Landmark Congressional Hearing on Childhood Trauma
What a landmark Congressional Hearing on Childhood Trauma last Thursday!
I imagine Doctors Vincent Felitti and Robert Anda, co-principals of what is now known as the CDC-Kaiser ACE Study, were heartened and deeply moved by that July 11, 2019 House Oversight and Reform Committee hearing on childhood trauma. Twenty-one years after their study findings were published, the swelling momentum to raise awareness about childhood trauma (aka Adverse Childhood Experiences) in order to prevent and to help those affected had finally made it to a Congressional Committee hearing!
For readers who are not familiar with the background on this study, I encourage you to read Jane Stevens, Founder/Editor of the ACEs Connection Network’s, article, “The Adverse Childhood Experiences Study — the largest, most important public health study you never heard of — began in an obesity clinic.”
Congressional Hearing on Childhood Trauma – Committee on Oversight & Reform
Congressional Hearing in the Committee on Oversight and Reform on Childhood Trauma July 11, 2019. Source: Article by Elizabeth Prewitt, ACEs Connection Staff, “Personal stories from witnesses, U.S. Representatives provided an emotional wallop to House Oversight and Reform Committee hearing on childhood trauma.”
Elizabeth Prewitt, ACEs Connection Staff, has done a remarkable job of summarizing this hearing in her post, “Personal stories from witnesses, U.S. Representatives provided an emotional wallop to House Oversight and Reform Committee hearing on childhood trauma.”
What may surprise readers is just how many witnesses and U.S. Representatives have experienced childhood trauma. I’d like to quote a few of their testimonials from Elizabeth’s article:
- Chairman Elijah Cummings (D-IL) set the tone early in the hearing by recalling his childhood experience of being in special education from kindergarten to sixth grade, and being told he would “never be able to read or write.” Still, he “ended up a Phi Beta Kappa and a lawyer.”
- Near the end of the hearing, Rep. Mark DeSaulnier (D-CA) spoke about the “personal and private,” multi-generational experience of addiction and abuse in his family, including the death of his father by suicide. (Click here for video of Rep. DeSaulnier’s statement). He said he often recalls the metaphor he heard years ago about children drowning downstream before someone finally said “let’s go upstream to see why.”
- William Kellibrew, the first witness, described how he finally got help from a skilled and caring therapist after he became suicidal years after his brother and mother were killed—and his life threatened— by her partner. He asked to yield the reminder of his time to have his grandmother in the room stand and be acknowledged. The room erupted in applause as it did at the end of the survivor’s panel with a rare standing ovation by the representatives and everyone else in the room. Dan Press, legal advisor to the Campaign for Trauma-Informed Policy and Practice, said he had never seen a standing ovation in a hearing in his 45 years of working with Congress.
Why Understanding Childhood Trauma Is So Critical
Background
Much of what we now know about ACEs — commonly known as childhood trauma — has been advanced in the recent 10 years, even though Doctors Anda and Fellitti first published their study findings in 1998.
ACEs (commonly referred to as childhood trauma) refers to traumatic or stressful events that happen to a child before age 18.
As I stated above, the concept of ACEs and their physical and emotional health consequences came out of a study conducted in the late 1990s by Kaiser Permanente, San Diego and the Centers for Disease Control (CDC).[i] It was a huge study involving 17,000 Kaiser patients. The study participants were mostly white, mostly middle to upper-middle class, all had health insurance, and all had jobs. In other words, it wasn’t considered to be a population society typically thinks of as having much childhood trauma.
Participants were asked to fill out a 10-question questionnaire. Then, their answers were compared to their medical histories. The results showed that experiencing adverse childhood experiences were linked to a variety of physical and emotional health problems across a lifetime.[ii]
These health problems included: depression, substance abuse or addiction to alcohol or other drugs, obesity, diabetes, suicide attempts, heart disease, cancer, STDs, broken bones, smoking, and having a stroke. The more ACEs a person had, the more likely they were to have or develop one or more of these health problems.
10 types of Adverse Childhood Experiences Measured in the ACE Study Questionnaire
Of the 10 questions asked:
Five were personal, meaning it was something done to the child. These five included:
- physical abuse
- verbal abuse
- sexual abuse
- physical neglect
- emotional neglect.
Five were related to other family members’ behaviors that affected the child. These five included:
- a parent who abused alcohol or other drugs or was addicted to alcohol or other drugs
- a mother (or step-mother) who was a victim of domestic violence
- a family member in jail
- a family member diagnosed with a mental illness
- the disappearance of a parent through divorce, death, or abandonment.
The study found that almost two-thirds of the 17,000 participants had experienced at least one ACE. Of those with one ACE, 87% had two or more. The more ACEs the person experienced, the more likely they were to have developed an alcohol (or other drug) use disorder, marry someone with an alcohol (or other drug) use disorder, have depression,[iii] or any of the other health problems listed above.
Since that original CDC-Kaiser ACE Study, many other kinds of adverse childhood experiences have been identified. These other ACEs include: poverty, racism, bullying, watching a sibling being abused, losing a caregiver (grandmother, step-mother, grandfather, etc.), homelessness, surviving and recovering from a severe accident, living in a war zone, witnessing a grandmother abusing a parent, involvement with the foster care system, and involvement with the juvenile justice system, as examples.
What is the Connection Between Experiencing Childhood Trauma and Physical and Emotional Health
When a child experiences a traumatic or stressful event before the age of 18 — such as those measured in the CDC-Kaiser ACE Study — that child may experience toxic stress.
Toxic stress is what happens when a person’s fight-or-flight stress response is repeatedly triggered – like that which occurs when repeatedly coping with stressful or traumatic events as a child. This fight-or-fight stress response is one of the survival instincts built into humans to keeps us safe when threatened with danger.
When it is triggered, a cascade of stress hormones causes a series of changes in the body to prepare it to fight or run – changes like the tensing of the muscles, increasing the heart rate, and shutting down of the digestive system. These changes enable us to jump out of the path of an oncoming car or experience superhuman strength to lift a fallen beam pinning our child to the ground. The physical act of jumping out of the way or lifting the beam – averting the danger – allows the body to return to normal functioning. This triggering and resolution is known as positive stress.
But when our fight-or-flight stress response is repeatedly triggered, and we never physically fight or run, the cascade of stress hormones and physical changes “marinate.” They “sit” in body organs and tissues – like the brain, heart, muscles, and stomach. This is when stress becomes toxic.
The consequences of toxic stress include migraines, stomach problems, muscle aches, sleep difficulties, tension headaches, anxiety, depression, difficulty concentrating, racing heartbeat, and skin problems, to name a few. When children experience toxic stress, it “weakens the architecture of the developing brain, with long-term consequences for learning, behavior, and both physical and mental health,” according to the Center on the Developing Child Harvard University.[iv]
And it is these toxic stress consequences that are the far, far deeper problem of having experienced ACEs, commonly known as childhood trauma.
What Can You Do?
There is a huge movement working to raise awareness about programs, resources, and practices already in play across the country when it comes to treating, preventing and intervening with childhood trauma. You can learn about these by visiting the ACEs Connection Network and scrolling through the “Communities” section. I urge you to read through this website.
And I urge you to contact your Congressional leaders and ask them to get involved — this landmark Congressional hearing is just a beginning as far as federal legislation — but what a powerful, wonderful beginning it is!
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[i] Fellitti, Vincent J., MD, FACPA, Anda, Robert F., MD, MS, Nordenberg, Dale, MDC, Williamson, David F., MS, PhDB, Spitz, Alison M., MS, MPHB, Edwards, Valerie, BAB, Koss, Mary P., PhDD, Marks, James S., MD, MPHB, “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults, The Adverse Childhood Experiences (ACE) Study,” American Journal of Preventative Medicine, May 1998 Volume 14, Issue 4, Pages 245–258, DOI: https://doi.org/10.1016/S0749-3797(98)00017-8.
[ii] Felitti, Vincent J. “The Relation Between Adverse Childhood Experiences and Adult Health: Turning Gold into Lead,” The Permanente Journal vol. 6,1 (2002): 44-47, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220625/ (accessed 4.12.19).
[iii] Anda, Robert, MD, MS and Co-Principal Investigator Adverse Childhood Experiences (ACE) Study, “The Health Impacts of Growing Up With Alcohol Abuse and Related Adverse Childhood Experiences: The Human and Economic Costs of the Status Quo,” http://www.nacoa.net/pdfs/Anda%20NACoA%20Review_web.pdf (accessed 5.7.19).
[iv] Center on the Developing Child Harvard University, “Toxic Stress Derails Healthy Development,” https://developingchild.harvard.edu/resources/toxic-stress-derails-healthy-development/ (accessed 7.2.19).
Lisa Frederiksen
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Thank you Lisa. What great coverage of an absolutely epic topic. it’s equivalent to the germ theory and how much it took for the world to be convinced of “invisible little creatures” that could cause death.
actually, this is even bigger.
Nice work. Loved your article. thank you
Thank you Donna – I appreciate your comment very much!