Toxic Stress and ACEs

Stress is a strange thing. It’s both a feeling (a sense of being under intense pressure or emotional strain) and a mechanism by which the body’s systems respond to those feelings. We hear opposing statements about stress. Either stress is good for us because it motivates us to succeed, or all the stress in our lives in going to kill us… Which one is true? When it comes to stress, it’s a matter of degree. Yes, a little stress is part of human survival. It focuses us, energizes us, and helps us get things done. On the most primitive levels, feelings of danger trigger our body’s autonomic responses, flooding us with the hormones that once allowed us to flee from predators or enemies, or stand and fight them. Although that dramatic response is seldom needed these days, except in extreme cases of danger or sudden emergency, the stress response mechanism is still in place and vital in the rare instances when we need it. But this powerful system that’s built into every human body can be very dangerous—especially to children—when it’s triggered too frequently.

The body has several reactions to extreme danger or fear:
1.) It can embolden us to stand our ground and fight for our survival (FIGHT)
2.) It can trigger the strength and stamina we need to run away (FLIGHT)
3.) It can cause a state of near inertia in some people, thus the phrase “paralyzed with fear” (FREEZE)

It’s often hard to predict which response we’ll have in any given situation. In many cases, it seems that our body innately chooses for us but, in every case, the presence of danger sets off a series of chemical reactions in the body led by the brain and the endocrine (or glands and hormones) system.

The Immediate Effects of Adrenaline and Cortisol

The presence of danger or even severe unpredictability causes the brain to send a message to the glands to release adrenaline and cortisol. Between them, these two hormones do quite a lot to the body in a very short time:
1.) They increase the heart rate which raises blood pressure
2.) They expand the air passages to the lungs, bringing more oxygen to the body
3.) They rush sugar to the bloodstream
4.) They dilate the pupils of the eyes
5.) They prioritize the sharing of oxygen with muscles to give us power we may not know we had. Think about those news stories where people suddenly display incredible strength to save others, by lifting up a wrecked car to save a child, for example. Thank you, adrenaline!

However, adrenaline and cortisol are emergency measures — the last resort response for extreme situations. You might feel exhausted or quite nauseous after an extreme adrenaline dump, for example. That’s because your body is recovering from the intense activation and takes some time to manage and re-balance all the hormones in the blood. The body is always looking for homeostasis, or balance, where all systems are operating normally. Spikes of adrenaline and cortisol severely disrupt homeostasis and that’s a problem.

It’s true that there are good levels of stress. These are short periods of pressure that push us to complete tasks or focus on something we need to achieve. The stress passes and the body recovers quickly. However, when the stress is prolonged or repeated and there aren’t enough positive resources to counteract their effects, stress becomes dangerous and we call that toxic stress.

ACEs and Hormones

So why all this information on hormones and toxic stress? And how does it all tie back to understanding Adverse Childhood Experiences? Dr. Nadine Burke Harris, a pioneer in ACEs research, explains that adrenaline and cortisol are great if you encounter a bear in the woods. “The problem,” she says, “is what happens when the bear comes home single night?”

Continuous and repeated activation of the fight or flight response can “burn out” the system which is not intended to be in constant use. Adults suffer physical health issues if adrenaline and cortisol are released too frequently into their bodies. High blood pressure, chronic inflammation, high glucose levels, and low bone density are just a few of the numerous side effects which can result in:
• Anxiety
• Depression
• Digestive problems
• Headaches
• Heart disease
• Sleep problems
• Weight gain
• Memory and concentration impairment

The Effects on Children

For children, the situation is even worse. When little human brains and bodies are growing, there is a lot to do. The brain is developing at its fastest rate. Brain growth surges for the first 3 years of life, expands rapidly for the next ten years, then plateaus in the early 20s. But during the formative years, the body is using resources like the energy from food to accomplish countless tasks – building muscle, growing bone, honing the senses, and developing coordination and communication skills. With only a finite number of resources available, the brain allocates them to the most immediate and vital needs. In the case of constant fear and danger, the adrenaline process is triggered again and again at the expense of developing other parts of the brain and body.

Since survival must come first, that’s where all the energy goes, neglecting cognitive development and impeding those sectors of the brain vital for reasoning, self-regulation, and ultimately behavior and learning ability for the rest of a child’s life. In many cases, the lost ground is difficult, if not impossible, to make up.

A Life of Fear

So, imagine a child living in a home with domestic violence. He lives with daily uncertainty and apprehension. He is on constant alert, waiting for the next tragic event. He is always in fear of witnessing or being the victim of abuse. When it occurs, he suffers extreme terror and a sense of helplessness. He lives his life in a constant state of toxic stress. The healthy development we owe all children has, in a sense, been stolen from him.

Effects of Toxic Stress on the Body Systems of a Child

Nervous System:
Toxic stress disrupts the developing brain, including changes to the hippocampus, prefrontal cortex, and amygdala. This raises the risk of cognitive impairment, learning disabilities, hyperactivity, poor self-regulation, inhibited memory and attention span, and anxiety.

Cardiovascular System:
Toxic stress increases a child’s risk of developing high blood pressure later in life because it elevates levels of inflammation that can damage the arteries. This can lead to heart disease, stroke, and other serious heart issues.

Immune System:
Toxic stress raises the risk of infections and autoimmune diseases due to chronic inflammation and other factors. This can impair the normal development of the body’s immune system.

Endocrine System:
Toxic stress can inhibit the functioning of hormones that regulate growth and development. It can also lead to obesity and impede or accelerate the onset of puberty.

This is what toxic stress looks like: It’s the relentless fear, anxiety, uncertainty, and terror that can cripple a child’s developing brain and body.

ACEs are not just experiences, they are events that cause chemical disruption in the body and result in lifelong mental and physical health issues. When a child is traumatized, abused, or neglected, we are changing who they are at a cellular level and causing damage from which it is very difficult to recover.

But hormones are powerful agents for good, too. A few months ago, this blog series focused on resilience and how to be a buffer for a child. Science shows that the presence of just one positive adult influence in a child’s life can help mitigate against the detrimental effects of ACEs. How does that work on a cellular level?

The Science of Kindness
As well as hormones that protect us, we have hormones that keep us close as a society. Human beings are communal creatures and we’ve developed to co-operate and help one another. Our bodies are even programmed to want to do this because it facilitates our survival imperative: we are stronger together than we are alone.

Acts of kindness often bring us a good, warm feeling. That’s not just an emotion, it’s a chemical reaction in the body. Kindness or altruism releases a chemical in our blood called oxytocin which sends positive, self-affirming signals to our brain. It’s often called the happiness drug. Oxytocin, along with dopamine and serotonin, make up what’s called the Happiness Trifecta. They increase the production of neurochemicals that lift your mood.

Kindness, care, support, warmth, compassion, and love all release these amazing chemicals which have positive health effects like lowered blood pressure, which reduces strain on the veins and arteries and can help stave off heart disease. These positive chemicals are fast-acting, too. In fact, chemicals resulting from a kind or loving interaction can positively influence the brain in as little as 3 seconds!

Remember a time when you felt anxious or depressed. Think how good a simple hug from a loved one felt at that time. That’s oxytocin! There’s a reason it’s called the “cuddle hormone”. Think about how uplifting an unexpected compliment can feel. That’s dopamine! The Happiness Trifecta help both the giver and the receiver to raise their levels of good, happy hormones. And its these hormones that counteract and neutralize the effects of adrenaline and cortisol.

Every time you have an interaction with a child that’s focused on giving something positive to them–even if it’s a high-five, a thumbs up or a big smile–that’s medicine that works as an antidote to ACEs. It hardly seems possible that it’s also doing great things for your own body, too.

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ACEs and Divorce

Between 40 and 50 percent of US marriages end in divorce. Divorce may seem commonplace, even mundane, these days but its prevalence is exactly what makes it such a threat to the healthy mental and physical development of children. While divorce may have become more socially acceptable in recent decades (or even ‘normalized’) the experience for children is almost universally difficult. There is no doubt that the conflict and chronic stress involved in divorce is one of the leading causes of trauma in young children and a very significant ACE (Adverse Childhood Experience).

Even when both parents agree that it’s the best decision, divorce is a confusing, difficult process for adults, let alone children. Divorce introduces new stressors into a child’s life. Whether the separation occurs when they’re three or 13, children worry about what’s happening to their family. Often, children experience feelings of fear, uncertainty, anger, and disappointment. To a child, a divorce can feel like a violation of trust or a broken promise. Most children rely on their homes to be a place of security and safety. Breaking up that home shakes their world to its core. Little brains that are still forming cannot process information in the same way a more reasoning adult can. Children tend to internalize feelings of guilt or self-blame over their parents’ divorce that can affect them for the rest of their lives.

True, there are millions of successful adults who grew up as children of divorce. While ‘pro-marriage’ groups say all divorce has negative impact on children, other studies do seem to indicate that it is preferable for unhappy parents to separate and care individually for their children than for children to be raised in two-parent homes filled with resentment or even rage. A recent British study shows that 82% of children (aged 14 to 22) whose parents divorced  preferred their parents to separate agreeably than to ‘stay for the kids’. Divorce becomes an even more urgent decision when domestic abuse or violence against one or both partners (or the children themselves) is occurring. But there are as many adult children of divorce who are still trying to deal with the emotions and experiences their parents divorce caused them. Some studies indicate that the death of a parent (one of the most significant ACE indicators) may be easier for some children to understand and manage than divorce. In a child’s mind, it is easier to think that a parent died rather than that they left by choice.

Why is divorce such a powerful ACE?

• It introduces intense feelings of uncertainty, often for the first time if it happens very early in a child’s life
• It can cause an environment of chronic stress from anger, bitterness, and fighting
• It may cause economic strain on one of the divorcing parents
• It may separate the child not only from one parent but that parent’s family members who may have been a loving and stable influence
• It may expose a child to a parent’s new partners, which can increase risk of physical or sexual abuse

Of course, resilience levels among children are different. Some children cope and adapt better to divorce than others. Even among siblings experiencing the same divorce environment, the reactions may vary dramatically.

What Are the Warning Signs?

Here are just some of the indicators that your child may be having difficulties coping with your divorce:
• Poor performance or declining grades in school due to inability to focus
• Behavioral problems like attention seeking, “acting out”
• Mood swings or prolonged sadness/depression
• Apathy or loss of interest in places or activities they once enjoyed
• Less interest in spending time with friends
• Unwillingness to cooperate with everyday activities/defiance
• Low self-esteem and withdrawal
• Regressing to younger behaviors in an attempt to return to babyhood, clinginess
• New or increased irrational fears

If you’re dealing with divorce, be aware that even very young children may struggle emotionally. Short-term sadness and anger are normal. If negative emotions and behaviors continue beyond a few months, experts suggest counseling. Organizations like the Center for Child Counseling can provide expert, age-appropriate therapy to help children during and after a divorce. If an ACE like divorce is not addressed adequately, children may be impacted long-term and have a higher likelihood of using drugs and getting involved in criminal behavior later in life.

Adults Recall the Childhood Trauma of Divorce

When adult children of divorce look back on their childhood experiences, many express that it was the stress and conflict that was created by the divorce and not the splitting of parents itself that was so difficult to overcome. Often, children are used as pawns or become weapons in the fight between the separating partners. Asking children to choose between parents is extremely traumatic and brings feelings of anxiety and guilt that can last a lifetime.

Most times, parents go into self-protective, offensive mode and “lawyer up” which, while advised for many reasons, can create an immediately hostile and adversarial environment into which the children are inevitably dragged. The numerous emotions adults feel during a divorce—grief, anger, disappointment, loss of control, fear, loss of status, antagonism, bitterness, sadness, etc.—may also be experienced by children in different ways and for different reasons.…and if adults find it difficult to identify and cope with the emotions being raised, how much harder must it be for a child’s growing brain to process?

Parents who prioritize their children’s needs during a divorce should be viewed as heroes who have managed to look beyond their own emotions and chosen not to put their children at risk for long-term repercussions associated with ACEs.

Minimizing the Impact of the Process

You don’t have to put your own interests/needs last in order to put their children’s interests first. There are different ways to get a divorce. Parents can try to choose a non-adversarial form of divorce, if possible. They can consider mediation or collaborative resolution, if the nature of the divorce allows for it. It’s cheaper and often less traumatic for everyone involved.

Of course, there are as many different kinds of divorce as there are marriages. Some divorces are divisive and going to court may be inevitable. Center for Child Counseling board member and partner at Ward Damon, Eddie Stephens views ACEs from a family court perspective. He sees the trauma in families going through divorce: “There is an incredible amount of dysfunction out there. It is on full display in family courtrooms across the nation. Most professionals are just dealing with symptoms (substance abuse, violence, reckless behaviors), but little is done to address the root cause. In more cases then not, these individuals have suffered through some kind of traumatic experience(s) as a youth. That is the problem that needs to be addressed… not just the symptoms.”

Stephens sees how childhood trauma is transmitted from one generation to the next.

“The goal should be to create a trauma-informed society that appreciates the impact ACEs can have on an individual throughout their lives. If we shifted resources and provided the needed therapy when these kids were young, we would be more likely to stop the generational cycle which would lead to a healthier society. If we don’t embrace that approach as a society, we will continue to spend money on the symptoms while further generations become entrapped in this horrible cycle of dysfunction.”

Try to Have a ‘Grown-Up Divorce’

Children mimic grown-ups’ behavior. They learn what maturity is by watching adults. Parents teach us lessons of sharing, listening, playing fair, and being honest and kind, yet so often these simple rules are broken during a divorce. For a little brain seeking to process these events, it’s all very confusing. Positive or negative world views are being formed at this stage of life and witnessing a mature versus an acrimonious divorce can skew a child’s views on the safety or danger of adult relationships for the rest of their lives.

Mature parents can minimize the impact of their divorce by focusing on some simple guidelines. They may sound like common sense but, in the heat of the moment, practicing these rules can be a challenge. However, it will benefit your child during your divorce and for the rest of their lives.

Communicate:
Wherever possible, communicate decisions about the divorce as a family. Ideally, if all parties are present, the child will understand what is happening and see that both parents still love them. Do not share intimate details of the causes of the divorce; share age-appropriate facts only. Avoid the “blame game” or “he said, she said” story-telling.

Prepare:
Tell your children ahead of time what will be happening and when. Nobody, especially a child, likes to be sidelined by dramatic, unexpected events. Tell your children, as early as possible, about major life events like moving houses, changing schools, etc.

Acknowledge Emotions:
Don’t try to pretend that this decision is the best choice and “better for everybody”. Your child may not feel that way. Empathize with their sadness and fear and allow them to talk about their emotions. Always allow them to talk positively about the other parent.

Prevent Stress:
Try not to expose your child to adult concerns. Ensure they don’t overhear cruel arguments or intimate issues. You need to walk a fine line between keeping them informed and protecting them from age-inappropriate facts, no matter how true.

Provide Structure:
Some of the biggest changes for a child going through a divorce is the loss of significant time with one parent or the other and the constant moving between new living spaces. If you can agree on universal rules that are obeyed at both homes, it will reduce stress for your child. Try to maintain routines and not change/cancel plans at the last minute. This will only add to your child’s anxiety and insecurity.

Keep Loving Buffers in Their Lives:
Your child should never have to choose one parent over the other and that goes for extended family members, too. Your child may be very close to your ex’s siblings (their aunts, uncles, and cousins) and your ex’s parents (their grandparents). These positive influences in their lives can help buffer against the stress of the divorce and minimize the effects of ACEs. Do your best to nurture those relationships and let your child enjoy the stability of still having these good, kind people in their lives.

Use Kind Words:
In the case of biological children you have in common, it helps to remember that your amazing, precious children are 50% your ex. Every bad thing you say about him or her, you’re saying about the children you share, too.

Don’t Force Them to Hide Things From You:
Your children are likely to feel torn or periodically disloyal during and after the divorce. Allow them to share positive thoughts or feelings about your ex. They shouldn’t feel that they have to hide funny stories or happy thoughts about your ex from you. You can find ways to reinforce these in a way that’s both honest and supportive of their feelings:
“I always loved how smart your mom is.”
“You dad always tells the best jokes.”

Love Them Extra:
It goes without saying that during this difficult time you should support your child even more than usual. Smother them with love and encouragement. In the case of an especially hard divorce, you might try to remind yourself that you love your child more than you hate your ex.

There is no reason your divorce should be a childhood trauma that scars your children for life. So many parents manage to get it right and provide two secure, stable and happy homes for their children after their divorce. The ultimate goal is not to “win your divorce” but for your children to have a lifelong positive relationship with both their parents.

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ACEs and Pregnancy

For many women, seeing a positive result on a pregnancy test is a moment of pure joy, the culmination of months (or even years) of hope, and the start of a fulfilling journey to motherhood. But pregnancy isn’t easy, physically or emotionally. It places extraordinary demands on a woman’s body and may cause stress in relationships, introduce financial hardship, and affect self-esteem. It is undoubtedly the most dramatic and permanent life change most women will ever face.

As wonderful as the prospect of bringing a new life into the world may be, it comes with its own unique set of challenges when viewed through a trauma-informed lens. The two lives of a mother and her growing infant are inextricably intertwined, and stress and trauma can have a startling impact on both. While a mother brings her own childhood experiences to her pregnancy, she may also be encountering new ones, and since the baby is exposed to all the hormones and emotions of the mother during its crucial in-utero development, pregnancy is a critical time to discuss Adverse Childhood Experiences (ACEs).

To discuss ACEs and pregnancy fully, we need to understand it from two points of view.
1.) How ACEs have affected the mother’s life, how they may still be affecting her mentally and physically, and how they might interfere with her ability to nurture and care for her child.
2.) How a mother’s ACEs affect her developing baby and what effects the infant might experience in the womb and during its first few years of life.

A Time of Change and Challenge

Some of the issues a prospective new mom might be going through include:
• identity shifts
• fear of inadequacy as a parent
• loss of independence
• delay or loss of personal goals and dreams
• relationship conflicts
• financial uncertainties
• ambivalence about bonding with her baby
• body image difficulties
• hormonal dysregulation
These issues are especially magnified if the pregnancy is unplanned or unwanted.

In addition to all these new feelings and insecurities, finding out that she is pregnant often focuses a mother-to-be's attention on the concept of parenting. This can bring past traumas to the surface, especially if she was a victim of childhood abuse or neglect. Symptoms of depression, anxiety, or post-traumatic stress may return, or surface for the first time, during pregnancy. It's a tumultuous time and one when the consequences of ACE can be clearly seen but also an opportunity to intervene and hopefully prevent the cycle of ACEs from continuing into the next generation.

For example, a recent study using data from the 2010 Nevada Behavioral Risk Factor Surveillance System showed that a history of childhood stressors, such as physical, sexual, and emotional abuse, influenced alcohol use among pregnant women. The research found a dose–response relationship between ACEs and alcohol use during pregnancy. This study contributes to a growing body of research that shows that the factors affecting alcohol use during pregnancy begin long before pregnancy...in fact, they likely begin in the pregnant mother’s own childhood.

Health Risks Associated with High ACE Scores

When adults become parents, the effects that ACEs have had on their own bodies, minds, and behaviors can influence how they experience their pregnancy as well as the physical health of their growing baby.

  • When a pregnant woman is exposed to chronic stress, large amounts of neurohormones are released into her blood stream and can change the developing fetus' own stress response system.
  • Maternal stress hormones can cross the placenta as early as 17 weeks into pregnancy.
  • Women with high ACE scores are more likely to develop gestational diabetes and high blood pressure.
  • They are more likely to deliver prematurely or have a baby that is underweight or requires NICU care.
  • Even when they deliver full-term, their babies are at greater risk for developmental delays.

The good news is that during pregnancy mothers are particularly receptive to ideas on how to positively impact their baby’s life and more open to positive reinforcement about improving their own lives. Pregnancy represents the perfect point to intervene on behalf of both mother and child. Often, just finding out that she is pregnant brings a new sense of hope and determination to a woman. Pregnancy offers the opportunity for her to discuss her own childhood issues, make improvements in her life, and perhaps really confront past traumas for the first time. Pregnant women should be encouraged to openly and honestly ask for support from family and friends. In most cases, once loved ones are aware of past trauma, they respond with concern and compassion, which can be a relief for the mother-to-be and a source of comfort. For some, this may well be the right time to consider counselling or seek professional support, if needed.

Identifying At-Risk Moms

Identifying moms-to-be with high ACE scores is crucial. A simple ACE questionnaire conducted during routine pre-natal care visits can indicate the need for early intervention. This tool can help begin discussion around the concept of ACEs -- that a mom's (and other caregivers') behaviors when the baby is in utero and during its first few years of life can position their baby either for success and wellbeing or for possible lifelong poor health outcomes.

According to a study published earlier this year in the Journal of Women’s Health, when moms-to-be were surveyed at two Kaiser Permanente clinics in Antioch and Richmond, CA, from March through June 2016, clinicians discovered that the women were receptive to filling out an Adverse Childhood Experiences (ACE) survey. The researchers found that the vast majority of the pregnant women — 91 percent of the 375 surveyed— 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. Simply using the ACE questionnaire as a tool provides an opening for discussion and thus plays a small part in providing a safeguard for the unborn baby and hopefully preventing multigenerational trauma transmission. For the most at-risk women, an intensive course of action might be necessary.

How Can We Protect a Baby in utero When ACE Scores are High?

Providing an at-risk pregnant woman with intensive support and practical resources will benefit her, her baby, and those around her.
The ideal approach would include all or most of the following:

  • Conduct joint counseling sessions with a professional therapist, the mother, the father, and other children in the home. This can be extremely helpful and informative for all involved.
  • Fully integrate behavioral health services with the mother’s medical team to optimize outcomes.
  • Train all medical staff (including pediatricians, midwives, OB-GYN practitioners, and ultrasound technicians) to be trauma-informed.
  • Connect the mother with a nutritionist and other ancillary support services for after she delivers.
  • Encourage the mother to connect with the baby in utero to promote bonding and stimulate mothering instincts.

Center for Child Counseling works extensively to implement some of these best practices. Therapists in our Infant Mental Health Program (funded by the Children's Services Council) provide services throughout Palm Beach County for pregnant women, new mothers, and young children. We also partner with Healthy Mothers, Healthy Babies in their efforts to provide support to all new moms and their babies born in the County.

Research increasingly shows that the connection between a pregnant mother and her unborn baby is even more powerful than previously imagined. While love may be instantaneous and natural for most moms-to-be, it may not be as intuitive for women who have a history of abuse, neglect, or trauma. These mothers can work on building that bond by practicing some loving exercises with their unborn baby.

For example, here are some ideas to help a pregnant woman connect with her growing baby girl:

  • Tell the baby often that she is loved.
  • Share how happy you are that she is a girl.
  • Reassure the baby that you are eagerly waiting to meet her.
  • You are ready to care for her, meet her needs, and protect her.
  • Her birth is welcome. She is good news.
  • Read stories to her, sing to her, and laugh as often as possible.
  • Choose and use silly, loving nicknames for her.
  • Babies seem to respond strongly to music and rocking/swaying. Dance with her.
  • Your voice forms a bond with your baby. Talk to her.

The Role of "Buffers" for Moms and Babies

Since we know that “buffers” are the single greatest weapon in the fight against ACEs, pregnancy is the perfect time to be the buffer for an expectant mom.

Listening, showing genuine concern, and offering love and support is the single greatest gift you can give a mom with a high ACE score.

You might share strengths you see in her. Constantly reassure her that she is a kind, capable, strong woman and that she is going to be a wonderful, giving mom. She does not have to repeat mistakes from her past and can give her baby the gift of a happy childhood, even if she never experienced that herself. Support should come, crucially, from spouses or partners (if they are present), but friends, family members, and neighbors can help, too. Community support is key. Women who connect with no- or low-cost community support programs fare better than those who remain isolated. Mothers-to-be support groups, centering circles, and even children’s reading groups at local libraries are places where pregnant women and new moms can meet and share with one another.

Pregnancy is a time for teamwork at every level. When mothers who have experienced childhood trauma feel supported by the people around them, their risk of pregnancy complications and repeating negative patterns are substantially reduced.

ACEs don’t define who we are or who we will become. Every pregnancy is a brand-new start, a fresh chance to bring a happy, healthy new life into the world. With support, people who have endured ACEs can achieve emotional and physical well-being and be given a better chance to avoid repeating trauma-causing cycles. It is compelling to realize the real difference each of us can make in someone else’s life – simply by choosing to be a kinder, more compassionate, and more giving person.

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ACEs and Minorities

ACEs and Minorities

ACEs can affect anybody, anywhere. Children experiencing adverse situations, and adults who experienced adversity when they were children, come from all walks of life. ACEs are not confined to any particular race, religion, socio-economic background, or nationality. Any child can experience the sustained toxic stress associated with untreated trauma and suffer negative mental and physical health effects.

The original study on Adverse Childhood Experiences conducted by the Centers for Disease Control and insurance giant Kaiser Permanente in the mid-1990s unearthed this fact early in their research. Their study was conducted among 17,000 middle-class Americans living in Southern California. Even though these original participants were not necessarily representative of the average American, approximately half of them had still experienced at least one ACE.

Subsequent US-based ACE studies, including the largest study conducted to date between 2011 and 2014, have consistently shown the same general prevalence of ACEs among American children. This far larger sample group, and the data accumulated from many studies, highlighted some startling differences in who is most likely to suffer from ACEs. Children from minority backgrounds—whether based on race, socio-economic standing, or sexual orientation—were at distinctly higher risk of ACEs and their devastating life-long effects than middle-class white children.

At-Risk Minority Groups

Children of different races and ethnicities across the country do not experience the same exposure to ACEs. In the United States, 61% of black children and 51% of Hispanic children have experienced at least one ACE, compared to 40% of white children. In every part of the country, the lowest rate of ACEs was among Asian children. In most areas, the population most at risk was black children.

Geographic regions also showed different results. Compared to the national average of 1 in 10 children experiencing and ACE score of 3 or more, in 5 states—Arizona, Arkansas, Montana, New Mexico, and Ohio—1 in 7 children had experienced the same.

In Florida, 49% of children between birth and 17 reported no ACEs. 26% reported 1 ACE, 14% reported 2 ACEs and 10% reported 3 or more ACEs. This is generally in line with national averages.

The high occurrence of ACEs among minorities can likely be attributed to the uneven provision of services and opportunities in minority neighborhoods. This inequity is caused by social determinants of health. The World Health Organization describes the social determinants of health as “the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources.” These result in the unfair but avoidable differences in health status seen between different neighborhoods, zip codes, and even states. The social determinants of health are responsible for most health and other social disparities.

ACEs Clusters

ACEs are the result of not only situations children face within their own homes or families but the general circumstances in which they live. Because the impact of ACEs is cumulative, we see high rates in areas where several detrimental situations are occurring simultaneously. For example, a neighborhood where there is a high rate of unemployment, few educational opportunities, a strong gang presence, and high rates of domestic violence is likely to produce children who are suffering from clusters of ACEs. Because of this, ACE studies now look at the cumulative effects of ACEs rather than the individual effects of any one specific ACE.

ACEs caused by the community environments where a child is raised go hand-in-hand with the ACEs occurring in individual homes and within families.

So, ACEs aren’t a racial issue; they’re a societal one. People with low incomes and limited education are also more likely to experience ACEs, as are people who identify as gay, lesbian, bisexual, transgender, or are questioning their gender or sexuality (the LGBTQ community). According to numerous research papers, including one published by the US National Library of medicine/National Institutes of Health, this group has a dramatically higher chance of experiencing childhood trauma, probably the result of lack of understanding among family members, the taboo of discussing these issues in some communities, and the stigma often imposed by society at large.

Helping children in these particular minority groups involves cultural sensitivity and the kind of community education that takes a long time to penetrate established ways of thinking. For many children confronting overwhelming adversity and inequity, buffering relationships are needed. It is essential to address the rejection and hardships they are statistically likely to experience in their lives - with a mental health professional or caring mentor or teacher who understands the impact of these experiences. Success among marginalized groups involves developing strong internal fortitude in children and encouraging them to eventually find accepting, supportive friends, if these relationships are not available at home or school.

It’s clear that minorities, children living in economically challenged neighborhoods, and members of traditionally marginalized groups are in particular need of support in the fight against ACEs.

Solutions

Now that we know that certain groups are more likely to experience ACEs, what can we do? As individuals and communities, we can channel our efforts. A high ACE score does not predestine a child for poor life outcomes, but it does identify that child as vulnerable. Since the fight against ACEs has two primary weapons, namely 1.) building resilience and 2) promoting healthy relationships (the internal and external supports, if you like), we can provide two practical forms of assistance to targeted groups.

Building Internal Coping Skills

To build resilience in children, they need to be taught how to self-regulate and cope. Anybody can help a child to develop these vital skills. Simple techniques like providing encouragement, supporting special interests, and even just taking notice of a child is, in some small way, building self-esteem and promoting independence and strength. Children will copy the actions of adults, especially those they admire. Showing children how to calmly and fairly negotiate, compromise, demonstrate empathy, and look at all sides of an issue can help them establish a new way of thinking. Remember that children mimic both positive and negative behaviors, so it’s important to carefully consider the messages you’re sending with your behaviors and choices.

Providing External Support Systems

Of course, the most at-risk children may need professional assistance to build effective coping skills and resilience. Offering age-appropriate early intervention and mental health care in childcare centers and elementary schools (especially in at-risk neighborhoods) is the obvious place to start. Center for Child Counseling, with support from local funders including Quantum Foundation, has developed a comprehensive model for childcare centers and schools, including trauma-informed education for all caregivers, classroom-based mindfulness activities, and direct services for children identified as needing assistance. The model focuses on transforming the school environment, which in the long-term, impacts all students.

Another approach is to provide supplemental support systems in at-risk neighborhoods. Many highly-respected nonprofits do just this by creating places where children can meet, play, and be in contact with positive, caring role models and mentors. Local organizations like Urban Youth Impact, the YMCA, Compass, and Big Brothers Big Sisters are all examples of nonprofits in Palm Beach County  focused on creating positive relationships that may be absent from the home.

And, as always, every one of us can play a role in the fight against ACEs by advocating for children, encouraging every child we encounter in our lives, and being on the alert for children who may need the support and help of a caring, ACEs-aware adult.

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ACEs: How to Be a Buffer for a Child

Research shows that just one positive adult can dramatically improve the outlook for a child suffering from Adverse Childhood Experiences (ACEs). Learn how your simple actions can provide a buffer against toxic stress and change the course of a child's life.

Remember when you were a child. Think back. Remind yourself how vulnerable you were. The world was big; you were little. Was there ever a time when someone protected you? For many of us, it was an older sibling, maybe a big brother, who stepped in, literally, and came between us and a bully or danger. Do you remember how safe that made you feel? How exhilarating it was, in your moment of need, to know that you could rely on help to arrive. When you hurt yourself or had your feelings hurt, you probably ran to a parent who gave you a caring hug and soothed you. Without consciously knowing it, those of us with these sorts of memories were running to a buffer, looking for the concern and protection every single child needs and deserves…but which not every child gets.

For millions of children worldwide, Adverse Childhood Experiences (ACEs) make growing up a challenge at best and a chaotic nightmare at worst. The brain of a child growing up in a home with attentive parents will create a world view where adults as safe, predictable, and a source of love and sustenance. But the brain of a child living in a home plagued by domestic violence or neglect will create a world view where adults are unreliable and a source of fear and pain. Children carry these ideas with them and they color all future relationships. Depending on their experiences and outlook, children can grow to become nurturing, invested adults or mistrustful, suspicious and withholding.

During this blog series, we’ve learned about ACEs, their tragic lifelong consequences for individuals and communities, and how we must urgently address this greatest of all public health crises. Rather than being overwhelmed by the statistics though, let’s focus on hope because healing is possible.

As a society, we now know more about ACEs than ever before. That knowledge empowers us. On a system level in Palm Beach County, we’ve mobilized the community to fight ACEs, but the truly encouraging news is that you don’t need to be an expert to help turn a child’s life around. Of course, severely traumatized children might need the professional help and compassion provided by skilled therapists like those at the Center for Child Counseling, but for many of the others the answer is relatively straight-forward. The answer is you.

As someone who loves and cares for a child, or who interacts with children often, it is vital to be ACEs educated and trauma informed. Simply by reading this educational blog series, you’ve demonstrated an interest in the subject. You’re already equipped to play your small but vital part in the fight.

Adjust Your Approach
Being trauma-informed really means adjusting our thinking and the way we respond and react to a child’s behavior. Instead of asking: “What’s wrong with you?” the focus should be: “What happened to you?” This changes our attitude to consider what the child has experienced rather than the resulting behaviors which may be frustrating. Follow-up questions will help get to the cause of the problem, questions like: “When did this happen?”, “How long has it been going on?” and “Who has been there to help you since this happened?” This way of approaching children helps to avoid re-traumatizing already traumatized people. It creates a safe, non-judgmental place where children feel secure enough to share their experiences and ask for help without fear of punishment or retribution.

Be a Buffer
Supportive, loving caregivers can buffer the effects of toxic environmental stress. There are many ways you can support a child with ACEs. Studies show that a positive, nurturing relationship with even one engaged adult can help a child cope with adversity. Consider how you interact with children—your own and other people’s—and focus on being loving, kind, and genuinely interested in them.

Easy Ways to be a Buffer
In the bestselling novel “The Help” by Kathryn Stockett, a devoted nanny repeatedly tells the young child in her care: “You are kind. You are smart. You are important.” Let that be your mantra when helping a child who has experienced ACEs. Whether you’re a teacher, neighbor, coach, community volunteer, or friend of the family, being a buffer means employing several different approaches aimed at:
• Reducing stress
• Building positive relationship
• Strengthening life skills

Here are some practical, real-world ways you can combat the toxic stress caused by ACEs.

Celebrate:
When we celebrate a child’s achievements and challenges, both big and small, and affirm who they are as individuals, we support the development of their self-identity and remind them of their competence, importance, and lovability. When we acknowledge their birthdays, graduations, or everyday accomplishments like completing their homework, making a new friend, or doing chores, we help children build positive self-esteem. It may be something as simple as a clap, a smile, or a ‘thumbs up’. These simple gestures are expressions of support that can build self-confidence and help a child to thrive.

Comfort = Safety:
Children who have experienced trauma or toxic stress need comfort. Often, they need help to manage their emotions and to calm themselves down. Practicing relaxation, patience, and emotional regulation may help them connect with their feelings. Creating a safe environment is one of the most valuable components in re-establishing a sense of security and stability for a child. Whether the issue seems big or small, offer reassurance and always reinforce your commitment to be there for them. Sometimes it can be difficult to stay calm and supportive when a child exhibits the behaviors associated with toxic stress, but a measured response tells them that you are solid and reliable.

Help Children Collaborate:
Science shows that children who have been exposed to toxic stress may struggle to appreciate others’ perspectives. They may lack a sense of belonging. They may not have the skills or the know-how to reach out. And they may need help controlling their emotions, working through their problems, and gaining independence. Every day there are opportunities to collaborate or work with children towards common goals. With simple examples, you can teach problem solving and basic negotiating techniques to deal with conflict. When children learn to collaborate fairly, they feel like part of a team rather than isolated.

Grow Optimism:
We’ve already learned that a young child’s growing brain has plasticity – it’s still forming neural pathways and those pathways can be altered for the better. Brain science shows that we can actually train our brains to be more optimistic and hopeful about the future by practicing positive self-talk. You can reinforce this kind of positive brain growth in the children you know.

Don’t Just Hear…Listen:
It may sound easy, but listening is a skill we all need to practice. For all children, especially those who have experienced traumatic stress and violence, a patient and receptive adult who listens can help them feel safe and valued. Active listening means paying careful attention to what is being said, rather than simply hearing it. Listening is the foundation of learning and understanding what a child is trying to communicate. It shows care and concern. Listening to a child and teaching them how to listen helps them communicate and see situations from other people’s perspective – a key to empathy. Whether children are sharing happiness, sadness, anger, or fear, having someone truly listen to them matters.

Hold on to Healthy Relationships:
Often, when parents separate or divorce, it becomes a challenge to help kids maintain healthy contact with grandparents, supportive adults, and extended family members. One key to reducing stress is making the effort to maintain contact with these positive influences. It’s never a bad idea to let your children interact with people who truly love them…sometimes it means setting aside personal feelings in the best interest of the child.

Inspire:
To inspire someone means to lift them up with your words. Children need constant encouragement to recognize and reach their full potential. They need help identifying dreams and working towards them. Children who have witnessed violence and experienced traumatic stress can become negative, often have a low sense of self-worth, expect to be unsuccessful, and fail to foresee a positive future. But caring adults can help children reverse these negative responses. You can help inspire a child by identifying their strengths and natural talents and by connecting them to programs that help develop self-confidence.

Those who spend more time with children, like teachers, caregivers and, of course, parents have a greater opportunity to provide the tools that can really have a positive impact. Increasingly, schools, sports clubs and community events aimed at children are including elements of mindfulness training, self-care, and self-regulation activities in their work. But every one of us, even those of us who only have time to give a child a quick high-five, can consider it a privilege that we are contributing to that child’s resilience, health, and wellbeing.

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Center for Child Counseling selected for New York Life and Alliance for Strong Families and Communities “Building Resilience in the Face of Disaster” Program

Center for Child Counseling is one of sixteen nonprofits receiving funding to provide trauma and grief support to those who have experienced devastation or loss

Recognizing the need for long-term local assistance for those who have experienced a natural disaster or act of mass violence, New York Life and the Alliance for Strong Families and Communities announced the selection of Center for Child Counseling as one of sixteen nonprofit, community-based organizations to receive a grant to continue work in communities affected by disasters in 2017 and early 2018. These grants are part of a new program, Building Resilience in the Face of Disaster, jointly operated by New York Life and the Alliance for Strong Families and Communities that seeks to provide long-term emotional and mental health services and support from communities that have faced large-scale tragic events.

Center for Child Counseling's Childhood Trauma Response Program was selected for its work with children experiencing trauma on the heels of Hurricane Irma, which occurred in 2017. The program will provide home, school, and community-based crisis support, assessment, and evidence-based treatment and caregiver education for children and families impacted by stress related to Hurricane Irma, further complicated by other events, such as the school shooting in Parkland.

"Over the past year, we have seen significant increases in the levels of depression and anxiety in children, directly related to stress in the environment. This has resulted in hundreds of new referrals for counseling, so we continue to seek funding to support this increased need. We want each child and family to get the support they need as quickly as possible," says Center for Child Counseling's CEO, Renee Layman. "This grant is so needed and deeply appreciated. It will support home and school-based services for the most vulnerable children in Palm Beach County, who often face barriers to receiving effective care to address this type of stress. Especially children already experiencing adversity related to home or community violence."

 Center for Child Counseling will receive $50,000 as part of the $750,000 available through the program. Recipients were selected based on their level of experience and knowledge in trauma-informed care and/or grief support services; level of experience in providing support to individuals who have experienced tragedy; and plans to measure success, effectiveness, and impact. More than 90 organizations applied to the program.

“This program aligns closely with New York Life’s commitment as a company, which is to be there for people for the long-term, even when the unthinkable happens,” said Heather Nesle, vice president, corporate responsibility, New York Life. “After a disaster, the response is typically focused on addressing immediate needs or physical losses. The 16 grantees will help those traumatized by disaster, violence or loss to cope with long-term, ‘invisible’ grief, which can be detrimental if it’s not addressed.”

 “This program reflects our continued focus at the Alliance to accelerate and integrate the latest in brain science research and trauma-informed care into social sector practice, policy and systems,” noted Susan N. Dreyfus, president and CEO of the Alliance for Strong Families and Communities. “By building resilience in the face of disaster, we can strengthen the capabilities of community-based organizations to promote the health and well-being of individuals, children, and families in the communities they serve.”

The grant, which are provided by New York Life, will be administered by New York Life in Partnership with the Change in Mind Institute at the Alliance for Strong Families and Communities.

About Center for Child Counseling

Center for Child Counseling was founded in 1999 to serve young, vulnerable children in Palm Beach County. The organization provides an array of early intervention and mental health programs to build the foundation for playful, healthful, and hopeful living for children and families. Over the past 19 years, Center for Child Counseling has been recognized for its excellence in programming, including being the 2018 Hats Off Nonprofit of the Year, and winning the Blue Foundation's Sapphire Award for innovation in community health and the National Easter Seals Award of Excellence. Go to www.centerforchildcounseling.org  or call 561-244-9499 for more information.

About New York Life

New York Life Insurance Company (www.newyorklife.com), a Fortune 100 company founded in 1845, is the largest mutual life insurance company in the United States* and one of the largest life insurers in the world.  Headquartered in New York City, New York Life’s family of companies offers life insurance, retirement income, investments and long-term care insurance. New York Life has the highest financial strength ratings currently awarded to any U.S. life insurer from all four of the major credit rating agencies**.

*Based on revenue as reported by “Fortune 500 ranked within Industries, Insurance: Life, Health (Mutual),” Fortune magazine, 6/1/18.  For methodology, please see http://fortune.com/fortune500/
**Individual independent rating agency commentary as of 7/30/2018: A.M. Best (A++), Fitch (AAA), Moody’s Investors Service (Aaa), Standard & Poor’s (AA+)

About the Alliance
The Alliance for Strong Families and Communities is a strategic action network of thousands of committed social sector leaders who through their excellence, distinction, and influence are working to achieve a healthy and equitable society. We aggregate the very best sector knowledge and serve as an incubator for learning and innovation to generate new solutions to the toughest problems. We accelerate change through dynamic leadership development and collective actions to ensure policies and systems provide equal access and opportunity for all people in our nation to reach their fullest potential through improvements in health and well-being, educational success, economic opportunity, and safety and security. Go to alliance1.org for more information.

In January of 2018, the Alliance and the American Public Human Services Association (APHSA) released a groundbreaking report that offers an important cross-sector call to action to address the challenges facing human services community-based organizations (CBOs), which play a vital role in the human services ecosystem, comprised of the nonprofit sector, government agencies, and the philanthropic sector. A National Imperative: Joining Forces to Strengthen Human Services in America  was commissioned by the Alliance and APHSA and was conducted and written by Oliver Wyman and SeaChange Capital Partners. The report was supported by a national advisory council whose members came from nonprofit human services, government, the private sector, and academia. Funding for the project was provided by The Kresge Foundation and the Ballmer Group, with additional support from the Health Foundation for Western & Central New York, Mutual of America, Selective Insurance Company of America, and the U.S. Chamber of Commerce.

About the Change in Mind Institute
The Change in Mind Institute at the Alliance for Strong Families and Communities aims to increase the common understanding of the core story of brain development and intensify this knowledge into the social and public sectors. We believe through continuous innovation and alignment of practice and policy with knowledge, research, and evidence on how the brain develops, we will enhance the skills and capacities we all need to be healthy, happy, and contributing citizens. The Change in Mind Institute operates as a hub for disseminating knowledge, provides training and technical assistance on the integration of brain science research, and engages in cross-sector innovation on the transformation of organizations, sectors, and systems as they adapt to the new applications of the science.

The Alarming Effects of ACEs on Our Community

We have to share the world we live in. That might seem obvious but consider the hundreds of ways we interact with others every day, adhering to an unwritten social contract. When a traffic light turns red, we stop. We rely on others to obey this signal, too. We share space with total strangers in grocery stores, at gas stations, and on public transport. We spend hours a day with co-workers we need to get along with. No matter the natural human inclination towards self-interest, we all have high stakes in keeping our communities as healthy and safe as possible. We’re social creatures and we’re in this together – sharing communal space.

This makes us vulnerable to the behavior of others. When there’s another tragic school shooting, our community’s children lose their lives. When a local teenager overdoses on drugs, we suffer the pain and confusion of that senseless loss. When a child in the neighborhood watches his father hit his mother, science indicates that the behavior tends to be repeated generation after generation. All these ACEs (Adverse Childhood Experiences) affect us. Nobody is insulated by the location of their home, their economic privilege, or perhaps even their conscious efforts to isolate and protect themselves and their families. Whether for humanitarian, religious, altruistic, or even selfish reasons, it’s in our best interests as individuals and a society, to care about others.

Through this blog series, we’ve learned what ACEs are and the profound implications they have on the lives of individuals, but whenever children are exposed to ACEs, each and every one of us may end up paying the price. Domestic and community violence is directly correlated to ACEs. So are substance abuse, alcoholism, depression and many diseases.

However, we can reduce future violence, substance abuse and many other social ills by intervening and acting as a buffer for our community’s children. Anne-Marie Brown, LCSW, MCAP, CIP, ICADC, Director of Center for Child Counseling’s Childhood Trauma Response Program, has seen the results of non-intervention firsthand. Before joining CfCC, she spent over a decade working with adults overcoming substance abuse and, without fail, Anne-Marie saw where her clients’ problems began.

Every single adult she encountered had a history of childhood trauma, illustrating a direct link between ACEs and greater societal issues. Palm Beach County has a significant number of parents who abuse substances or suffer the cycle of domestic abuse.

In the County and State, children aged 0-6 enter the child welfare system at very high rates. In just one four-day week recently, Center for Child Counseling (CfCC) handled calls for 20 children who needed assessments because they were removed from their families, most due to substance abuse and domestic violence.

The Negative Toll on Community Wellness

ACEs often negatively affect a family for generations. Kids who are abused or neglected grow up and find themselves in similar situations with domestic violence or substance abuse. Their children suffer abuse and neglect, turn to drugs or alcohol, and the cycle starts all over again.

Karen Baldwin, a clinical therapist for the Palm Beach County Sheriff’s Office Crisis Intervention Team, says she receives calls every day about situations where people are unable to regulate their emotions or think rationally.

“Adults who experienced ACEs and didn’t get some sort of intervention have been using coping mechanisms for a very long time. Unfortunately, most of them don’t work,” she says. “Eighty percent of the women in our jail system have a history of trauma they’ve likely never dealt with. They get trauma counseling when they’re released, but they needed it long before then.”

The lack of community awareness about ACEs’ generational impact is a roadblock to securing more resources and greater involvement. That’s why CfCC works so hard to educate, train, and build the skills of a wide range of community stakeholders.

The Economic Argument

The financial implications for society are staggering.

Besides the obvious losses caused by a criminal act, determining the true economic impact of antisocial behavior on a community is complicated. A research paper co-authored by Dr. Kathryn E. McCollister of Miami’s Miller School of Medicine estimates the total tangible cost of one murder at $1.5 million, one rape/sexual assault at $47,500, and one aggravated assault at $23,000 – not to mention the psychological damage perpetuated by a violent act over several generations. (Figures adjusted for inflation.)

Fighting the Immediate and Lifelong Impact

Organizations and individuals do fight back. Since 1999, the Center for Child Counseling has been addressing the immediate and lifelong impact that exposure to toxic stress and traumatic experiences has on children. Two years ago, CfCC’s Childhood Trauma Response (CTR) Program was developed in collaboration with ChildNet to serve children aged 0-5 entering the foster care system. In the last eight months, through funding from the Moran Foundation, CTR has assessed more than 130 children. The program provides services that help build resilience and provide coping techniques, so children can process what they’ve experienced.

Both Brown and Baldwin say they need the community’s help. Here are some of their goals:
1.) Every clinician and every adult in contact with children needs to commit to early intervention.
2.) Every adult in a child’s life must be aware of ACEs and their dire consequences.
3.) All of us can find ways to share information about ACEs.

Evidence shows that early intervention for ACEs, like that provided by CfCC, can reduce or prevent someone from engaging in harmful or violent behaviors later in life. Every child should grow up feeling safe and loved. You can be a buffer against childhood trauma and adversity by joining us in the fight against ACEs in Palm Beach County. How do you become a buffer? What does a buffer need to do to be an effective shield for a child? You’ll learn the answers in our next blog.

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CENTER FOR CHILD COUNSELING NAMED “2018 TOP-RATED NONPROFIT” by GreatNonprofits

Center for Child Counseling announced today it has been named a “2018 Top-Rated Nonprofit” by GreatNonprofits, the leading provider of user reviews of charities and nonprofits.

Center for Child Counseling is building the foundation for playful, healthful, and hopeful living for children and families in Palm Beach County. The organization cares for some of the most vulnerable children in the community, focusing on healing the effects of trauma and adversity that impact lifelong health and well-being. Prevention, early intervention, and mental health treatment is provided throughout Palm Beach County within childcare centers, schools, agencies, and shelters to increase access to care. The organization’s expertise is grounded in developmental and neuroscience research, using evidence-based strategies to stop the intergenerational transmission of adversity through advocacy, intervention, education, and strong partnerships.

“We are honored to be named a Top-Rated Nonprofit again this year,” says Renée Layman, CEO at Center for Child Counseling. “We are so proud of our accomplishments because it means we are helping more children. We have been able to deepen our impact, serving over 2,500 children in the past year alone and educating over 3,000 professionals and caregivers on effective ways to help children facing trauma and ACEs.”

Center for Child Counseling was also selected as Nonprofits First 2018 Nonprofit of the Year (medium-sized) for their work and impact in Palm Beach County.

The Top-Rated Nonprofit Award is the based on the rating and number of reviews that Center for Child Counseling received from volunteers, donors, and clients. From one caregiver – “Great counseling! I'm really thankful for the support my family received here. It helped us tremendously to learn to take a moment to think about how different situations affect each one of us and how our response would impact our relationship. The best part is to feel that I have been able to improve the way I communicate with my son to make him feel loved and supported!”

“Center for Child Counseling a great example of a nonprofit making a real difference in their community,” said Perla Ni, CEO of GreatNonprofits, “Their award is well-deserved recognition not only of their work, but the tremendous support they receive, as shown by the many outstanding reviews they have received from people who have direct experience working with Center for Child Counseling.”

GreatNonprofits is the leading website where people share stories about their personal experiences on more than 1.6 million charities and nonprofits. The GreatNonprofits Top-Rated Awards are the only awards for nonprofits determined by those who have direct experience with the charities – as donors, volunteers and recipients of aid.

Hats Off Nonprofit of the Year!

Center for Child Counseling Selected as Nonprofit of the Year!

We are very pleased to share that Center for Child Counseling was selected as Nonprofit of the Year (medium-sized nonprofit) at the 2018 Nonprofits First Hats Off Awards!

Nonprofits First Hats Off Awards 2018 photos by CAPEHART

In addition, Lauren Scirrotto, our Chief Program Officer, was nominated for Nonprofit Professional of the Year and Eddie Stephens, Board Director was nominated as Nonprofit Volunteer of the Year.

In addition to his work with Center for Child Counseling, Eddie also volunteers with Leadership Palm Beach County, Kelsey Cares, Delta Sigma Pi, Kibblez of Love, and Boy Scouts of America.

Highlighting our dedication to collaborating with other organizations, we were included in three Community Collaborators Award nominations:

  • Family Strengthening Program: Support For Families To Navigate Systems And Stressors
  • Immediate On-Site Mental Health Care For Expectant and New Mothers
  • Raising Awareness And Fostering Safe Spaces To Talk Openly About Behavioral Health And Trauma

Congratulations to all of the amazing nonprofits nominated for their work in Palm Beach County. Click here to see all of the 2018 honorees.

Resilience: A Powerful Weapon in the Fight Against ACEs

Think about a toddler who is just learning to walk. Picture the number of times that toddler stumbles and tumbles. Researchers at New York University, directed by Dr. Karen Adolph, showed that newly-walking infants travel about 2,360 steps each hour. They also fall down an average of 17 times during that same period. Imagine you failed at something you were trying to achieve 17 times every hour. You’d be experiencing a setback once every 3.5 minutes – very disheartening. But do toddlers stop trying to walk successfully? Never. They get up again and again and keep moving. This is a compelling way to describe resilience. As Oliver Goldsmith, an 18th century Irish poet, put it: “Success is simply standing up one more time than you fall down.”

What makes some people so resilient and what does this have to do with ACEs? As we’ve learned, ACEs are Adverse Childhood Experiences that have a dramatically detrimental effect on a person’s lifelong mental and physical health. The statistics for those with high ACE scores seem bleak. They suffer from more diseases, greater levels of depression, alcoholism, and substance abuse. They die, on average, 20 years younger than those with no ACEs. But there is hope and resilience might be the key.

What is resilience?

Resilience is the ability to bounce back from life’s difficulties. It can be described as a varied and dynamic mix of many traits like determination, toughness, optimism, faith, positivity and hope. Resilience isn’t necessarily something a child is born with, although scientists now believe that certain children are genetically predisposed to higher levels of resilience. But the good news for all children is that resilience is like a muscle - the more you exercise it, the stronger it grows, especially in very young children where neural pathways are still forming and thinking patterns are elastic.

ACEs are only one half of any equation to try and predict a child’s future course. While each child is exposed to different degrees of trauma, they also have their own unique set of characteristics that can protect them against that trauma. A high ACE score is not a guarantee of negative outcomes in life. It’s a big warning sign but no child is doomed by their ACE score.

Two crucial factors are at play: 1.) The child’s own biological and developmental characteristics (their “nature”) and 2.) external influences from their family, community, and support systems. When these influences are positive, we call them “protective factors”. Protective factors help explain why some people who have sustained a great deal of adversity as children fare relatively well in adulthood.

Like a balancing scale, resilience is the result of interactions between a person’s ACEs on one side and his or her protective factors on the other.

How does resilience develop?

Researchers continue to refine their understanding of the components and processes involved in resilience. However, there is agreement about a variety of important conditions that support resilience.

• Close relationships with competent caregivers or other caring adults
• Parental resilience
• Caregiver knowledge and the use of positive parenting skills
• Having a sense of purpose (through faith, culture, identity, etc.)
• Individual competencies (problem solving skills, self–regulation, autonomy, etc.)
• Opportunities to connect socially
• Practical and available support services for parents and families
• Communities that value people and support health and personal growth

Protective factors help a child feel safe more quickly after experiencing the toxic stress of ACEs. Protective factors can neutralize the physiological changes that naturally occur during and after trauma. This protects the developing brain, the immune system, and the body as a whole from negative effects.

If the child’s protective factors are firmly in place, development can be sound, even in the face of severe adversity.

If these protective factors are inadequate, either before or after the traumatic experience, then the risk for developmental problems is much greater. This is especially true if the environmental hazards are intense and prolonged.

Resilience can be the antidote to ACEs

The negative consequences of ACEs can be counteracted with support, care, and appropriate intervention. Through positive relationships, children learn to develop crucial coping skills. They know that they are not alone, and they adopt healthy ways to process stress.

When children are taught coping mechanisms at a young age, they start to exercise their resilience muscle. As a child moves into maturity, they need to keep working their resilience muscle. When they do, they continue to grow stronger and are better equipped to manage the ups and downs of life.

Support in Childhood Pays Off in Adulthood

A 2017 “ACEs and Resilience” study conducted by the National Health Service in Wales found that, overall, having supportive friends, opportunities to engage with their community, people to look up to, and other sources of resilience in childhood more than halved the current mental illness in adults with four or more ACEs from 29% to 14%. Adults who acknowledged having childhood protective factors reported a reduced rate of suicidal thoughts and self-harming of 19% versus those without protective factors, who reported 39%.

We know that resilience requires that a child can rely on the presence of at least one supportive, caring adult. But who are these people? Are you one of them? Every child is surrounded by adults who can help them: family members, friends, neighbors, teachers, counselors, coaches, medical professionals, etc. These positive adult role models can be a buffer in a child’s life. A buffer is like a shield that helps to block some of the negative effects of ACEs exposure.

We’ll share more about being a buffer in our next blog.

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