Oregon Parenting Education Collaborative

Tips for Working with Adoptive Families

By Megan McQueen

Download a copy of the full tip sheet PDF.

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For families seeking more detailed information, see our earlier blog post.

Megan McQueen is a warmhearted teacher, coach, consultant, and writer. She grounds her work in empathetic education, importing a strong sense of community and social skills to those with which she works. Megan prioritizes emotional learning and problem solving skills. When not at work, she is most likely playing with her husband, two children, and puppy.

Tips for Building Community with Diverse Families

By Megan McQueen

Download a copy of the full tip sheet PDF.

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Megan McQueen is a warmhearted teacher, coach, consultant, and writer. She grounds her work in empathetic education, importing a strong sense of community and social skills to those with which she works. Megan prioritizes emotional learning and problem solving skills. When not at work, she is most likely playing with her husband, two children, and puppy.

Parenting During Pandemic

By Megan McQueen

Along with you, my family is in quarantine to prevent the spread of the nasty Coronavirus. Our work and school lives are disrupted, our anxiety is heightened, and we are missing our social connections. I am reminding myself of how I can help my family best through these next few weeks; creating, and noticing the small moments of joy in our days together. 

Emotions are high right now as we navigate the ever-changing news. We are worried for our health and safety, for our family members, our bank accounts, and our most vulnerable in our society. We are flooded with information. As we all navigate a new challenge together, we may need a little extra help from one another so that we don’t feel alone as parents and caregivers. Here are a few strategies to try along with me.

Protect yourself. Beyond the necessary health precautions that we are learning, take steps to protect your emotional health as well. Stay off your phone for the first hour you are awake to avoid starting the day feeling overwhelmed. Instead, read a book, meditate, snuggle with your children, take a walk, or sneak in some quiet work at home time if that is an ideal time. Avoid “panic scrolling” through social media and news headlines. This is a wonderful time to begin or restart a gratitude practice for yourself and with your children. Give yourself grace. You may be grappling with balancing working from home and parenting at the same time. Be gentle with yourself.

Reassure your children. Depending on the age of your children, provide helpful news for them. This npr comic may be helpful, or this BrainPOP video (K-3). Older kids (3rd grade and older) may appreciate the Newsela site. Be honest about what you know, but keep it simple. Acknowledge the fearful feelings they may have and empathize with them. Let them know all of their feelings are okay and share your feelings as well. Be sure to talk about how you and they can manage those feelings (e.g., “When I feel worried, I think about what we are doing to help others. Sometimes I don’t want to talk about it, but I might want a big hug.”). Also share ways in which people are helping each other through this. As I talk with my partner, I am careful to save dire information for when my kids are out of earshot. When I hear positive stories and find fun videos of people making the most of their quarantines, I share those with my kids. 

Create fun moments of joy. Do not feel the need to begin full-fledged homeschooling right now. You may be working from home, going to work, or caring for someone. Take this pressure off yourself. Many school districts are sharing resources to continue learning at home and some are even starting to support children and youth through distance learning. Build some of these ideas into your days. Also, brainstorm a list of things your family would like to do. Bake (why didn’t I buy Nutella at the store?), hike, play a family game, read a book together, build a fort, watch a movie, have a dance party. My kids pulled out the sidewalk chalk and filled our street with art. Later, as I was walking my dog, neighbors told me that seeing their artwork made them smile. 

Design a routine for your family. Kids (and adults) thrive on routines. This quarantine is a bit uprooting for us. If your children are old enough, they can help create a routine. I made a list that had several required items (caring for pets, chores, outdoor activity) and my 9 & 12 year-olds filled in the table with the times they would like to complete these tasks. There were choices for other projects such as creative time, academic time, and screen time. Their learning is self-paced and initiated by them. They may research someone they are interested in, work on a science project, jump on an online academic site, virtually visit a museum. We try to keep up the reading that kids are missing during their school day as well by building in some reading routines before bed, after lunch, before naps, or during breakfast. Self-paced or self-directed learning may not work for other children, depending on their age, energy level, and learning needs, but you might find that your children like to choose some of their own activities each day, too.

Connect with friends and family. We are social creatures and isolation is difficult for us. I love the idea of friends cooking the same meal (over Zoom, Skype, or FaceTime), sitting down at the same time and eating “together.” One of my kids wandered around the house, chatting about nothing with their friend on FaceTime. We are missing the chatting and small talk with our friends and colleagues. We may connect online for professional meetings, but remember to build in the time for bantering as well. My parents and children usually FaceTime weekly, but I imagine this will become more frequent. We are also going to take advantage of being able to connect with our family that lives in other time zones much easier now that we are all home throughout the day. 

Help each other! Some of the most challenging parts of this quarantine is our disconnection and the feelings of helplessness that may come along with that. Having social support is one of the biggest predictors of resilience. We need others to talk through challenges, brainstorm, and problem-solve. We can become anxious when we lose or have a change in our social lives to some extent. But, we can be creative about how we help each other. Do you know a mom who has young kids and a partner who is a healthcare worker in quarantine? Leave some fancy chocolates on their doorstep. Offer to pick up some items at the store for an elderly neighbor or a friend who has young children. Your children can also benefit from finding ways to help. Mail your kids’ sweet artwork to cousins and grandparents. Paint rocks to leave out on neighborhood walks. Send thank you cards to hospitals and grocery stores. If your kids are old enough, perhaps they can walk a dog for a neighbor, mow their lawn, take out their trash bins, or weed their garden.

This is our opportunity to slow down our lives a bit and make choices about how we spend our days. Take advantage of this time to strengthen your family. Most of us cannot and should not go out in public. We can still find ways to connect with each other and spend quality time with our own families and networks of friends. Minimize the time you spend offline as much as possible to help your mental health and stay present with your family. How else are you helping your children and your family navigate these days? 

Be well! 

Megan McQueen is a warmhearted teacher, coach, consultant, and writer. She grounds her work in empathetic education, importing a strong sense of community and social skills to those with which she works. Megan prioritizes emotional learning and problem solving skills. When not at work, she is most likely playing with her husband, two children, and puppy.

Parenting Adopted Children

Photo by Simon Rae on Unsplash

By Megan McQueen

As my sister prepared to adopt her daughter, our family excitedly gathered clothes, books, and toys for her. My sister shared photos and advice that she received from her case workers. She read about how best to transition a child to a new home and planned as much as she could for a new addition to the family. As delighted as we all were, we also wondered about additional considerations my niece would need because of her past experiences.

Welcoming a child to the family through adoption or fostering is exciting! Adoption might come with other feelings as well, including doubt, love, grief, and joy. Each child brings their own personality, needs, and quirks that we as parents and caregivers learn about as we get to know our children. You may have a lot of information about your child’s experience and you may not – and that’s okay. You can still build a trusting, loving attachment relationship and we can help build their resilience. Depending on the age of our child when they join the family and their experiences before adoption, adopted children may have missed important developmental milestones or faced trauma. Of course, you are able to raise a happy, well-adjusted child – especially with extra knowledge about child development.

Whether you are preparing for adoption or have already adopted and welcomed one or more children into your family, try these strategies at home: 

Learn about child development. Find reputable resources, such as Just in Time Parenting (which is available in English and Spanish). Learn about different stages of child development – those leading up to your child’s time joining your family as well as your child’s current age and stage. This website shares research, activities, advice, and fun from birth through age five. Some of the tips provided are simple games to build coordination. For example, 25-26 months olds can play with a spoon and pan to copy sounds you make drumming. This builds rhythm, coordination, and builds your relationship. 

Focus on building a positive, trusting relationship. At seven months old, Just in Time Parenting reminds readers that babies are learning about different people. They may have developed caring, trusting attachment relationships with their caregivers before coming to your family or they might be developing these relationships for the first time. Even with trusting relationships, children at this age may cry or scream with other people (including family members they know and love!). This is normal and part of the process of learning who they can trust. Again, babies that may not have attached to a loving parent or caregiver before this age may be dealing with trust, attachment, and abandonment issues that will require extra patience, effort, and time to build those healthy relationships.

Value play time together! Children and adults need to play. The time spent together will build your relationship and many skills. Gross-motor (large muscles: leg & arm muscles & balance) and fine-motor (small muscles in fingers) skills are built through running, dancing, skipping, drawing, painting, and building. Children will solve problems, use their imagination, and build a strong connection with their playmates. Play time is also an opportunity to work through issues they may have faced, such as a stressful separation, a long plane ride, or difficult doctor visits.

Join a parenting class. Connect with other families, build confidence, and establish better relationships with your children as well as with families in your community. Learn ways to raise confident, kind, independent children.

Seek out any needed medical support and therapy for your child. This may mean dentist appointments, occupational therapy, play therapy and speech and language support. Ask your pediatrician about Early Intervention services that may be useful. Boost your child with experts to prevent or minimize issues later in childhood. 

Advocate for your child. Ask your child care providers to share signs of emotional distress they may see so you can bring them to the attention of your child’s medical team or social workers.Educate the people in your child’s life (daycare providers, grandparents, or teachers) about your child’s specific needs and how best to bolster them so your child is surrounded by people who can care for them in the most meaningful manner. For example, tell caregivers that you are working to build trust with your child. If they refuse to share a toy, use this as an opportunity to build empathy. Talk to your child about how they feel when they want something someone else has. How does it feel when that person shares? How does it feel when that person won’t share? How does it feel when you share with someone? These conversations will boost relationships and build social and emotional skills. 

My niece has brought much joy to our family and we have all learned from her. One of my favorite lessons she has shared is unconditional love. We accept her for who she is and do our best to support her. Our utmost goal has always been to meet her needs. She is perfect as she is and our job is to love her; just the same as for all the other children in our family.

Tips for parents and caregivers:

  • Parent children based on emotional age.
  • Instead of “time out”, take a break together to help build attachment.
  • Be consistent and predictable.
  • Model and teach desirable behaviors.
  • Be patient (with yourself and your child).
  • Remain calm and help the child regulate herself before discussing consequences.
  • Allow extra time transitioning between activities.
  • Create a “safe place” for family members to calm down and take a break.

Children’s Books:

Web Resources:

For a downloadable tip sheet for parenting educators, see this blog post.

Megan McQueen is a warmhearted teacher, coach, consultant, and writer. She grounds her work in empathetic education, importing a strong sense of community and social skills to those with which she works. Megan prioritizes emotional learning and problem solving skills. When not at work, she is most likely playing with her husband, two children, and puppy.

Tips for Co-parenting After Separating

By Megan McQueen

Download a copy of the full tip sheet PDF.

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For more detailed information about working with families with foster children, please refer to our earlier blog post.

Megan McQueen is a warmhearted teacher, coach, consultant, and writer. She grounds her work in empathetic education, importing a strong sense of community and social skills to those with which she works. Megan prioritizes emotional learning and problem solving skills. When not at work, she is most likely playing with her husband, two children, and puppy.

Parenting Children with Disabilities

A young child with a hearing aid playing.

By Megan McQueen

When my nephew received a diagnosis of a rare genetic syndrome, our family was grief-stricken, scared, confused, and also relieved. Doctors tested for multiple issues, some of them grave. We knew this would lead to more questions, life-changing effort on his mother’s part, and constant anxiety. Our love for him was steady – we all quickly gained perspective and gratitude for healthy days.

A diagnosis of a disability in your child can flood you with many emotions including anger, denial, sadness, and grief. Parents may also feel relief. You may have felt that something was “off” and your child was struggling or you were failing as a parent, when in fact, there were underlying issues leading to your child’s overall needs. Cope with your emotions and understand that there is no shame in how you are feeling. Raising a child can be stressful and considering extra ability issues may be overwhelming at times. Find healthy ways to manage your stress: walk with friends, join a social group, trade baby-sitting with a neighbor. Work with your emotions so that you can reach full acceptance of your child and be willing to ask others for help. 

Make a plan with your medical team to support your family. Here are suggestions to get you started.

Focus on what your child can do. This one goes for all parents! Focusing on the positive developments in our children will be uplifting for us and them. We see more of what we look for, so keep your eye out for growth and moments of joy. Connect with your child and express your unconditional love for them.

Seek out early intervention. Childrens’ needs vary widely based on their diagnosis and often within the disability. You know your child better than anyone else and can help figure out how your child fits in with their diagnosis. Ask your pediatrician about what services are available to help your child. Early intervention can make crucial differences for young children. 

Write down your questions. Oftentimes, you will feel as though you have more questions than answers, especially when searching online for advice. Keep a notebook or a notes app on your phone to record all your thoughts and questions so that you can stay organized when you’re meeting with professionals. It also may help to have someone attend doctor’s appointments with you so they can record information and you can focus on the conversation and your emotions.

Find a support network. Reach out to a support network that “gets it.” Every parent can share stories about their children, but sometimes you need a group that understands just what you’re going through. Connect with other caregivers that have children with additional needs. Look for online groups specific to your child’s diagnosis and also seek out families in your community that can share insights to your local resources. Many school districts have a special education parent network.

Provide a variety of social opportunities. Nurture friendships with many different children. Look to your neighbors, schools, daycare, even friendly families you meet at the park. Diverse friend groups offer glimpses into other worlds and promote accepting, inclusive relationships for everyone. Give your child opportunities to problem solve and struggle a bit to build their resiliency and independence skills. 

When I become overwhelmed with sadness about my nephew, I remember that strength comes from love. He and I are both stronger when we focus on the love we have for each other and our time together. You may not be able to change news from doctors, but you can always choose love, kindness, and tenderness.

Children’s books:

Books for Parents:

Online Resources:

  • Common Conditions The CDC has compiled information about a variety of disabilities and disorders.
  • Early Intervention Information about Early Intervention services, including contact info by state.
  • Global Genes Resources for rare diseases and disorders.
  • Search your child’s specific diagnosis for a research-based organization

For a downloadable tip sheet, please visit our other blog post.

Megan McQueen is a warmhearted teacher, coach, consultant, and writer. She grounds her work in empathetic education, importing a strong sense of community and social skills to those with which she works. Megan prioritizes emotional learning and problem solving skills. When not at work, she is most likely playing with her husband, two children, and puppy.

Tips for working with foster families

By Megan McQueen

Download a copy of the full tip sheet PDF.

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For more detailed information about working with families with foster children, please refer to our earlier blog post.

Megan McQueen is a warmhearted teacher, coach, consultant, and writer. She grounds her work in empathetic education, importing a strong sense of community and social skills to those with which she works. Megan prioritizes emotional learning and problem solving skills. When not at work, she is most likely playing with her husband, two children, and puppy.

Co-parenting After a Separation or Divorce: For Parents

Photo by Blake Barlow on Unsplash

By Megan McQueen

When I was teaching, I often supported families as they navigated a transition from parenting together in one house to co-parenting in different households. I reminded families that children are resilient and there were ways to support them through the process. Families are also resilient! Caring for yourself and holding your family in your heart will help guide you in making helpful, hopeful decisions for your loved ones.

Going through a separation or a divorce can be traumatic for both children and parents. Take steps to temper the stress. You may be navigating feelings of grief, anger, disappointment, or maybe even relief, freedom, and joy. Many children and adults have many different feelings and that is okay. Lean into your support network for help managing your emotions. Find a trusted counselor who can help you through this process. By caring for yourself, you will model important habits for your children. You will also be a stronger, more present parent if you can maintain your focus on your childrens’ needs when you are with them.

There are tools you can use to put your child at ease and build their resiliency as you move through this transition. 

Focus on the positive moments. Talk with your children openly about the strength of your family. When processing a traumatic event in my life, I learned the phrase, “Strength comes from love.” This has become my mantra when facing challenges large and small. Relationships may affect me deeply at times, because I am loving deeply. I don’t want to change that about myself. Remembering my love as my source of strength becomes powerful. We must learn to accept things out of our control (while working toward improving them, if possible). We cannot be positive about everything, of course. It is important to acknowledge our true feelings and deal with them. But try to reframe things when you can. As Neil Barringham says, “The grass is greener where you water it.” 

Build a social network. Find people who care for you, share your joy, and listen to your struggles. Realize that each family member will need people for these roles. Help your children connect with counselors, teachers, cousins, and friends. You may need to seek out new or different resources as you navigate new economic situations and possible new legal territory. There is no shame in asking for help. You are caring for yourself and your family and allowing others to do the same.

Teach your child healthy ways to process their feelings. Give your kids quiet time with you to connect. Even if the separation happened a while ago, kids may unknowingly have feelings of resentment or abandonment that it might help them to work through. Try the “Rewind, Remind” technique adapted from The Whole-Child Brain. You can go back through a stressful story and retrain your mind to think differently about a situation. Talk through a stressful event and tell your child that they can pause the story whenever they would like to by saying “pause.” They can fast-forward to another part of the story until you arrive at the end when there is some closure. Then, go back to a part of the story that was skipped and talk through why that part was difficult. Notice any physical changes – increased heart rate, shallow breathing, etc. and talk your child through calming exercises. Breathe deeply together. When calm and processing the challenging parts of the story, you are telling your brain that you are safe, even though this hard thing happened to you. This resiliency-building exercise can be used for all kinds of difficult life events or future challenges you’re anticipating. 

Show interest in your child’s life when you’re not together. Ask about how they spent their days apart from you. First, center yourself so that your conversations are genuine and do not seem that you are digging for information about their other parent. Ask open-ended questions such as: What was the best part of your day? What was your not-the-best part? (Some families call this the Rose and Thorn or Highs and Lows). If you are not getting many details back from your child, try questions such as: Did you go anywhere in the car? What did you do after lunch? Or you can play games such as Guess Which is Real. Your child can tell you two things that happened and one they make up. Your job is to guess which is which. This is a fun way to cultivate connections and build your child’s ability to remember and recall.

Maintain consistent boundaries and expectations at both homes. Kids thrive with structure and routine. As best as you can, talk with your co-parent about what expectations are important to keep in place at both homes. Try to maintain consistent guidelines and routines. 

Just as your marriage or partnership did not fail, it just completed its time, your family is not broken; it is evolving. As difficult as this period may be, know that you are not alone. Many other couples have had to navigate this transition and you will also. Keeping your childrens’ needs as priorities will help guide you through this time. 

Books:

Picture books:

Middle grade: 

Adult: 

Web Resources:

  • Co-Parenting The University of Wisconsin-Madison’s Parenting Advice contains ideas specific for co-parenting.
  • Co-Parenting Tips for Divorced Parents The Help Guide focuses on mental health and wellbeing as they explore tips for parents.
  • Family Resiliency The University of Wisconsin-Madison’s Parenting Advice site shares research-based ideas for building resiliency.

Please visit our tip sheet for more suggestions about co-parenting.

Megan McQueen is a warmhearted teacher, coach, consultant, and writer. She grounds her work in empathetic education, importing a strong sense of community and social skills to those with which she works. Megan prioritizes emotional learning and problem solving skills. When not at work, she is most likely playing with her husband, two children, and puppy.

Working with Families with Foster Children

A smiling woman and young child cuddling.
Photo by Bruno Nascimento on Unsplash

by Megan McQueen

As an educator, I had the chance to work with families as they became foster parents. I watched excitement build as families anticipated meeting their new children. I watched families field comments from well-meaning friends and was struck by one conversation in particular. When one parent shared they were getting ready to bring a new child into their family. Another parent said, “I could never do that. I would just get too attached.” The foster parent (who already had children) responded, “Oh, I will get attached too. But, isn’t that the point?” 

*

Working with foster children and parents requires sensitivity and understanding of the parenting needs they may have that are similar to those other families face as well as needs that may be unique.  Foster families may be in transition to adoption or may be fulfilling a temporary need. Many of the children in foster care have experienced multiple forms of trauma and neglect. They may be experiencing fear, deep distrust, grief, and nonattachment. Parents may be exhausted and overwhelmed from emotional outbursts, living with children who are unhappy, and navigating social work systems, and also joyful as they get to know a new child in their family, and excited about experiences they will share together. Parents may also be carrying a range of emotions, including excitement and joy or worry and fear. They may also be dreading a looming date when they will have to say good-bye to their foster children.

Considering the unique needs of foster families can help parenting educators better support and serve all families across their community. Try these strategies with the families you serve: 

Teach self-care and calming strategies. Caregivers may experience a range of emotions – from joy to relief to depression and demoralization. Learning calming strategies may be especially helpful for this group of parents. Self-care can ward off bleakness, provide families tools to manage hectic schedules, and model positive habits for their children. Begin parenting classes with a small practice to calm parents, give them a tool to practice at home at the end of classes (there is a list of some practical ideas here – such as #29: Start a genuine conversation with someone you care about that covers the following: things that are going well, things you’re having a hard time with, and things you are grateful for), then check in at the next session about their homework. Demonstrate with your time the importance of this effort. Tools can be simple, such as taking a quick walk around the block, scheduling medical appointments, and a time-out for parents, or more thoughtful and time intensive, such as finding back-up childcare and creating an organization system for schedules. Move beyond bubble baths and manicures; prioritize routines and efforts that will create a long-lasting effect.

Help families learn about child development. Validate families’ feelings by sharing child development milestones. The University of Wisconsin-Madison has a helpful website to bookmark for families. When people understand children’s emotional phases and why they may be “stuck” there, families can offer more patience and compassion to the children and themselves. They will be more likely to react in helpful ways because they better understand what their child needs from them. Parents can build in practices at home that will provide growth in emotional intelligence that may be missing. 

Encourage families to play together. Never underestimate the power of play! Create time for play before, during, or after your class. Inspire families to play together by sharing simple ideas that they could try at home with minimal resources. Play will help new families bond and create positive memories. Children may also work through some of their fears or stress through role-playing, safe physical play, or free play. Adults need to play too! Even if the children are in childcare during parenting classes, create a playful atmosphere, laugh together, and blow off steam through playful exercises built into your classes. I love the idea (found here) of classmates writing answers to a question on a small piece of paper, then putting their paper inside a balloon. Everyone blows up the balloons, ties them, then takes a few moments to toss the balloons around the room. After 30 seconds or so, people grab a balloon, take turns popping it open and reading the suggestion inside. Put out coloring sheets and colored pencils for students to use throughout class, build in short games that will ask students to move and laugh together, find things to celebrate together.

Build community within your class. Foster parents need to connect with others they can lean on. This may be friends, extended family, or a religious group. It can also be your parenting class cohort! By getting to know each other better, families will find common ground and relate. Community is often built in small ways over time. Help the group connect with each other and encourage them to share contact information or social media names so they can continue their friendship after the class ends. Often people are reluctant to ask others for help. It takes a village to raise a child, no one can go it alone. Remind parents of this often. There is no shame in asking for support.

Foster parents know that the reason for their efforts is to create positive connections with their children. When we hold onto our “why” of creating strong resources for families, we can all make powerful, positive progress. 

  • Play together!
  • Share the importance of self-care for children and adult
  • Teach stress management techniques for children
  • Teach child development science – help children reduce shame, help caregivers feel validated about what they see
  • Provide calm, consistent environment
  • Teach self-regulation skills
  • Encourage families to visit with birth parents if possible
  • Promote strong connections between babies and foster parents
  • Encourage connections with medical team, early intervention, early education

Children’s books:

Picture books: Maybe Days by Jennifer Wilgocki and Marcia Kahn Wright and Families Change by Julie Nelson

Middle Grade: Half a World Away by Cynthia Kadohata

Young Adult: Three Little Words: A Memoir by Ashley Rhodes-Coulter

Web Resources:

Applying the Science of Child Development in Child Welfare Systems : Harvard’s Center of the Developing Child created suggestions based on research to help support children.

A Home Within : Trainings to educate about the impacts of trauma.

Every Child Oregon : An organization that works with the Department of Human Services to support vulnerable children.

National Foster Parent Association : This website complies many resources for foster parents.

Please visit our tip sheet of working with foster families.

Megan McQueen is a warmhearted teacher, coach, consultant, and writer. She grounds her work in empathetic education, importing a strong sense of community and social skills to those with which she works. Megan prioritizes emotional learning and problem solving skills. When not at work, she is most likely playing with her husband, two children, and puppy.

Adverse Childhood Experiences (ACEs): What can we do to protect our small humans?

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BY: Nadia King

Did you know that toxic stress as a child can lead to cancer as an adult?

Before very recently, I didn’t either.

It makes intuitive sense that health outcomes would be worse for a child who has experienced trauma. They are likely to cope with the experiences by adopting unhealthy habits such as smoking or drinking, and these behavioral coping mechanisms have costly effects on health. Interestingly, the toxic stress itself can have a lasting impact on the brain and body. It disrupts neurodevelopment and the stress response system, creating a hyper vigilant state of being accompanied by skyrocketing, unnecessary levels of stress hormones like cortisol.  

In 1998, the Adverse Childhood Experience (ACEs) study was published. Looking at over 17,000 participants at Kaiser Permanente Hospital in San Diego, the researchers found a very strong correlation between childhood trauma and adult health outcomes. The researchers included 10 highly stressful events for their measure of ACEs including:

  1. Emotional abuse
  2. Physical abuse
  3. Sexual abuse
  4. Emotional neglect
  5. Physical neglect
  6. Absence of a parent through divorce, death, or abandonment
  7. Parent violently treated by other parent
  8. Drug/ alcohol abuse in home
  9. Mental illness in home
  10. Household member incarcerated

A dose-wise relationship was found, meaning that for every ACE a person experienced, the worse their health outcomes were as an adult. This relationship holds true for over 40 different health outcomes from heart disease to depression. Shockingly, ACEs predict the development of 7 out of 10 of the leading causes of death and having an ACE score of 6 results in a 20 year reduction in lifespan compared to a person with 0 ACEs, on average.

Yikes. This study discovered some pretty dreadful information, especially considering over 60% of the population has experienced at least one ACE.

“Adverse Childhood Experiences (ACEs) are the single greatest unaddressed public health threat facing our nation today.”

Robert Block, former President of the American Academy of Pediatrics

I want to reassure you; there is hope and it comes in the form of resilience and prevention.

This summer, I worked on a research project with the OPEC team at the Hallie Ford Center (funded through the SURE Science program at Oregon State University) that assessed how Oregon healthcare systems are incorporating ACEs science and parenting education into practice. Healthcare systems are an excellent avenue to help families develop this important concept of resilience that I mentioned above. By screening all families for ACEs, practitioners can identify those who are at risk and connect them with helpful resources such as parenting education, therapy, support groups, or stress reduction techniques. These connections can help families both cope with trauma that has occurred and prevent additional ACEs from happening.

As a piece of my research, I had the privilege to interview some of the leaders in the area of ACEs. The interviewees included family care practitioners, researchers, and parenting education professionals. Here are a few selected quotes that highlight some of the emerging themes.


Why ACEs? Why trauma informed care?

“CCOs started looking into ACEs because they wanted to provide preventative care and get to the root of illness and then the more they looked into ACEs they realized what a strong correlation— actually causation there is between ACEs and physical and mental health and well being.”

“How do we cut cost and improve health? Well we go upstream and prevent ACEs as much as possible to improve the health of the community.”

“We get the majority of our parenting information from how our parents treated us… if that’s a negative experience, how do we change the trajectory to help prevent that from happening again?”

“Trauma informed care is looking at the underlying cause to the problem, not just treating the physical symptoms.”

What does this look like in practice?

“Our intervention is primarily doing what we already do as pediatricians: giving advice about positive parenting and doing this even more intentionally for families who have trauma histories.”

“Asking, listening, and accepting as a powerful form of doing is a very important idea.”

Addressing the commonly held belief that families will fight the process:

“We have screened over 440,000 people at Kaiser and have had 0 patient complaints.”

“What I’ve found over and over again in parents who have had these experiences is that there’s a worry in the back of their mind that they will pass this on to their kids, and so they’re usually more relieved than anything else when we ask about ACEs…Families often see their pediatrician as a trusted bridge to services so if we have these conversations in a meaningful way with them then they view it as a way they can get the help that they need. They don’t fight the conversation.”

Recognizing a stigma:

“Many of the these things are too uncomfortable to think about or have been taught very successfully to us as small children that “Nice people don’t talk about it, and my God don’t ask questions about it.”


From these insights, it became clear that this ACEs screening and intervention can be transformative for the way pediatric and family healthcare is approached. It enables the important shift from “What’s wrong with you?” to “What happened to you?”.  Despite the benefits of screening for ACEs, I identified some major barriers to implementation including a lack of time, a lack of resources to provide to families, the absence of a universal screening process, and provider discomfort. Those practices who were able to overcome these barriers and implement ACEs screening were met with positive results. They were able to support families with connections and resources and help them to build resilience.

So what does this mean for parents?

Well, resilience can be strengthened in many ways, especially through the secure and consistent attachment of one meaningful adult relationship. By helping families build these positive relationships with their children, parents can become that person who acts as a buffer against hardship and stress. Parents can also benefit from the knowledge of ACEs science because they can recognize the severe impact that ACEs can have on their family and start finding resources to help them.

ACEs are preventable. Let’s not forget this important fact.

If we can create a society that is aware of the lasting health outcomes resulting from ACEs, then we can ignite people to change and work toward preventing ACEs from occurring in the first place. Although the conversation of ACEs is commonly seen as taboo in our society, it is important that we address it. We need a multi-generational approach where resilience is built and toxic stress is reduced.

If organizations and people come together to address ACEs, we can improve the health and well being of families and children for years to come.


There are some excellent resources where you can learn more about the science of ACEs, toxic stress, and resilience:  

If you join the Ford Family Foundation Select Books program, you can be delivered a free copy of the book “The Deepest Well” by Dr. Nadine Burke Harris. Nadine explores the science of ACEs and how she utilizes ACEs knowledge in her practice.

http://www.tfff.org/select-books/book/deepest-well

How childhood trauma affects health across a lifetime”

Ted Talk by Dr. Nadine Burke Harris on ACEs

 

Centers for Disease Control and Prevention- CDC on ACEs

https://www.cdc.gov/violenceprevention/acestudy/index.html

An interesting video on ACEs-

“Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.”

https://www.ncbi.nlm.nih.gov/pubmed/9635069

Building Resiliency: Preventing Adverse Childhood Experiences (ACEs)

https://www.oregon.gov/oha/PH/HEALTHYPEOPLEFAMILIES/DATAREPORTS/Documents/OregonACEsReport.pdf

Trauma Informed Oregon

https://traumainformedoregon.org

Center on the Developing Child- Harvard University: Aces and Toxic Stress Frequently Asked Questions

https://developingchild.harvard.edu/resources/aces-and-toxic-stress-frequently-asked-questions/

Center on the Developing Child- Harvard University: Information about Resilience

https://developingchild.harvard.edu/science/key-concepts/resilience/

Center on the Developing Child- Harvard University: Information about Toxic Stress

https://developingchild.harvard.edu/science/key-concepts/toxic-stress/

This article discusses parent perspective on ACEs screening.

http://psycnet.apa.org/fulltext/2017-54863-001.pdf

This blog post was written by Nadia King, a student at Oregon State University as part of a summer internship funded by Summer Undergraduate Research Experience (SURE) program.

About Nadia: My name is Nadia King. I’m a third year undergraduate student at OSU studying biology with the hopes to attend medical school. I can see myself becoming a pediatrician or family physician, but I’m keeping my options open. As well as my interest for the hard sciences, I love learning about public health. I’ve enjoyed working with the OPEC team and broadening my perspective and understanding of how parenting education benefits families. I think it’s incredible that OPEC offers free education statewide and even more incredible that this education has the potential to prevent ACEs. Thank you for taking the time to read this blog and I hope you enjoy learning a little bit about ACEs!

 

References:

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., . . . Marks, J. S. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventive Medicine,14(4), 245-258.

Photo 1 by Bess Hamiti on Pexels.com

Toxic Stress. (n.d.). Retrieved October 30, 2018, from https://developingchild.harvard.edu/science/key-concepts/toxic-stress/

Violence Prevention. (2016, April 01). Retrieved from https://www.cdc.gov/violenceprevention/acestudy/

 

 

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