Ace: Impetus for Community Action

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  • Adverse Childhood Experiences determine the likelihood of the ten most common causes of death in the US
  • Point out that these coping strategies are solutions that almost work. More effective coping strategies will be suggested at the end of the presentation. Felitti quote: “It is hard to get enough of something that almost works.”
  • The pyramid helps to visualize the process by which harsh experiences such as abuse, neglect, and loss of birth parent(s) during childhood result in health problems in adulthood.
  • Still have a profound effect 50 years later. ACEs are the main determinant of health and social well-being of our nation.
  • The early years of life matter because they affect the architecture of the maturing brain The quality of that architecture establishes either a resilient or a fragile foundation for all of the development and behavior that follows
  • The following graphs visually show the increasing correlation between the number of ACE scores (along the bottom from left [ 1] to right [6 ]) and the % of people engaging in the risky behaviors (vertically from 0% at the bottom to 100% at the very top). Note:—even 6 or more ACEs does not automatically mean a person will engage in the risky behavior or have the adult chronic disease, but the % of those with high ACE scores who also engage in the behavior or have the disease/condition is increased. Note: These can be run through fairly quickly.
  • Red = unintended pregnancy Yellow = elective abortion
  • Females are red; males are yellow
  • individual with an ACE score of 4, is 12 times more likely to attempt suicide than those with none.
  • As you can see the higher the number of ACEs, the greater the risk . In fact an ACE score of 6 or more results in 20 year decrease in life expectancy.
  • Diabetes, depression, heart disease, chronic lung disease
  • Experience a range of emotions -- joy, connectedness, sadness, and anger
  • Give the group a couple of minutes to share. Ask for volunteers to share one important protective factor in their community.
  • Note: Explain Community Circle of Care to Trainers One caring adult can make a significant difference in the life of a child.
  • Exercise: Hand out to the audience the 7 Strategies to Build Strong Communities Personal Commitment Checklist and the Evaluation Form. This is also an opportunity to pass out a contact information sheet if people want to be contacted or get involved with the Regional Prevention Council. Explain that the Personal Commitment Checklist is a summary of the last several slides with ideas of ways people can get involved to reduce ACEs, Build Strong Communities and Raise Strong Kids. Ask audience to take 5 minutes to review the form and make a personal commitment to engage in at least one activity. The audience members keep their personal commitment forms. Answer questions. Ask audience to complete the evaluation form and collect them.
  • Ace: Impetus for Community Action

    1. 1. Strong Communities Raise Strong Kids Adverse Childhood Experiences: Impetus for Community Action Regional Child Abuse Prevention Councils 2010
    2. 2. <ul><li>“ The solution of all adult problems tomorrow depends in large measure upon the way our children grow up today.” </li></ul><ul><li>- Margaret Mead, Anthropologist </li></ul>Regional Child Abuse Prevention Councils 2010
    3. 3. What Are ACEs? Adverse Childhood Experiences <ul><li>ACEs are experiences in childhood that are unhappy, unpleasant, hurtful. </li></ul>Regional Child Abuse Prevention Councils 2010
    4. 4. ACEs Often Last a Lifetime . . . But They Don’t Have To <ul><li>Healing can occur </li></ul><ul><li>The cycle can be broken </li></ul><ul><li>Safe, stable, nurturing relationships heal parent and child. </li></ul>Regional Child Abuse Prevention Councils 2010
    5. 5. Complete ACE Questionnaire <ul><li>What does it make you think about? </li></ul><ul><li>Keep in mind your thoughts as we present the ACE Study </li></ul>Regional Child Abuse Prevention Councils 2010
    6. 6. What are Adverse Childhood Experiences (ACEs)? <ul><li>Growing up (prior to age 18) in a household with: </li></ul><ul><li>Recurrent physical abuse. </li></ul><ul><li>Recurrent emotional abuse. </li></ul><ul><li>Sexual abuse. </li></ul><ul><li>Emotional or physical neglect. </li></ul>Regional Child Abuse Prevention Councils 2010
    7. 7. Growing up (prior to age 18) in a household with (cont): <ul><li>An alcohol or drug abuser </li></ul><ul><li>An incarcerated household member. </li></ul><ul><li>Someone who is chronically depressed, suicidal, institutionalized or mentally ill. </li></ul><ul><li>Mother being treated violently. </li></ul><ul><li>One or no parents. </li></ul>Regional Child Abuse Prevention Councils 2010
    8. 8. Why is This Important? <ul><li>Because ACEs are: </li></ul><ul><li>Surprisingly common </li></ul><ul><li>The basis for many common public health </li></ul><ul><li>problems </li></ul><ul><li>Strong predictors of later social functioning, </li></ul><ul><li>well-being, health risks, disease, and death </li></ul>Regional Child Abuse Prevention Councils 2010
    9. 9. ACE Scores <ul><li>1/3 of adults have an ACE score of 0 </li></ul><ul><li>The majority of adults with an ACE score of 0 have few, if any, risk factors for diseases that are common causes of death in the US. </li></ul>Regional Child Abuse Prevention Councils 2010
    10. 10. <ul><li>An ACE Score of 4 or more results in having multiple risk factors for these diseases or the disease themselves. </li></ul><ul><li>An ACE score of 6 or more results in a 20 year decrease in life expectancy. </li></ul>Regional Child Abuse Prevention Councils 2010
    11. 11. Do you know the top 10 risk factors/behaviors for death in the USA? <ul><ul><li>smoking, </li></ul></ul><ul><ul><li>severe obesity, </li></ul></ul><ul><ul><li>physical inactivity, </li></ul></ul><ul><ul><li>depression, </li></ul></ul><ul><ul><li>suicide attempt, </li></ul></ul><ul><ul><li>alcoholism, </li></ul></ul><ul><ul><li>illicit drug use, </li></ul></ul><ul><ul><li>injected drug use, </li></ul></ul><ul><ul><li>50+ sexual partners, </li></ul></ul><ul><ul><li>history of STD </li></ul></ul>Regional Child Abuse Prevention Councils 2010
    12. 12. Evidence Suggests: <ul><li>Many chronic diseases in adults are determined decades earlier, by experiences in childhood </li></ul><ul><li>Risk factors/behaviors for these diseases are initiated during childhood or adolescence and continue into adult life. </li></ul>Regional Child Abuse Prevention Councils 2010
    13. 13. Seeking to Cope <ul><li>The risk factors/behaviors underlying these adult diseases are actually effective coping devices. </li></ul><ul><li>What is viewed as a problem is actually a solution to bad experiences. </li></ul><ul><li>Dismissing these coping devices as “bad habits” or “self destructive behavior” misses their functionality. </li></ul>Regional Child Abuse Prevention Councils 2010
    14. 14. Family Centered Practice, June 8, 2007 Regional Child Abuse Prevention Councils 2010
    15. 15. Behavior is Predictable <ul><li>All Behavior has meaning - both good behavior and bad behavior </li></ul><ul><li>We need to look closely at the antecedents to behavior - What happened first that is causing this behavior? </li></ul>Regional Child Abuse Prevention Councils 2010
    16. 16. Life in a Tough World <ul><li>If trauma/toxic stress occurs early in life, the brain becomes wired to survive it. </li></ul>Regional Child Abuse Prevention Councils 2010
    17. 17. Early Brain Development <ul><li>Healthy brain architecture builds on nurturing, responsive, and individualized interactions from birth. </li></ul><ul><li>Healthy brain architecture is the foundation for all future learning, behavior and health. </li></ul>Regional Child Abuse Prevention Councils 2010
    18. 18. Stress and the Brain <ul><li>Excessive and repeated stress: </li></ul><ul><ul><li>Neglect, violence </li></ul></ul><ul><ul><li>Chaos, unpredictability </li></ul></ul><ul><ul><li>Hostility, rejection </li></ul></ul><ul><li>Causes disruption of brain architecture: </li></ul><ul><ul><li>Impairs cell growth </li></ul></ul><ul><ul><li>Interferes with healthy neural circuits </li></ul></ul>Regional Child Abuse Prevention Councils 2010
    19. 19. Regional Child Abuse Prevention Councils 2010
    20. 20. What Does This Look Like? <ul><li>Teen that is: </li></ul><ul><ul><li>Edgy, hot tempered </li></ul></ul><ul><ul><li>Impulsive </li></ul></ul><ul><ul><li>Hyper-vigilant </li></ul></ul>Regional Child Abuse Prevention Councils 2010
    21. 21. By adolescence, children seek relief through: <ul><li>Drinking alcohol </li></ul><ul><li>Smoking tobacco </li></ul><ul><li>Sexual promiscuity </li></ul><ul><li>Using drugs </li></ul><ul><li>Overeating/eating disorders </li></ul><ul><li>Delinquent behavior </li></ul>Regional Child Abuse Prevention Councils 2010
    22. 22. High Risk Teen Behaviors <ul><li>May not be the core problem </li></ul><ul><li>They may be the coping devices </li></ul><ul><li>A way to feel safe or just feel better </li></ul>Regional Child Abuse Prevention Councils 2010
    23. 23. Adverse Childhood Experiences vs. Smoking as an Adult Regional Child Abuse Prevention Councils 2010
    24. 24. Adverse Childhood Experiences vs. Adult Alcoholism Regional Child Abuse Prevention Councils 2010
    25. 25. ACE Score vs. Intravenous Drug Use Regional Child Abuse Prevention Councils 2010
    26. 26. Adverse Childhood Experiences vs. Likelihood of > 50 Sexual Partners Regional Child Abuse Prevention Councils 2010
    27. 27. ACE Score vs. Unintended Pregnancy or Elective Abortion Regional Child Abuse Prevention Councils 2010
    28. 28. Childhood Experiences Underlie Chronic Depression Regional Child Abuse Prevention Councils 2010
    29. 29. Childhood Experiences Underlie Later Suicide Regional Child Abuse Prevention Councils 2010
    30. 30. ACE Score vs. Serious Job Problems Regional Child Abuse Prevention Councils 2010
    31. 31. US Health Care Costs <ul><li>US Health Care Spending 2007: </li></ul><ul><li>- $7,600 per person </li></ul><ul><li>- $2.3 Trillion </li></ul><ul><li>- 4.3 times the amount spent on national defense </li></ul>Regional Child Abuse Prevention Councils 2010
    32. 32. Reducing Costs <ul><li>Asking about ACEs – significantly decreases doctor office visits and costs. </li></ul>Regional Child Abuse Prevention Councils 2010
    33. 33. Pay Now or Pay Later <ul><li>Pay now for programs that have been proven to buffer the stress, or pay later in rising health costs. </li></ul><ul><li>“ Early childhood investments of high quality have a lasting effect.” </li></ul><ul><li>“ $10 return on investment for every $1 spent.” (James Heckman, Noble Laureate, Economics) </li></ul>Regional Child Abuse Prevention Councils 2010
    34. 34. Our Challenge <ul><li>We can and must “immunize” kids against the effects of ACEs. </li></ul><ul><li>We can and must reduce the numbers of ACEs for all children! </li></ul>Regional Child Abuse Prevention Councils 2010
    35. 35. Caring Communities Can Help Reduce ACEs Regional Child Abuse Prevention Councils 2010
    36. 36. Mental Health <ul><li>“ Mental health is indispensable to well-being, relationships, and contribution to the community or society.” </li></ul><ul><ul><li>U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General, 1999. </li></ul></ul>Regional Child Abuse Prevention Councils 2010
    37. 37. Mentally Healthy Children <ul><ul><li>Experience a range of emotions in appropriate and constructive ways </li></ul></ul><ul><ul><li>Possess positive self-esteem and a respect for others </li></ul></ul><ul><ul><li>Have a sense of security and trust in themselves and the world </li></ul></ul><ul><ul><li>Hagan JF, Shaw JS, and Duncan PM, eds. Bright Futures Guidelines for Health: Supervision of Infants, Children, and Adolescents , Third Edition, Elk Grove Village, IL: American Academy of Pediatrics, 2008. </li></ul></ul>Regional Child Abuse Prevention Councils 2010
    38. 38. Safe, Stable, Nurturing Relationships…… <ul><li>are the key to mentally healthy children and adolescents </li></ul>Regional Child Abuse Prevention Councils 2010
    39. 39. What is Resilience? <ul><li>Good outcomes in spite of serious threats, toxic stress. </li></ul><ul><li>Resilient people: </li></ul><ul><li>are prepared to be effective in the world </li></ul><ul><li>can adapt to challenges </li></ul><ul><li>are mentally healthy </li></ul>Regional Child Abuse Prevention Councils 2010
    40. 40. Resilience is: <ul><li>Feeling connected to caring family and community </li></ul><ul><li>Self-regulation skills </li></ul><ul><li>Positive view of self </li></ul><ul><li>Motivation to be effective in your environment </li></ul>Regional Child Abuse Prevention Councils 2010
    41. 41. Protective Factors <ul><li>Are conditions that increase health and well-being for children </li></ul><ul><li>Are buffers that provide support and coping strategies for parents </li></ul>Regional Child Abuse Prevention Councils 2010
    42. 42. Group Exercise <ul><li>Turn to your neighbor </li></ul><ul><li>Share some of your thoughts about important resilience and protective factors in your community </li></ul>Regional Child Abuse Prevention Councils 2010
    43. 43. Protective Factors <ul><li>Parental Resilience </li></ul><ul><li>Social Connections </li></ul><ul><li>Knowledge of Effective Parenting Skills and Child Development </li></ul><ul><li>Concrete Supports in Time of Need </li></ul><ul><li>Nurturing and Attachment </li></ul>Regional Child Abuse Prevention Councils 2010
    44. 44. Safe, Stable, Nurturing Relationships <ul><li>SAFE = free from harm </li></ul><ul><li>STABLE = a high degree of consistency </li></ul><ul><li>NURTURING = compassionate, responsive caregiver(s) </li></ul>Regional Child Abuse Prevention Councils 2010
    45. 45. What Can We Do To Promote Good Beginnings for Kids? Regional Child Abuse Prevention Councils 2010
    46. 46. “ Never doubt that a small group of thoughtful, committed people can change the world. Indeed it is the only thing that ever has.” Margaret Mead Regional Child Abuse Prevention Councils 2010
    47. 47. 7 Strategies to Build Strong Communities Regional Child Abuse Prevention Councils 2010
    48. 48. Provide Information <ul><li>Raise public awareness </li></ul><ul><li>Display Strong Communities Raise Strong Kids posters </li></ul><ul><li>Hand out Strong Communities Raise Strong </li></ul><ul><li>Kids brochures </li></ul>Regional Child Abuse Prevention Councils 2010
    49. 49. Enhance Skill <ul><li>Help educate colleagues about ACEs </li></ul><ul><li>Educate parents about how to build resilience in children from birth </li></ul><ul><li>Teach child care providers, home visitors, physicians and others to build resilience in families </li></ul>Regional Child Abuse Prevention Councils 2010
    50. 50. <ul><li>Teach skills </li></ul><ul><li>to youth </li></ul>Regional Child Abuse Prevention Councils 2010
    51. 51. Be a caring adult Spend quality as well as quantity time with a child; read a book, share a meal. Regional Child Abuse Prevention Councils 2010
    52. 52. Talk with Family, Friends and Neighbors <ul><li>Share and discuss the ACE questionnaire with your family </li></ul><ul><li>Ask about ACEs, acknowledge your own </li></ul><ul><li>De-stigmatize ACEs – it can be therapeutic </li></ul><ul><li>Volunteer, start a Community Circle of Care. </li></ul>Regional Child Abuse Prevention Councils 2010
    53. 53. Contribute to Community Programs Regional Child Abuse Prevention Councils 2010
    54. 54. Enhance Access Reduce Barriers <ul><li>Seek support for needed resources (grant proposals, local collaborations, etc) </li></ul><ul><li>Offer concrete supports (food, shelter, seek professional help if needed) </li></ul><ul><li>Link clients to effective community resources (faith based activities, after-school programs, recreation, parenting classes, counseling, domestic violence shelters/education) </li></ul>Regional Child Abuse Prevention Councils 2010
    55. 55. <ul><li>When communities make family mental health services available, they bolster kids’ ability to handle stress and prevent damage to the developing brain. </li></ul>Regional Child Abuse Prevention Councils 2010
    56. 56. Change the Physical Environment <ul><li>Lead or participate in a clean up effort </li></ul><ul><li>Initiate a change making your community safer </li></ul><ul><li>Volunteer to paint a home </li></ul><ul><li>Support your Child Abuse Prevention Council </li></ul>Regional Child Abuse Prevention Councils 2010
    57. 57. Change Consequences <ul><li>Thank someone for their hard work </li></ul><ul><li>Publicly recognize a community group that strengthens families </li></ul><ul><li>Publish an article in a newspaper highlighting someone in the community </li></ul><ul><li>Give rewards to individuals or businesses for helping in the community </li></ul>Regional Child Abuse Prevention Councils 2010
    58. 58. Support Family-Friendly Public Policies Regional Child Abuse Prevention Councils 2010
    59. 59. Modify/Change Policy <ul><li>Talk to legislators and philanthropists about supporting effective programs </li></ul><ul><li>Contribute to child abuse prevention programs via a tax check off </li></ul><ul><li>Support positive parenting programs, domestic violence and mental health education and services </li></ul>Regional Child Abuse Prevention Councils 2010
    60. 60. <ul><li>If our society is to prosper in the future , we will need to make sure that all children have the opportunity to develop intellectually, socially and emotionally. </li></ul>Regional Child Abuse Prevention Councils 2010
    61. 61. To Get Involved Contact <ul><ul><li>Insert Local Regional Prevention Council Contact Info </li></ul></ul><ul><ul><li>Insert Other Relevant Local Resources Contact Info </li></ul></ul><ul><ul><li>Marcia Stanton, Child Abuse Prevention Coordinator, Phoenix Children’s Hospital </li></ul></ul><ul><ul><ul><li>[email_address] </li></ul></ul></ul><ul><ul><li>Mary Warren, New Parent Resource Coordinator, Prevent Child Abuse Arizona </li></ul></ul><ul><ul><ul><li>[email_address] </li></ul></ul></ul>Regional Child Abuse Prevention Councils 2010
    62. 62. Parenting Resources <ul><li>1-877-705-KIDS (5437) </li></ul><ul><ul><li>Birth to Five Parenting Questions Helpline </li></ul></ul><ul><li>1-800-4-A-CHILD (422-4453) </li></ul><ul><li>Crisis Line for emotional needs and information about child abuse and neglect. Also go to www.childhelp.org </li></ul><ul><li>Insert Local Resources </li></ul><ul><li>www.apa.org/books </li></ul><ul><li>www.pbs.org/parents/childdevelopment </li></ul><ul><li>www.cdc.gov/parents </li></ul>Regional Child Abuse Prevention Councils 2010
    63. 63. Information & Resources <ul><li>ACE Study findings and information </li></ul><ul><li>- www.acestudy.org or www.cdc.gov </li></ul><ul><li>National Scientific Council on the Developing Child at Harvard University </li></ul><ul><li>- www.developingchild.net </li></ul><ul><li>Academy of Pediatrics </li></ul><ul><li>- www.brightfutures.aap.org </li></ul>Regional Child Abuse Prevention Councils 2010
    64. 64. More Information & Resources <ul><li>National Center for Trauma-Informed Care – www.mentalhealth.samhsa.gov/nctic </li></ul><ul><li>National Child Traumatic Stress Network – www.nctsnet.org </li></ul><ul><li>Center for the Study of Social Policy -Information on Strengthening Families and Protective Factors – www.cssp.org </li></ul><ul><li>Center for Injury Prevention and Control – www.cdc.gov/violenceprevention </li></ul>Regional Child Abuse Prevention Councils 2010
    65. 65. Strong Communities Raise Strong Kids Regional Child Abuse Prevention Councils 2010
    66. 66. Personal Commitment Exercise <ul><li>Review the 7 Strategies to Build Strong Communities Personal Commitment Checklist </li></ul><ul><li>Get Involved to Reduce ACEs, Build Strong Communities and Raise Strong Kids. </li></ul>Regional Child Abuse Prevention Councils 2010

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