Category Archives: ACE Study

Talking ACEs and building resilience in prison

March 6, 2019 By in ACE Study, Adverse childhood experiences, Child trauma, Community prevention programs, Education, Solutions, Trauma, Washington State 11 Comments

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They’re the forgotten, the 2.3 million people in US prisons. The overwhelming majority of them have experienced significant childhood trauma. Before you click out of here, this isn’t another boo-hoo story, as some of you might describe it, about the dismal state of our corrections system, for inmates and guards alike. (Oh, yes, it is profoundly dismal.) This is a story about how one tiny part of it isn’t so dismal, and actually addresses head-on the fact that most (91 percent) of the approximately 2.3 million prisoners will finish their sentences and go home. To your neighborhood. So….wouldn’t you want the prisons to help these guys and gals so that they, and by definition, we, come out happier and more well-adjusted than when they went in?

Well, yea-uh.

Ok. Just in case you glossed over it, let’s go back to that sentence about childhood trauma. It is precisely why the 2,300 inmates at Washington State Penitentiary in Walla Walla, Wash., ended up there. Over the last 20 years some profound, intense research revealed that people who have a lot of childhood adversity have seven times the risk of becoming an alcoholic, 12 times the risk of attempted suicide, twice the risk of cancer and heart attacks. They’re more violent, more likely to be victims of violence, have more broken bones, more marriages, and use prescription drugs more often than people who have no childhood adversity. And those are just the few drops in the bucket of how childhood trauma affects people’s lives.

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Shifting the focus from trauma to compassion

February 13, 2019 By in ACE Study, Adverse childhood experiences, Community prevention programs, Solutions 10 Comments
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Dr. Arnd Herz

Dr. Arnd Herz, a self-described champion for ACEs science, would like nothing more than to witness a greater appreciation of how widespread adverse childhood experiences are. Herz, a pediatrician and director of Medi-Cal Strategy for the Greater Southern Alameda Area for Kaiser Permanente Northern California, would also like to encourage more people in health care to engage in a trauma-informed care approach, a change in practice that he says not only benefits patients, but also health care providers and their staff.

“It makes so much sense,” say Herz. “This is why I went into medicine. I don’t want to just click off diagnoses, but create relationships and help people by understanding them better, and trauma-informed care is just a way to bring compassion back into the care that we do.”

For the uninitiated, a trauma-informed approach includes an awareness that adverse childhood experiences (ACEs) are common, knowing how to recognize the signs and symptoms of trauma, creating a safe environment where the focus is on “What happened to you?” rather than “What’s wrong with you?”, engaging trauma survivors as equal decision-makers in their care, and offering patients referrals to supportive services as needed, according to a report by the Substance Abuse and Mental Health Services Administration and a primer by the Center for Health Care Strategies.

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Investing in cross-sector networks to build a trauma-informed region

January 28, 2019 By in ACE Study, Community prevention programs, Solutions Leave a comment

Participants at a Pottstown Trauma Informed Community Connection community meeting, which typically draw between 75 and 130 people. Courtesy of Valerie Jackson/PTICC.

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When Suzanne O’Connor first joined the Philadelphia ACE Task Force (PATF)—a group then composed mostly of pediatricians who wanted to put ACE science into practice—she did more listening than talking.

“I wasn’t a doctor, I wasn’t a clinician, but a teacher trying to integrate trauma-informed care into early childhood education,” she says. “What struck me the most was what educators didn’t know about social services, mental health and even physical health. We didn’t have language for what we were seeing with kids who were particularly challenging.”

ACEs gave O’Connor that language. She became a passionate advocate for trauma training for early childhood and K-12 teachers. Now, as director of education for United Way of Greater Philadelphia and Southern New Jersey, O’Connor is helping trauma-informed practice to ripple across the region.

United Way, which recently honed its mission to focus on ending intergenerational poverty, funds and supports cross-sector networks in Philadelphia, surrounding counties and the borough of Pottstown, all part of United Way’s effort to “build a trauma-informed region.”

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Radical Inquiry: Research Practices for Healing and Liberation

October 16, 2018 By in ACE Study, Adverse childhood experiences, Community prevention programs, Resilience 7 Comments

Radical Inquiry

RYSE Center in Richmond, CA, was born of out of young people of color (YPOC) organizing to shift the conditions of violence, distress, and dehumanization in which they suffer, survive, succeed, dream, and die.  We center the lived experiences of YPOC, we lead with love and sacred rage to cultivate healing and build movement, and we take risks as an essential part of transformation and justice, of liberation. We do this in a physical space that feels safe, welcoming, and affirming; that is vibrant with aesthetics created by and for YPOC, and in which members feel ownership, agency, and responsibility.  We do this through cultivating a staff team and organizational culture that is reflective of and responsive to our members, and which engages in ongoing learning, healing, and movement-building.

A third of our current staff started at RYSE as members, half of our staff are under the age 27, and over 90% are people of color. RYSE runs programs across areas of community health; education and justice; youth organizing and leadership; and media, arts, and culture. All programs serve as platforms to cultivate connection, healing, love, and resistance.

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Kaiser family medicine clinic launches 4-question ACE survey pilot for adults

September 27, 2018 By in ACE Study, Adverse childhood experiences, Solutions 9 Comments

In July, medical residents in family medicine at Kaiser Permanente in San Jose, CA, began screening adult patients for adverse childhood experiences (ACEs). But it’s an ACE survey with a twist: it’s shorter, not the  10-question survey of the original CDC-Kaiser Permanente ACE Study, according to Dr. Kathryn Ridout who is leading the pilot along with Dr. Francis Chu and Dr. Alec Uy.

Why a shorter ACE survey?

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“When we were doing our initial discussions with stakeholders in the clinical setting, one of the barriers was the perception of the amount of time it takes to do a screening,” says Ridout. So, she and her colleagues developed a shorter ACE survey of four questions. The questions were adapted from the original ACEs screen of 10 questions as well as expanded ACE surveys that include statements about experiencing bullying or racism, living in a war zone, or in a violent neighborhood. (Since the four-question survey is currently being piloted, it’s not yet available for public release, according to Ridout.)

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Oakland, CA, trying out model used in Baltimore to reduce trauma, increase resilience

August 15, 2018 By in ACE Study, Adverse childhood experiences, Community prevention programs, Solutions 1 Comment
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Baltimore BSC faculty and planning team

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When a group of community organizations in Baltimore came together in 2015, they already knew trauma figured large in many lives. There was violence in the community, in schools, and in community members’ homes. Police brutality occurred. Many suffered the loss of loved ones to incarceration or death. There were house fires and homelessness. Much of the dysfunction was systemic and rooted in racism, according to a report on a collaborative effort to restructure city organizations and agencies. The goal was to build community resilience.

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Study shows most pregnant women and their docs like ACEs screening

July 19, 2018 By in ACE Study, Adverse childhood experiences, Community prevention programs, Solutions 1 Comment

Would pregnant women participate in surveys from their doctors asking them about whether they had experienced trauma in their childhood? In surveying moms-to-be at two Northern California Kaiser sites, clinicians discovered that the women were receptive to filling out an adverse childhood experiences (ACE) survey, according to a study that was published earlier this year in the Journal of Women’s Health.

In fact, researchers found out that the vast majority of pregnant women — 91 percent of the 375 women— were “very or somewhat comfortable,” filling out the ACE survey. Even more, 93 percent, said that they were comfortable talking about the results with their doctors. The women were surveyed from March through June 2016 at Kaiser Permanente clinics in Antioch and Richmond, CA.

ACE refers to the groundbreaking CDC/Kaiser Permanente Adverse Childhood Experiences Study that tied 10 types of childhood trauma, including living with an alcoholic family member or experiencing verbal abuse from a parent, to a host of health consequences. (Got Your ACE Score?)

The higher the number of ACEs that people have, researchers learned, markedly increases their risk for poor health outcomes, as well as social and economic consequences. Having four ACEs, for example, nearly doubles a person’s risk for heart disease and cancer, raises the risk of attempted suicides by 1200 percent and alcoholism by 700 percent.

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

June 25, 2018 By in ACE Study, Adverse childhood experiences Leave a comment

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

June 19, 2018 By in ACE Study, Adverse childhood experiences, Attachment, Child abuse, Child trauma, Epigenetics, Neurobiology, Solutions, Trauma 11 Comments
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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. John Moore/Getty Images
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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.

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Tonier Cain Deserves an Evidence-Based Apology

April 4, 2018 By in ACE Study, Adverse childhood experiences, Child trauma, Community prevention programs, Resilience, Solutions 6 Comments

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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