Tennessee looks to change culture on childhood trauma
Many of the state’s top officials spent Thursday morning playing a brain game — fitting together pipe cleaners and straws to create brain networks that would withstand weights that represent the effects of toxic stress on a child’s developing brain.
First lady Crissy Haslam worked with Tennessee Supreme Court Chief Justice Sharon Lee. At a nearby table TennCare Director Darin Gordon and Department of Human Services Commissioner Raquel Hatter puzzled through creating their own sturdy brain model, as did lawmakers, mayors, judges, doctors, child welfare experts, philanthropists, business executives and educators.
The exercise was intended to educate community leaders about the devastating and lifelong impact of adverse childhood experiences. Known as ACEs, experiences such as abuse, neglect, exposure to domestic violence and addiction, divorce, poverty, incarcerated parents and homelessness can permanently rewire children's brains, leading to long-term societal costs as those children age.
Organizers of the ACEs Summit set an ambitious goal for the meeting: to make Tennessee the first state in the nation to launch a comprehensive and seismic shift in public policy that would focus on prevention in young children before exposure to ongoing "toxic stress" leads to greater costs to taxpayers and communities.
“It’s a preventative effort that really involves a culture of change,” said Chris Peck, CEO of the newly launched, Memphis-based ACE Awareness Foundation. “A lot of people are going to have to quit what they’re doing and do something else."
In the next few years, those changes could include a restructuring of state budget priorities, redirecting funds now spent on education or incarceration toward far earlier interventions, said Deputy Governor Jim Henry, former head of the Department of Children's Services.
Twenty years ago, neuroscientists at Harvard University revealed that trauma experienced by children 5 years and younger can permanently rewire a child's brain. Social scientists have since documented that the
number of traumatic events a child faces has a direct correlation with their risk for incarceration, addiction, heart disease and other health risks when they become adults.
Meanwhile, Tennessee, like other states, directs most of its budget and resources toward addressing the “downstream” costs that stem from early childhood experiences — costs to taxpayers that include incarceration, drug treatment, health care, the juvenile justice system and interventions after child abuse is discovered by DCS.
"All of us would rather invest upstream," Gov. Bill Haslam told the group.
The summit was organized by the ACE Awareness Foundation, the Nashville-based Baptist Healing Trust and Casey Family Programs, a Seattle foundation focused on reducing the number of children who need foster care. Crissy Haslam and Pat Henry, wife of Jim Henry, also are among the organizers.
Tennessee was one of the first states to begin to measure the prevalence of childhood adversity. Surveys by the Department of Health in 2008 and 2012 found that more than half of Tennessee residents have experienced some form of childhood adversity. One in five state residents have experienced at least three categories of adverse childhood experiences.
Simply being exposed to one or more childhood traumatic events in the crucial period of birth to 5 years when a child's brain is "plastic" and rapidly growing does not inevitably lead to poor outcomes in adulthood, said Judy Cameron, a professor of psychiatry at the University of Pittsburgh School of Medicine and an expert in adverse childhood experiences.
Having a stable, caring relationship with at least one adult can mitigate the effects and make so-called "toxic stress" tolerable, Cameron said.
Children who do not have that caring adult face huge challenges. A child exposed to seven categories of toxic stress has a 100 percent chance of experiencing developmental delays and a threefold chance of experiencing a heart attack later in life, Cameron said.
Such trauma also affects a child's outlook on the world, permanently. In one experiment, researchers showed children pictures of sad, fearful and angry faces. Children exposed to ongoing stress at home were more likely to see all those faces as angry "because they've seen anger over and over and over," she said.
There's no blueprint for addressing such a widespread problem, but organizers hope that by educating state leaders about the science of toxic stress and giving them the language to be able to communicate it serves as the beginning.
Lee said she plans to hold a summit within the state judiciary system about adverse childhood experiences. Criminal, juvenile and mental health courts confront the consequences every day, she said.
"The judiciary is ready to do its part," Lee said.
Jim Henry said that millions of dollars going toward interventions later in life have not paid off.
"Culture change is a very difficult thing," he said. "We need to make it happen in the next few years because the urgency of this is losing another child … a child who doesn’t have the same chances other kids in this state have."
Reach Anita Wadhwani at 615-259-8092 and on Twitter @AnitaWadhwani.
Adverse childhood experiences
More than half of Tennessee residents experienced childhood adversity; one in five have experienced three or more adverse childhood experiences.
Separation/divorce: 31 percent
Violence between adults: 19 percent
Exposure to mental illness: 18 percent
Physical abuse: 14 percent
Incarceration: 11 percent
Substance abuse: 31 percent
Sexual abuse: 12 percent
Source: Tennessee Department of Health