HAVING SOMEONE TO LISTEN, HAVING SOMEONE GIVE YOU PRAISE, BEING ABLE TO SHARE A PAINFUL SECRET, RESEARCHERS ARE LEARNING THAT THESE SIMPLE THINGS MAY BE EFFECTIVE TOOLS IN RESCUING KIDS FROM THE EFFECTS OF AN ABUSIVE CHILDHOOD. FROM A SAN DIEGO CITY ATTY. CASEY GWINN, AN ADVOCATE FOR ABUSED CHILDREN IS THE AUTHOR OF A NEW BOOK ABOUT KIDS EXPOSED TO TRAUMA. THE BOOK EXPLORES HOW SOME SIMPLE TECHNIQUES CAN OFTEN TURN A CHILD'S LIFE AROUND. AND AS ONE OF THE FIRST BOOKS TO BRING DETAILS OF THE ADVERSE CHILDHOOD EXPERIENCES STUDY TO THE GENERAL PUBLIC. JOINING ME IS CASEY GWINN, HIS BOOK IS CALLED CHEERING FOR THE CHILDREN, CREATING PATHWAYS TO HOPE FOR CHILDREN EXPOSED TO TRAUMA. CASEY, WELCOME TO THE SHOW. THANK YOU. GREAT TO BE WITH YOU. MAUREEN CAVANAUGH:. DR. VINCENT FELITTI IS HERE, HE IS ONE OF THE PRINCIPAL INVESTIGATORS OF THE ADVERSE CHILDHOOD EXPERIENCES STUDY. YOU'RE WELCOME. MAUREEN CAVANAUGH: , CASEY, YOU HAVE A QUOTE FROM 10-YEAR-OLD JAZZ AND AT THE BEGINNING OF THE BOOK, SHE SAYS NO ONE HAS EVER CHEERED FOR ME BEFORE. THE CHANCE FOR THE TITLE OF THE BOOK? SHE REALLY DID. IT WAS AMAZING MOMENT. A NUMBER YEARS AGO A CAMP HOPE WHEN WE WERE RUNNING IT IN EAST SAN DIEGO COUNTY AND I WAS JUST PRAISING HER AT A CAMPFIRE FOR BEING KIND TO THE FROGS THAT WERE JUMPING AROUND ON THE SHORE OF THE LAKE ONE AFTERNOON AND THAT NIGHT I HONORED HER IN FRONT OF THE WHOLE GROUP AND ALL THE KIDS CHEERED FOR HER. AFTER THE CAMPFIRE WAS OVER SHE CAME UP TO ME AND SHE SAID THANK YOU, NO ONE HAS EVER CHEERED FOR ME BEFORE. IT HAD NEVER DAWNED ON ME THAT MOST KIDS GROWING UP WITH VIOLENCE AND TRAUMA AND ABUSE AND WITNESSING DOMESTIC VIOLENCE, NOBODY HAS EVER CHEERED FOR THEM. IT WAS ONE OF THE MOST SIGNIFICANT MOMENTS OF PER WEEK TO HAVE 50 PEOPLE CLAPPING FOR HER BECAUSE OF HER KINDNESS AND HOW SHE HAD SHOWN KINDNESS TO FROGS. THAT WAS THE INSPIRATION FOR THE NAME OF THE BOOK. MAUREEN CAVANAUGH: WHAT DOES THE ME TO'S CHAIR FOR A CHILD? IT MUST BE THAN JUST SAYING YOU ARE AWESOME OR SOMETHING LIKE THAT. IT REALLY IS. AS WE HAVE JUMPED DEEPER AND DEEPER AND DEEPER INTO THIS WHOLE NOTION OF HOW DO YOU CHANGE THE ENDINGS FOR KIDS EXPOSED TO TRAUMA, IT IS. CLEAR THAT YOU CAN'T JUST BE CHEERING FOR THEM BECAUSE THEY DID SOMETHING WELL OR BECAUSE THEY ACHIEVED SOMETHING. YOU HAVE TO BE FOCUSING ON WHO THEY ARE AND WHO THE ARE BECOMING. YOU HAVE TO GO TO CHARACTER ISSUES AND YOU HAVE TO GO DEEP DOWN AND SAY I BELIEVE IN YOU. I BELIEVE IN YOU BECAUSE OF WHO YOU ARE. YOU ARE VALUABLE BECAUSE OF WHO YOU ARE CONDO BECAUSE OF SOMETHING YOU HAVE DONE OR BECAUSE OF SOMETHING THAT IS HAPPENING TO YOU. AND THAT'S CORE PIECE, I THINK IS WHAT WE MEAN BY CHEERLEADING. IT IS A DEEP ABIDING LONG-TERM COMMITMENT, USUALLY FROM AN ADULT, TO INVEST IN A CHILD I JUST BASICALLY SAY AT THE BEGINNING OF THE BOOK EVERY CHILD NEEDS ONE PERSON TO PASSIONATELY BELIEVE IN THEM, LOVE THEM KOCHER FOR THEM, SUPPORT THEM AND THEY CAN GET THROUGH A LOT OF BAD THINGS IN THEIR LIVES IF THEY HAD THAT ONE PERSON. THAT ONE PERSON HAS TO BE LONG-TERM.IT CAN'T JUST BE SOMEBODY THAT COMES AND GOES FROM THERE LIFE. MAUREEN CAVANAUGH: JAZMINE WAS ONE OF THE KIDS AT YOUR CAMP FOR ACCUSED -- ABUSED KIDS CALLED CAMP HOPE. THESE KIDS HAVE BEEN THROUGH A LOT. WHY WOULD SOMETHING AS SIMPLE AS A SINCERE COMPLIMENT OR CHEERLEADING AS YOU CALL IT, WHY WOULD THAT MAKE A DIFFERENCE? I THINK THE REASON IT IS SO TRANSFORMATIVE FOR KIDS IS BECAUSE IN SO MUCH OF THE LIVES OF CHILDREN EXPOSED TO TRAUMA THEY ARE LIVING CON NUMBER ONE, IN A STATE OF WHAT WE CALL HYPERVIGILANCE. THEY ARE CONSTANTLY ON A JUDGE ON ALERT AND CONSTANTLY DEAL WITH HIS CHRONIC TRAUMATIC STRESS IN THEIR LIVES. ONE THING THAT HAPPENS A CAMP IS WE GET THEM AWAY FROM THAT STRESS. AND THEN ONCE WE KIND OF HELP THEM REGULATE AND LEARN HOW TO SELF REGULATE AND CALM THEMSELVES DOWN THEN THEY ARE ABLE TO ABSORB THAT KIND OF PRAISE AND AFFIRMATION AND ENCOURAGEMENT AND SUPPORT. WE HELP THEM LEARN TO DO THINGS WHICH IS CALLED COMPETENCY. AS THEY LEARN A SKILL IT CAUSES THEM TO RISE UP. CONFIDENT THE IN WHAT WE CALL RESILIENCY ARE TWO THINGS THAT HAVE A PROFOUND IMPACT IN CHILDREN'S LIVES. SOME OF IT IS INNATE IN SOME KIDS BUT A LOT OF KILLS YOU DON'T -- KIDS YOU CAN BUILD A. WHEN YOU BUILD IT YOU SEE SOMETHING HAPPEN IN THEM THAT IS TRANSFORMATIVE. WE CAN LOVE THESE KIDS AT SEVEN, EIGHT OR 10, AND QUITE FRANKLY IN A LOT OF CASES WE WILL LOCK THEM UP AT 17 OR 18 OR 19 OR 20. THEY WILL BE PREGNANT AT 15. WE WILL BE DEALING WITH ALL KINDS OF OTHER ISSUES IN THEIR LIVES IF WE DON'T FIGURE OUT HOW TO MITIGATE THAT TRAUMA EARLY. MAUREEN CAVANAUGH:. DR. VINCENT FELITTI, CHEERING FOR THE CHILDREN PREFERENCES YOUR WORK IN DEVELOPING THE ADVERSE CHILDHOOD EXPERIENCES OR THE ACE STUDY. THE SURVEY ASKS PEOPLE ABOUT CHILDHOOD TRAUMA AND FINDS HEALTH AND SUBSTANCE ABUSE RISKS LINKED TO THOSE NUMBERS WERE TO THOSE ANSWERS TO THOSE QUESTIONS. WHAT KIND OF QUESTIONS -- THE SURVEY ASKED? WE STUDIED 10 CATEGORIES OF ADVERSE LIFE EXPERIENCES DURING CHILDHOOD AND ADOLESCENCE. THREE OF ABUSE AND THAT WAS HEAVY DUTY PHYSICAL ABUSE. I DON'T MEAN SPANKING, I AM TALKING SERIOUS BEATING WITH THIS CAUSTICS AND OTHER OBJECTS. CONTACT SEXUAL ABUSE, NOT SO MANY FLASHING A KID, BUT ORAL, ANAL, OR VAGINAL CONTACT SEXUAL ABUSE. AND A MAJOR EMOTIONAL ABUSE, BASICALLY HEAVY-DUTY HUMILIATION, YOU ARE THE STUPIDEST KID I HAVE EVER SEEN, ETC. OR AS A MAN TOLD ME RECENTLY HIS FATHER USED TO LINE THEM UP AS CHILDREN AND TELL THEM YOU KIDS OUGHT TO JUST BE TAKEN OUTSIDE AND SHOT. TWO CATEGORIES OF NEGLECT, EMOTIONAL AND PHYSICAL NEGLECT AND FIVE CATEGORIES OF MAJOR HOUSEHOLD DYSFUNCTION, GROWING UP IN A HOME WHERE MOTHERS ARE BEING BEATEN, GROWING UP AT HOME FOR SOMEONE WAS CHRONICALLY DEPRESSED SUICIDAL, MENTALLY ILL GROWING UP IN A HOME WHERE ONE OF THE MEMBERS OF YOUR HOUSEHOLD HAS BEEN IMPRISONED DURING YOUR CHILDHOOD OR ADOLESCENCE, GROWING UP WITHOUT BOTH BIOLOGICAL PARENTS AND -- THE 10th ONE, WELL, THAT ESCAPES ME. SUBSTANCE ABUSE. YES, GROWING UP AT HOME WERE SOMEONE IS AN ALCOHOLIC OR DRUG USER. THOSE WERE THE 10 THAT WE STUDIED. AND THE AMAZING THING IS IN A CLEARLY MIDDLE-AGED MIDDLE-CLASS POPULATION, HOW REMARKABLY COMMON THOSE WERE. OF COURSE, YOU WOULD HAVE TO ASK EVERYONE TO FIND THAT OUT. MAUREEN CAVANAUGH: THAT IS THE POINT. WHEN YOU DO AS PEOPLE AND YOU DO FIND THIS OUT AND IF THEY SAY YES TO A NUMBER OF THESE DIFFERENT TRAUMA OR ACE EXPERIENCE QUESTIONS WHAT HEALTH RISKS OR OTHER LIFE RISKS ARE INCREASED? WHAT, A SURPRISING DIVERSITY OF THEM. MANY OF THEM, A DIRECT RESULT OF AREAS COPING MECHANISMS THAT ARE PUT IN PLACE TO TRY TO FEEL BETTER. EATING. SIT DOWN AND HAVE SOMETHING TO EAT, YOU WILL FEEL BETTER. OKAY, OBESITY IS A BIG RELEVANCE TO THIS. ALCOHOLISM. SITDOWN, HAVE A DRINK, RELAX, SITDOWN, HAVE A SMOKE, RELAX. STREET DRUG USE. A GOOD EXAMPLE IS CRYSTAL METH. EVERYBODY KNOWS OR HAS HEARD ABOUT THE EVILS OF CRYSTAL METH. VIRTUALLY NO ONE SEEMS TO REMEMBER THAT THE FIRST SUCCESSFUL PRESCRIPTION ANTIDEPRESSANT INTRODUCED FOR SALE IN THE UNITED STATES IN 1940 WAS METHAMPHETAMINE. BUT IS NOT DANGEROUS? WELL, NO MORE THAN ANY OTHER MEDICATION IF IT IS USED AND IN A PURE FORM AND UNKNOWN -- OF PEOPLE WHO HAVE NO IDEA WHAT DOSAGES. MAUREEN CAVANAUGH: SO THESE PEOPLE ARE SELF MEDICATING. -- CRATING -- MAUREEN CAVANAUGH: EITHER INNATE HEALTH RISKS INVOLVED IN HAVING SCORED HIGH ON THIS? -- IT PREDISPOSE PEOPLE TO GETTING DIFFERENT DISEASES, EVEN BEYOND OF USING CERTAIN SUBSTANCES? ABSOLUTELY. AND THEIR THE MAIN PATHWAY IS RELATED TO THE EFFECTS OF CHRONIC MAJOR UNRELIEVED LONG-TERM STRESS. AND THE EFFECT THAT THAT HAS ON THE FUNCTION OF VARIOUS PORTIONS OF ONE SPRAIN AND CENTRAL NERVOUS SYSTEM. FOR INSTANCE, CHRONIC MAJOR UNRELIEVED STRESS COMMONLY CAUSES SUPPRESSION OF ONE'S IMMUNE SYSTEM. THAT HAS GREAT RELEVANCE TO PREDISPOSITION TO INFECTIOUS DISEASES HAVE TO DO DEVELOPMENT OF MALIGNANCIES. THAT WAS A SURPRISE. ETC. TO THE DEVELOPMENT OF VARIOUS AUTOIMMUNE DISEASES, WE STUDIED THE RELATIONSHIP OF THE NUMBER OF CATEGORIES OF ADVERSE CHILDHOOD EXPERIENCES AND THEIR RELATIONSHIP TO VARIOUS AUTOIMMUNE DISEASES. THINGS LIKE MULTIPLE SCLEROSIS, ETC. MAUREEN CAVANAUGH: I WANT TO ASK YOU, CASEY, YOU SUFFERED CHILDHOOD ABUSE AND YOU HAVE TAKEN THIS SURVEY. WHAT DID YOU LEARN FROM IT? IT WAS VERY SOBERING. I WISH I HAD TAKEN IT A LONG TIME AGO. I HAVE BEEN DOING THIS WORK FOR 30 YEARS. I BECAME A PROSECUTOR IN SAN DIEGO 30 YEARS AGO. I HAVE SPENT A LOT OF TIME SENDING GUYS TO JAIL AND PRISON THE PROBABLY HAD REALLY HIGH EAST SCORES. IT NEVER EVEN DAWNED ON ME. I WORKED WITH A LOT OF ADULT VICTIMS OF SEXUAL ASSAULT AND DOMESTIC VIOLENCE THE PROBABLY HAD REALLY HIGH EAST SCORES. I NEVER EVEN ASK THEM ABOUT IT. WHEN I TOOK IT IT WAS JUST VERY SOBERING. I ACTUALLY APPLY THIS QUESTION TO WHAT I KNEW OF MY GRANDFATHER, THE SCALE FOR ACE THE DR. FELITTI IS TALKING ABOUT BASICALLY PRODUCES A SCORE OF UP TO 10 WITH THESE MAJOR CHRONIC FROM AREAS. AS A CHILD I WAS A THREE. MY DAD WOULD HAVE BEEN A SIX. I BELIEVE MY GRANDFATHER WOULD HAVE BEEN AN EIGHT. WHEN WE STARTED TO DO BUSINESS WITH THAT IN MY A FAMILY I ASKED MY WIFE TO TAKE THAT. SHE WAS A ZERO LIKE 30% OF THE POPULATION. MY KIDS THANKFULLY WERE ALL ZEROS PICK I GUESS THAT IS THE BLESSING OF THIS. THE GOAL NOW IS HOW DO YOU BREAK THIS CYCLE? HOW DO CHANGE THE ENDING? LAST SUMMER AT CAMP HOPE WE ADMINISTERED ACE WITH DR. FELITTI'S RECOMMENDATION TO ALL OF OUR TEENAGERS I CAN. OUR AVERAGE SCORE WAS SIX. FOR EVERY CHILD COMING TO CAMP WHEN YOU GET TO THE SCORE OF SIX DR. FELITTI FOUND THAT YOUR LIFE EXPECTANCY GOES DOWN 20 YEARS. IT IS LIKE A DEATH SENTENCE. TO HAVE UNMITIGATED TRAUMA LIKE THIS THAT YOU NEVER DEAL WITH IN YOUR LIFE. THE CONSEQUENCES OF YOUR CHOICES OUT OF THAT TRAUMA AND THE LONG-TERM HEALTH EFFECTS TENDED TO REDUCE LIFE EXPECTANCY QUITE DRAMATICALLY. I AM LOOKING AT THOSE KIDS RIGHT NOW, THEY ARE 12 AND 13 AND 14, AND I'M THINKING WE HAVE TO DEAL WITH THIS NOW. MAUREEN CAVANAUGH: DR. FELITTI, IN AN AMAZING OFFSHOOT OF THIS RESEARCH YOU HAVE ACTUALLY FOUND THAT JUST BEING ASKED, JUST BEING ASKED AND BEING ABLE TO ANSWER SIMPLE QUESTIONS, BECAUSE OF QUESTIONS THAT ARE IN THIS CASE STUDY ABOUT CHILDHOOD TRAUMA HAS A BENEFICIAL HEALTH EFFECTS? IT HAS A BENEFICIAL EFFECT WHETHER IT WOULD BE CORRECT TO CALL IT A HEALTH AFFECT IS A MORE COMPLEX ISSUE. WHAT WE FOUND HER WHAT WAS FOUND BY THE UNIVERSITY OF CALIFORNIA MATHEMATICIAN WHO CARRIED THIS WORK OUT FOR US IN A 130,000 PATIENT STUDY, WAS WHEN WE INTEGRATED THESE QUESTIONS ROUTINELY INTO A GENERAL MEDICAL QUESTIONNAIRE, IN THE YOUR SUBSEQUENT FOR THAT GROUP THERE WAS A 35% REDUCTION IN THE NUMBER OF DR. OFFICE VISITS THEY HAD AND AN 11% REDUCTION IN THE NUMBER OF EMERGENCY ROOM VISITS THEY HAD. SO THE QUESTION COMES, HOW DOES THAT WORK? WHY? YOU SEND EVERYBODY TO THERAPY. NO. WE SENT ESSENTIALLY NO ONE. HOW DID YOU DO THAT? GOOD QUESTION. WE REALLY OUGHT ABOUT IT A GREAT DEAL AND ULTIMATELY ENDED UP REALIZING THAT ASKING, INITIALLY BY AN INNER MECHANISM, AN IMPORTANT POINT, WILL DEVISED, EXTENSIVE QUESTIONNAIRE FILLED OUT AT HOME, AND THEN FOLLOWING UP TASTE OF PHASE IN THE EXAM ROOM. CAN YOU TELL ME HOW THAT AFFECTED YOU LATER IN YOUR LIFE? AND LISTENING AND IMPLICITLY ACCEPTING TURNS OUT TO BE A VERY POWERFUL FORM OF DOING. MAUREEN CAVANAUGH: AS I SAY, THE CHURN FOR THE CHILDREN BOOK THAT CASEY HAS JUST WRITTEN IS ONE OF THE FIRST TO BRING THE ACE STUDY TO THE PUBLIC. HAVE YOU ENCOUNTERED, DR. FELITTI, RESISTANCE TO THE USE OF THIS QUESTIONNAIRE? OH YES. WHEN WE SUBMITTED THE PROTOCOL FOR THE STUDY IN 1994 TO THE INSTITUTIONAL REVIEW BOARD THROUGH WHICH ALL MEDICAL RESEARCH HAVE TO GO NOW DAYS, OTHERWISE SENSIBLE PEOPLE INSISTED YOU CAN'T USE THAT QUESTIONNAIRE. YOU ARE GOING TO CAUSE PATIENTS TO DECOMPENSATE, MAY BE OCCASIONALLY BECOME SUICIDAL ETC. WE BATTLED THAT POINT FOR NINE MONTHS. FINALLY WE GOT AGREEMENT ON CONDITION ONE OF US WOULD CARRY A CELL PHONE FOR 24 HOURS A DAY TO TAKE EMERGENCY CALLS FROM PEOPLE THAT WE WERE GOING TO MAKE JUMP OFF THE SAN DIEGO BAY BRIDGE BY ASKING THEM ABOUT THEIR LIVES. WE NEVER GOT ONE CALL. INSTEAD I HAVE A NOTEBOOK OF LETTERS LARGELY FROM ELDERLY WOMEN TO ONE OF WHICH MEMORABLY SUMMARIZES THE REST, SHE WROTE THANK YOU FOR ASKING. I FEARED I WOULD DIE AND NO ONE WOULD EVER KNOW WHAT HAD HAPPENED. MAUREEN CAVANAUGH: CASEY, AT CAMP HOPE AS YOU INCORPORATE THE KIND OF EVALUATIONS THAT YOU MAKE AT CAMP HOPE WITH THE ACE STUDY, WHAT ARE THE CHANCES, YOU THINK, FOR SUCCESSFUL LIFE FOR KIDS LIKE JASMINE? I THINK THE CHANCES ARE GREAT IF WE REALLY FIGURE OUT HOW TO MEASURE THE SUCCESS THAT WE NEED TO FIND THAT GETS THEM OVER THOSE IMPACTS. IN CHURN FOR THE CHILDREN I TALK ABOUT THIS JUXTAPOSITION BETWEEN DR. FELITTI'S WORK AND THE ACE STUDY AND WHAT WE CALL THE COPE VERY AND HOPE RESEARCHERS, I HAVE A WHOLE CHAPTER CALLED HOPE HEELS IN THE BOOK, OF FOCUSES ON THIS AMAZING MOVEMENT NOW TOWARD MEASURING AND QUANTIFYING HOPE IN THE LIVES OF TRAUMA EXPOSED KIDS. WE ARE IN IT FIVE YEAR LONGITUDINAL STUDY NOW WITH CAMP HOPE ACROSS CALIFORNIA. WE HAVE GONE STATEWIDE NOW WHERE WE ARE MEASURING HOPE THEY SPECIAL INDEX BEFORE CAMP, AFTERCARE, 30 DAYS AFTER CAMP AND SIX MONTHS AFTER CAMP. WE HAVE PUBLISHED THE FIRST RESULTS IN TURN FOR THE CHILDREN WITH UNIVERSITY OF OKLAHOMA JUST ANNOUNCED THEY'RE GOING TO PUBLISH ACADEMICALLY THE FINDINGS. WE ACTUALLY CAN SHOW THAT WE CAN CHANGE HOW CHILDREN VIEW THEMSELVES AND THEIR FUTURES BY ADMINISTRATING A PROGRAM THAT IS REALLY BUILT INTO HELPING THEM TELL THEIR STORY, LETTING THEM TELL THE TRUTH ABOUT WHAT HAPPENED TO THEM AND THEN BEING ABLE TO HELP THEM PROCESS AND UNDERSTAND WHAT IS GOING ON IN THE BRAIN, THEIR BODY. WAYS THAT ARE 10 THAT HAVE REACH, THEY DON'T KNOW THAT IS. AIR RAGE PRODUCES HOMICIDAL RAGE. THAT RIDGE PRODUCES SERIAL RAPISTS. THAT RIDGE PRODUCES BRAIN CHANGES THAT PRODUCE PSYCHOPATH AND SOCIOPATHS. THE KIDS DON'T UNDERSTAND WHAT IS GOING ON AND WE HELP THEM PROCESS ALL OF THAT THEY HAVE A CHANCE TO COME OUT OF THAT AND HEAL. I SAY IN THE BOOK IF WE APPLY DR. FELITTI'S WORK ACROSS THE BOARD AND WE STARTED REALLY INVESTING IN CHANGING THE ENDINGS WE WOULD EMPTY PRISONS IN THIS COUNTRY IN 20 YEARS AND MENTAL HEALTH INSTITUTIONS WITH THE DRAMATIC DROPS IN THEIR POPULATIONS. THE PROBLEM IS WE ARE ALL AT THE BOTTOM OF THE CLIFF, WE ARE NOT AT THE TOP OF THE CLIFF, WE ARE WAITING WAY TOO LONG FOR WHAT WE NOW KNOW FROM DR. FELITTI'S WORK IS SO OBVIOUS AND YET WE HAVE IGNORED IT AND WE HAVE IGNORED IT AND WE HAVE A IGNORED IT AND THE COST IS IN THE BILLIONS AND BILLIONS AND WILLIAMS OF DOLLARS NOT TO MENTION THE MORALITY OF ALL OF THIS. AND HOW MANY KIDS AND ADULTS WE COULD SAVE FROM A LIFELONG SET OF CONSEQUENCES IF WE DEALT WITH HIS IN THERE. MAUREEN CAVANAUGH: THIS IS SUCH AN IMPORTANT WORK. I WANT TO THANK YOU BOTH SO MUCH FOR COMING IN AND SPEAKING TO ME. I HAVE BEEN SPEAKING WITH CASEY GWINN, AUTHOR OF CHURN FOR THE CHILDREN CONCRETING PATHWAYS TO HOPE FOR CHILDREN EXPOSED TO TRAUMA AND DR. VINCENT FELITTI, ONE OF THE PRINCIPAL INVESTIGATORS OF THE ADVERSE CHILDHOOD EXPERIENCES STUDY. THINK ABOUT. THANK YOU. THANK YOU.
An experience with a 10-year-old girl named Jasmine stuck in former San Diego City Attorney Casey Gwinn's mind for years.
"It was an amazing moment a number of years ago at Camp Hope when we were running it out in east San Diego County," Gwinn said. "I was just praising her at a campfire for being kind to the frogs that were jumping around on the shore of the lake one afternoon, and that night I honored her in front of the whole group and all the kids cheered for her."
After the campfire was over Gwinn recalled Jasmine came up to him and said, "Thank you, no one has ever cheered for me before."
That interaction inspired the title of Gwinn's new book, "Cheering for the Children: Creating Pathways to HOPE for Children Exposed to Trauma."
As co-founder of the national Family Justice Center Alliance, Gwinn works with children like Jasmine, who attended Camp Hope because she was exposed to domestic violence.
But how would something as simple as a sincere compliment make a difference in the life of a child like Jasmine?
"In so much of the lives of children exposed to trauma they’re living, number one, in a state of what we call hyper vigilance," Gwinn said. "They’re constantly on alert, they’re constantly dealing with this kind of chronic, traumatic stress in their lives."
Once they get to Camp Hope, the goal is to get them away from chronic stress they live with as a result of being exposed to trauma, and teach them how to calm themselves down, according to Gwinn.
Once that happens they’re able to absorb praise, affirmation and encouragement which Gwinn hopes will lead them on a path to become healthy, strong and successful.
He points to research that shows people who are exposed to trauma during childhood have poor health outcomes and even a shorter life expectancy.
Vincent Felitti has been studying the effects of adverse childhood experiences since 1994. His research, which became the ACE study, looked at 10 categories including major physical, sexual and emotional abuse, emotional and physical neglect and household dysfunction including domestic violence and mental illness.
Felitti, then an internist at Kaiser Permanente in San Diego, asked nearly 17,500 Kaiser members whether they had been exposed to any of the 10 categories. The number of categories the subjects were exposed to determines their "ACE score."
What Felitti found astonished him: exposure to any three, five or seven of the categories were equally damaging to the study subjects later in life.
It put them at risk for heart disease, emphysema, cancer and auto-immune disease. He says the list goes on.
"The amazing thing is, in a clearly middle aged, middle class population, how remarkably common those were," Felitti said.
For example, Felitti said, in the population studied, 28 percent of women and 16 percent of men acknowledged a history of child sexual abuse.
"A person exposed to any six [categories] was 4,600 percent more likely to become an IV drug user than someone exposed to none," Felitti said.
Gwinn knows his ACE score. He's a three.
"My dad would have been a six and I believe my grandfather would have been an eight," Gwinn said. "The goal now is, how do you break the cycle?"
He has broken the cycle in his own family, his three kids all have ACE scores of zero. He wants to break that cycle for other children through Camp Hope.
The ACE test was given to all teenagers attending Camp Hope last summer and the average score was six, Gwinn said.
"For every child coming to camp – when you get to the score of six, Dr. Felitti found that your life expectancy goes down 20 years," he said. "It’s like a death sentence to have unmitigated trauma like this that you never deal with in your life."
But Gwinn has hope for these kids because he says even just asking the hard questions that make up the ACE test can have an beneficial impact.
Felitti said in one study of 130,000 patients who had been asked the ACE questions as part of a general medical questionnaire, the year following they had a 35 percent reduction in the number of doctor office visits and an 11 percent reduction in the number of visits to the emergency room.
Why did that happen?
Felitti said researchers think by having these patients to fill out the extensive questionnaire at home and then having a physician in the exam room ask how their childhood trauma affected them later in life really helped.
"Listening and implicitly accepting turns out to be a very powerful form of doing," Felitti said.
Gwinn said he believes the chances for kids like Jasmine are great. In addition to measuring kids' ACE scores they are now also measuring their "Hope scores."
"We actually can show that we can change how children view themselves and their futures by administering a program that is really built into helping them tell their story, letting them tell the truth about what happened to them and then being able to help them process it and understand what’s going on in their brain their body," Gwinn said.
All proceeds for "Cheering for the Children" will go to Camp Hope.
