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How a natural disaster led one town to do something about its ACEs, past and future

 

Darrington Elementary Principal Tracy Franke (l), counselor Megan Lucas (r)
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At 10:37 a.m. on Saturday, March 22, 2014, the side of an enormous unstable slope high above a rural neighborhood near Oso, Wash., collapsed. A wall of wet dirt and rock rocketed down the hill across the North Fork of the Stillaguamish River to bury a square mile of the community, including 49 homes, under 30 to 70 feet of mud. Forty-three people died, about one-third of the Oso community. Although the nation remembers the largest mudslide in the U.S. as the Oso mudslide, the people who live in the area call it the Highway 530 slide. 

Two months later, the community was still reeling from the loss of family and friends, and the problems that the landslide generated (State Highway 530 was closed for more than two months). That’s when Natalie Turner, from the CLEAR project (Collaborative Learning for Educational Achievement and Resilience)at Washington State University, paid a visit to Darrington Elementary School and to talk about trauma.

About 1,500 people live in Darrington, 75 miles northeast and a couple of lifestyles away from Seattle. Whitehorse Mountain towers more than a mile above the town, which nestles in the North Cascade Range. Gold mining and logging built Darrington; it still boasts a state-of-the-art lumber mill. The area attracts hikers, climbers, anglers and birders. Many of the kids in Oso go to school in Darrington, about 15 miles from Oso. Everybody from Darrington knew someone who’d died in Oso.

NatalieTurner

Natalie Turner explains 
how you "flip your lid."

“They were pretty much still in shock,” recalls Turner. “Everyone at school was impacted by the slide on a personal and professional level.” The dead included two students, a teacher (who was the mother of one of the students), a custodian and a school board member, who managed Darrington’s library.

“The trauma of the landslide had ripped away their internal resources,” continues Turner. “Because of all of the trauma in the community, those families that had barely been coping with their own normal family issues were no longer coping. And those that had been doing okay were barely getting by.”

Tracy Franke, principal of Darrington Elementary School, a K-8 school with 300 students, had heard about CLEAR, and called Dr. Christopher Blodgett, who runs the program, to arrange a visit from Turner. “We were hurting,” says Franke. “Our students and staff needed some tools to get through the trauma.”

On that late spring day, the entire staff — teachers, administrators, custodians, and bus drivers — gathered to listen to Turner. They learned about how the trauma of a mudslide can cause kindergartners and first-graders to act out in school. They learned how every person in the room was affected by trauma. They heard about how teachers and schools could help traumatized kids get back on track to learn, and how those same approaches could also help adults. She took a few questions, and then left for the airport.

“I don’t even think she was out the door when someone said, ‘Sign her up right now!’”, Franke recalls.

Turner wasn't halfway to the airport before Franke called. “The staff voted,” she told Turner, “and 100% of the school agreed that we want you to come back.”

With that call began a journey that’s in its fifth year. It’s helping the people of the Oso-Darrington area heal from a disaster that had ripped the heart out of their community. It also set them on a path to creating a resilient community, which — in these early days of disasters from fires, floods, and tornados due to climate change — should be at the top of every city and town’s to-do list.

In Darrington, the change began with the children in the community’s center: the school.  

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What convinced the school staff to work with Turner was what she said about kids and their ability to learn when they’re traumatized. It’s pretty simple: They can’t. And no amount of blame, shame and punishment will make them learn. That just adds more trauma to an already traumatized kid.

When a child or an adult experiences trauma, they instantly flip into survival mode. It’s a human response, and it’s universal. The thinking parts of their brains shut down. The survival parts of their brains throw their bodies into fight, flight or freeze mode. The severity of the trauma, how long it lasts, the burden of previous or co-existing trauma, and the supports they receive determine how long it takes to recover. When a whole community is traumatized — as was Darrington, or as is Paradise, CA, or Mexico Beach, FL — it can take months to years to heal.

If young children aren’t given a way to talk about their trauma, if they aren’t taught how to calm themselves or communicate what they need and to ask for it, they’ll continue to act out their trauma by getting in fights, running away or disconnecting from the world around them. In the elementary school students at Darrington, that was plain to see.  

School'“We could see in their bodies and behaviors that they weren’t regulating,” says Franke. “We had to help them get to that place where they’re ready to learn. They need consistency and structure and tools. By providing them the tools to regulate, we were going to help them be more accountable and help them receive their education. It wasn’t a ‘boo-hoo for them because they’d experienced a disaster’ approach. That was important for our community. By offering kindness, we were still holding them accountable. It was a mix of having compassion, while still setting high standards and expectations.”

Over the next four years, Turner visited the school for a day or two every month during the school year. She did a half-day of training for the entire staff about some aspect of the science of adverse childhood experiences, and trauma-informed and resilience-building practices. She spent time with Franke to strategize how to integrate changes schoolwide, and how to solve problems.

She learned about the community to understand its needs, so that she could continue to tailor her work. In the process of building relationships, the community and school staff identified a much larger set of traumas that existed in Darrington for generations and that had been unaddressed. Some of the lingering trauma was due to the boom and bust history of the economy; some of it had been passed down from generation to generation, just as it has in every community in the U.S.

ACEs...The Most Powerful Factor in People's and Communities' Health

“Most adults in North America have experienced at least one adverse experience in their childhoods,” explains Dr. Andres Sciolla. “And the science also tells us that if a person has experienced one type of childhood adversity, there’s an 87 percent chance they’ve experienced more. With more than one childhood adversity, there’s a higher risk for developing PTSD, but also other physical and mental health problems.”

Sciolla
Dr. Andres Sciolla

Sciolla, a psychiatrist on the faculty of the University of California Davis School of Medicine, learned about ACEs science in 2005, during a meeting with Dr. Vincent Felitti arranged by friends who knew about their overlapping interests. That meeting changed his whole approach to psychiatry. Sciolla is a pioneer in moving from a focus on andtreatment of symptoms with drugs (i.e., “What’s wrong with you?”) to focusing on the traumatic reasons why people are depressed or addicted (i.e., “What’s happened to you?”), or trauma-informed psychiatric care. 

This understanding about the link between childhood adversity and the adult onset of chronic disease, mental illness and violence was captured in the groundbreaking CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study), one of whose principle investigators was Felitti. The ACE Study looked at adversity within families and identified situations that many people didn’t consider as doing long-term harm, such as divorce, living with a parent who’s addicted to alcohol, or experiencing emotional abuse, such as a parent telling a child they aren’t wanted or that they’re worthless. 

But there’s no question that the most powerful factor in the development of mental and physical health in an adult is the presence of ACEs in their childhood, says Sciolla. The research has clearly shown that.

Researchers found that the more types of ACEs a person experiences, the higher the risk of unhealthy or coping behaviors such as smoking or overeating, and the adult onset of chronic disease. And the consequences of childhood adversity are linked to most of the nation’s chronic diseases and premature death. Having four out of the 10 types of ACEs that were measured, for example, doubles a person’s risk of cancer and heart disease, raises their risk of becoming an alcoholic by 700 percent, and their risk of attempting suicide by 1200 percent. People with high ACE scores have a higher risk of lung disease and autoimmune disease; they have more marriages, more broken bones, and are more violent and are more likely to be victims of violence. Without intervention, the lifespan of those with ACE scores of six or higher is cut short by 20 years,

Since the first publication of the ACE Study in 1998, the field of ACEs science has expanded, and now brain and epigenetic research shows that ACEs cause chronic disease, mental illness and other problems. And there’s much more awareness now that “societal context is also important,” says Sciolla., which is often referred to as social determinants of health. ACE surveys now include racism, living in a violent neighborhood, being bullied, and involvement with the child welfare system, to name but a few community ACEs. And with more awareness of the long-term effects of natural disasters such as hurricanes and floods, another category has been added to ACEs: Adverse climate experiences.

Toxic Stress is Toxic Stress, No Matter Where It Comes From

But the bottom line is the same. The brain and body can’t tell the difference between toxic stress caused by sexual abuse or stress caused by living with an alcoholic or stress caused by escaping from a mudslide. It’s all toxic stress, and it harms the brain and the body. 

All stressful experiences have a final expression in the body,” says Sciolla. “The chronic activation of stress results in multiple long-term changes in the brain, as well as having physiological effects in the here-and-now to enable survival. Stress affects the immune system, which in turns produces a low-grade, chronic state of inflammation that affectsall organ systems. These adversities are associated with a decrease in the ability to buffer stress in the future. Resilience diminishes.”

This is important for children, because one of the main ways that children develop resilience is to have a safe, stable and nurturing relationship with adults who can reassure them and help them cope, explains Sciolla. So one of the first things a community that’s experienced a disaster can do is make sure the kids have adults who are there for them. Because Franke and the rest of the teachers knew that many adults with children were having trouble coping, they wanted to make sure that the adults at the school were creating a safe and nurturing environment.

“Every month, professional development was delivered to staff,” says Franke. “Natalie provided support for staff, including refining the language being used by the teachers, examining the physical environment of the classroom, learning what the teacher experienced, and helping them make adjustments to create more trauma-informed classrooms.”

Turner taught the staff about self-regulation and co-regulation(how teachers can regulate themselves when they are stressed and how to model regulation for their students); strategies to help students regulate when they are struggling with big emotions and behaviors; how to have empathy and compassion while holding kids accountable; how to increase safety, predictability and consistency across environments; what self-care is and how to integrate it; and how to understand triggers for children and adults.

She introduced them to ACEs science, including taking them on a deep dive into the neurobiology of behavior by providing “lots of information about brain science,” she says. “Providing this information normalizes the trauma response and helps depersonalize behavior for staff and kids.” In other words, we’re all human, and we all have predictable responses to trauma. Nobody escapes.

Even though Turner said it every time she visited, it took the entire first year for the staff to understand that this approach of using trauma-informed practices based on ACEs science wasn’t a program. It wasn’t like restorative justice or PBIS (positive behavior interventions and supports) or social-emotional learning. Those are tools. 

“It’s a shift in your philosophy,” says Franke. It’s a shift in mindset, a profound shift in understanding human behavior.

It means changing the current approach to changing the unhealthy, unwanted or criminal behavior of kids and adults from using blame, shame and punishment to understanding where a kid’s behavior is coming from, providing a child with what they need to recover from trauma, and helping the child heal themselves. Once the teachers and other staff experienced that mind-shift, they were determined to cement it in place.

“Every year, the staff had to agree that was this still something that was working for us,” says Franke. And every year, they did.

The Changes are Working

Franke started seeing big changes after each classroom was equipped with a set of trauma-informed tools in their toolbox. These included creating quiet corners in classrooms, and educating teachers to understand that when a kid was fighting or yelling or withdrawing, that they weren’t doing those behaviors to bug the teachers. It was just kid speak for “I’m having troubles. Help!”

“We’ve stopped talking so much to students,” Franke explains. “We give the students the time and space to recover before we start problem-solving. If there was a shoving match between two students, we gave the kids time to de-escalate before we started questioning them.” Each fight, each meltdown, each “stubborn” refusal to engage is an opportunity to envelope those kids in kindness and patience while they recover, and then show them how to handle the situation differently next time.

The teachers and administers also gave themselves permission to take a break. “We model it for our students,” says Franke. “One day, I was working through a conflict with a group of students, and I could feel that I was ready to 'flip my lid.' Another group of students was waiting for me. I told them: ‘You know what, guys? You and I need to make appointment to talk about this later.’ They respected that I shared with them that it was not a good time for me to talk with them. To me it’s important to communicate to students and staff that everyone has emotions and that it’s important to manage them in a respectful way.”

They also spent a lot more time talking about how they were coping. “I always ask the staff how they’re doing,” says Franke. “We have potlucks together. We laugh a lot during that time that we’re together.”

During the second year, Turner began to talk with parents about ACEs science when Franke invited her to family nights that the school co-sponsored with North County Family Services. 

“We talked a lot with families,” says Franke. “There’s a book we read to students about how to prevent flipping your lid. It’s called The Way I Feel (by Janan Kain). The kids took that language to heart and use it a lot. Families began asking us about it.” 

Still, there are families whose way of coping with the slide was to isolate themselves and live off the grid, says Turner. That’s common in all communities that experience trauma, and particularly common for families that already have a lot of their own family trauma and have experienced other trauma in their environment, such as racism and violence. There are also families where children suffer because their parents haven’t grappled with their own childhood adversity, which manifests itself in alcohol and other drug abuse, family violence, parents who separate, older siblings who run away from home, etc. A lot of the abuse is hidden within the family and doesn’t rise to the level of coming to the attention of child protective services. But it still damages a child.

“We had to give up the fact that we can control their home lives,” says Franke. “But we can model behaviors, and the kids find their support in school.”

Nevertheless, this knowledge about ACEs science and trauma-informed practices is rippling out to the rest of the Oso-Darrington community. All new staff at Darrington Elementary receive training on ACEs science and trauma-informed practices, as does the staff at a local day care center run by North County Family Services, which provides the parent education classes. With support from the Red Cross, Cascade Valley Hospital Foundation and United Way, the school was able to hire school counselor Megan Lucas. 

It normally takes three years to start to see substantial change in a school that’s becoming trauma-informed. At the beginning of the 2015-2016 school year, Turner noticed a difference when she walked into the school, and she’s seen progress every year since.

“There was a sense of calm, hope, positivity,” she says. “When I arrived in 2014, the middle school kids were having lots of behavioral problems. Four years later, the elementary school kids are now in middle school, and that cohort looks totally different. When they were in elementary school, they were given permission to talk about issues and their emotions, to self-regulate, to learn how to communicate a need and how to get a need met. I see them thriving in middle school." 

“It’s something we continually have to keep on the front burner,” says Franke about learning to become a resilient school by integrating ACEs science. “We have to keep talking about it. It’s easy to slip back when things are stressful. We have to give ourselves grace in order to give students the grace that they need.”

Besides the normal stresses of everyday life, other violent acts have rattled the community. Over the last four years, this included a mall shooting and a school shooting in two nearby communities, and $1 million in damage done to the school by three of the school’s students, one boy aged 10, and two girls aged 13 and 14.

“We continually have to teach students how to self-regulate and teach them expectations. And then go back and teach them expectations again,” says Franke. “We tell them we’re not being punitive; this is about learning to get along. Learning how to be resilient, there’s not an end to it. It’s just as important as the math and the reading training.”

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 After a Disaster, There's More to Trauma Than PTSD

In the science of traumatic stress, says Sciolla, most people focus on only one outcome from a calamity such as a fire, flood, or war: PTSD, post-traumatic stress disorder. “But only a minority of people develop PTSD after a natural disaster or some other adverse event,” he says. In fact, PTSD barely scratches the surface of what’s actually happening to people and communities after disasters, Sciolla says, mostly because that limited understanding ignores what happened in their individual and community lives prior to the disaster.

Sciolla cites the case of an older man who’s retired and living in Sacramento. He and his wife lost their home in the Santa Rosa fires in 2017. Although his wife has adapted better to life in Sacramento than her husband, he has had great difficulty adjusting, says Sciolla. Losing his home, as well as the regular support of a group of friends who met weekly in his old neighborhood, overwhelmed him and he became severely depressed. Although he had led a fulfilling professional and personal life free of mental illness, it turned out that he had been exposed to a few ACEs while growing up. It was the exposure to ACEs in his childhood that has limited his ability to recoverfrom the wildfire, says Sciolla.

“This is guy who has resources,” he explains. “He’s well-off. He’s educated. He has a very affectionate close-knit family. But when he was a child, he was emotionally neglected and sexually abused, experiences that happened in the context of a dysfunctional mother-son relationship.” As a result ofthe the fire, the unfinished business from the past moved to the foreground for the first time in his life. It’s been during the sessions with Sciolla that he is finally grappling with what happened to him decades ago, and how it is affecting his health and recovery now.

Zoom out from one person in a community that suffers a disaster to many communities and tens of thousands, perhaps hundreds of thousands of adults in those communities, most of whom have one or more ACEs, and all of their children, many of whom are developing ACEs, and the prospects of recovery for individuals, families and communities can seem daunting.

“Those adults who are less prepared and more vulnerable are less inclined to have effective parental interactions with children, especially under circumstances such as a wildfire,” says Sciolla.“In particular, children who are already being exposed to ACEs will suffer the effects of a natural disaster more than those who aren’t.”

It’s important to take that same mindset when looking at communities as a whole. “The more under-resourced a community is, the less likely it will recover,” explains Sciolla. “If it has a high unemployment rate, a high rate of violence, the continuing cascade of events will lead it to have fewer resources.” 

There’s even a description for this process. It’s called a risk factor caravan passageway and describes the “often disadvantaged, resource-poor, and danger-laden socioeconomic conditions that foster the occurrence and accumulation of risk factors”, such as the accumulation of ACEs in childhood. On the other hand, resource caravan passageways “consist of conditions within the social and physical ecologies that supply, enrich, protect, and pool the resources of individuals or groups” that give rise to healthier people and thus healthier communities. The descriptions are mostly used to describe individuals — the more ACEs you have, the more consequences that can lead to more ACEs — but the approach can also be used for describing communities. A community with very few resources will have a more difficult time recovering. 

In the case of natural disasters, the community response is often a knee-jerk reaction, says Sciolla, to want to distribute everything equally. But ACEs science shows that there will be people who need more help than others, and that help must be tailored to what they need. In particular, the community needs to make an extra effort to search out parents who aren’t coping well to provide them with support AND make sure their children get extra support from adults who create a safe and supportive environment for them. 

“The media need to familiarize themselves with science and research,” says Sciolla. “So does public health, government, law enforcement need to be familiar with science so that traumatic stress is understood as well as infectious diseases.”

There’s beginning to be more awareness of how communities can incorporate ACEs science into the aftermath of natural disasters. A group of several people participating in the MARC project (Mobilizing Action for Resilient Communities), which was funded by the Robert Wood Johnson Foundation, produced “Addressing Trauma and Building Resiliency as Comprehensive Disaster Planning and Response.” (It's attached, below.) Most were living in towns and cities that had been hit by wildfires and hurricanes. The memo offers recommendations, with links to examples.

Also attached are the slides from a webinar about the Community Resilience Model created by Elaine Miller-Karas, director of the Trauma Resource Institute. She did this webinar for people in northwest Florida who are dealing with the aftermath of Hurricane Michael.

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“I think it’s going well,” says Tracy Franke of the work the school and community are doing in Darrington. “Although everyone has their moments, the community is healing.”

In October, for the second year in a row, the Center for Educational Effectiveness named Darrington Elementary a School of Distinction, as one of the 5% of highest improving schools in the state. Prior to the landslide, Darrington schools struggled significantly in meeting academic expectations. Being in the top 5% of improved schools on standardized test performance is a big deal. Although Darrington hasn’t followed the path of communities such as Walla Walla, Wash., in establishing a local ACEs initiative that reaches all sectors in a community, if it continues on its current path and continues to see results and awards like its school award, integrating ACEs science is likely to spread into other sectors besides day care and parenting programs.

What this community is integrating into its daily life, and through the sectors that are using ACEs science, are life skills that can shift future generations in the community to be healthier, says Turner. “What we’ve found is that the principles that we train translate across communities,” she says. “By helping adults understand the need to create safe and nurturing environments and doing this in different communities, we are seeing the change happening.”  

After the mudslide in 2014, the kindergarteners planted a garden dedicated to their classmate Kaylee Spillers, a five-year-old who died in the slide. Last spring, the kids, now third-graders, decided that the garden needed some TLC.

“They worked on Kaylee’s garden,” says Franke. “It was a good healing time. They talked about her and did some processing.”

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Jane:
It's another great and in-depth piece here. I almost missed it and am glad I didn't! There's so much to think about! and learn from. It's great reporting and great writing! 

I wonder how people manage short and long term after natural disasters, in general, and if we'll start to see studies that compare that based on ACE scores or other factors? I've heard that the rates of PTSD after natural disasters are much lower for men and women than following other types of trauma, such as sexual assault, in part, because communities go through it together, often with less shame than interpersonal traumas, and generally with more support (public, practical, social, emotional, public) and also because the more intimacy and personal the trauma, the more likely it is to produce symptoms. David Morris wrote about that some InThe Evil Hours: A Biography of Post-Traumatic Stress Disorder. 

I wonder though, as climate disasters and threats keep happening, if this will be more of a chronic threat and adversity and if he looked at the impact to kids as well as adults when noting the different responses to different types of trauma.

I also wonder, as with military trauma, that even for people who experience combat trauma while serving, there's still a higher risk of PTS for those with ACEs, childhood adversity or interpersonal violence. 

So many questions!!!

It's hopeful to learn how a school that starts so hurt, can do so much not only to heal from a specific traumatic event/catastrophic losses/natural disasters is also able to look, eventually, at other types of trauma, adversity and what kids and communities need to heal. And it's sad that there is so much more climate trauma.

Cis

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