Improbable Few(in celebration of healing) Improbable people Always lay low They take short sips And never throw fits There are things that only they know Like, love is real Yet hard to feel When the screen was so blank And only God to thank For that nightlight hung on the soul Research would say They shouldn’t be this way But love sprung out Their improbable out-spout Until eventually, even they run dry Improbably then The real journey begins Held down with a howl An in-spout installed Pain rising up to be skimmed So they start having fits And taking long sips And people smile wide God beams with pride Held strong in the love that they grew From that place that already knew These the improbable few (may the improbable few become the improbable many) Author: Christina Bethell, January, 2011
Childhood Trauma and Positive Health
The mission of the CAHMI is to promote the early and lifelong health of children, youth and families. Part of fulfilling this mission it to disseminate data, information and ideas to understand and address social determinants of health, like adverse childhood experiences and the trauma and chronic and toxic stress that can result and impact lifelong health. A primary focus is on promoting the development of positive health, such as resilience, engagement in life and the safe, stable and nurturing relationships most essential to child development and well being.
The above video is taken from a national meeting sponsored by the CAHMI to begin the design of a national resesarch and action agenda on adverse childhood experiences (ACEs).
What are ACEs?
The term Adverse Childhood experience (ACEs) refers to a range of events that a child can experience, which leads to stress and can result in trauma and chronic stress responses. Multiple, chronic or persistent stress can impact a child’s developing brain and has been linked in numerous studies to a variety of high-risk behaviors, chronic diseases and negative health outcomes in adulthood such as smoking, diabetes and heart disease. According to the CDC, Adverse childhood experiences are broken down into three groups including abuse, household challenges, and neglect. The presence of adverse childhood experiences can lead to risky health behaviors, chronic health conditions, and low life potential or early death.
The CDC’s ACE Pyramid represents the conceptual framework for the ACE Study. The ACE Study has uncovered how ACEs are strongly related to development of risk factors for disease, and well-being throughout the life course.
Image from: https://www.cdc.gov/violenceprevention/acestudy/about.html
Focus Area #1: Support Research, Education, and Advocacy
The CAHMI supports the use of available national, state and local data to fast track research and educational applications of available data and tools to prevent and mitigate the impact of adverse childhood experiences and promote positive health. As part of this, we provide “point and click” access to micro-data findings on childhood trauma and positive health from the NSCH as well as “ready to run” NSCH datasets and codebooks, and helpful technical assistance through our National Data Resource Center for Child and Adolescent Health (www.childhealthdata.org)
- ACEs Resource Packet: This packet is intended for use by clinicians, health care professionals, and health care students to open and enhance dialogue with patients, families, colleagues, friends, and community leaders about ACEs and resiliency. It contains four information sheets: ACEs Basics, The Science Behind ACEs, What Can We Do?, and Resources on ACEs and Resilience.
- Click here to search the NSCH for data on ACEs (NSCH 2011/12->Survey Sections->Parental Health->Indicator 6.11 Adverse Family Experiences)
- Explore your state’s findings on ACEs using the Child & Adolescent Data Resource Center
- Request a cleaned and coded dataset from the CAHMI’s Data Resource Center
- Ask Technical Assistance Questions to the expert staff of the Data Resource Center
- Link for providers wanting to translate this learning into practice
Focus Area #2: Facilitating a Research and Policy Agenda
As a part of a larger commitment to facilitate a whole-child, whole-family and whole-community health model of well-being, the CAHMI has partnered with AcademyHealth and many others to specify a child health services research and policy agenda to advance knowledge and action in addressing childhood trauma, toxic stress and promote positive health.
CAHMI work in this area with AcademyHealth and a wide range of other partners will continue throughout 2015 and result in a research and action agenda, communications toolkit and a series of research papers
April 25-28, 2015, Advancing the agenda & increasing participation through co-digital software (Pediatric Academic Societies Annual Meeting)
- Promoting Early and Lifelong Health: From the Challenge of Adverse Childhood Experiences (ACEs) to the Promise of Resilience and Well-Being (PAS presentation slides part 1 and part 2)
- Promoting Early and Lifelong Health: a CAHMI and AcademyHealth partnership
- In March 2016, the CAHMI and Health Resources in Action collaborated to coordinate and host a summit on “Hope and the New Science of Thriving,” with participants from many fields, including research, health care, health systems, policy, philanthropy, and more.
- Summary proceedings: includes pre-meeting survey results, summit presentations and discussions, and agreed-upon next steps
Focus Area #3: Building a Knowledge Base and Putting Data into Action
The CAHMI envisions the development of a clearinghouse of publications and resources to advance and translate into practice and policy, and seeks to contribute to this knowledge base through papers and resources developed by our team and partners.The CAHMI is also dedicated to the development and actionable use and dissemination of data to inform evidence based programs and policies. Below are examples of publications, presentations, newsletters, data briefs, and reports the CAHMI has developed or contributed to that draw on information on adverse childhood experiences and related factors from the 2011/2012 National Survey of Children’s Health (NSCH):
- ACEs Supplement, Academic Pediatrics, 2017: Methods to Assess Adverse Childhood Experiences of Children and Families: Towards Resilience and Well-Being Based Approaches in Policy and Practice, Technical Appendix
- ACEs Supplement, Academic Pediatrics, 2017: Prioritizing Possibilities for Child Wellbeing: A Field Building Agenda to Address Adverse Childhood Experiences and Promote Resilience in Children’s Health Services, Technical Appendix
- Adverse Childhood Experiences, Resilience and Mindfulness-Based Approaches: Common Denominator Issues for Children with Emotional, Mental, or Behavioral Problems. Child and Adolescent Psychiatric Clinics of North American, January 2016 (online).
- Adverse Childhood Experiences: Assessing The Impact On Health And School Engagement And The Mitigating Role Of Resilience, Health Affairs, December 2014
- Optimizing Health and Health Care Systems for Children with Special Health Care Needs Using the Lifecourse Perspective, Maternal and Child Health Journal, October 2013
- National ACEs data brief summarizing the 9 adverse child and family experiences evaluated in the National Survey of Children’s Health (NSCH), as well as variation across states and child subgroups
- View the 2011/2012 National Chartbook which reports on ACEs and related topics
- California data brief presented at a CA legislative briefing on ACEs and school success
- Arizona report on ACEs created in collaboration with the Phoenix Children’s Hospital
- Baltimore City, Maryland data brief on ACEs
- Richmond, California data brief on ACEs (illustration of several county/city level briefs developed
- HRSA, Trauma CoIIN online meeting, January 25, 2017
- Robert Wood Johnson Foundation, Institute for Safe Families National Summit on Adverse Childhood Experiences
- American Association of Adolescent and Child Psychiatry Annual Meeting
- AMCHP Annual Conference, January 2015
- National Child Health Policy Conference, February 2015
- Healing Together: Community-Level Trauma — Its Causes, Consequences and Solutions (JHU Urban Health Institute’s 4th Annual Social Determinants of Health Symposium)
- Dean’s Lecture at JHSPH on Nov 23rd, 2015: “We Are the Medicine: A population health framework for addressing childhood adversity, promoting positive child and family health and integrating mindfulness based approaches”
- Stanford University ChildX Symposium, April 2016
- Leveraging Mind-Body Neuroscience and Mindfulness to Improve Pediatrics: A national collaboration to promote the translation of research into pediatrics training, practice and policy
- Pediatric Academic Society Annual Meeting Workshop, May 2013
The Center for Human Thriving and Child Well-Being: Prioritizing Possibility
The science of human development opens the door to unprecedented advances in human health and well-being. Breakthrough findings in neuroscience, epigenetics, biology, psychology, sociology and humanities point to a new science of thriving that illuminates largely untapped capacities for self-healing and squarely places the locus of human health and development within the social, emotional and environmental context we create and live within. We seek to bring together existing capacities and partners in research, education, innovation, advocacy and leadership capacity to catalyze and advance a new integrated science of thriving into the everyday lives of all Americans. Our work will bring awareness to the requirements for well-being and the critical need to build resilience, mindfulness and thriving skills to promote health. It will also address the early life adversities and trauma science shows become biologically embedded, resulting in devastating losses in human potential and life expectancy. Sectors of impact include public health and health care systems, education and community-based organizations, business and economics and arts and entertainment.
- TEDtalk by Nadine Burke Harris: How Childhood Trauma Affects Health Across a Lifetime
- Toxic Stress, Health, and ACEs for Two Generations webinar slides (Ascend at the Aspen Institute)
- Toxic Stress, Health, and ACEs for Two Generations webinar video (Ascend at the Aspen Institute)
- “Paper Tigers”: A Documentary about Adverse Childhood Experiences
- Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal (new book by Donna Jackson Nakazawa — also available in paperback from July 26, 2016)
- Adverse Family Experiences Among Children in Nonparental Care, 2011-2012 (Bramlett, MD & Radel LF, National Health Statistics Reports, May 7, 2014)
- Resilience in a Life Course Perspective: Reflections on Research and Life (presentation by Kay Johnson at the Martha May Eliot Award Ceremony at APHA Annual Meeting on November 2, 2015): Text and Slides
- The Nurture Effect: How the Science of Human Behavior Can Improve Our Lives and Our World (book by Anthony Biglan)
- 3 Ways Undiagnosed Trauma Disrupts Lives: This short video from the National Institute for the Clinical Application of Behavioral Medicine discusses signs and symptoms of childhood trauma.
- Building Core Capabilities for Life (from the Harvard Center on the Developing Child)
- Preventing Child Abuse and Neglect: A Technical Package for Policy, Norm, and Programmatic Activities: A compilation of a core set of strategies to help achieve the goals within the CDC’s Essentials for Childhood Framework
- The Time is Now for Building Community Resilience & Healing (blog post and short movie)
- Childhood Violence and the Whac-a-Mole Effect: Blog post on ACEsConnection.com which includes quotes from Dr. Bethell
- Childhood Trauma Leads to Lifelong Chronic Illness — So Why Isn’t the Medical Community Helping Patients? Article by Donna Jackson Nakazawa on the Huffington Post
- Three policy briefs on the impact of ACEs in the health, justice, and education systems developed by the Illinois ACEs Response Collaborative
- Talking to Children about Disasters (American Academy of Pediatrics)
- Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event (Substance Abuse and Mental Health Services Administration (SAMHSA))
- Helping Youth after Community Trauma: Tips for Educators (The National Child Traumatic Stress Network)
- Teaching Tolerance (Southern Poverty Law Center)
- How to Talk to Your Kids about Ferguson (Time)
- How to Teach Kids about What’s Happening in Ferguson (The Atlantic)
- To Talk Baltimore With Kids, Focus on the Positive (The New York Times)