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Tuesday, August 3, 2021

Eradicating the roots of childhood trauma

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On the east side of Indianapolis in late March, a barrage of bullets sprayed through a home, killing 1-year-old Malaysia Robson as she slept on the couch. It was a drive-by shooting in the middle of the night by two men in their late 20s. It’s the kind of violence that can shake a community, leaving its distraught members wondering how much more they can take.

Community violence — and other forms of trauma — are especially harmful for children. They’re called adverse childhood experiences (ACEs), and they include trauma such as abuse, domestic violence and neglect, as well as systemic trauma such as racism and poverty. Accumulated, they negatively impact long-term health. As the number of ACEs increase, so does the risk of ailments such as depression, alcoholism and financial stress, according to the Centers for Disease Control and Prevention (CDC).

Poor African-American children are more likely to experience this trauma. The Robert Wood Johnson Foundation reports nearly 64 percent of Black children have at least one ACE, compared to 40 percent of white children and 51 percent of Hispanic children. And 62 percent of children with family incomes under 200 percent of the federal poverty level have at least one ACE, compared to 26 percent of children in families with income higher than 400 percent of the federal poverty level.

“When you’re from a community that’s been historically oppressed, that makes you more vulnerable,” Jaleel Abdul-Adil, co-director of the Urban Youth Trauma Center at the University of Illinois at Chicago, said. “Then when there’s a continuation of reduction of resources, you’re even more vulnerable than someone who might just be in the wrong place at the wrong time, but they’re from a high socioeconomic status.”

Abdul-Adil said living in a violent Chicago neighborhood, as an example, can be even worse than a war zone, since victims of war are more readily embraced than victims of community violence.

Ernestine Briggs-King, director of the data and evaluation program at the National Center for Child Traumatic Stress at Duke University, added Black children are especially vulnerable to ACEs because of the far-reaching impact of poverty, which limits access to education, health care and safe housing.

“Many of those circumstances are just overwhelming and atypical,” Briggs-King said. “You’re trying to figure out a way to cope with those experiences.”

Ultimately, ACEs can degenerate life through disrupted neurodevelopment and the adoption of harmful behaviors, leading all the way to early death. Those who experience at least six ACEs have a life expectancy that is 20 years shorter than other people, according to Kate Roelecke, the early intervention and prevention initiative director at the Marion County Commission on Youth (MCCOY).

While there is a plethora of national research about how ACEs affect long-term health, Roelecke said data is lacking in Indiana. The CDC issues a Behavioral Risk Factor Surveillance System (BRFSS) survey each year to states, It includes core and optional modules, and states can add their own questions. The ACEs module was optional as recently as 2012, but it hasn’t ever been a core module. Megan Wade-Taxter, media relations coordinator for the Indiana State Department of Health, said Indiana added its own set of ACEs questions to the 2018 survey for the first time.

There are two basic avenues to addressing ACEs: intervention and prevention. Brad Stolbach, clinical director of Healing Hurt People Chicago, a hospital-based violence intervention program, spends some time working directly with traumatized kids and teens. Stolbach said he talks with patients about how to handle the trauma they’ve experienced by teaching breathing techniques and reminding them they’re “not crazy.”

“If we want to have any kind of lasting effect on the larger problem of violence, it has to include attention to their psychological, emotional and spiritual injuries,” he said.

Preventing ACEs in the first place is a long-term effort that involves addressing fundamental issues in society. Roelecke said this could involve initiatives such as universal health care and education to close disparity gaps.

“I think we all know in our minds, in our hearts, we can come up with the logical things that make sense for kids,” she said. “We know what those things are.”

A simple fact is almost every child experiences at least one ACE, whether it’s bullying or divorce or other common occurrences that transcend race and class. But another simple fact is race and class bring on higher concentrations of ACEs, and they inform the implementation of intervention and prevention methods.

“We have to make the supports available to everyone,” Abdul-Adil said. “It’s all hands on deck. That’s the only chance we have of fighting back.”

 

Contact staff writer Tyler Fenwick at 317-762-7853. Follow him on Twitter @Ty_Fenwick.

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