On May 13th and 14th, 2013, the Institute for Safe Families and the Robert Wood Johnson Foundation cohosted
The National Summit on ACEs. Our goal for the Summit was to advance the national dialogue on ACEs, trauma, toxic stress and resilience and to focus on creating a shared vision, language and plan of action. This group of national leaders met for two full days at the Independence Visitor Center in Philadelphia. The Summit culminated in a evening symposium, entitled. "Childhood Restored: The Path from Adversity to Wellness." Here is an overview of the Summit, is followed by a series of six short reports from this important and energizing gathering. You also can read more about the Summit at our website www.instituteforsafefamilies.org, under "News from the Summit" and "What's Happening" Here is our first piece, "You Say You Want A Revolution." - Martha Davis, Executive Director, Institute for Safe Families
In 1854, London physician John Snow traced a cholera epidemic to a tainted water pump and launched a revolution in the understanding of health and illness. A hundred and sixty years later, a similar revolution is under way, a ground-shift in the way we think about health and illness, human suffering and strength. It is a revolution with the potential to reshape physical and mental health care practices, schools, social services, juvenile justice systems, communities, families and individual lives. That was the passionate consensus at the
National Summit on Adverse Childhood Experiences (ACEs), held May 13 and 14 in Philadelphia, which drew nearly 200 physicians, nurses, researchers, policy makers and child advocates to share expertise, compare notes and envision a world in which the crucial question to ask of someone suffering physically or emotionally would be not "What's wrong with you?"but "What happened to you?" "What ACEs is doing for the field is making us
question all our assumptions about what happens to human beings," said Sandra Bloom, a psychiatrist and co-director of the Center for Nonviolence and Social Justice at Drexel University in Philadelphia. "ACEs demonstrates that all context matters; every experience human beings have matters to health outcomes." The National Summit, hosted by the Institute for Safe Families and the Robert Wood Johnson Foundation, brought together national and local leaders to discuss the research, policy and practice implications of ACEs. Since the original ACE study was published in 1998, showing that toxic stress in childhood can lead to poor health outcomes for adults, numerous studies have drummed home the same stark conclusion: that childhood adversity-experiences such as living with a mentally ill parent, witnessing violence or suffering physical or sexual abuse-changes the way kids learn, play and grow. Emerging developmental science shows that trauma re-wires the brain, alters the expression of our genes, floods our systems with stress hormones, hikes our risk of engaging in unhealthy behaviors and increases our vulnerability to heart disease, depression, diabetes and a host of other physical and mental health problems. Conference participants-many of whom work directly with children and adults affected by toxic stress-already knew that grim news. And yet, the overriding message of the Summit was one of hope: ACEs are not destiny, but opportunity. If the human brain can be hurt, it can also heal.
Robert Anda was the co-principal investigator of the original ACEs study; he is now a senior consultant to the Centers for Disease Control and Prevention. Fifteen years after publishing the data that launched a new way of thinking about trauma and well-being, he believes in the power of individuals to repair brokenness in themselves and in others. "Our job in doing this work is to help people find meaning in what they've experienced," he said, "so they can take responsibility in changing their own lives, in healing themselves, their families and people around them, in interrupting the intergenerational transmission of toxic stress."For many of the Summit's speakers, who are putting the theory of ACEs into practice and policy in locations from Alaska to Oklahoma to Maine, a particular child or adult became the touchstone for their work.
For Jane Isaacs Lowe, it was a 10-year-old named Reynaldo. Lowe, now senior adviser for program development at the Robert Wood Johnson Foundation, was a young social worker in the South Bronx when Reynaldo met her at his apartment door, saying, "There is something wrong with my mother." When Lowe checked the bedroom, she found the boy's mother tangled in bloody sheets. Lowe hired a gypsy cab to rush mother and son to an emergency room. The mother was admitted; Reynaldo was not allowed to visit because he was under 14. The mother begged Lowe to gather a few items from the family's apartment-a locket, a basketball, some clothing-for Reynaldo and his siblings. She died, at 33, and Lowe fulfilled her request, bringing the items to the children, by then in foster care. That was 1971, Lowe said, and doctors and researchers didn't yet understand how childhood trauma translated into adult suffering. Now, she said, "We understand how a child who is exposed to violence or neglect or chronic homelessness may develop physical and health problems later in life. We can improve the systems that are designed to help people in need."
Lowe and others at the Summit emphasized that doing so will take a concerted, collective effort, bringing together people and agencies that have not typically collaborated: health care providers and educators, probation officers and social workers, policy makers and clergy members, community activists and mental health advocates. "It is our job...to improve life for a new generation of children," Lowe said. Addressing and preventing ACEs may mean new ways of delivering health care, by integrating behavioral and physical health in community settings that also include parenting classes, mindfulness workshops, employment counseling and nutrition education. It means educating health care providers so that they understand the mechanisms and impact of toxic stress and have tools for preventing and treating it.
Nadine Burke Harris, who heads the Center for Youth Wellness in San Francisco, urged Summit participants to adopt a full-spectrum response to ACEs-just as, for clinical care, there are inpatient and outpatient clinics, emergency rooms and intensive care units. "We need protocols and tools for early detection" of childhood adversity, she said, and a range of interventions to treat both its symptoms and root causes. That vision will require innovative funding strategies, said Susan Dreyfus, president and CEO of Families International. She described "social impact bonds," in which businesses or foundations invest funds with a specific social outcome, such as reducing recidivism among offenders; the government repays investors only if the interventions succeed.
Summit speakers drove home the need for a public health campaign about ACEs, so that everyone-providers and patients, teachers and students, judges and juries, parents and children-will come to understand the connection between childhood trauma and adult well-being. "As people who are profoundly committed to this cause," Dreyfus said, "we have to be chronically dissatisfied until we know this ACE science is hard-wired into all systems that interface with children and their families."
With Gratitude
An event such as this is only possible with generous support. In addition to the extraordinary support from our co-host, The Robert Wood Johnson Foundation, national sponsors included the American Academy of Pediatrics, the Academy on Violence and Abuse, Futures Without Violence, the National Council for Behavioral Health, Prevent Child Abuse America, and the Scattergood Behavioral Health Foundation. In addition, we had a wonderful team of local sponsors, which included: The American Academy of Pediatrics, The PA Chapter; The Children's Hospital of Philadelphia; The CHG Charitable Trust as recommended by Carole Haas Gravagno; The First Hospital Foundation; Health Partners; Multiplying Connections, A Project of the Health Federation of Philadelphia; The Philadelphia Department of Public Health; The Philadelphia Foundation, Prevent Child Abuse PA; St. Christopher's Hospital for Children; The Stoneleigh Foundation, and Suspected Child Abuse and Neglect (SCAN) of the PA AAP
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