What Has Happened to You?

When I was first joined the Mott Foundation, Bob Schwartz of the Juvenile Law Center gave me Juvenile Justice 101 tutorial in which he described how kids are categorized as mad, sad, bad or just can’t add determines which system they are funneled into. I couldn’t help but think of that simple categorization when I read the study a The Prevalence of Adverse Childhood Experiences (ACE) in the Lives of Juvenile Offenders. Are we labeling young people as “bad” when really they are just very, very scared and sad?

The study looks at the prevalence of ACEs among the juvenile offenders population in Florida (about 65,000 young people). If you need a refresher, ACEs include: emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, violent treatment towards mother, household substance abuse, household mental illness, parental separation or divorce, and having an incarcerated household member. Basically you get points for every experience that creates a composite score. As the authors describe, “The ACE composite score is precisely a measure of “what has happened to you.” The original research on ACE found that an enormous number of health issues are correlated with high ACEs – the more ACEs, the more stress. The more stress, the more it impacts the development of your brain, body and emotional health.

The findings from the study found that the most prevalent experiences were family violence, parental separation or divorce, and household member incarceration. The one big difference in experiences between genders was that “sexual abuse was reported 4.4 times more frequently by females than by males (31% and 7%, respectively).” Another difference in the experiences between genders is that young women had more types of traumatic experiences. The study reports, “Of the males, 27.4% reported five or more ACEs compared to 45.1% of the females.”

The study became more interesting as the authors came to the conclusion “ACEs not only increase the chances of involvement in the juvenile justice system, but increase the risk of re-offense.” The discussion section is worth reading as they argue for several practices to be put into place:
1) Early identification of ACEs and primary prevention: The authors emphasize early childhood development and engaging parents, teachers and health care providers.

2) Periodic screening children for ACE: “When school or health professionals observe behaviors such as overeating, substance abuse, smoking, disruptive classroom behavior, and bullying, a screening for a history of ACEs can be obtained and used to determine the appropriate intervention. When school personnel observe such behaviors, suspending or expelling students from school may deprive youth of the safest environment they can access. In-school programs to address bullying, disruptive classroom behavior, and aggression can keep youth in safe environments while they learn self-regulatory skills.”

3) Building childhood resilience and increasing protective factors: This of course includes strong relationships with adults, mentoring and youth development programs.

4) Trauma-informed care: The authors point out that at the point youth enter the juvenile justice system, powerful interventions are needed. The authors recommend “implementation of trauma screening and assessment for all youth entering the system, as well as the provision of evidence-based, trauma-informed treatment and interventions for youth identified.”

The authors mention a law in Washington (SHB 1965, 2011) designed to reduce ACEs. I’m wondering if this might be a new avenue for policy development in the context of advocating for the well-being of our young people. Can we set the expectation that children who have been traumatized during their childhood will receive appropriate trauma-informed care and interventions. Can we begin to ask the question “What has happened to you in your life” as a starting point for interactions with youth in all youth serving organizations?