is Cissy’s reaction.
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When Tonier Cain gave a keynote presentation at the Benchmarks’ Partnering for Excellence conference in North Carolina, it took me months to recover from her speech.
Seriously. It was hard to stand after she spoke. When I did, I went right to a yoga mat in the self-care calm room for a while. I took off my high heels and curled up in a ball for a bit.
I’m still digesting her words. It’s not that the content was intense and heavy, though it was. It wasn’t that she talked about a ton of traumatic experiences she had survived – though she did.

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Oprah learns about ACEs and trauma-informed care

Oprah on 60 minutes

Oprah interviews Dr. Bruce Perry

“Don’t ask ‘What’s wrong with you?’ Ask, ‘What happened to you?'” 

I watched the Oprah segment with my mother, Dr. Louise Hart, who heard Dr. Vincent Felitti speak about the CDC-Kaiser Permanente Adverse Childhood Experiences Study years ago.

At that time, she asked him, “What is being done with this incredible information?” And he replied, “not much.” It inspired her to come out of retirement and write another parenting book, which turned into The Bullying Antidote. Published in 2013, this was the first book (and still may be the only one) that shows how bullying relates to ACEs—and how parents can prevent it using positive psychology. Bullying—the use of dominance to create harm—is at the root of many of our social ills, and is one of the main vehicles for perpetuating trauma.

And now, Oprah has learned about ACEs science and how organizations are applying a wide range of ACE-informed approaches, including trauma-informed care. “It blew my mind,” she said. “It changed my life.”

And when Oprah talks about something, the world gets it.

Watch the full episode of “Oprah Winfrey discusses childhood trauma on 60 Minutes”, a CBSN video on CBSNews.com. View more CBSN videos and watch CBSN, a live news stream featuring original CBS News reporting.

Source: Oprah Winfrey discusses childhood trauma on 60 Minutes – CBSN Live Video – CBS News

Oprah Winfrey addresses the long-term effects of trauma on CBS’s 60 Minutes

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UPDATE:  Click here to view the segment (approximately 14 minutes) and the 60 Minutes Overtime interview with Oprah (about 5 minutes).
Oprah Winfrey addresses the long-term effects of childhood trauma this Sunday, March 11 on 60 Minutes (tune in on CBS at 7:00 p.m. ET). The word is spreading quickly about the potential impact of this 60 Minutes segment. One ACEs Connection member said “The cause now has an iconic “champion of champions.” This could be a significant game changer.” Another said we should all be prepared to respond afterwards with opeds and letters to the editors to local papers, meetings with legislators etc.

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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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ACEs science can prevent school shootings, but first people have to learn about ACEs science

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David Hogg, a senior at Marjory Stoneman Douglas High School, speaks at a rally calling for more gun control. Photo by Jonathan Drake / Reuters

After 17 people, mostly teens, were shot and killed by another teen last week in Parkland, FL, what seems to be a real movement is growing, propelled by kids devastated by their friends’ deaths and wanting to prevent such a massacre from ever happening again.

Their rallies and marches and lie-downs probably won’t have much effect in the short-term, as some of the Parkland teens learned as they witnessed — and some of them wept during — today’s lightning vote by state lawmakers along party lines to end debate on an assault weapons ban, which killed any further consideration of the bill in the Florida legislature’s current session.

But their persistence can make a difference in the long run, especially if they — and we — widen this to include the dozens of kids shot on the streets of Chicago or Camden or in other communities every week. We can even broaden the approach to include the 200 people, including many children, who died in Syrian air strikes in the last two days, because the roots and solutions are the same.

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