CHILDREN IN CHAOS

Identifying and Assisting Young Children Living in Substance-Abusing Families

David Love, MFT Valley Community Counseling Services Stockton, CA [email protected]

CHILDRENS’ POTENTIAL

• Any newborn is prepared to learn all the languages on the planet.

• They are prepared to be composers, artists, scientists, . . .

• They can learn sign language 8-12 mos. before they can speak.

Making the Connection: Children in Chaos

PRIMARY TRAUMA IN CHILDREN*

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Each year 5 million children in U.S. experience an extreme traumatic event

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40% will develop some form of chronic neuro-psychiatric problem

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Most problems classified as anxiety disorders with post-traumatic stress disorder being most common

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Trauma event will impair emotional, academic and/or social functioning

*B.D. Perry(1999)

CHILD MALTREATMENT IS LEADING CAUSE OF TRAUMA-RELATED DEATH FOR CHILDREN UNDER FIVE*

• Two-thirds occur at hands of parents under the influence of drugs or alcohol • 51% victims of abuse • 44% victims of neglect • 5% multiple forms * CASA

CHILDREN OF SUBSTANCE- ABUSING PARENTS*

• 2.7 times more likely to be physically or sexually abused • 4.2 times more likely to be neglected • Children also significantly more likely to be abused by others *CASA

PRENATAL EXPOSURE TO STIMULANT DRUGS VS HOME ENVIRONMENTS*

• Cognitive Problems-Related strongly to chaotic home environment • Behavioral Problems-Related to prenatal exposure to stimulant drugs *Ira J. Chasnoff, M.D.

The Impact of Family Chaos on Brain Development in Children

Impact of Stress on Brain Development NORMAL TRAUMA 2:1 ratio Cortical Modulation Ratio ~1:1 ratio

Adverse Childhood Experiences Study

Vincent J. Fellitti, MD The largest study of its kind ever done to examine the health and social effects of adverse childhood experiences (n=17,000 adults; RR=70.5%)

Death Disease & Social Problems Adoption of Health-Risk Behavior Social, Emotional & Cognitive Impairment Disruption of Neurodevelopment Adverse Childhood Experiences

POPULATION ATTRIBUTABLE RISK

(Per cent attributable to ACE)

       Alcoholism – 65% Drug Abuse – 50% IV Drug Abuse – 78% Current Depression – 54% Chronic Depression – 41% Sexual Assault – 62% Domestic Violence – 52%

THE ORIGINS OF ADDICTION Vincent Felitte, MD Kaiser Permanente Medical Care Program

“The major factor underlying addiction is adverse childhood experiences that have not healed with time and that are overwhelmingly concealed from awareness by shame, secrecy and social taboo.”

UNDERSTANDING TRAUMATIZED CHILDREN

The Pathway of Fear in the Brain Amygdala

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Brain’s rapid response system to fear that sends the body into high alert

Pathway of Fear in the Brain

Hippocampus

• Processing and storing information • Evaluate threats by putting them into context of previous experiences

Thinking Through Fear

FRONTAL CORTEX

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Reins in the amygdala and calms the body if the threat is determined to be insignificant

UW Extension, 2006

SYMPTOMS OF CHILDHOOD TRAUMA  Attachment Problems  Alcohol and Drug Abuse  Depression  Violent Behavior  Suicidal Behavior  Mood Disorders  Anxiety Disorders  Behavioral Problems

CHILDHOOD TRAUMA AND NEUROPSYCHIATRIC CONDITIONS

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Post-traumatic Stress Disorder

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Complex Trauma

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ADD-ADHD

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Dissociative Disorders

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Conduct Disorders

Implications for Learning

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Traumatized children often spend so much time in the lower level brain in a state of persisting fear that they consistently focus on non-verbal vs. verbal cues

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May be very intelligent but can’t learn easily

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must do verbal learning when calm

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Learning needs to be more experience-based

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when traumatized children are stressed they are reactive/ reflexive vs. accessing cognitive solutions

“Too Scared to Learn…”

Children who do not feel safe live in a state of emergency. Their energy is consumed by crises, making it impossible for them to focus on learning to read.

-“Too Scared to Learn” by Jenny Horsman, 2000

INTERVENTION TREATMENT

Specialized Programs

 Pre-school  K-3  K-6  Clinic-based

ASSESSMENT TOOLS

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Parent Stress Index (PSI)

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Addiction Severity Index (ASI)

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Trauma Symptom Checklist for Children (TSCC) (TSCYC)

SUPPORTING TRAUMATIZED CHILDREN-Interventions

Parenting Skills for Caretakers of Traumatized Children Socialization Skills for Children

PARENT EDUCATION

 Must understand the developmental needs of their children  Must recognize the damage the environment is doing to their children  Must learn how to provide a safe environment for their children and make the changes to accomplish the goal

SOCIALIZATION SKILLS FOR CHILDREN

 Must gain age appropriate developmental skills  Must be able to function in social environments  Must gain balance between chronological, emotional and cognitive development.

SUPPORTING TRAUMATIZED CHILDREN-Treatment

Parent-Child Interaction Therapy (PCIT) Trauma-Focused Cognitive-Behavioral Therapy (CBT) Trauma-Focused Play Therapy

COMMUNITY RESOUCES-

Prevention, Intervention & Treatment

California Victims of Crime Program CHAT Centers Human Service Agency Mental Health First 5

WEBSITES

www.zerotothree.com

(zero to three www.musc.edu/cvc (Child Abuse Tx Manual) www.childtrauma.org

(Child Trauma Academy) www.apsac.org

(American Professional Society on the Abuse of Children) www.calib.com/nccanh/ (National Clearinghouse on Child Abuse and Neglect Information) www.casacolumbia.org (Columbia University) www.johnbriere.com