IOWA COMMUNITIES

UNITE FOR

THE MAGNITUDE OF THE SOLUTION

Whats predictable is preventable.

Dr. Robert Anda

How do we move from prediction to prevention?

Dr John Snow 1854

Cholera Death is Caused by Miasmas
1. New Way of Thinking Shoe Leather Epidemiology

2.

3.

Lives Saved

Events
Patterns

Structures
Unseen

Increasing Probability of Lasting Change When We Address Underlying Issues

Mental Models
Values/Principles

Core Values
Fundamental Respect for the Wisdom in Every Person Transformational Improvement

Strengths Approach Hope Filled Action

Realize Health Through a Long Term Commitment with Uncommon Partners

Foundations for Change & Transformation

Develop Compassion that Shapes & Sustains New Ways

Motivate; Deliver Stunning Success

Empower Individual and Collective Action Illuminate High Leverage Solutions

For Transformational Change: See Through New Lens

TR

UM

TR
A

ACEs are Common, Interrelated, Highly Impactful

ACE Effects are Biologic Response to Toxic Stress; Plus:

ACEs Set Up a Cascade of Experience ACEs Have Population, Lifespan & Intergenerational Effects People Unite Through the Language of ACEs & Resilience

The Science Fuels Change & Transformation

Neuroscience : Develop Compassion; Shape Solutions

ACE Science Motivates & Delivers Reliable Outcomes

Resilience Science Lets Us Know Our Actions Matter Systems Science Shows High Leverage Solutions

HARDWIRED FOR ANTICIPATED WORLD

INDIVIDUAL Edgy Single focus No Social Cues Quick to act Hyper vigilant Hyper reactive Numb Detatched OUTCOME Individual & species survive the worst conditions

Brain Development for Dangerous World

TOXIC STRESS

BRAIN

NEUTRAL START

Hormones, chemicals & cellular systems prepare for anticipated world

Normal Biological Response Bumps Up Against Social Expectations INDIVIDUAL Laid back Relationshiporiented Thinks things through Process over power Multi-Focus

Brain Development for Safe World

OUTCOME Individual & species survive in good times; vulnerable in poor conditions

Adapted from the research of Martin Teicher, MD, Ph.D By Washington Family Policy Council

Toxic Stress & Sequential Development

Right-left brain communication Perception of social cues Insight learning Movement Language & math integration Visual memory/meaning making

Premature birth Maternal depression Attachment problems Emotional dis-regulation Ability to be soothed

Prenatal

Middle Childhood

Early Childhood
Emotional Reactivity Verbal, Spacial, Working Memory Self Awareness/Monitoring Motivation Judgment Stress set-point Attention Long term memory Mental health Movement through environment Awareness of peripheral happenings Goal oriented behavior and persistence

PubertyAdolescence

Each Person; A Unique Experience of the World

Examples How Neurobiology Informs Change Perception of Threat: Safe harbor Verbal memory: Corrections Officer Training Relationship/social cues: Okanogan Mini Grants

2013

 How might we systematically build on the strengths of people affected by ACEs?

Irritable or Passionate?

How might we engage communities where a large portion of the population have 6-8 ACEs?

Protecting Interests or Hyper vigilant? Lacking Empathy or Rational and Competitive Clear Headed? or Aggressive? Independent or Detached?

Decisive or Impulsive?

The Science Fuels Change & Transformation

Neuroscience : Develop Compassion; Shape Solutions

ACE Science Motivates & Delivers Reliable Outcomes

Resilience Science Lets Us Know Our Actions Matter Systems Science Shows High Leverage Solutions

ACEs Set-Up a Cascade of Often Co-Occurring Effects

INTERGENERATIONAL TRANSMISSION

PSYCHIATRIC DISORDERS EARLY & PROBLEM ALCOHOL, TOBACCO, DRUGS DISABILITY

RELATIONSHIP PROBLEMS CRIME

EPIGENETICS

CRITICAL & SENSITIVE DEVELOPMENTAL PERIODS

ADVERSE CHILDHOOD EXPERIENCE

HOMELESSNESS

ADAPTATION

RISKY SEX CHRONIC DISEASE POVERTY UNEMPLOYMENT

HISTORIC TRAUMA

JOB INJURY SOCIAL ISOLATION DISREGULATED EMOTION LEARNING & MEMORY PROBLEMS

Elementary Children
Greatest single predictor for health, attendance, behavior Second strongest predictor for academic failure (after Spec. Ed.)

Court Involved Youth

Higher ACE Scores; among those with 4 51% of Kids Special Ed (vs 33% 0-1) 74% Below 2.0 GPA (58%) 64% 4+ Suspensions (43%) 85% Began to be suspended in 2nd grade (71%) 33% have felony re-offense in two years (13%)

Adult Adversity
Homelessness Incarceration Disability Victim of IPV Poverty Health Limits Activity Drug/Alcohol Problems Unemployment Mental Illness On-the-job injury Divorce Work-related illness

Parenting Adults
with 5 ACE

14 TIMES
more likely to have

2 or more conditions that make ACEs for Kids

Adults

Understanding Adverse Childhood Experiences isnt to know ones life path.

It is to open doors for the future you would like for yourself and for future generations.
Dr. Ronald Voorhees, MD PhD Chief Office of Epidemiology & Biostatistics Allegheny County Health Department

Examples Using Ace Info for Change

Transitions from Preschool to Kindergarten
Better Treatment Fit for Adjudicated Youth ACEs are Common Work in Universal Systems High ACE Parents Become Powerful Leaders of Next Generation ACE Reduction

The Science Fuels Change & Transformation

Neuroscience : Develop Compassion; Shape Solutions

ACE Science Motivates & Delivers Reliable Outcomes

Resilience Science Lets Us Know Our Actions Matter Systems Science Shows High Leverage Solutions

RESILIENCE
The natural human capacity to navigate life well.
(HeavyRunner & Marshall, 2003)

Individual Family Community National, Global, Ecosystem

RESILIENCE OCCURS AT ALL LEVELS

KEY SYSTEMS FOR RESILIENCE

COMMUNITY, CULTURE, SPIRITUALITY

ATTACHMENT & BELONGING

CAPABILITY

CAPABILITY

Intellectual & Employable Skills Self regulation self control, executive function, flexible thinking Ability to direct and control attention, emotion, behavior, Positive self view Efficacy

Capabilities can be impacted by trauma. As we relate to one another, its important to strike a balance between knowing that individuals efforts are valuable, and accepting that some things are beyond our control.

Cultivating a Positive View; Making Meaning

What Helps? 1. Naming the problem 2. Doing small good works 3. Engaging in rituals 4. Forgiveness 5. Religion and spirituality 6. Hearing and telling stories 7. Seeking justice 8. Living into hope

CAPABILITY

ATTACHMENT & BELONGING

Our capabilities and attachments are interrelated. One Community Network in WA found that projects that help youth develop capabilities that are highly desired by adults like animal care or search and rescue naturally and systematically improved healthy belonging in the community.

Intellectual & Employable Skills

Self regulation self control, executive function, flexible thinking Ability to direct and control attention, emotion, behavior, Positive self view Efficacy

Bonds with parents and/or caregivers

Positive relationships with competent and nurturing adults Friends or romantic partners who provide a sense of security / help with emotion coaching Social/Emotional Support

Attachment, Belonging, Social-Emotional Support

What Helps? 1. Developing ceremonies or rituals 2. Including others in therapeutic and healthpromoting activities 3. Engaging in multiple family or whole community/workplace dialogues 4. Setting up mutual support or helping systems 5. Creating art, movement, rhythm, music 6. Learning together

CAPABILITY

ATTACHMENT & BELONGING

COMMUNITY, CULTURE, SPIRITUALITY

Intellectual & Employable Skills

Self regulation self control, executive function, flexible thinking Ability to direct and control attention, emotion, behavior, Positive self view Efficacy

Bonds with parents and/or caregivers

Positive relationships with competent and nurturing adults Friends or romantic partners who provide sense of security / help with emotion coaching Social/Emotional support

Faith, hope, meaning

Engagement with effective orgs schools, work, pro-social groups Network of supports/services & opportunity to help others Cultures providing positive standards, expectations, rituals, relationships & supports

Efficacious Community
What Helps? 1. Opportunities for Everyone to Help to Co-Lead 2. Coming Together to Understand Matters of Importance 3. Learning Together Reciprocity 4. Results-Based Decisions Acting from Desired Future

Examples:
Resilience & ACE Education for All Hospital Nursing Staff Roosevelt Neighborhood: A Great Place to Live Take Back the Light Boosting Employment among People with Disabilities

A communitys capacity to respond to the needs of ALL children is reflected in the coherence and alignment of its beliefs - not just in public policies and procedures, but in daily decisions made by community members and our leaders.
Walla Walla Childrens Forum, 2013

Keys to Success Safety

Physical, Emotional, Social, Moral

Continuous Learning
Emerging Science, Innovation-Evaluation Cycles

Celebrate Success
Movement, music, artistic expression, cultural traditions, building efficacy, shared identity

MAGNITUDE OF THE SOLUTION

ACE reduction reliably predicts simultaneous decrease in all of these conditions.

Population attributable risk