This chart, from the Minnesota Department of Health’s 2013 Adverse Childhood Experiences in Minnesota report, shows how Minnesotans with more adverse childhood experiences (ACEs) were more likely to suffer from a variety of health problems. The graph depicts how likely Minnesotans with ACEs are to suffer from health problems versus Minnesotans with zero ACEs. For example, Minnesotans with five or more ACEs were 4.5 times more likely to suffer from depression than those with none.
by CHRIS ROGERS
When Samantha Wagner and her colleagues at the Winona Area Learning Center watched the documentary “Paper Tigers,” their first thought was: “That’s our school.”
The film traces a big change in a small town, Walla Walla, Wash., where the community capitalized on new science to help turn around the lives of struggling students.
When Winona State University (WSU) Professor Ruth Charles gave a presentation on that science in Winona, a girl in the audience exclaimed: “Me! This is me!”
After using that science to change up everything from early childhood education to juvenile justice, Walla Walla saw a 33 percent drop in domestic violence, a 59 percent drop in youth suicide attempts, and a 62 percent drive in high school dropouts, according to the film and its follow-up documentary, “Resilience.” Both are playing in Winona in the coming weeks.
The film and Charles’ presentation focused on recent research on how childhood trauma affects teens’ brain development and their wellbeing throughout their lives. From substance abuse to graduation rates, that science seems to explain a lot and promises strategies for fixing seemingly intractable problems. Numerous Winona area educators, social workers, criminal justice officials, and mental health providers — and their colleagues across the U.S. — are focusing on it and looking for ways to mimic Walla Walla’s success.
Trauma’s effect on lives
In the late '90s in Southern California, researchers from the federal Centers for Disease Control (CDC) and the health firm Kaiser Permanente studied childhood trauma among Kaiser clients. From abuse to absent parents, the researchers looked at several types of adverse childhood experiences. ACEs they called them. (See sidebar for a full list.) They found that the more ACEs their subjects had been through, the more likely they were to suffer from a host of problems: substance abuse, heart disease, depression, sexually transmitted diseases, and liver disease. People with ACEs were more likely to do poorly in school, to do poorly at work, to struggle financially, to be the victims of sexual violence and domestic violence, to commit sexual and domestic violence, to smoke tobacco, to be obese, to have asthma, and to get cancer, according to CDC studies and a 2013 report by the Minnesota Department of Health (MDH).
CDC researchers described a “dose response” relationship between childhood trauma and those health and life problems. In other words, the more ACEs a person had — the more “doses” of trauma they got — the more likely they were to have those problems. (See bar graph.)
Fifty-five percent of Minnesotans had at least one ACE, according to the MDH report. Elsewhere studies found higher rates. “These 10 things are common. They are very common,” Charles said.
Trauma’s effect on brains
What causes this link between childhood trauma and health and social problems? Further studies found that ACEs actually disrupts the development of young brains, according to the CDC. Charles explained, “Every experience you have, whether it’s positive or negative, builds your brain.” Sexual abuse and neglect may damage the corpus callosum, which connects left and right halves of the brain, and abuse may shunt blood flow to parts of the brain that produce the chemicals responsible for making people feel happy and for regulating mood, Charles summarized. Maltreatment of infants and toddlers and sexual abuse of children up to age five kills off “seedling” brain cells in their limbic system, she said. The limbic system processes panic, fear, and social cues. It is responsible for humans’ “fight or flight” response in dangerous situations. When children whose “seedling” brain cells were damaged by abuse reach adolescence, they have trouble turning off that “fight or flight” response, Charles said. Young people in that situation may have trouble behaving, making friends, focusing on school, or even sitting still, she explained. “If your limbic system is always aroused, you think someone is constantly after you. If you feel like that, can you sit down and do math?” Charles added.
This evidence suggests there may be physiological reasons for bad behavior. Charles used a student pacing around in class as an example. If that student’s limbic system is overactive as a result of abuse, “they physically, biologically cannot sit down,” she stated.
For many, this new science affirms and underlines old ideas. “Working as a counselor, we’ve always known that trauma is bad and affects kids,” Wagner said. “They’re not just being bad kids to be bad kids. There’s a reason they’re doing things, and it’s really important to understand that,” she added.
Trauma passed down for generations
Researchers across the country have also reported that ACEs are “transmitted” between generations. “If I went through this and it changed how my brain worked, it could change how I parent,” Charles explained. For example, if a person’s own childhood trauma makes them more likely to abuse drugs and alcohol or to be the victim or perpetrator of domestic violence, their children are more likely to witness those things. The CDC considers witnessing parents’ violence and substance abuse to be an adverse childhood experience itself. CDC researchers also counted living with parents who have mental illness as an ACE, especially if the parent attempted suicide.
The Walla Walla-based Children’s Resilience Initiative added that people who have trouble making social connections because of changes in their brain physiology from ACEs may have fewer people to call on for help as parents.
There is also some evidence that ACEs may actually affect people’s genes and that there may be a genetic component to the “intergenerational transmission” of ACEs. MDH experts said more research is needed to understand that issue.
Resilience and hope
“Having an ACE score is not a life sentence,” Wagner said. Even if children experience trauma, children with supportive, loving relationships may not suffer all the bad, potential effects, according to the MDH report. Caring relationships and coping skills can help protect children when they experience trauma and it can help people who have already suffered the negative effects of trauma recover. Even if someone’s brain development was affected by trauma, they can overcome it, Charles said. “It’s not always as easy, but you can learn, you can do things differently,” she stated.
ACEs can be prevented through parenting support and education programs, including home visits for pregnant women and young mothers, through programs to prevent and treat mental illness and substance abuse, and through financial support for poor families, according to the CDC.
“It’s revolutionized the way we work with children,” said Winona County Child Welfare Supervisor Karen Sanness, who oversees programs to support and educate parents and to connect children with services to mitigate the effects of trauma.
Across the country, teachers, social workers, and public health leaders are promoting “trauma-informed care,” the idea of using what experts know about ACEs’ and the brain to better relate to young people. Winonans are implementing some of these ideas in school discipline and juvenile justice. “We have to change our lens of how we look at children so that we’re not asking ‘What’s wrong with this child?’ But instead saying, ‘What is this child going through?’” said Mark Brown of the Children’s Resilience Initiative in the film “Resilience.”
Documentary screenings coming up
“Paper Tigers,” the James Redford documentary on Walla Walla’s response to ACEs, made a big impression at last year’s Frozen River Film Festival (FRFF). “That film was so powerful, I was in tears,” said FRFF Executive Director Crystal Hegge. Charles will host a screening of the film on Wednesday, January 25, at 7 p.m. at WSU’s Science Learning Center auditorium (SLC 120).
“Resilience,” Redford’s follow-up to “Paper Tigers” will be shown at FRFF this year. Organizers have not schedule a screening time yet, but the festival runs from February 15-19.
According to the U.S. Centers for Disease Control, adverse childhood experiences (ACEs) include:
- Emotional abuse
- Physical abuse
- Sexual abuse
- Domestic violence between parents or other household members
- Abuse of drugs or alcohol by parents or other household members
- Mental illness or suicide attempts among parents or other household members
- Divorce or separation of parents
- Incarceration of parents or other household members