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Understanding and Responding to Early Childhood Trauma: Systems and Program Approaches . Beth L. Green, Ph.D. green@npcresearch.com www.npcresearch.com March 18, 2009. Informing policy, Improving programs. Presentation Overview. What is Early Childhood Trauma?

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Understanding and Responding to Early Childhood Trauma:Systems and Program Approaches

Beth L. Green, Ph.D.

green@npcresearch.com

www.npcresearch.com

March 18, 2009

Informing policy, Improving programs


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Presentation Overview

  • What is Early Childhood Trauma?

  • Some Effective Programs for Preventing or Reducing the Impact of Early Childhood Trauma?

  • Development of a “Trauma-Informed” Early Childhood System?


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What is Early Childhood Trauma?

  • Definition: A reaction to a traumatic event or situation that overwhelms a child’s ability to cope, and inhibits him/her from moving forward with life in a normal manner

  • Multiple causes: Child abuse/neglect, family violence, crisis situations, extreme environmental events, prolonged absence of a supportive caregiving environment, chronic poverty, homelessness, etc.

  • Vulnerability: Very young children are particularly vulnerable to traumatic & stressful events


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Consequences of Early Childhood Traumatic Stress

  • Impedes Brain Development

  • Impedes Emotional Development

  • Impacts Behavior and Physical Health

  • Effects are Cumulative

  • Effects are Long-Term



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Some Effective Approaches

  • Prevent maltreatment

  • Evidenced-based parenting and parent-child attachment programs

  • Effective mental health and substance abuse treatment for parents

  • Early identification & treatment among young children (e.g., mental health consultation in child care, pediatric screening)

  • Evidence-based therapeutic treatments for identified trauma


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Example Local Programs

Oregon Relief Nurseries

  • Provide home visitation, therapeutic center-based care, case management, parenting education and support, and respite care

  • Serve very high risk families with children ages 0-5, including those with involvement in child welfare system

  • Recent evaluation showed several important outcomes


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Improved Parenting Outcomes

More stable family functioning

Improved quality of parent-child interactions

More frequent reading to young children


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Improved Family Stability

Increased employment

Increased income

Less frequent ER use


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Decreased Involvement with Child Welfare

Less time in foster care

High rate of reunifications – 100% for RN vs. 64% statewide


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Example Local Programs

Oregon Healthy Start

  • Universal screening of first-birth mothers

  • Intensive home visiting and parent education and support for high risk families

  • Recent evaluation showed several important outcomes

    • Improved quality parent-child interactions

    • Improved frequency of reading to young children

    • Improved immunization rates

    • Reduced parenting stress


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Reduced Maltreatment Among Healthy Start Families


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What is a “Trauma Informed” Early Childhood System?

  • An preventive system that effectively prevents, identifies, and treats trauma as early as possible

  • A coordinatedsystem that prevents re-traumatization

  • A well-trained system in which providers understand issues related to early childhood trauma

  • An effectivesystem that uses evidence-based approaches and evaluates outcomes


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Developing A Trauma-Informed Early Childhood in Multnomah County

  • 2005: Children’s Relief Nursery (CRN, Portland)

    • Grant from SAMSHA to be a Community Treatment Site within the National Child Traumatic Stress Network (NCTSN)

    • National network intended to advance knowledge about effective approaches to childhood trauma

  • Portland CRN is one of the few nationally focused on the 0-3 population, twofold goals:

    1. To provide services to prevent and ameliorate early childhood trauma

    2. To begin to develop a “trauma informed” early childhood system



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Multnomah County Policy Panel on Early Childhood Trauma Nursery

  • A high-level group of policymakers charged with:

    • Defining key elements of a Trauma Response System for young children

    • Committing and developing resources for this system

    • Identifying an agency or group to lead this effort


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Current Status of ECT System Nursery

  • Multnomah County Commission for Children, Families, and Communities responded to an RFP and now is leading this effort (working with NWECI)

  • A few have committed resources (County, United Way)

  • Actively seeking further support for this effort