ACES for Leaders in Learning by Joe Neigel

Responding to ACES at Leaders in Learning

Joe Neigel December 4, 2014

Our Goals This Morning Review the Adverse Childhood Experiences Study and how early life trauma influences behavior, health outcomes and readiness to learn. Discover how ACES impact students and educators at Leaders in Learning.

Consider simple, evidence-based strategies educators can adopt to mitigate the harm ACES cause to students and the learning environment.

Adverse Childhood Experiences Study (ACES) ACES began as a weight-loss study at Kaiser-Permanente in Southern California. It became the largest study ever completed to examine the health and social effects of traumatic childhood experiences over the lifespan.     

Middle class, average age of 57 80% white, 10% black, 10% Asian 74% some college 44% graduated college 49.5% men

Examines three general forms of abuse and household dysfunction.

The Adverse Experiences • Child physical abuse • Child sexual abuse • Child emotional abuse

• Neglect • Mentally ill, depressed or suicidal person in the home • Drug addicted or alcoholic family member • Witnessing domestic violence against the mother • Loss of a parent to death or abandonment, including abandonment by divorce • Incarceration of any family member

ACE Score Calculator

ACE Study Findings  ACEs are very common.  They are well-concealed.  The ACE Study found that the number of categories, not necessarily the frequency or severity of the experiences within a category, determine health outcomes across the population as a whole.  ACEs are strong indicators of what happens later in life, in terms of health risks, diseases and premature death.

The Science Behind ACES  A child’s environment and experience shapes their behavior and health.  Our brain is designed to prioritize survival.  Cortisol is released when our “Fight, Flight, or Freeze” response is triggered.

Toxic Stress

Toxic Stress  Prolonged exposure to Cortisol is toxic, and makes permanent changes to the brain.  This means your students may be perfectly suited to survive in their home environment, but they may not know how to act in the classroom or other “normal” situations.  Toxic Stress Hormone exposure even changes how genes are expressed, allowing for Mothers or Fathers to pass on survival characteristics from generation to generation.

Recognizing some signs of traumatic brain development  Hypervigilance - “Always on the ready.”  Display of trauma induced ADHD symptoms, including an inability to stay on task or follow directions.  Early onset of sexualized behaviors and activity.  More impulsive, aggressive and disruptive behaviors, including those leading to suspension.  Being less able to tolerate stress.

Other Negative Effects 

Prolonged exposure to Cortisol is shown to have negative effects, such as: 

Impaired cognitive performance

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Weakened immune system

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Hyperglycemia (fatigue, excessive thirst/urination)

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Decreased bone density

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Decrease in muscle tissue

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Higher blood pressure

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Slower healing, and other health consequences

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Increased risk of physical and mental health problems, including development of health risk behaviors

Graded Relationships in Health Risk Behaviors • There is a strong “dose/response” relationship between a person’s ACE score and the likelihood they will adopt personal solutions that lead to serious health problems. • Dose/Response is a direct measure of “cause and effect.”

Dose-Response: More Gas = More Miles Number of Miles You Can Drive (Response)

350 300 250 200 150 100 50 0 1

6 7 8 9 Gallons of Gas (Dose Gets Bigger)

10 11 12 13 14 15

Smoking â&#x20AC;˘ We can see the cause and effect relationship ACEs create in people and in populations.

Alcoholism â&#x20AC;˘ We can see the cause and effect relationship ACEs create in people and in populations.

Intravenous Drug Use â&#x20AC;˘ We can see the cause and effect relationship ACEs create in people and in populations.

Chronic Depression

% With a Lifetime History of Depression

â&#x20AC;˘ We can see the cause and effect relationship ACEs create in people and in populations. Women Men

80 70 60 50 40 30 20 10 0 0

2 ACE Score

>=4

Attempted Suicide â&#x20AC;˘ We can see the cause and effect relationship ACEs create in people and in populations.

ACEs lead to risk factors for the 10 most common causes of early death in the United States

Early Death in the US •

With an ACE score of 0, the majority of adults have few, if any, risk factors for diseases leading to early death

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With an ACE score of 4 or more, the majority of adults have multiple risk factors for these diseases, or the diseases themselves.

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Prepare yourself for this –

The things we identify as risk factors (obesity, illicit drug use, promiscuity) are, in fact, effective short-term devices – coping mechanisms – for the trauma experienced as a child

Reframing Our Point of View • This is an important idea. Framing this another way, many of the things termed public health problems are actually personal solutions. “What is conventionally viewed as a problem is actually a solution to an unrecognized prior adversity.” Dr. Vincent Felitti, co-principal investigator of ACE Study

ACEs Impact Leaders in Learning We also know ACES drive : • Special education needs • Grade repetition • Problems at school

• Educator burnout

Meet Mallory

Getting to Know Mallory • Mallory is in 11th grade at Leaders in Learning. • Her Counselor, JeNell Buchanan, knows Mallory’s mother physically abused her in the past. As a result, her known ACE Score is “1.”

• Keep in mind - ACEs travel in clusters: Among people exposed to physical abuse, 84% report at least 2 additional ACEs.

Mallory’s Grades Mallory appears to have trouble paying attention in class. She doesn’t turn in her homework and seems to have a hard time following directions; her grades reflect this. • Students like Mallory, who indicated being victims of physical abuse on our Healthy Youth Survey, were nearly twice as likely (1.7x) to report getting C’s, D’s and F’s.

Bullying and Safety at School Mallory has trouble making lasting friendships and is frequently the target of bullying behavior. • 8th graders like Mallory, who indicated they had been physically abused by an adult, were:  Twice as likely (2.0x) to report being the victims of bullying.  2.5x more likely to report missing days of school because they felt unsafe.

Mallory’s Mental Health Mallory seems pretty disengaged in class and always looks tired. She can’t seem to remember facts from 10 minutes ago. • Students who report being physically abused by an adult were 2.5x more likely to report being depressed on the last HYS. • Students like Mallory were also 3.4x more likely to report contemplating suicide.

Mallory’s Personal Solutions Mallory was caught bringing a flask of alcohol to school in 7th grade. She talked with Sandra Olson and avoided most of her suspension, but she and her family really haven’t engaged with any helping adults since then. • Students like Mallory are 2.6x more likely to report current alcohol use, and • They are 2.7x more likely indicate any other type of current drug use, including Marijuana.

Malloryâ&#x20AC;&#x2122;s in every classroom

Nearly 1 in 7 8th graders at Park Place Middle School indicated they had been physically abused by an adult on the last Healthy Youth Survey.

ACE Effects in School Low School Engagement 60% 50% 40% 30% 20% 10% 0% 0 ACE

1 ACE

2 ACE

3+ ACEs