Adverse Childhood Experiences and Child’s Brain Development by Dr. Patricia Avila, Pediatrician

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Did you know that suffering a potentially traumatic event during childhood also known as ACE or Adverse Childhood Experience can have long lasting negative effects on a child’s health, brain development, and life potential? 

Adverse Childhood Experiences can include experiencing violence, abuse, neglect, witnessing violence in the home, loosing a family member, mental health issues in a parent, substance/alcohol abuse by a parent, or instability from divorce or having a parent become incarcerated. 

These events lead to what is called toxic stress. Research shows that this toxic stress negatively changes a child’s brain and body by affecting the child’s brain development, hormonal system and immune system. These changes can persist for years and can lead to long term behavioral, mental, physical health problems.

The toxic stress from ACEs on brain development can impact a child’s potential to: 

  • Develop normally – leading to delays in development.
  • Focus and learn – leading to learning disabilities, dropping out of school, lack of future job opportunities.
  • Make decisions – leading to increase risk taking behaviors such as involvement in drugs and unprotected sex, unwanted or teen pregnancy.
  • Develop mental illness – leading to increase depression, anxiety, and rates of suicide.
  • Form healthy, stable relationships – leading to continuing this cycle of toxic stress in their children and families.

Research also shows that toxic stress from Adverse Childhood Experiences negatively affects a child’s body and can lead to chronic health problems like: 

  1. Obesity.
  2. Cancer.
  3. Heart disease.
  4. Autoimmune problems.
  5. Asthma and chronic lung disease.
  6. Headaches.
  7. Early death from general poor health.

The more of these events a child has suffered, the higher the risk of developing these long-term problems.

The GOOD NEWS is that we can do something about this! Research also shows that we can PREVENT and UNDO the harm done and the future harm on a child’s brain and body. There are some simple things that parents/caregivers can do at home to help regulate a child’s stress response and change the negative impacts of the stress hormones to keep them healthy and on track with brain development.

These include providing our children with: 

1. Supportive and nurturing relationships.
a. Tell them and show them how loved, special, and important they are.
b. Spend quality time doing activities that they enjoy. Simple activities like making art, dancing, cooking, playing games, reading, and singing together are excellent choices.
c. Keep connections outside the home with friends and family members.
2. Regular physical activity. Recommendation for 1 hour of physical activity which does not have to be all at the same time. These can include sports, dance parties, hula hooping contests, hiking, playing tag, chasing the family dog, or anything you can think of to get your child physically active.
3. Healthy meals.
a. Avoid high sugar foods/drinks. Avoid high fat foods or foods/snacks high in carbohydrates.
b. Include fruits and vegetables with every meal. 5-9 servings of fruits/veggies per day are recommended. Fruits and veggies provide nutrients that no other foods can provide.
c. Include foods rich in healthy Omega 3 fatty acids such as fish, nuts, avocados, flax seeds.
4. Restful sleep.
a. Keep a routine with a regular bedtime.
b. Make sure the bedroom is quiet, calm and free of distractions.
c. Avoid all electronics including cell phone, tablet, computer, and TV 1-2 hours prior to bedtime.
5. Getting mental health care for yourself as parent/caregiver and for your child.
6. Practicing mindfulness.
a. This can include meditation, breathing exercises, and prayer.
b. Talk with your child about how they are feeling physically and emotionally.
c. Practice talking about, writing down, or drawing what you are grateful for each day with your child.

All of these will build connections in their brains to help them succeed in school, behave in ways you would expect and become happier, healthier, and more successful.
When parents and caregivers manage stress in positive ways as well, your brain also changes in ways to make you happier and healthier.

Learn ways to manage your stress as a parent/caregiver:

  1. Know what is stressing you out. When you know what exactly it is, you can better deal with it.
  2. Ask yourself “can I do something about this?” If the answer is no, then let it go and focus on something else. If the answer is yes, break it down to small steps so that it is not overwhelming.
  3. Have faith. Think of other times you have overcome challenges. It has been proven that people who attend church, pray or practice other forms of spirituality have less stress.
  4. Relax. Use breathing exercises, meditation, listen to music, or take a nap.
  5. Form healthy habits for yourself by getting good sleep, exercising, and eating well.
  6. Take time for yourself like reading a book, picking up a hobby, or spending time with friends.
  7. Make connections with others. Have a support network that includes friends and family. Don’t be afraid to ask for help.
  8. You are never alone. Your child’s Pediatrician or Family Doctor can also be a great resource and support person for you. They can help give you ideas, resources, and help connect you with others who can help.

Additional resources:
Crisis Text Line Text HOME to 741-741 to connect with a Crisis Counselor. It is Free and is available 24/7.
National Domestic Violence Hotline 1-800-799-SAFE (7233) or text LOVEIS to 22522. Available 24/7.
Childhelp National Child Abuse Hotline 1-800-4-A-CHILD, 1-800-422-4453 or chat/text at www.childhelphotline.org. Available 24/7.

Amazing Brain Series of booklets to help parents/caregivers:
http://preventchildabuse.org/wp-content/uploads/2016/02/ABSapps.pdf
preventchildabuse.org/wp-content/uploads/2016/02/ABSwhateveryparent.pdfpreventchildabuse.org/wp-content/uploads/2016/02/ABStrauma.pdfpreventchildabuse.org/wp-content/uploads/2016/02/ABSteen.pdf

Other websites with great ideas for parents/caregivers:
https://childdevelopmentinfo.com/family-building/everyday-practices-to-make-your-child-feel-loved/#gs.4csgtk
https://childdevelopmentinfo.com/family-building/family-life-is-important-for-kids-mental-health-and-adjustment-to-life/#gs.4csmks

5 Tips for Practicing Empathy During the COVID-19 Pandemic

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With the current coronavirus pandemic going on around the world there have been many changes and disruptions in nearly every aspect of daily life. For many, change is difficult and with the added stresses of the economy, whether you have a job or not, are able to put food on the table and preventing you/others from getting sick, you may be feeling overwhelmed with anxiety and stress. The thought of the unknown and what’s going to happen next can affect your mental health as well.

One way in which we can combat the unknown is to show empathy towards others. There are many benefits to empathizing with others which may help you feel less alone and more connected with your loved ones and your community. Im times of uncertainty, empathy allows us to reach out and help others that need it most.

Empathy allows us to:

  • Boost our social connectedness in our communities so that we may increase helping behaviors.
  • Improve our ability to regulate our emotions during times of stress.
  • Better manage our anxieties and stress without feeling overwhelmed.

Some people are naturally empathetic in nature, but many need a little help to remember what empathy means and how they can cultivate their own empathy skills. The good news is this emotional skill can be learned – here are some ways to build empathy:

  • Listening to others.
  • Engage in acts of service.
  • Put yourself in another person’s shoes.

Tips for Practicing Empathy in Your Community

Staying connected – one of the best ways to fight feelings of isolation is to reach out to others. Showing empathy and engaging in helpful actions can increase your feelings of social connectedness. While practicing social distancing, self-isolation and quarantine, you may consider writing a note to a special friend or family member you haven’t spoken to in a while. You may also use your skills such as sewing for example, to help make masks for those in need. Maybe you can reach out to your neighbors, friends or family members that are unable to go out and buy groceries and offer to buy them and place them on their doorstep.

Be aware – how has the COVID-19 pandemic affected your life? Are your kids now being home schooled? Do you have food and other necessities to sustain healthy living during this uncertain time? How do you think your friends, family, neighbors or complete strangers would answer these questions? It is important to remember that while you may be doing okay, others are not. Many have lost their jobs, cannot feed their families and are unable to make healthy lifestyle choices. Some can’t afford childcare so they can continue to work and many are suffering from anxiety and depression due to their situation and circumstances.

“Empathy and the willingness to understand are a critical part of compassion which leads to action. Think of others and look for ways you can help in your community.”

Be kind – It’s okay if your routine is ever changing and what your ‘normal’ was is no longer possible. If your kids are watching too much television or are playing video games longer than you’d like, that’s okay. Everyone, all ages, are trying to cope with the unknown. This is a lot to deal with and everyone copes with fear, stress and anxiety differently. Focus on being kind to one another. Seek the positives in your new ‘normal’ and practice self-compassion by becoming emotionally flexible, navigate through your emotions and give yourself and your family a break.

Be considerate – sometimes we are quick to criticize others without knowing their circumstances or understand their situation that may impact their choices. Some people may feel overwhelmed with an overload of conflicting information from various outlets. While you cannot control how others behave, you can control your own actions by sharing only the facts by reliable sources. You can also gently remind others to kindly wash their hands, practice social distancing and stay home if they show any symptoms of COVID-19.

Help others – when the world feels unpredictable, find tangible ways to do good and make things better for others. This may provide comfort and a sense of control and empowerment.

Some ways to practice empathy:

  • If you are financially stable, look for ways you can support others who may be struggling.
  • Support your local businesses by buying food or gift cards from them and encouraging others to do the same.
  • Only buy what you need for the week, don’t overbuy.
  • Make care packages for healthcare workers, elderly neighbors or those who may have lost their jobs.
  • STAY HOME – follow the guidelines outlined by the CDC. Practice social distancing.

At NOAH, we practice empathy for our patients, staff and community daily. This is especially important during a public health crisis. Practicing empathy during COVID-19 not only opens your mind to what others are experiencing, but it also reminds us that we are in this together. Our behavioral health consulting and traditional outpatient counseling behavioral health staff work alongside our medical and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.

Food Safety Tips During COVID-19

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Food safety tips during COVID-19 for grocery shopping, takeout and delivery and meal delivery kits.

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COVID-19 Tips for Caregivers

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Home care tips for caregivers tending to people with suspected or confirmed cases.

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National Child Abuse Prevention Month by Katelyn Millinor, LPC

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April is National Child Abuse Prevention Month. This month and throughout the year NOAH encourages all individuals and organizations to play a role in making our community a better place for children and families. By ensuring that parents have the knowledge, skills, and resources they need to care for their children, we can help prevent child abuse and neglect by creating strong and thriving children and families in our communities. Research shows that protective factors are present in healthy families. Protective factors are conditions or attributes that lessen risk and promote healthy development and well being. 

Promoting the following protective factors is one of the most effective ways to reduce the risk of child abuse and neglect:

  • Nurturing and attachment.
  • Knowledge of parenting and of child/youth development.
  • Parental resilience.
  • Social connections and support.
  • Concrete support for parents.
  • Social and emotional competence of children.

April is a time to celebrate the vital role that communities play in protecting children and strengthening families. Focusing on ways to connect with families is the best thing our community can do to strengthen families and prevent child abuse and neglect. Visit www.childwelfare.gov for more information.

What is child abuse and neglect?
When a parent, guardian or custodian inflicts or allows the infliction of physical, sexual or emotional abuse, neglect, exploitation or abandonment.

  • Physical abuse includes non-accidental physical injuries such as bruises, broken bones, burns, cuts or other injuries.
  • Sexual abuse occurs when sex acts are performed with children. Using children in pornography, prostitution or other types of sexual activity is also sexual abuse.
  • Neglect occurs when children are not given necessary care for illness or injury. Neglect also includes leaving young children unsupervised or alone, locked in or out of the house, or without adequate clothing, food, or shelter. Allowing children to live in a very dirty house which could be a health hazard may also be considered neglect.
  • Emotional abuse of a child is evidenced by severe anxiety, depression, withdrawal or improper aggressive behavior as diagnosed by a medical doctor or psychologist, and caused by the acts or omissions of the parent or caretaker.
  • Exploitation means use of a child by a parent, guardian or custodian for material gain.
  • Abandonment means the failure of the parent to provide reasonable support and to maintain regular contact with the child, including providing normal supervision, when such failure is intentional and continues for an indefinite period.

What you can do:
Take an active role in your children’s lives. Learn about their activities and people with whom they are involved. Stay alert for possible problems.

  • Make sure your children know that they can talk to you about anything that bothers or confuses them.
  • Teach children accurate names of private body parts and the difference between touches that are “okay” and “not okay.”
  • Educate children about the difference between good secrets (such as birthday surprises) and bad secrets (those that make the child feel unsafe/uncomfortable).
  • Monitor children’s use of technology, including cell phones, social networking sites, and messaging. Review their friend’s lists regularly and ask about any people you don’t recognize.

How to Report?
A report of suspected child abuse, neglect, exploitation or abandonment is a responsible attempt to protect a child. Arizona law requires certain persons who suspect that a child has received non-accidental injury or has been neglected to report their concerns to DCS or local law enforcement (ARS §13-3620.A). You may be a child’s only advocate at the time you report the possibility of abuse or neglect. Children often tell a person with whom they feel safe about abuse or neglect. If a child tells you of such experiences, act to protect that child by calling the toll free Arizona Child Abuse Hotline at 1-888-SOS-CHILD (1-888-767-2445).

Statistics

  • Every year more than 3.6 million referrals are made to child protection agencies involving more than 6.6 million children.
  • About 1 in 4 girls and 1 in 13 boys experience child sexual abuse at some point in childhood.
  • The United States has one of the worst records among industrialized nations – losing on average between 4 and 7 children every day to child abuse and neglect.
  • At least 1 in 7 children have experienced child abuse and/or neglect in the past year, and this is likely an underestimate.
  • Children living in poverty experience more abuse and neglect. Rates of child abuse and neglect are 5 times higher for children in families with low socio-economic status compared to children in families with higher socio-economic status.

At NOAH, we offer behavioral health consulting and traditional outpatient counseling programs and services where these highly skilled and trained behavioral health staff work alongside our medical and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.

Coping Tips During the Coronavirus Pandemic

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For the first time ever, we’ve been asked to practice social distancing, self-quarantine and even shelter in place. These changes affect the way we work, socialize and live. Until our circumstances return to “normal” we have a few tips to help you cope with these temporary changes.

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