Hopeful Frontiers in Pediatric Medicine
Meanwhile, there is hope closer at hand. Change is afoot in pediatric medicine
and education. Jack Shonkoff, MD, the director of Harvard’s Center on the
Developing Child, believes that the new science on toxic stress in childhood will
inspire subspecialists in medicine to share data and treatment systems. “It’s one
science,” Shonkoff emphasizes in a recent radio interview. “It’s as much about
health as it is about education. It’s as much about pediatrics as it is about
gerontology.” With the scientific evidence at hand, he says, “Now you have both
a science-based imperative and a moral responsibility to say, ‘We can’t allow
this to go by.’ We must respond urgently to this, as we have to other public
health threats.”
In June 2014, the Academy of American Pediatrics, or AAP, convened a
symposium on the long-term dangers of childhood toxic stress, urging
pediatricians, policy makers, and federal agencies to develop a stronger national
response. To help further those efforts, the AAP has recently launched a new
Center on Healthy, Resilient Children, which will promote education for
pediatricians and other clinicians on protecting the brain during development,
provide tools to help pediatricians screen families for traumatic stress, and
connect parents with appropriate resources.
Robert W. Block, MD, past president of AAP, and head of the Center on
Healthy, Resilient Children, says “Pediatric medicine now recognizes the real
and significant effects when children grow up with toxic and persistent stress.”
The battle to help intervene in the lives of children facing adversity and
trauma has, however, only just begun. According to Robin Karr-Morse, “We are
a nation of idiots about infancy. We are the only postindustrial First World
nation that hasn’t signed the U.N. Rights of the Child. We have a huge black eye
in our nation regarding our rate of child abuse and neglect.” Adding to the
problem is the fact that, “our child care system in this country is still deplorable.
It is simply not keeping up with the need. We’re leaving a lot of children
behind.”
So far, the greatest changes are happening, slowly, in pediatrics, social
services, the juvenile justice system, and K–12 educational settings that serve at-
risk students. Living in poverty and violence can add to an accumulation of
stress that blunts individuals’ learning potential, and derails their emotional and
physical health, for life. This gives us a new framework to rethink our schools
and how schools can become more trauma-sensitive to students.
Adverse Childhood Experiences research also should prompt new questions
about military service and who should serve, potentially using ACE
questionnaires as a screening tool to help determine who might be more prone to
long-term PTSD—as well as to help encourage those returning from combat to
seek treatment to lessen their trauma. ACE research also shows a new way to
help understand and treat addiction by seeing it as self-medicating—an
unsuccessful attempt to lessen the pain created by adversity.
In some cities, counties, and states, people from different sectors such as
health care, business, child welfare, and schools are coming together to make
their communities trauma-informed and resilient. Nearly thirty states, including
Washington State, Iowa, Maine, and Vermont, have already begun collecting
Adverse Childhood Experiences data in order to better develop state public
health programs that address child and family problems, including child abuse,
domestic violence, and substance abuse.
“Communities are working together to change organizations and systems to
replace blame-shame-punishment rules and policies with understanding-
nurturing-solutions and approaches,” says Jane Stevens, founder of the news site
ACEsConnection.com
and the social network
ACEsTooHigh.com
. “Although
much of the reason for doing this is economic—it can save a city hundreds of
millions of dollars in reduced costs for health care and social services—it also
helps people and their communities to become healthier and happier places to
live.”
Meanwhile, real people are hurting.
I encourage you to go take a look at the adult you see in the mirror, and try to
see, in your eyes, the child you once were. Pay attention to his or her story.
Think back to the many strategies and modalities now available to help you
come back to who it is you really are—and become even better, wiser, stronger
for the journey. And promise that child you once were that you will take him or
her on a quest to heal.
LET’S CONTINUE THE CONVERSATION ABOUT ADVERSE CHILDHOOD EXPERIENCES
In order to help further our conversation, connect us, and help you to find and
share resources and stories of hope, I invite you to join me on my community
forums. You can do this in one of three ways:
• Join my community discussion on my Facebook page at
https://www.facebook.com/donnajacksonnakazawaauthor
.
• Join my CHILDHOOD INTERRUPTED blog at
www.donnajacksonnakazawa.com
.
• Be part of my CHILDHOOD DISRUPTED group forum on
AcesConnection.com
, at
http://www.acesconnection.com/g/childhood-
disrupted
, where I’m moderating a CHILDHOOD DISRUPTED discussion
group. All are invited.
I’ll look forward to hearing from you. Let’s work together by sharing stories
about how to find a healing path—so that you can finally live the life you
deserve.
ACKNOWLEDGMENTS
Being grateful for the good in one’s life is one of many ways to enhance well-
being, and I’m glad to have a chance to express my appreciation here to the
many people who helped make this book possible.
My reporting benefited from the generosity and wisdom of many scholars,
scientists, and researchers, but I am especially grateful to Vincent J. Felitti, MD,
for his kindness, generosity, and patience during our many conversations and
communications. As the “scientific fathers” of Adverse Childhood Experiences
research, Felitti and Robert Anda, MD, have created a life-changing paradigm
for better understanding human suffering and healing. I am grateful to them for
allowing me to delve into their findings.
The generosity of spirit shown by the following leading experts and thinkers
in the fields of neuroscience, neurobiology, and immunology provided great
help, and none of them should underestimate how helpful they have been:
Margaret McCarthy, PhD, professor of neuroscience at the University of
Maryland School of Medicine, welcomed me to shadow her in her lab, and
served as an unflagging scientific advisor to whom I turned when I had questions
large and small. DeLisa Fairweather, PhD, associate professor of toxicology at
the Johns Hopkins Bloomberg School of Public Health and the Mayo Clinic,
generously helped me understand her important work on women and Adverse
Childhood Experiences, and how these intersect with female immunology. Dan
Siegel, MD, child neuropsychiatrist and clinical professor at the University of
California, Los Angeles (UCLA); neuropsychiatrist Ryan Herringa, MD, PhD,
assistant professor of child and adolescent psychiatry at the University of
Wisconsin; and Ruth Lanius, MD, PhD, neuroscientist and professor of
psychiatry and director of the post-traumatic stress disorder (PTSD) research
unit at the University of Western Ontario in Canada, generously provided time
and insights so that I might better understand how Adverse Childhood
Experiences affect the developing brain, our interpersonal biology, and early
development.
I am grateful to the following individuals for conversations that shaped my
understanding of their work and findings: Bernie Siegel, MD; Francine Shapiro,
PhD, senior research fellow at the Mental Research Institute in Palo Alto,
California
;
Mark D. Seery, PhD, associate professor of psychology at the
University at Buffalo; Kerry Ressler, MD, PhD, professor of psychiatry and
behavioral sciences at Emory’s department of psychiatry and behavioral
sciences; and Vicki Abeles, documentarist of
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