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Hidden, lifetime scars: States address the needs of children who have experienced trauma, aim to stem the cycle of negative outcomes

by Kate Tormey ~ May 2014 ~ Stateline Midwest »
Imagine being a young boy waking up one morning to the sound of your parents arguing and your mother being abused.
You don’t get breakfast and you miss the bus — so you’re late for school. You get in trouble for being tardy, and by mid-morning, you’re hungry and frustrated, so you lash out at another student.
You’re back in the principal’s office instead of learning in the classroom — and the vicious cycle continues.
It’s the type of scenario that plays out all too often, says Wisconsin Rep. Janet Bewley.
“The idea is not to say to the child, ‘What’s the matter with you?’ Instead, we ask, ‘What happened to you — not just this morning, but in your life — that led to this behavior?’” Bewley says.
That’s the idea behind “trauma-informed care,” which uses scientific research to help reverse the negative consequences of adverse childhood experiences.
Bewley is part of a council of experts, state officials and legislators working to integrate the technique into Wisconsin state policy, from child welfare to education.
It’s one of several efforts in the region aimed at improving the response to early trauma, not only as an investment in young people, but also in the future of states themselves.
Long-term effects of early trauma
By age 16, two-thirds of American children have experienced a traumatic event, according to the National Child Trauma Stress Network. These can include:
Neurological research shows that these events can spur an overproduction of stress hormones, which, in turn, can actually change the makeup of the brain and immune system.
“Toxic stress in early life and common precipitants of toxic stress — such as poverty, abuse or neglect, parental substance abuse or mental illness, and exposure to violence — can have a cumulative toll on an individual’s physical and mental health,” according to a report done by Megan Gunnar, a professor of child development at the University of Minnesota.
“The more adverse experience in childhood, the greater the likelihood of developmental delays and other problems.”
The consequences can last into adulthood. And the more negative experiences a person has endured, the more likely he or she is to experience mental health issues (depression, substance abuse and suicide attempts, for example) as well as chronic health problems such as obesity and heart disease. (See sidebar, below.)
“We have more evidence than ever before about the importance of early development,” says Amy Susman-Stillman, co-director of the Center for Early Education and Development at the University of Minnesota.
“It sets the foundation for later development. Your experiences as a young child still have an impact on you as an adult.”
The negative outcomes related to early stress and trauma not only affect individuals, but can also generate a high “public cost” to society in the form of higher health care costs, unemployment, criminal-justice expenditures and the need for public assistance.
State leaders are looking at ways to increase the number of at-risk children who receive help and get on the path to healthy adulthood.
For example, Michigan’s Mental Health and Wellness Commission issued a report last year that included recommendations for better addressing the needs of children with mental health issues. It suggests giving priority to children in long-term foster care (who are likely to have experienced trauma) and case management systems that follow high-risk families and children throughout the state and in different care settings.
The report also calls for developing standards for how to respond to and care for young people who have experienced trauma; those standards would then be employed across Michigan’s mental-health, human-services and juvenile-justice systems.
Earlier this year, Wisconsin lawmakers passed a seven-bill package to strengthen the state’s mental health system.
One of the measures calls for new regional hubs that will coordinate care for pediatric mental-health patients. Another bill will require local public-health programs to offer in-home care to severely disturbed children, including telehealth services that allow children to remain in a familiar environment and that help prevent further trauma.
Meanwhile, Bewley is one of four Wisconsin legislators working with Fostering Futures, an initiative to increase awareness about the effects of adverse childhood experiences, or ACEs, around the state. Promoting trauma-informed care has also been a priority of Wisconsin’s first lady, Tonette Walker.
Bewley uses the lessons learned from Fostering Futures to guide her work as a legislator, including how she interacts with constituents and evaluates state policy.
For example, after learning about childhood trauma and its long-term effects, Bewley realized that out-of-school suspensions are “impractical and cruel” in many cases.
“You are putting a child right into the environment that probably causes the bad behavior in the first place,” she says. “School may be the only place where students are receiving care, so if you send them home, you are denying them the one place where they can be fed and taken care of.”
Bewley points to other policies that she now sees in a new light — for example, the importance of the state requiring telephone companies to continue offering landline service, which can literally be a lifeline in an emergency or in a family at risk for violence.
“[This project] has allowed me to realize that legislation can unintentionally cause harm we aren’t looking for,” Bewley says. “People can fall off the edge so easily because of legislation about which we didn’t think carefully.”
School-based policies to prevent bullying, other trauma
Children with mental illness — or who have been through trauma — are more likely to struggle in school because of the negative effects on their developing brains. Most efforts aimed at trauma-informed education have been implemented by individual schools, but the issue has begun to attract the attention of states as well.
Outside the Midwest, for example, the state of Washington has “compassionate schools,” which focus on students who are chronically exposed to stress and trauma. Teachers and other staff receive special training; discipline is handled through “restorative justice,” a technique that focuses on repairing harm in lieu of punishments such as detention.
Lawmakers in Vermont, Massachusetts and Pennsylvania are also considering measures to create schools that are more supportive of children affected by trauma. The bill in Vermont, for example, would integrate screenings for childhood trauma into health care settings.
Every state in the Midwest has taken on the issue of bullying, and several new bills have been considered during this year’s legislative sessions. Minnesota’s HF 826/SF 783, signed into law in April, strengthens the state’s old law by requiring school policies on bullying and by providing new state support for teacher training.
The measure also includes “cyberbullying” in state statute and allows for school policies to cover the use of electronic technology and communications off school premises — if that use is seen to “disrupt student learning or the school environment.”
Legislation has also been introduced in Michigan (SB 74) to address concerns about cyberbullying.
The bill is meant to complement legislation already on the books in Michigan to deal with bullying. But many legislators — and the governor — agree that cyberbullying is a serious concern that needs to be addressed more forcefully.
“Spreading something about another student is so much easier and much more prevalent today because of the instant nature of social media,” Sen. Glenn Anderson says.
Anderson started working on the state’s current bullying law about 10 years ago after learning that a member of his staff had been a victim. And the need for the legislation was amplified by a tragedy right in the state’s capital: a Lansing teenager took his own life after being tormented in school.
Anderson says he was at first hesitant to get in touch with the grieving family.
“I did not want to inject myself into their sadness and what they were dealing with,” he says. But after waiting a bit, Anderson contacted the family.
“I was surprised to learn they absolutely wanted to help work on some legislation.”
In fact, the current law is named Matt’s Safe School Law after the young man who helped inspire the efforts to prevent future tragedies. SB 74 would update that law to include cyberbullying.
Under the proposal, schools would be required to include cyberbullying in the anti-bullying policies they are currently required to create. The bill also includes language that, for the first time, would require school districts to report incidents of bullying to the state once a year.
Current law does not require districts to report back to the state to determine whether the legislation is working.
“If the state wanted to review what is going on around the state,” Anderson says, “it would have to seek the information from over 400 districts.”
As of late April, Anderson’s bill was being considered by a Senate committee. He is hopeful that it will pass this year.
“Bullying is so detrimental to [children’s] feeling of self-worth, their interaction with other students, their success as a student, and their achievement. ... It’s very difficult to concentrate on algebra when you’re scared for your own safety and you’re being constantly harassed,” he says.