2. CHILDREN IN CHAOS Identifying and Assisting Young Children Living in Substance-Abusing Families David Love, MFT Valley Community Counseling Services Stockton, CA davidlove@vccsinc.org

3. 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.

4. Making the Connection: Children in Chaos DomesticViolenceSubstanceabuse Elder Abuse Child Abuse and Neglect Sibling Abuse Incest

5. *B.D. Perry(1999) PRIMARY TRAUMA IN CHILDREN*  Each year 5 million children in U.S. experience an extreme traumatic event  40% will develop some form of chronic neuro-psychiatric problem  Most problems classified as anxiety disorders with post-traumatic stress disorder being most common  Trauma event will impair emotional, academic and/or social functioning

6. 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

7. 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

8. 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.

9. The Impact of Family Chaos on Brain Development in Children

10. 2:1 ratio NORMALTRAUMA ~1:1 ratio Cortical Modulation Ratio Impact of Stress on Brain Development

11. 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%)

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

13. 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%

14. 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.”

15. UNDERSTANDING TRAUMATIZED CHILDREN

16.  Brain’s rapid response system to fear that sends the body into high alert Amygdala The Pathway of Fear in the Brain

17. Pathway of Fear in the Brain Hippocampus Processing and storing information Evaluate threats by putting them into context of previous experiences

18. UW Extension, 2006 Thinking Through Fear FRONTAL CORTEX FRONTAL CORTEX Reins in the amygdalaReins in the amygdala and calms the body if and calms the body if the threat is determined the threat is determined to be insignificant to be insignificant

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

20. CHILDHOOD TRAUMA AND NEUROPSYCHIATRIC CONDITIONS Post-traumatic Stress Disorder Complex Trauma ADD-ADHD Dissociative Disorders Conduct Disorders

21. Implications for Learning  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  May be very intelligent but can’t learn easily  must do verbal learning when calm  Learning needs to be more experience-based  when traumatized children are stressed they are reactive/ reflexive vs. accessing cognitive solutions

22. “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

23. INTERVENTION TREATMENT

24. Specialized Programs Pre-school K-3 K-6 Clinic-based

25. ASSESSMENT TOOLS Parent Stress Index (PSI) Addiction Severity Index (ASI) Trauma Symptom Checklist for Children (TSCC) (TSCYC)

26. SUPPORTING TRAUMATIZED CHILDREN-Interventions Parenting Skills for Caretakers of Traumatized Children Socialization Skills for Children

27. 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

28. 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.

29. SUPPORTING TRAUMATIZED CHILDREN-Treatment Parent-Child Interaction Therapy (PCIT) Trauma-Focused Cognitive-Behavioral Therapy (CBT) Trauma-Focused Play Therapy

30. COMMUNITY RESOUCES- Prevention, Intervention & Treatment California Victims of Crime Program CHAT Centers Human Service Agency Mental Health First 5

31. WEBSITES www.zerotothree.comwww.zerotothree.com (zero to three www.musc.edu/cvcwww.musc.edu/cvc (Child Abuse Tx Manual) www.childtrauma.orgwww.childtrauma.org (Child Trauma Academy) www.apsac.orgwww.apsac.org (American Professional Society on the Abuse of Children) www.calib.com/nccanh/www.calib.com/nccanh/ (National Clearinghouse on Child Abuse and Neglect Information) www.casacolumbia.org (Columbiawww.casacolumbia.org (Columbia University) www.johnbriere.com