Limits of Understanding. by Paul Klee ( )
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1 Limits of Understanding by Paul Klee ( )
2 When I approach a child, he inspires in me two sentiments; tenderness for what he is, and respect for what he may become. --Louis Pasteur--
3 March Madness 2013
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5 The Biology of Adversity 2013
6 Stress (adrenaline, cortisol) Unpredictable Severe Predictable Moderate Brain development Epigenetics Number of Episodes Chronicity High Vulnerability Low Vulnerability
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8 Functioning of the Genome--Epigenetics 2013
9 epigenetics Methylation patterns ACEs Influence Gene expression Chromosomes tightly packed DNA Source: NIAA Alcohol Alert Number 86
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12 The Adverse Childhood Experiences (ACE) Study Examines the health and social effects of ACEs throughout the lifespan among 17,421 members of the Kaiser Health Plan in San Diego County
13 Adverse Childhood Experiences Are Common Household dysfunction: Substance abuse 27% Parental sep/divorce 23% Mental illness 17% Battered mother 13% Criminal behavior 6% Abuse: Emotional 11% Physical 28% Sexual 21% Neglect: Emotional 15% Physical 10%
14 Adverse Childhood Experiences Rarely Occur in Isolation They come in groups. 2013
15 ACEs tend to come in groups If you grew up with: Additional ACEs (%) or more Household Substance Abuse
16 Adverse Childhood Experiences Score Biologic Stress Dose ACE Score Prevalence 0 33% 1 26% 2 16% 3 10% 4 or more 16%
17 ACEs and Adolescent Health 2013
18 % early initiation 12 ACE Score and Early Initiation of Drug Use (by age 14) >5 ACE Score
19 Adverse Childhood Experiences and Teen Pregnancy ACE Score
20 Mental Health and Substance Abuse 2013
21 % addicted ACE Score and Ever Addicted to Drugs >5 ACE Score
22 Percent atempted (%) The ACE Score and the Prevalence of Attempted Suicide >=4 ACE Score
23 ACEs are a Pathway to Disease 2013
24 Percent (%) The ACE Score and Liver Disease >=4 ACE Score
25 Percent (%) The ACE Score and Coronary Heart Disease >=4 ACE Score
26 ACEs and Leading Causes of Death Heart disease Chronic lung disease Stroke Diabetes Cancer Lung cancer Liver disease Suicide Injuries HIV and STDs -Autoimmune diseases -Premature mortality 2013
27 ACEs Lead to Adaptations With a Downside 2013
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29 Being Trauma Informed It s not what s WRONG with you It s what HAPPENED to you
30 The Kiss Constantin Brancusi 1909
31 Faculties of the Mind (Consciousness) Reason Memory My fault (ACEs) Shame Fear Hopelessness Imagination Fixed patterns Fear Coping is easily overwhelmed Hopelessness by memory and imagination 2013
32 Understanding ACEs (Reframing Consciousness) Reason Memory Not my fault I m not alone I am good (Divine) conscious reframing embeds a new narrative Imagination I create new patterns Hope, meaning, and purpose I seek Truth Love 2016
33 Rewriting the Narrative of Your Life The ACE Score provides a chance to see the story of your life And to create a different path for the future 2013
34 Rewriting the Narrative of Your Life From shame, confusion, and adaptations with a downside. To create a different path for the future with hope, meaning, and purpose 2013
35 Building Self-Healing Communities Education System Medicine & Public Health Justice System Child & Family Services 2013
36 Taking Unifying Sciences to Everyone: A Grassroots Approach 2013
37 How do we use the collective wisdom and Take it to SCALE In ways that are SUSTAINABLE?
38 Teach It Community wide Statewide Nationally and Globally Create synergy between the people affected by ACEs and the systems that serve them 2013
39 Building Self-Healing Communities Education System Medicine & Public Health Justice System Child & Family Services 2013
40 Implications for the Education System 2013
41 Among Elementary Students with 3 or more ACEs The Risk of Multiple Problems Increase Academic failure: 3 times Poor Health: 4 times Severe Attendance Problems: 5 times Severe Behavior Problems: 6 times Source: Chris Blodgett, PhD Washington State University
42 Source: Chris Blodgett, PhD Washington State University
43 6 students with no ACE 5 students with 1 ACE 6 students with 2 ACEs 3 students with 3 ACEs 7 students with 4 or 5 ACEs 3 students with 6 ACEs Average High School Classroom 42% have 3 ACEs
44 Building Self-Healing Communities Education System Medicine & Public Health Justice System Child & Family Services 2013
45 Implications for the Justice System The Prison Pipeline 2013
46 ACE Score and Repeated Suspension/Expulsion Youth on Probation, Pierce County, WA History of > 7 expulsions or suspensions since the first grade Prevalence (%) % (n=11) 25.5% (n=69) 35.3% (n=158) 35.7% (n=148) 38.6% (n=124) 39.4% (n=148) 1 aor (95% CI) ACE Score 0.1
47 ACE Score and Felony Re-offense Tacoma Urban Network Felony Re-offense Post Probation and ACE Score 40% 30% 20% 10% 16% 12% 10% 18% 16% 25% 11% 20% 19% 25% 23% 31% 0% ACE Score Within One Year Within Two Years
48 Large numbers of youth in the juvenile justice system are experiencing mental health disorders Prevalence of Mental Disorders- Findings From Recent Studies Positive Diagnosis NCMHJJ (2006) 70.4% Teplin et al. (2002) 69.0% Wasserman et al. (2002) 68.5% Wasserman, Ko, McReynolds (2004) 67.2% 48
49 Most have co-occurring substance abuse disorders % Without Co-Occurring Substance Use Disorders 28% % With Co-Occurring Substance Use Disorders 72% Source: The National GAINS Center,
50 Power of the ACE Study? -A Common Language -And Conceptual Framework ACEs are common ACEs are highly interrelated ACEs pile up and have a cumulative impact (ACE Score) ACEs account for a large percentage of health and social problems Biologic Understanding (Neuroscience and Epigenetics) -Gateway to Truth, Compassion, and Healing 2013
51 Time to Unify. ACEs are a Common Source Mental illness Addiction Domestic violence Poverty Homelessness Health disparities Violence Disrupted families/ relationships Suicide Crime/mass incarceration School failure Chronic Illnesses
52 Transcendence Existence or experience beyond the normal or physical level Latin Latin transacross scandiereclimb 2013
53 Limits of Understanding by Paul Klee ( )
54 Building Self-Healing Communities Education System Medicine & Public Health Justice System Child & Family Services 2013
55
56 States With ACE Studies States No data Source: Robert Anda, MD ACE Interface 2013
57 Implications for the Justice System The Prison Pipeline 2013
58 What If.? This Science Unifies Our Approach And Prevents Major Public Health Problems? 2013
59 Building Self-Healing Communities Education System Medicine & Public Health Justice System Child & Family Services 2013
60 Per 1,000 adolescents ages 0-17 Child Out-of-Home Placements 6 Out-of-Home Placements Out-of-Home Placements FPC Funded (n=28) Non-Funded (n=10)
61 Proportion dropping out in a single year Dropping Out of High School 9 Yearly H.S. Drop-out Yearly H.S. School Drop-out FPC Funded (n=28) Non-Funded (n=10)
62 Percent dropping out Dropping Out During High School Freshman to Senior Drop-out Freshman to Senior Drop-out FPC Funded (n=28) Non-Funded (n=10)
63 Arrests Per 1,000 adolescents ages Juvenile Arrests for Violent Crime 4 Juv. Arrests for Violent Crime Juv. Arrest for Violent Crime FPC Funded (n=28) Non-Funded (n=10)
64 Per 1,000 adolescents ages Juvenile Convictions for Felony Or Misdemeanor Offenses Juvenile Offenders Juvenile Offenders FPC Funded (n=28) Non-Funded (n=10)
65 Live Births per 1,000 female adolescents Births to Teen Mothers 12 Large Communities** Large Communities** FPC Funded (n=28) Non-Funded (n=10)
66 Completed Suicide or Admitted to Hospital per 100,000 adolescents Juvenile Suicide 10 Large Communities Large Communities FPC Funded (n=28) Non-Funded (n=10)
67
68
69 Understanding Adverse Childhood Experiences Building Self-Healing Communities Robert Anda, MD, MS Co-Founder ACE Interface
70 Implications for the Education System 2013
71 Building Self-Healing Communities Education System Medicine & Public Health Justice System Child & Family Services 2013
72 Power of the ACE Study? -A Common Language -And Conceptual Framework ACEs are common ACEs are highly interrelated ACEs pile up and have a cumulative impact (ACE Score) ACEs account for a large percentage of health and social problems Biologic Plausibility (Neuroscience and Epigenetics) 2013
73 Adverse Childhood Experiences A National Health Issue ACEs have a strong influence on: -adolescent health -reproductive health -smoking -alcohol abuse -illicit drug abuse -sexual behavior -mental health - risk of violence and revictimization -stability of relationships -performance in the workforce
74 Rewriting the Narrative of Your Life The ACE Score provides a chance to see the story of your life And to create a different path for the future 2013
75 Taken out of Anchorage 45 min
76
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