Childhood trauma a public health crisis

By Katie Kerwin McCrimmon

Dr. Nadine Burke Harris could easily become despondent over the sick and troubled children she sees in an area of San Francisco that houses a sewage treatment plant and the poor.

Instead, Burke Harris’ eyes light up as she talks about confronting the disturbing topics of childhood trauma and the toxic stress that results from it.

Dr. Nadine Burke Harris sees childhood trauma as a public health crisis that can be reversed.

Dr. Nadine Burke Harris sees childhood trauma as a public health crisis that can be reversed.

That’s because this young doctor is utterly convinced that she can help find effective medical and behavioral treatments to reduce the damage from trauma. What’s more, she sees toxic trauma as a public health battle that can be won. Like smoking or lead poisoning, she’s certain all of us will someday know that adversity in childhood can change our bodies, cause cancer and shorten our lives.

Once we know, we can work together to stop harming kids, Burke Harris says.

Ultimately, Burke Harris predicts that treating the damage from child trauma will be like fighting childhood leukemia.

“Back in the day, pediatric leukemia came with a 90 percent mortality rate,” Burke Harris told hundreds of children’s advocates who gathered Tuesday for the Colorado Children’s Campaign’s annual luncheon at the Denver Center for Performing Arts.

Then, she said, pediatric oncologists created a study group and started testing protocols to figure out which ones resulted in the best survival rates for various types of leukemia.

“It took decades of working together, but now there’s a 90 percent survival rate,” Burke Harris said. “That is what I hope to see happen with this issue of adverse childhood experiences and toxic stress. Let’s lift up (the protocols) that work.”

Burke Harris did her medical training at Stanford after having earned a masters degree in public health from Harvard along with her medical degree from the University of California, Davis.

After opening a clinic in the Bayview-Hunters Point area of San Francisco, Burke Harris was seeing children suffering from both physical and mental health ailments like asthma and anxiety. A colleague shared a study with her that ended up sparking a new mission. It was called “The Relationship of Adverse Childhood Experiences to Adult Health: Turning Gold Into Lead.” The study — known as ACE for short — found that adverse childhood events, like abuse, divorce of a parent or coping with a parent’s alcohol and drug abuse, were incredibly common. The study authors also found a direct link between adverse events in childhood and illnesses later in life. In fact, the more adversity children had suffered, the sicker they were likely to be as adults.

Inspired by the study, Burke Harris began screening the children in her clinic for adverse events.

The results were striking. While the patients were only 8, on average, some already had “ACE scores” of 4 or more, meaning they had experienced that many adverse events. Those who had the highest ACE scores also were sicker.

The correlation with school was remarkable too. Of kids who had a 0 ACE score, only 3 percent had learning and behavioral problems.

“Our kids are not inherently broken. They are manifesting symptoms of a toxin, which is adversity,” Burke Harris said.

For instance, she screens kids for homelessness as a “dose of adversity.”

“It’s just like lead. There’s a certain dose at which your physiology doesn’t work well,” Burke Harris said.

Whenever she gets referrals for children who are acting up in school, instead of immediately writing a prescription for Ritalin, Burke Harris screens the patients for adversity.

She and colleagues have created the Center for Youth Wellness in San Francisco with a triple mission to treat children for adversity, prevent harm through policy changes and research the best treatment methods. (Click here to read a New Yorker profile about Burke Harris and here to view videos about Burke Harris and her work.)

Burke Harris said she’s remarkably hopeful about making progress because there are treatment options that work to help kids do better, among them biofeedback and mindfulness.

“This is not a foregone conclusion that if you grow up in a household or a community where this stuff is going on, this is your lot in life,” she said. “We have the resources, the technology and the wherewithal to be able to address this.”

A good starting point, said Burke Harris, is to “reduce the doses of adversity.”

Second, she suggested the people talk about the harms of hurting children, like she does, everywhere.

“How do you stay hopeful?” asked Chris Watney, president and CEO of the Colorado Children’s Campaign.

“Here’s what’s crazy,” Burke Harris said. “I know, No. 1, based on science … how common this is and No. 2, how much of a public health crisis this is. We are going to make huge strides on this in the next 30 years.”

Burke Harris said individuals can make a difference by spreading the word that, “early exposure to adversity affects your health, your behaviors and lifelong outcomes.”

Once the connections are widely known, prevention and healing will be relatively swift.

“In my mind, it’s a no brainer, and what’s crazy is I get to be part of that movement.”



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