Preventing, Healing Childhood Trauma Before It Damages Kids’ Chances

Lilo H. Stainton | July 30, 2019 | Health Care
Violence, racism, substance abuse — children can wind up paying for early trauma for the rest of their lives, but there are meaningful solutions

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Children who grow up with poverty, violence, racism, parental divorce, incarceration or drug abuse — or suffer other multiple adverse experiences as youngsters — are seven times more likely to develop alcoholism as adults, four times more likely to become juvenile offenders, and three times more likely to repeat a grade, when compared with kids who did not face these traumas.

They also have higher incidences of asthma, obesity and cancer as grown-ups, and a greater chance of dying prematurely.

The short- and long-term effects of these adverse childhood experiences (ACEs) — family- and community-based problems that impact roughly 40 percent of Garden State children — is one focus of a report released today by the New Jersey Funders ACEs Collaborative, an organization founded in the fall of 2018 to call attention to these issues.

And while New Jersey has a “strong cadre” of professionals and organizations working to address childhood trauma, their efforts are hampered by limited coordination and a lack of comprehensive data on ACEs, the collaborative found. But models for improvements exist, the group notes, and research suggests that children can be safeguarded from traumatic experiences and, when they do occur, can be helped to recover. They key is to identify the problem and act quickly.

According to the collaborative — three philanthropic organizations, the Burke Foundation, The Nicholson Foundation and the Turrell Fund that worked with social-services consultant FSG on the report — more than 782,000 children, or more than 40 percent of New Jersey’s youth, are estimated to have experienced at least one traumatic experience. Some 18 percent have faced multiple ACEs, they found.

At risk of multiple traumas

Like the national trends, ACEs in the Garden State are more prevalent among certain demographic groups, the collaborative determined. In New Jersey, more than one-quarter of black children, and greater than one-fifth of Hispanic youth, have faced multiple traumas; the same held for 28 percent of children in poverty, it found.

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To that end, the 50-page report identifies five areas of opportunity for government officials, private funders and other stakeholders to direct their investments and suggests specific actions these groups can take. It also presents case studies of various programs that are starting to reduce the burden of ACEs among Garden State youth and assesses a handful of models developed by other states.

“We know from our work in child welfare that childhood adversity can contribute to social, emotional and behavioral challenges, generationally,” said Christine Norbut Beyer, New Jersey Department of Children and Families commissioner, who has worked with the collaborative on these issues.

Teaming public and private sectors

“Families need the public and private sectors to come together with strategies that promote healing and resilience through prevention and post-crisis clinical and non-clinical services,” Norbut Beyer said. “We can break the generational cycle of trauma by introducing positive experiences that counter — and ultimately remediate — the adverse events, helping New Jersey residents to be safe, healthy and connected.”

The issue was also the focus of a five-part television series by Michael Hill, a correspondent at NJTV, NJ Spotlight’s sister site, which aired in January and focused on Newark’s effort to combat ACEs.

Scientists have found that adverse childhood experiences — including physical or sexual abuse, neglect and other struggles — can trigger a unique stress response in the body that disrupts ordinary childhood development. These traumas induce a “fight-or-flight” response that leads to rapid breathing and heartbeat and can flood a youngster’s bloodstream with hormones that impact decision-making, according to the report.

This reaction is designed to keep humans safe from danger, but it can also cause a buildup of toxic stress in young children that affects their long-term development, resulting in physical and behavioral issues down the road. An early study, published in 1998 by the federal Centers for Disease Control and Prevention and Kaiser Permanente, found a strong relationship between multiple ACEs and several leading causes of death among adults, including cancer and cardiovascular disease.

While this initial research focused almost entirely on upper-middle-class white children, the collaboration’s report said numerous other studies with broader geographic and demographic scope have shown that exposure to ACEs is most common among youngsters who are nonwhite; identify as gay, lesbian or bisexual; or those who grow up in poverty. In addition, experts have found that kids who suffered the most traumas in their youth have a greater likelihood of experiencing health and behavioral problems as adults.

“These data likely reflect some of the structural barriers experienced by families who have been historically disenfranchised. Families lacking access to quality housing or facing other barriers to economic success also have increased vulnerability to ACEs,” the authors wrote.

Five areas of opportunity

To address those concerns, the collaborative identified five areas of opportunity for future investment: supporting parents and caregivers; training adults who work with children in trauma-informed care, which takes into account these underlying issues; promoting community and public awareness of ACEs; advancing policies that help children and families thrive; and beefing up data collection and analysis related to ACEs.

The group also identified ongoing efforts around the state that are working to help children and families reduce stress, develop stronger coping and life skills, and connect with community supports. Among others, it praised the state’s 57 Family Success Centers, one-stop shops for social services run by the Department of Children and Families, and noted some entities, like the Middle Township Police Department, have implemented trauma-informed care programs. (Robert Wood Johnson University Hospital, in New Brunswick, has created a similar approach.)

“By addressing the childhood traumas that individuals face early in life and the consequential long-term effects on health and wellbeing, we are setting children on the path to brighter and healthier futures,” New Jersey First Lady Tammy Snyder Murphy said in November, at the kickoff event for the collaboration. “[Partnerships] play an important role in our efforts to break the cycle of childhood adversity and build a stronger New Jersey.”

Prevention and treatment in the Garden State can also be improved by a more robust understanding of the trends and problems, the report notes. It encouraged government officials to work across agency divisions to collect more data, urged communities to consider participatory research, and suggested everyone should distribute the findings widely. The collaboration flagged successful efforts by the Camden Coalition of Healthcare Providers and its partners to create a shared health information exchange that has allowed for more coordinated care among at-risk individuals in that region.

The funders are now planning a series of meetings with stakeholder groups and the public to solicit input on next steps; these recommendations will be compiled into an action plan to drive future work. The report includes a detailed appendix with some 75 specific recommendations for immediate actions, directed at government agencies, community groups, healthcare and social service providers and other organizations working with children and families.