State to target trauma in children
State to target trauma in children
Sunday, February 5, 2012
There's no shortage of children affected by trauma -- whether it's trauma linked to domestic violence, sexual abuse or other events. But until relatively recently, there has been accompanying lack of strategy on the part of national and state child welfare officials to try to prevent trauma from impacting the child's life forever.
With the help of a five-year, $3.2 million federal grant to the Department of Children and Families, and research developed by the Yale Child Study Center, the Child Health and Development Institute and other experts, this is about to change in Connecticut.
The plan is to train state workers and private providers in how to help children work through post traumatic stress disorder. The effort was the subject of two meetings last week at the state Capitol complex.
Up to 80 percent of the nearly 30,000 children the agency helps monthly are dealing with trauma, says the Connecticut Collaboration on Effective Practices for Trauma, the federally funded initiative.
"We are in the midst of a dramatic transformation of the agency, and from the start we have identified the need to make our child welfare system more trauma-informed," DCF Commissioner Joette Katz told anti-violence and child advocates.
"We have a lot of work to do," Katz said.
The plan is multi-faceted, and includes making sure that children who've had traumatic experiences feel safe; that they have ongoing healthy relationships with loved ones; that they can develop daily routines, and that they have someone to talk to.
The results of a pilot program involving nearly 2,000 children that have received this series of treatments show remarkable results," said Robert Franks, director of the Connecticut Center for Effective Practice with CHDI, a consortium of state agencies, medical centers and advocacy groups involved with children's issues. The symptoms for those with post-traumatic stress -- such as flashbacks, sleep problems and depression symptoms -- have been cut in half, he said
The DCF plan is to train workers so they are equipped to screen every child they come across for trauma so intervention and recovery can start as early as possible.
Traditionally, training has been hit or miss for DCF employees and for those community providers that routinely deal with these children.
"It not something our work force has been well trained to handle," said Allon Kalisher, who works at the DCF office that oversees the Middletown, Norwich and Willimantic areas.
One parent told her story Friday at the Capitol.
"Their life is falling out from below them. They don't know how to cope," Karrie McAvoy said, explaining that her three children had not told her for years that they were being sexually abused. When she learned what was happening, she was able to get her children into one of the few programs in the state whose workers have received training in treating trauma.
"It's important to get through it together," McAvoy said. "We can now cry together."
Experts confirmed the often dire results if trauma is left untreated. Children's reactions can include drug dependency, sexual deviancy, aggression and/or obesity and even suicide.
"It can be overwhelming" for a child to deal with, Franks said.
Up to 15 million children will witness domestic violence across the country each year. Kids -- no matter how young and seemingly unaware -- are always vulnerable to the effects of trauma which can cause longterm problems if left untreated.
"Being a bystander to violence may be as psychologically traumatizing for a child as being the direct victim," Betsy McAlister Groves of the Boston-based Child Witness to Violence Project told the group. "Even young children's eating and sleeping cycles are disturbed long term by witnessing trauma."
The Centers for Disease Control's decade-long Adverse Childhood Experiences study confirms that stressful, traumatic childhood experiences leads to social, psychological and physical impairments in adulthood.
These events "disrupt neurodevelopment and can have lasting effects on brain structure and function," according to the study.
Connecticut's Child Advocate Jeanne Milstein told of cases where the state will remove an abusive parent, but won't take action to treat the effects of the trauma in the children.
She related an anecdote from her office: Two girls, 2- and 3-year-old siblings, were removed from an abusive environment. The state breathed a sigh of relief, Milstein said, and moved on. Neither the children nor their mother received further support or counseling for the effects of the trauma.
What happened next was that the girls began acting out in school.
"Then we just start to not treat them for their trauma," Milstein said, "but start to hold them accountable for their behavior. And then they become adolescents, and we start to blame them."
"That's where we get to the importance of screening," Groves said, noting that for children who have been victims of trauma, they average eight incidents before they reach adulthood. "If we can get to them at age 5 or 3 instead of 17, we have a lot better chance of making a difference."
Being part of the solution
State Rep. Mae Flexer, who has been researching domestic violence issues, said there are large gaps in the prevention and education that would help children in the state.
"A lot of the things we'd like to do cost money -- and money has been a serious issue," the Democrat from Killingly said.
With the exception of expanding staffing and hours at emergency shelters, she said the state has been unable to spend money to move forward on providing preventative and intervention services to child victims.
"Expanding training, improving educational programing in our schools, moving to a prevention model, those are the things we're still missing," Flexer said.
Janice Gruendel, a deputy commissioner for DCF, said her organization is honing in not only on child's physical safety but also their emotional and psychological wellbeing.
"We're attentive right now to younger children because of the neuroscience of all of this," said Gruendel, who has long led early childhood development efforts in the state.
On any given day, she said, DCF serves 6,000 children under 5, many of whom have a family member dealing with domestic violence, substance abuse or mental health issues.
"And these factors co-occur with other risks that place children at extraordinary risk," she said. "So we need to be part of the solution more than perhaps we have been able to."