It can be a vicious cycle, but it doesn’t have to be. First, parents who have experienced adverse childhood experiences (ACEs) as they were growing up are more likely to have difficulties that become the next generation of ACEs for their children. These intergenerational ACEs include depression, suicide risk, alcohol and drug abuse, substance abuse problems, and relationship problems. While many parents do not repeat the violence that they experienced and/or were exposed to as children, the mental health consequences and unhealthy coping behaviors associated with childhood victimization can compromise parenting skills and create adversity for their children. The best parenting interventions in the world may not be effective if we don’t meet parents where they are at in terms of their own life experiences and struggles to be the kind of parents they want to be.
This realization led the Institute for Safe Families to develop an educational resource about ACEs for parents that was launched on May 14th at the National ACEs Summit in Philadelphia, Pennsylvania. Partnering with Parents: Apps for Raising Happy Healthy Children is a colorful, parent-friendly booklet designed to look like a smartphone App. QR codes (Quick Response Codes), a type of matrix barcode, are featured throughout the booklet so parents can access resource information quickly by scanning the image with their smartphone. You won’t find potentially stigmatizing words like trauma, toxic stress, or even adverse childhood experiences (except for acknowledging the research) and there are no startling statistics. Language that might be unfamiliar such as “resiliency” is nowhere to be found although that’s what this resource is all about. While our focus was to create a tool that health care providers can use to help educate parents about ACEs at pediatric visits, Parenting with Parents (PWP) can be used in any parent-serving setting.
PWP uses a positive approach to meet parents where they are at by acknowledging that parents want to do their best and parenting can be hard work. It helps parents to become more trauma-informed by describing how tough times during their childhood can affect them as adults and how these experiences can affect their own children. The conversation about ACEs begins by describing that while all stress is not bad, stress related to ACEs can pile up and cause a wide range of physical, mental, and behavioral health problems for children and adult survivors. Simple strategies for parents to reduce stress, including an App for deep breathing, are highlighted.
One of the many things we’ve learned from the expansive body of ACE research, and most recently, universal education with embedded assessment for domestic violence using the safety card approach (go to www.futureswithviolence.org for more information), is that self-assessment for sensitive issues can be very effective. Like the quizzes about depression, sleep problems and other psychosocial issues that are often featured in magazines, the center of this booklet is a self-administered questionnaire about ACEs. The “violent” ACEs--child abuse, neglect and exposure to domestic violence are lifted out of the questions and highlighted on one page with questions about household dysfunction (mental illness, substance abuse, incarcerated family member, etc.) on the opposing page. Parents are asked to answer the questions for themselves and their children. By doing so, parents can see how they are changing the future for their children and/or recognize that their children are facing some of the same challenges that they did. You may be surprised to see some new ACE questions about bullying, discrimination, and physical punishment. The World Health Organization’s International ACEs data collection project, the Philadelphia Urban ACE Study, and other research is expanding our thinking about what other questions should be included as part of ACEs assessment. Parents who answer yes to any of the questions are encouraged to talk to their health care provider about how these experiences may be affecting them or their children now.
Self-assessment not limited to just asking about ACEs. There are several questions that ask parents about what helped them through tough times when they were growing up. The central theme of resiliency for children and parents is constructed with building blocks that describe the skills that can help us to overcome adversity. There are specific examples and sample wording that parents can use to promote secure, healthy relationships with their children, teach empathy skills, help their children learn how to self-regulate, and grow their self-esteem.
The booklet, which is co-branded by several organizations including the American Academy of Pediatrics, Prevent Child Abuse America and the Scattergood Foundation, can be downloaded for review in PDF format at www.instituteforsafefamilies.org (where you will also find other Partnering with Parent resources such as the Amazing Brain Series booklets for parents on early brain development and trauma). The camera ready version for printing can be obtained by contacting the Institute for Safe Families. We hope you will find this free parenting resource on ACEs useful and welcome your feedback.
Thank You to the Scattergood Foundation
This blog signals the end of an extraordinary experience as the Inaugural Scattergood Scholar on Child Behavioral Health and new beginnings as I continue to work on what we can do to support families and children and prevent future ACEs. I am full of ideas and optimism because, together, as a team, we are making a difference every day.