Pediatrician Helps Treat Childhood Trauma

When San Francisco pediatrician Nadine Burke Harris opened her clinical practice in Bayview Hunters Point in 2007, she discovered an alarming trend: Exposure to violence, a parent with a mental illness and other traumatic experiences can affect a child’s health later in life.
This discovery that childhood trauma isn’t something you get over prompted Burke Harris to open the Center for Youth Wellness in 2012. The center, which works in close partnership with Burke Harris’ practice, Bayview Child Health Center, focuses specifically on treating toxic stress.
If left untreated, she says these traumatic experiences can put children at a higher risk of problems such as asthma, diabetes and obesity as well as learning difficulties and social problems. They can lead to an increased risk of adult heart disease and cancer.
For more information about the Center for Youth Wellness, go to www.centerforyouthwellness.org.
 
What is toxic stress?
For many kids who are repeatedly exposed to “Adverse Childhood Experiences (ACE),” such as violence at home or having a parent who suffers from depression, emerging research demonstrates that their body’s stress response system is activated so often that it stays on. These high levels of “fight or flight” hormones can lead to changes in the structure and function of children’s developing brains, immune systems, hormonal systems and even the way their DNA is expressed.
 
What triggered your research?
When I founded the Bayview Child Health Center, I had the wonderful experience of being the “community doc” for the Bayview Hunters Point neighborhood in San Francisco. Over time, I started noticing a disturbing trend. A lot of kids were being referred to me for ADHD (Attention Deficit Hyperactivity Disorder), but when I actually did a thorough history and physical, what I found was that for most of my patients, I couldn’t make a diagnosis of ADHD.
So when my colleague introduced me to the Adverse Childhood Experiences Study, I had this incredible “Aha” moment. It really explained the connection I was seeing between the challenges my patients were experiencing and the poor health outcomes I saw in my patients and the community.
 
What is the ACE Study?
It is groundbreaking research that was published in 1998 by Dr. Vincent Feletti at Kaiser and Dr. Robert Anda at the CDC (Centers for Disease Control and Prevention). The study surveyed over 17,000 California adults for Adverse Childhood Experiences including physical, emotional or sexual abuse; physical or emotional neglect; having a parent who experienced mental illness, substance dependence, incarceration or domestic violence; or having parents who were separated or divorced. What they found was that ACEs were common. Almost two third of participants reported having at least one ACE and 12.5 percent reported having four or more ACEs. As the number of ACEs increased, the risk of negative health outcomes increased as well.
The ACE study changed the course of my career and led me to create the Center for Youth Wellness. At CYW, we prevent, screen and heal the impacts of ACEs and toxic stress.
 
Does toxic stress impact just low-income families?
Absolutely not. Adverse Childhood Experiences and toxic stress are a public health crisis and affect everybody – regardless of income, race, geography or education. Last year, CYW released a report that analyzed California data on ACEs. The most common ACE experienced by California adults is emotional or verbal abuse with almost 35 percent of adults. The next most prevalent ACE are parental separation or divorce reported by 26.7 percent of adults and substance abuse by a household member reported by 26.1 percent of adults.
ACEs are prevalent among all racial and ethnic groups in California with 63.4 percent of Caucasians, 65.6 percent of African Americans, 64.3 percent of Latinos and 45.5 percent of Asian, Pacific Islander or other reporting one or more ACEs.
 
How is it treated?
You know the old saying: An ounce of prevention is worth a pound of cure? That has never been more true than with the issue of toxic stress. Parents and caregivers are a child’s best shield. When a parent or caregiver is able to help the child make sense of the world, manage difficult feelings and develop healthy coping skills, toxic stress can be prevented. The quality of a parent or caregiver’s interaction with a child is the key building block for healthy emotional, social and physical development. Some of the best ways to support a child’s health and development involve simple things like talking, reading, singing and taking time to play with a child one-on-one and just slowing down to spend time together.
In addition, high quality mental health interventions like therapy and psychiatry are important to healing the cascade of stress hormones that are activated by the “fight or flight” response. In our center, we also recommend the healing power of good nutrition, sleep hygiene and daily exercise. In addition, emerging research is showing that practices like mindfulness and biofeedback can help to regulate the neurologic, hormonal and immune systems.
 
How will the $3 million gift from Google help in treating toxic stress?
Can I say that Google is totally amazing? They really stepped up and invested in our clinical model. Many of the interventions that we do are currently not reimbursable by insurance. Google has allowed us to bring the most cutting edge clinical services free of charge to the families in greatest need.
 
Teresa Mills-Faraudo is an associate editor at Bay Area Parent and mother of two.