Giving and Leading: Phoenix Children’s Hospital ACES Forum

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The Third Annual Adverse Childhood Experiences Forum will be held November 2nd by the Phoenix Children’s Hospital and the Dion Initiative. A new report will be unveiled at the forum that looks at the impact of adversity on the well-being of communities in our state, and what’s needed to help ensure resilience in individuals and the community. We’ll get more on the forum and report from Nicole Stanton, the founder of the Dion Initiative, and Dr. Vinny Chulani of Phoenix Children’s Hospital.

TED: TONIGHT'S EDITION OF ARIZONA GIVING AND LEADING FOCUSES ON THE THIRD ANNUAL ADVERSE CHILDHOOD EXPERIENCES FORUM WHICH WAS HELD THIS MORNING. SPONSORED BY PHOENIX CHILDREN'S HOSPITAL AND THE DION INITIATIVE. THE FORUM INCLUDED THE RELEASE OF A STUDY THAT LOOKS AT THE IMPACT OF THE ADVERSITY ON THE WELL-BEING OF THE COMMUNITIES. JOINING US IS NICOLE STANTON, THE FOUNDER OF THE DION INITIATIVE, AND DR. VINNY CHULANI, THE SECTION CHIEF FOR ADOLESCENT MEDICINE AND MEDICAL DIRECTOR FOR THE HOMELESS YOUTH OUTREACH PROGRAM AT PHOENIX CHILDREN'S HOSPITAL.
TED SIMONS: THE ACES FORM, WHAT IS THIS ALL ABOUT?
NICOLE STANTON: WELL ACES ARE ADVERSE CHILDHOOD EXPERIENCES AND THEY RANGE FROM VIOLENCE IN THE HOME, DRUG USE IN THE HOME AND INCARCERATED PARENTS AND ANY VIOLENCE PERPETRATED ON A CHILD. BE IT SEXUAL, EMOTIONAL OR PHYSICAL. ANY BAD THING, THOSE ARE ADVERSE CHILDHOOD EXPERIENCES OR ACES.

TED: AND THE IDEA IS TO LOOK AT HOW THINGS THAT HAPPEN IN THE HOME AFFECT THE COMMUNITY?

NICOLE STANTON: NOT JUST THE COMMUNITY BUT THE INDIVIDUAL CHILD. WHAT THE STUDY SHOWS IS THE EFFECT OF THESE ACES ON A CHILD'S LONG TERM HEALTH AND THAT IS NOT A GOOD CORRELATION. THESE HAVE LONG TERM HEALTH CONSEQUENCES ON CHILDREN.

TED: TALK ABOUT THOSE LONG TERM CONSEQUENCES, THOSE CAN'T BE GOOD.

DR. VINNY CHULANI BRAIN DEVELOPMENT REALLY CONTINUES FROM ALL THE WAY BEFORE BIRTH TO ADULTHOOD AND THERE'S A CONSTANT PROCESS OF BRAIN REMODELING THAT GOES ON AND WHEN CHILDREN ARE EXPOSED TO TOXIC STRESS, TO ADVERSE EXPERIENCE, EMOTIONAL ABUSE OR PHYSICAL NEGLECT, IT CHANGES THEIR NEURO BIOLOGY, IT ACTIVATES THEIR FLIGHT RESPONSE AND THAT CHANGES WAY THE BRAIN IS WIRED AND WHAT WE FIND IS THAT THE FOR ACES EXPOSURE CHILDREN HAVE HAD -- MORE LIKELY IN THE FUTURE TO DEVELOP HEALTH PROBLEMS, NOT JUST PHYSICAL BUT EMOTIONAL. WHAT WERE SEEING IN ADULTS WHO HAVE THE GREATER EXPOSURE TO ACES ARE MORE LIKELY TO HAVE SUFFER FROM ASTHEMA AND SHORTER LIFE EXPECTANCIES AND GREATER RATE OF DISEASE AND GREATER INCIDENCE OF HAVING ATTEMPTED SUICIDE, THE IMPACT IS TREMENDOUS AND LIFE LONG.

TED: AS FAR AS THE RESEARCH ON THESE ACES ON KIDS AS THEY EVOLVE INTO ADULTS, EVOLVING ALL THE TIME?

NICOLE STANTON: IT'S UPDATED ROUTINELY BUT THE STUDIES FROM A COUPLE YEARS AGO, SHOWS THAT ARIZONA'S CHILDREN ARE NOT FARING WELL COMPARED TO THEIR NATIONAL COUNTERPARTS.

TED: I WAS GOING TO ASK IF ARIZONA PRESENTS SPECIAL CHALLENGES.

NICOLE STANTON: THE INCIDENCES OF ONE ACE IS HIGHER IN ARIZONA AND OF HAVING MORE THAN ONE ACE IS HIGHER. WHEN YOU TALK ABOUT HAVING MORE THAN ONE ACE, IN CARD GAMES THAT MIGHT BE A GOOD THING BUT HERE IT IS NOT. WHEN YOU COUPLE ACES TOGETHER. THE HEALTH CONSEQUENCES GO UP WHEN YOU COUPLE ACES TOGETHER AND IF YOU HAVE ONE BAD THING GOING ON IN A HOME, YOU LIKELY HAVE MORE THAN ONE BAD THING GOING ON AND YOUCAN SEE HOW THEY START TO CLUSTER.

TED: INDEE AND SO WHEN THEY CLUSTER HOW DO YOU APPROACH THIS? IS THERE A PLAN FOR RESILIENCE, TO GET THE INDIVIDUAL AND THE COMMUNITY AS WELL, BETTER ABLE TO COPE WITH THESE THINGS?

DR. VINNY CHULANI: IT'S REALLY A COMMUNITY AND PUBLIC HEALTH ISSUE AND THAT'S WHY WE'RE RAISING AWARENESS REGARDING ADVERSE CHILDHOOD EXPERIENCES, IT REQUIRES A SYSTEM WIDE RESPONSE. I, FOR EXAMPLE, IN MY PRACTICE, SEE THIS A LOT. I SEE YOUNG PEOPLE COMING TO US WITH TRAUMA, HARD HITS THEY'VE TAKEN. ONE OF THE FIRST THINGS WE BEGIN WITH IS TREATING. HOW DO WE IDENTIFY THOSE AFFECTED BY THIS? AND THEN MOVING ON TO WHAT ARE THE BEST WAYS FOR US TO INTERVENE AND THAT'S WHY BUILDING THE BODY OF EVIDENCE AND LITERATURE COMES IN.

TED: DO YOU SEE -- OBVIOUSLY, YOU SEE IT IN CHILDREN, BUT WHEN DO YOU USUALLY SEE IT IN ADOLESCENTS AND YOUNG ADULTHOOD? WHEN DO THESE THINGS UNFORTUNATELY FLOWER?

DR. VINNY CHULANI: I WOULD SAY IT PRESENTS IN MANY WAYS ALL ALONG THE LIFESPAN. IN YOUNG EARN CHILDREN IT MIGHT PRESENT AS THE YOUNGER CHILD WHO IS AFRAID TO EXPLORE THEIR ENVIRONMENT. AS YOUNG CHILD FOR EXAMPLE WHO MIGHT NOT BE DOING WELL IN SCHOOL. IN ADOLESCENCE IT MIGHT PRESENT AS ACTING OUT AND REBELLION AND RISK BEHAVIORS. IN ADULTHOOD IT OFTEN PRESENTS AS DEPRESSION AND IN THE ORIGINAL ACES STUDY, IT CAME OUT OF A OBESITY CLINIC AND WHAT THEY FOUND, AMONG THE INDIVIDUALS WHO WERE DOING WELL AND LOSING WEIGHT, THEY WERE DROPPING OUT OF THE OBESITY CLINIC AT A RATE THAT WAS GREATER THAN THOSE -- IT WAS A SURPRISE. IF YOU WERE DOING SO WELL AND LOSING WEIGHT, WHY WERE YOU DROPPING OUT OF THE CLINIC? THEY FOUND THERE WAS A SIGNIFICANT HIGHER RATE OF SEXUAL ABUSE AMONG THE WOMEN WHO DROPPED OUT AND KEEPING THE WEIGHT ON WAS THEIR WAY OF DEALING WITH THE STRESS THEY WERE DEALING WITH.

TED: WE'VE GOT TO FIND A BETTER WAY TO DEAL, TO BECOME MORE RESILIENT. EASY FOR ME TO SAY, BUT IT'S GOT TO BE AWFUL COMPLICATED.

NICOLE STANTON: IT IS AND IT'S A MULTIGENERATIONAL THING, WE CAN'T JUST LOOK AT CHILDREN, YOU HAVE TO LOOK AT IT AS DEALING WITH THE WHOLE FAMILY EXPERIENCE AND AS THE FOLKS FROM PCH WILL TELL YOU, IF YOU CARE ABOUT CHILDREN, YOU HAVE TO CARE ABOUT FAMILIES, BECAUSE THIS CAN'T BE DEALT WITH BY CHILDREN ALONE. WE AS GROWNUPS HAVE TO INSTITUTE POLICIES AND DO A BETTER JOB OF TEACHING PARENTS HOW TO PARENT AND CREATING THE SAFE ENVIRONMENTS.

TED: HOW DO YOU TEACH A PARENT TO BE A BETTER PARENT?

NICOLE STANTON: THERE ARE A LOT OF PROGRAMS OUT THERE THAT DO THAT AND THE DEPARTMENT OF HEALTH SERVICES ARE IMPLEMENTING, TRIPLE P IS ONE OF THEM THAT I'M FAMILIAR WITH AND THE RESULTS COMING OUT OF THOSE PROGRAMS ARE PROMISING.

TED: OK. SO THAT'S A NICE THING TO HAVE SOMETHING PROMISING COMING OUT OF THOSE PROGRAMS AND, OBVIOUSLY, THIS REPORT, THE IDEA IS TO GET SOME STUFF DONE. WHAT DO WE TAKE FROM THIS REPORT? WHERE DO WE GO FROM HERE?

DR. VINNY CHULANI: I THINK RAISING AWARENESS OF THE IMPACT OF ACES IN THE COMMUNITY AND THE EXTENT OF ITS REACH AND THE NUMBER OF ADULTS AFFECTED BY IT, IT'S WHERE WE BEGIN AND TRANSLATE THAT KNOWLEDGE INTO ACTION AND CREATING AND IDENTIFYING INDIVIDUALS AND FINDING OUT HOW DO WE INTERVENE AND THE BEST WAY DO IT?

TED: AND DOES THE REPORT SUGGEST, HAVE CONCLUSIONS AND RECOMMENDATIONS AND SUCH?

DR. VINNY CHULANI: SOME OF THE RECOMMENDATION IN THE REPORT REALLY INCLUDE -- THERE ARE THINGS WE KNOW THAT MAKE A DIFFERENCE. SUPPORTIVE RELATIONSHIPS AND HEALTHY ATTACHMENTS, HEALING RELATIONSHIPS, WE KNOW THAT THESE MAKE A DIFFERENCE. WE KNOW THAT THERE'S A SET OF FACTORS THAT PROMOTE HEALTHY FAMILIES AND COMMUNITIES AND INVESTMENTS IN EARLY CHILDHOOD EDUCATION AND QUALITY -- AND QUALITY CHILDCARE AND PARENT SUPPORT PROGRAMS. THESE ARE THE COMMON SENSE THINGS AND THESE ARE EASY INVESTMENTS TO PUT IN PLACE.

TED: ALL RIGHT, THE ACES FORUM AND REPORT. GOOD TO HAVE YOU BOTH HERE. WE APPRECIATE IT.

Nicole Stanton,founder of the Dion Initiative; Dr. Vinny Chulani, Phoenix Children's Hospital.

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