The Negative Effects of Violence on Child Development and What We Do About It.

     The closest I have ever come to experiencing severe childhood stress, was actually as an adult, in 1992, when I was teaching first grade in South Central Los Angeles.  In a paper I wrote for my previous class, Foundations: Early Childhood Studies, I described an experience that forced upon me the realities of violence and it’s affect upon young children.  The following excerpt from that paper is a description of the experience and what myself and others did in support of the students of St. Columbkille Catholic School.

In 1992, St. Columbkille Catholic School was predominantly Hispanic, and about 20% African American.  Many of the Hispanic families served by this school had recently immigrated to the U.S., spoke little to no English, and were exceedingly poor, but they all gained support from the Catholic community of which they and the school were a part.  This community was situated in the heart of one of the most violent areas of Los Angeles.  Sister Kathleen, a nun and my dear friend, once described St. Columbkille as an oasis of peace and spiritual nourishment surrounded by a desert of poverty and violence.  When civil unrest climaxed, on the day four Los Angeles police officers were acquitted, a year after they were accused of mercilessly beating a fugitive African American man named Rodney King; even this small, peaceful, Catholic community was not immune to the civil unrest that ensued.  Only a few hours after the acquittal was announced, a white truck driver passing through South Central L.A. verbally taunted an African American man.  That was the match that lit, what had accumulated as years of civil unrest, into a full-blown race riot.   For three days, groups of rioting citizens dominated the streets of South Central L.A.  Families from St. Columkille hid inside their homes in fear of becoming yet another target of the racial violence that surrounded them.  In particular mothers stood vigilant over their teenage sons forbidding them to even go outside.  Much of the area was burned to the ground, looting was rampant, many lives were lost, schools and businesses were closed. 

 Despite the terror and destruction of this event, for the families of St. Columbkille, this is an example of what the The National Scientific Council on the Developing Child actually calls “tolerable stress”.  Simply put, tolerable stress in children is caused by acute rather than chronic traumatic situations, where emotional support from caring and capable adults is available.  Other examples of tolerable stress include death of a loved one, or a natural disaster. (Shonkoff, J. P., 2006) & ((Shonkoff, J. P., 2010) Four days after the beginning of the riots, school re-opened.  It quickly became clear, that the focus of our day-to-day classroom activities would be in providing emotional support for the children.  In order to emotionally support the children of my class, I had to alter the curriculum.  New academic concepts could not be introduced, as it simply became apparent that the children were not emotionally and therefore cognitively “available” to take in new information in light of the emotional trauma they had just experienced.  Some of the children suffered from a decline in their executive functions, such as the ability to make sound judgments, focus, and plan ahead wisely.  These manifested themselves in behaviors such as increased sensitivity to others, fights on the play ground, fearfulness, and/or crying when in close proximity to others or when feeling isolated from others.  The emotional health and development of a child directly impacts that child’s executive functions, and cognitive abilities.  (Shonkoff, J. P., 2006), (National Scientific Council on the Developing Child, 2004) and (Shonkoff, J. P., 2010)

 However, I also noticed that some previously mastered academic skills were retained, and the skill most used in the aftermath of the violence was that of drawing, writing, and verbalization.  The children had stories to tell.  The telling, drawing, writing, and reading of those stories became prolific.  As long discussions between the children and myself developed, the working vocabulary of the children grew significantly.  The children asked many questions about new words and concepts, such as: racism, skin color, violence, AK-47, taser, spic, nigger, Crips, Bloods, overpass, underpass, graffiti, looting, interstate, cops, police, policia, bro, brothers, The Hood, white folk, honkey, anglo.  They also gave detailed accounts of what they experienced during those three days of unmitigated violence.  For most of this community, the stress of this event remained “tolerable” and did not have an opportunity to be come “toxic”.  I strongly believe that the reason the children of this community were able to tolerate this disruption to their lives so well, was because of the supportive and caring community, in which they lived.  The St. Columbkille Catholic community, that was already in place around them, and their families stepped up to council and protect all of the parishioners.  Mass was held daily as families came together to pray and also talk about their experiences, and gain support from one another. (Breeden, D., 2011)

     At St. Columbkille, the study of conflict and conflict mediation were taken very seriously, and started with the very young.  The younger grades used a book and curriculum called “Fuzzies a Folk Tale”. (Lessor, R. & Ricci, P. E., 1971) The curriculum was a great success and had been implemented in the school for over 15 years, before I began teaching there.  The curriculum teaches that we all have “warm fuzzies”, which are words and works of kindness, to give away to other people.  When one gives away a “warm fuzzie”, another one reappears, so one can never run out of “warm fuzzies”.  (Imagine a small pom pom ball in your favorite color.) The opposite of a “warm fuzzie” is a “cold prickly”.  “Cold pricklies” are words and acts of mal-intent.  In the story, “cold pricklies” are held by a very unhappy and angry Sorceress, who comes to town.  The Soseress successfully distributes some of her “cold priclkies” to residents of the town.  The “cold pricklies” are so unpleasant to retain that anyone who has them tries to give them away as quickly as possible to unsuspecting others.  After awhile the residents of the town learn to reject the “cold pricklies” and the unhappy Sorceress is forced to leave in search of some other unsuspecting town.  (Hopefully the unhappy Soseress is helped by a Wise Wizard who teaches her how to dispel all of her “cold pricklies” and replace them with a never-ending supply of “warm fuzzies”)  So, you get the picture.  In knowing the story well, and having worked with the curriculum, the children quickly connected the notion of “cold pricklies” to the riotous acts they had witnessed and “warm fuzzies” to all the ways their families and the community were coping with the aftermath.

     Because of the experience I had, with what is widely known as the “Rodney King Riots”, and the affect it had upon the young students of my class, I chose to do a little research about the affects of war on children, and what if anything is being done to support children who are exposed to the trauma of war.

      In Pediatrics, I found a very interesting study involving children of the Second Iraeli-Lebanon War in 2006.(Sadeh, A., Hen-Gal, S., & Tikotzky, L., 2008)  The study was conducted during the last week of the war, in a “sheltered camp”.  All of the children and their families were displaced from their homes and all of them were suffering from anxiety disorders related to their contact with the war.  This study focused on the affects of early intervention treatments (while the war was actually still on).  Being able to intervene with effective treatment during a war is tricky to say the least.  So the question was, how do we create an intervention that is doable given the limitations, including limited resources, available in war torn areas?  Because doctors, including pediatricians, are often called upon to enter these areas, the thinking was….  What can a pediatrician do to immediately treat children suffering from anxiety disorders?… Something that is doable given limited resources and is cost effective.  (War is incredibly expensive for everyone!)  How about a “Huggy Puppy", that comes with a good story?  The idea is that a cute, soft, stuffed dog, called “Huggy” is introduced to the child by the pediatrician.  “Huggy” is away from his family, unhappy, and needs to be cared for.  The pediatrician asks the child if he/she would like to take responsibility for the care of the puppy.  If yes, the pediatrician gives the “puppy” to the child, as a gift, upon the condition that the “puppy” is well cared for.  Mothers of the children were asked to encourage the child’s attachment to the “puppy”, and remind their children of their duty to care for the “puppy”.  The reasoning behind the “Huggy Puppy Intervention” is based upon the following: 

 One perspective is drawn from the literature suggesting that giving responsibility to care for others and encouraging active coping during stressful periods empower individuals and make them less vulnerable and susceptible to stress reactions. From a child development perspective, it has been well-established that young children, from as early as the middle of the second year of life, are capable of pretend play, which serves important developmental functions. The play therapy literature suggests that children are highly likely to project their feelings and anxieties onto toy figures (particularly animals) to identify with those feelings and to regulate those emotions while caring for the toy figures.(Sadeh, A. et al., 2008)

It has been suggested that anxiety disorders (in both adults and children) are associated with attentional biases that are linked to fear-inducing stimuli.35 Furthermore, it has been shown that anxious individuals are more likely to focus inwardly, on their fear-related sensations and thought processes, and that attention training and reduction of self-awareness may lead to significant improvement for anxious individuals.  The HPI provides the child with an incentive to focus on the puppy's feelings and needs and on the child's role as caregiver, thus offering a distraction from the child's own fears and anxiety. The child is encouraged to focus on his or her role as a competent caregiver, rather than as an anxious and needy individual.(Sadeh, A. et al., 2008)

In conclusion:

These studies suggest that a brief early intervention based on mobilizing the child's role as a caregiver to a needy puppy doll may serve as a cost-effective means to alleviate children's stress reactions after exposure to war experiences. If our results are validated by additional research, then this intervention could provide pediatricians and other child health care professionals with a valuable tool for early intervention for children exposed to stressful and traumatic events.(Sadeh, A. et al., 2008)

     In reading this study, I am reminded of when as a young person, I was outwardly creeped out by spiders.  If I saw a spider, my mother would simply catch it and release it outside, explaining to me that spiders are a useful part of the environment and that they should be protected, and of course, in removing the spider she was protecting me as well.  I once asked her with my face wrinkled in disgust, “How can you do that?” and then, “I could never do that!”   My mother said, “Don’t worry.  When you have children of your own, you’ll become brave.”   It wasn’t until much later, that my mother told me that she too had always been irrationally fearful of spiders, and that when she had children her focus moved away from her fear of spiders and more toward the protectiveness and care of her children.  I think a connection can be made between this scenario and the “Huggy Puppy Intervention”, as the children are given a means by which to divert their attention away from their internal fears and more toward the care of another individual, consequently reducing their stress levels.  Fascinating work!

References:

Breeden, D. (2011, December 11). The Shonkoff affect and the multidiscipinary scienc of early childhood development.

Lessor, R., & Ricci, P. E. (1971). Fuzzies a folk tale. Resources for Christian Living.

National Scientific Council on the Developing Child. (2004). Children’s Emotional Development Is Built into the Architecture of their Brains. National Scientific Council on the Developing Child. Retrieved December 3, 2011, from http://developingchild.harvard.edu/index.php/resources/reports_and_working_papers/working_papers/wp2/

Sadeh, A., Hen-Gal, S., & Tikotzky, L. (2008). Young Children’s Reactions to War-Related Stress: A Survey and Assessment of an Innovative Intervention. Pediatrics, 121(1), 46-53. doi:10.1542/peds.2007-1348

Shonkoff, J. P. (2006). A Promising Opportunity for Developmental and Behavioral Pediatrics at the Interface of Neuroscience, Psychology, and Social Policy: Remarks on Receiving the 2005 C. Anderson Aldrich Award. Pediatrics, 118(5), 2187-2191. doi:10.1542/peds.2006-1728

Shonkoff, J. P. (2010, November 4). Leveraging an Integrated Science of Development to Strengthen the Foundations of Health, Learning, and Behavior. Casey Family Programs/Early Learning Symposium. Retrieved December 10, 2011, from http://www.casey.org/Resources/Events/earlylearning/WA/default.htm

 

Extra: Recent News About Language Acquisition in Young Children and How the New Findings Relate to Early Diagnosis of Autism.

My fellow grad school buddies and I have been fine tuning our understanding of language acquisition in early childhood.  Some of us have experience working with autistic children.  My experience with autistic children, however, is basically... well, none at all.  With that said, I recently made a formal observation of a toddler who is likely autistic.  For any of you who want to take a minute... What do you think of the following article?

Babies learn to speak by lip reading, could offer autism clues

http://vitals.msnbc.msn.com/_news/2012/01/16/10152043-babies-learn-to-speak-by-lip-reading-could-offer-autism-clues

Finnish Fitness

We have learned about public health policies that affect the health of children all over the world.  Aspects of public health policy focus upon preservation of and improvement of human life.  These aspects of policy include access to and education about nutritional food sources, clean water, immunization, Sudden Infant Death Syndrome, breastfeeding and mental health. Billions of lives are preserved each year to due to the implementation of the previously mentioned policies.  I think now it is time to turn at least some of our attention to sustainable health practices.  Many societies, not just the U.S., but most developed countries are suffering from an epidemic of obesity.  Especially hard hit are people of the South Pacific.  One country that seems to take sustainable health practices seriously is Finland.  Finnish people have a reputation of loving sports.  They love playing sports and watching sports, and a good dose of healthy competition she to go a long way in keeping the Finns warm through their long dark winter.  The love of sport in Finland has spread to include a love of overall fitness.  Finns are some of the most active people in the world despite the long, cold, dark winters typical of the Scandinavian countries.  In 2009, the Finnish Ministry of Education was given the task of composing a document to address the need for all Finnish people to be physically active and fit.

Finland is a society where everyone has an equal opportunity to pursue a sportive way of life and to experience communality through sport. Sport is understood to be an essential element in the well- being of the individual and society. The prerequisites for sport are secured through sustainable choices made by citizens, communities and society together.”(Ministry of Education, 2009)

According to the Programme of Prime Minister Matti Vanhanen’s second government, sport policy will promote the well-being, health and functional capacity of the population at different stages of life, with an emphasis on child and youth sport. The aim is to strengthen the prerequisites of local activity, inclusive equality and the position of sports as a local basic service.(Ministry of Education, 2009)

The government contributes toward this end by means of statutory state aid, construction subsidies and various development programmes.(Ministry of Education, 2009)

The last point made above is telling of just how important this is to Finnish society, as government subsidies are allocated for the construction and maintenance of fitness facilities.  Beyond going to the gym, Finns enjoy cross-country skiing, cycling, ice skating and running.  Parks, tracks, trails, and icy waterways are all maintained with government subsidies.  In Finland, playing sports, or simply exercising is a popular way for people to get together after work and school to socialize.  I think some lessons can be learned from our Northern friends the Finns.  Just making it possible, namely safe, for children to walk to and from school everyday would help in making children more active.  In Canada, several school districts have adopted physical exercise as an integral part of the everyday curriculum.  Between classes, students have access to exercise equipment and allowed to put in 10 -20 minutes of cardio-work.  Taking “breaks” for physical activity is a proven way to boost cognitive efficiency, and has raised student academic performance across the board.(Sparking Life, n.d.)

References:

Ministry of Education. (2009). OKM - Government resolution on policies promoting sport and physical ativity. Ministry of Education. Retrieved from http://www.minedu.fi/OPM/Julkaisut/2009/Statsrxdets_principbeslut_om_riktlinjer_fxr_frxmjande_av_idrott_och_motion?lang=en

Sparking Life. (n.d.). Exercise before and fitness activities interspersed with lectures lead to a state of heightened awareness and improved academic performance. Sparking Life: Power Your Brain through Exercise. Retrieved January 15, 2012, from http://sparkinglife.org/page/successful-school-fitness-models

Making Things Better: What I Desire for My Daughters

As I reflect upon the birth of my children, some things were perfect, somethings were not.  My doctor was awesome!  What I lacked was a mentor.  Since having my children, I have found myself envious of  the mentorship and support that some of my friends have had for their pregnancies and birth of their children. I do not have sisters of my own, and by the time I had my first child my mother was not well.  I think I could have benefitted from 2 or 3 sisters and a healthy active mom.  I would describe my pregnancies as scientific rather than traditional.  I appreciate the traditions I learned about while researching Tibetan birth, and wish I had had some family tradition to take with me to the delivery room.  The Tibetans are cognizant of, and actually verbalize, through ritual, their hopes and dreams for the newborn child.  Seems like a great way to begin supporting a new life.   I think it would have been grounding and a great comfort to me to have had a similar experience, observing family members articulating their thoughts, wisdom, hopes, dreams, and commitment to the newest member of the family.  For that matter, my family could benefit from such intimate relations with one another at anytime.  I look forward to the time, when possibly, my girls have their own children.  God willing, I will be healthy and active as a mentor and great support to the needs of my daughters before, during and after giving birth to their own children.  I know too that as sisters, my girls will fulfill that role for each other as well.

A Tibetan Birth

Tibetan childbirth is steeped in Buddhist religion and Tibetan culture.  The belief in reincarnation plays a big part in the views associated with conception.  When a man and woman decide to have a child, they, in a sense, are deciding to provide a place (the mother’s womb) for an ”intermediate being” (a person who has died but has not yet been reborn into another life) to develop and be born into a new life.  At the same time “intermediate beings” are choosing a womb in which to develop and from which to be reborn.  Therefore, the mother must prepare herself for pregnancy through prayer, doing prostrations, and circumambulating the Buddhist temple, in this way purifying/preparing herself mentally and emotionally, as well as her womb for hosting another being (conception).  The family’s role is to provide for the health and well being of the mother through mental, physical, and emotional support.  Sounds like Tibetans understand the impact of environment upon the mother and prenatal development of the child.  During gestation, a mother’s dreams are considered significant and care is taken to interpret them.  When labor begins, a man “who has kept his moral obligations” usually the father blesses a square of butter and feeds it to his laboring wife to ease her labor.  If the labor is lengthy he may also feed his wife small amounts of fish which also has been blessed to give her strength.  The ritual of eating blessed food during labor is so entrenched in Tibetan culture that women are literally conditioned to relax and feel safe when they eat them during labor.  Upon delivery, and with the baby’s first breaths, the symbol of Dhih is “painted” using saffron onto the newborn’s tongue.  This ensures that the child will grow to be wise and articulate, have intelligence, and enjoy a long life of good fortune having enough to eat.

An astrologer reads the placenta.  Afterwards the father carefully wraps the placenta in a clean white cloth and buries it.  Burying the placenta is an act of gratitude and a showing of deep respect for the placenta in regard to the protection and nourishment it gave to the developing child.

The Tibetan symbol for Dhih Seed .  The seed of wisdom.

Farwell, E. & Maiden, A. (1992). The Wisdom Of Tibetan Childbirth. In Context A Quarterly of Humane Sustainable Culture. Retrieved January 7, 2012, from http://www.context.org/ICLIB/IC31/Farwell.htm

My First Birthing Experience

Ellie 8 Months,  Kira almost 3 Years

I was lucky to have children at all.  In 1992 I got married, and in 1995 I suffered from a blood clot and bleed on the outer surface of my brain.  I spent a week in the critical care unit heavily sedated for pain and nausea typically associated with head trauma.  Fortunately, I made a full recovery and suffered no adverse affects as many people who suffer from stroke actually do.  Birth control pills were blamed for the clot.   Hormone based birth control was no longer an option for me. So my husband and I decided it was time to try starting a family.  I was blessed with a fantastic OB/GYN, and discussed with her my plans to get pregnant.  Dr. Vigil explained to me, that given my prior health history, any pregnancy for me would be considered high risk as hormones produced by pregnancy are very similar to the hormones found in birth control pills, which caused cerebral clotting in the past. She told me that her number one concern was my health and coming in as a close second would be her concern for the health of my child.   She also assured me that given all the available data, she was confident that I could successfully carry a child to term, if I followed the special protocols she set up for me.  One of those protocols was to take blood-thinning medication upon conception, throughout the pregnancy and 6 weeks post term.  I had been on blood thinners before with my blood clot… a small pill taken once a day and lots of blood tests to monitor blood clotting times.  Okay, I thought I can do that.  But no…. The only blood thinning medication deemed safe for pregnancy was one that could only be administered through injection.  So I learned how to give myself injections, in the abdomen mostly, of a drug called Heperain twice a day every day.  The getting pregnant part for me was easy.  At least I did not have to worry about that.  My pregnancy progressed without a hitch… other than double the doctor visits as recommended by my OB/GYN as she wanted a perinatal specialist on board as well to help test and monitor my progress.   My OB told me that if my baby did not turn over by two weeks before my due date, we would do a planned c-section.  She explained that given my condition, and the fact that I would have to go off the blood thinners for labor and delivery she did not want me going through the extra effort to deliver a breech baby.  By week 38 my baby had not turned, so we did a c-section.  I went off the blood thinners 24 hours before the surgery.  I went into surgery at 8:00 a.m. spinal in place.  I could not feel anything below my chest.  My husband was there, barely able to stand upon his buckling knees.   The anesthesiologist told him, prior to the surgery, that if he fainted and fell to the floor he would just have to lay there, as everyone else would be too focused on the baby and myself to be of any assistance to him.  She, the anesthesiologist, did say they would try not to step on him if indeed he did faint.  During the surgery he took several deep breaths and stayed on his feet.  Incisions made on my body and uterus were 10 cm in length; the same size of a normally dilated cervix during a vaginal birth.  After cutting my uterus Dr. Martinez, the other OB in the room pushed down with all his strength on the top of my abdomen forcing the baby down to the bottom of my abdomen where the incision was.  Dr. Vigil reached in and carefully lifted out my baby.  When she saw that the umbilical cord was tightening around my baby’s neck Dr. Vigil placed her back in my uterus and deftly lifted the cord from her neck.  Dr. Martinez pushed again, and Dr. Vigil lifted my baby, a girl, and handed her to a team of pediatricians who cleaned her off, and performed an Apgar test finding that she passed with flying colors.  I remember hearing my baby cry a lot and loud!  She actually sounded angry.  As quickly as possible a nurse laid her on my chest, where she immediately, and I mean immediately, stopped crying.  I caressed her and talked to her as she made contented little grunting noises. All of that took only 7 minutes! After the surgery, I went back on the heparine, which made healing from the c-section difficult and lengthy, but heal I did.  I have two beautiful girls who are growing into powerful young women.  My oldest is 15 years and my younger is 13 years old.

Kira 15 Years,  Ellie 12 Years