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The Health Foundation of Central Massachusetts

September 20, 2017 - Telegram & Gazette - Adverse Childhood Experiences (ACEs)
Exploring childhood trauma

Click here to learn more about Worcester HEARS.

Research shows experiences can be linked to mental, physical health problems
By Scott O'Connell
T&G Staff




Janice B. Yost, president and CEO of the Health Foundation
of Central Mass., welcomes the audience to the talk Tuesday 
by Dr. Nadine Burke Harris. (T&G Staff/Christine Hochkeppel)


Until recently, health care professionals and educators would look at an unruly or seemingly unteachable child as the problem, said Dr. Heather C. Forkey.

“We would’ve asked the question, ‘what’s wrong with them?’” said Dr. Forkey, chief of the Division of Child Protection at UMass Memorial Medical Center. “It turns out, we were asking the wrong question.”

The right question, which she said has a lead to a “revolution” in pediatric care and education, is not what’s wrong with those kids, but what happened to them that made them that way. Many of them, researchers have discovered over the past two decades, suffered trauma that not only negatively affected their emotional well-being, but also worsened their mental health, their physical health – and even altered their DNA.

Dr. Nadine Burke Harris, a national leader in the emergent study and response to that trauma – known as “adverse childhood experiences,” or ACEs for short – explored its wide-ranging impacts at a presentation at Worcester Technical High School on Tuesday night attended by hundreds of health care professionals and educators. The event was presented by the Health Foundation of Central Massachusetts, which together with the city school system has attempted to tackle the ACEs problem in Worcester over the past couple years with new intervention programming in the schools.

“I am incredibly optimistic about this” movement, Dr. Burke Harris said at the beginning of her roughly hour-long address. “I feel like I have the best job in the world ... I have the benefit of seeing the work happening all over the country, and that this is something we’re really transforming.”


Dr. Nadine Burke Harris begins her presentation, “The Root of the Root: 
The Lifelong Impact of Adverse Childhood Experiences,” at Worcester
Technical High School. (T&G Staff/Christine Hochkeppel).

But it wasn’t that long ago that Dr. Burke Harris, fresh out of her medical residency, was flummoxed by the symptoms of ACEs that continue to challenge pediatricians and teachers even today. She recalled seeing repeated referrals for attention deficit hyperactivity disorder and asthma that raised her suspicions; she remembered one case specifically where the mother of one patient, after rejecting all other possible explanations for her daughter’s asthma, finally mentioned the girl’s condition flared up “whenever her dad punched a hole in the wall.”

“These insights were like pieces in a puzzle,” she said, until a landmark study released by the Centers for Disease Control and Prevention and Kaiser Permanente in 1998 finally fit them all together.

That study found that not only had two-thirds of the individuals included in the survey experienced at least one ACE, but that one in eight had endured four or more, which researchers linked to a range of negative health outcomes, from doubling those people’s chances of the most common forms of premature death, to increasing their likelihood of engaging in unsafe behaviors as adolescents.

One of the chief risks of multiple ACEs, Dr. Burke Harris said, is the compounding stress events they trigger. Stress is a natural, biological function, she explained, using a confrontation with a bear as an example; just seeing the predator will immediately unleash within a person a complex chemical reaction, which eventually results in a “fight or flight” response.

“The problem is, what happens when the bear comes home every night, and that system is enacted over, and over, and over, and over, and over again,” she said.

For kids with large numbers of ACEs, even a teacher’s calming touch on the shoulder can seem like a potential threat, and on the flip side, the reward center of their brain has been changed to the point that pleasing activities or experiences for most people are not enough to make them feel good. Even their DNA is worn down, to the point that children with multiple ACEs are more prone to chronic diseases like diabetes and even cancer.

The good news, she said, is that research has shown there are ways to counteract those effects; ample sleep, regular exercise, good nutrition, practicing mindfulness, addressing mental health, and engaging in healthy relationships have all been shown to help kids with ACEs regulate themselves, Dr. Burke Harris said. But getting that message out to health care professionals and teachers is not so simple.

“This is a young movement, and it inevitably will be facing some headwinds at some point,” she said, before encouraging audience members to become vocal advocates for their cause. With all the scientific research into ACEs that has already been compiled in a relatively short time, she said, “we should be able to do a heck of a lot more than we have been. It’s time for us to move from awareness to action.”

In Worcester, at least, that process has begun to happen. The city schools superintendent, Maureen Binienda, has prioritized social and emotional learning since she came onto the job just over a year ago, for instance – ”(it’s) so important,” she said, “that during the 2016-17 school year, we created a new position” focused specifically on that area.

In addition, last year the Health Foundation of Central Massachusetts awarded a major grant to the school system to implement a new program called “Worcester HEARS” that is introducing new ways to help kids who have experienced trauma.

Even seemingly unrelated school initiatives can be effective in reaching those students, according to Ms. Binienda, who cited as an example two events at the Goddard School of Science and Technology and Elm Park Community School that took place Tuesday morning in which players from the New England Patriots met with students to unveil new computer labs in the buildings.

“To see (the students) felt happy, no matter what the circumstances were,” was encouraging, she said. “Today, in their school, they had a very positive event.”