Dr. Mimi Graham is Florida’s Johnny Appleseed, but instead of planting apple trees, she’s been seeding hundreds of ACEs-science-informed schools, courts, juvenile detention centers, hospitals, childcare centers, home visiting programs, mental health agencies, law enforcement agencies, and drug treatment centers. Graham, who has served as director of the Florida State University Center for Prevention and Early Intervention Policy in Tallahassee since 1993, focuses on early childhood, specifically the first 1,000 days of life, from ages zero to 3.
Graham is one of the leaders of the statewide Trauma Informed Care Workgroup (here is the link to Florida ACEs Connection, which posts updates from the workgroup) and spearheads the statewide “baby” court teams to train judges and lawyers about taking a trauma-informed approach to parents appearing before the court. She is past president and cofounder of the Florida Association for Infant Mental Health and a fellow with the Zero to Three National Center for Infants, Toddlers, and Families. She’s won several awards from state organizations for her work to integrate trauma-informed training that includes practices to build resilience.
Now 63, Graham earned a bachelor’s and master’s in child and family studies. She learned that some of her classmates had never celebrated their birthday, so in her senior year, she made over 100 birthday cakes for them. She wanted everyone to feel special on their special day. She believes that having a happy childhood sets the foundation for a good adult life. She had a gloriously happy childhood in Virginia, she says, and therefore an ACE score of 0.
With this background, Graham’s first job was as the director of Head Start in Virginia. Then she worked for former President Jimmy Carter’s second presidential campaign, and when he lost, she went skiing in Aspen for a while before getting a “real job” in Miami as principal of the university lab school that mainstreamed children with disabilities. She became a believer in early intervention when she saw four-year-olds defy the odds after their parents were told they would never walk or talk. At the same time, she earned her doctorate in educational leadership from the University of Miami.
Last summer, while teaching about ACEs-science-informed baby courts to groups in China, she worked remotely to orchestrate publishing a booklet, “Creating a Trauma Informed State,” by asking people to send her information about their innovations in integrating ACEs science. Fifty different organizations sent in responses. They included one from a new clinic for immigrants that installed a kiosk in the waiting room with an ACE questionnaire so people could fill it out and then meet with doctors and psychologists to discuss ways to deal with their trauma. Another was from the Palm Beach public schools, which trained all their teachers in ACEs science. Lacking funds to publish the booklet, her colleague’s foundation — the Charles & Margery Barancik Foundation — offered to printed 500 complimentary copies.
That booklet was distributed to all 350 attendees at the ACEs Think Tank conference in Naples, FL,in 2018, which featured Dr. Vincent Felitti. Felitti was a co-principle investigator of the CDC-Kaiser Permanente Adverse Childhood Experiences Study. The ACE Study tied 10 types of adverse childhood experiences (ACEs) to adult onset of chronic disease, mental illness, violence or being a victim of violence. ACEs include experiencing physical, sexual or emotional abuse; living with a family member who abuses alcohol, or drugs or is mentally ill; experiencing divorce, and having a family member who is incarcerated. Many other types of ACEs — including racism, bullying, a father being abused, and community violence — have been added to subsequent ACE surveys. The epidemiology of ACEs is one part of ACEs science, which also includes how toxic stress from ACEs affects children’s brains, the short- and long-term health effects of toxic stress, the epigenetics of toxic stress (how it’s passed on from generation to generation), and research on resilience, which includes how individuals, organizations, systems and communities can integrate ACEs science to solve our most intractable problems.
“We had 33 different tables: sheriffs, hospital folks, school superintendents, state attorneys, judges, pediatricians, mental health, foundations, a table for each discipline,” says Graham. “We listened to Felittl for an hour, and then the professionals at each table shared best practices. A sheriff from Pensacola, FL, drove 10 hours each way to hear Felitti.”
Graham says that although she’s long been aware of the brain science and trauma-informed practices, she didn’t know about ACEs science until she heard pediatrician Nadine Burke Harris give a TED talk in 2014. Burke Harris is now California's first Surgeon General.
After Burke Harris’ talk, Graham started preaching about ACEs science everywhere she went. “For the judges and the lawyers, it was just so compelling,” Graham says. “It was never a hard sell because it just makes so much sense.” One of the judges told her, “We have been doing it all wrong. We’ve gotta change.”
In 2013, Graham received a grant, “Early Childhood Comprehensive Systems: Trauma & Toxic Stress: Changing the Trajectory for Florida’s Most Vulnerable Children”. She provided seed money for two baby court pilots and connected them with infant mental health specialists who simultaneously address parent and child trauma. When their early childhood traumas are finally addressed, the lives of families are usually turned around. Parents and children heal. She also won a productivity award for saving taxpayer money because the baby courts expedited permanency for reuniting the children with their parents, and in the process broke the multigenerational cycle of adversity.
“The judges were blown away by how parents changed when they were treated for trauma. When people understand that teen moms who are pregnant in the prison system are victims themselves, it changes everything,” Graham says. That’s why her current passion is to expand the successful baby courts, where, after a year out of court, 99 percent of children suffer no further abuse. Florida has 24 courts now. Despite their success, only 4% of eligible young children are served — that’s 350 that are being served, and 13,175 that aren’t, as of January 9, 2019. She hopes to have at least two more sites on board in 2020. Attached is new cost estimate Graham did which shows that Florida is already spending millions, and how many millions could be saved millions if all kids had access to baby court.
Graham compares the before and after knowledge of ACEs science to a painting by Salvador Dali, which hangs in the Dali Museum in St Petersburg, FL. Close up, the painting depicts the backside of Dali’s nude wife. But “when you get 25 meters away, it looks like Abraham Lincoln,” Graham explains. She says that’s the same with knowing about ACEs science: “When you have a trauma lens, you see things totally different.”
She cites a school she worked with that used to expel kindergarteners for bad behavior. She trained the whole school staff about ACEs science and trauma-informed care. The staff learned about their own ACEs and self-regulation, they learned how to handle students differently, and they wrote grants to introduce programs like yoga and meditation.
“The school no longer expels any students,” says Graham. Its staff learned that “there are no bad kids,” she explains.
She created an online training program on trauma-informed childcare, which more than 2,500 teachers have taken so they could learn what was happening behind challenging behaviors.
Her book, Finding the Gold Within: Overcoming Trauma to Create A Happy Life, is an interactive workbook to strengthen personal resiliency to gracefully overcome life’s challenges and create relationships that provide meaning and joy in your life.
Despite the inroads ACEs science has made into Florida’s public and private organizations and companies, there still is much to do. Graham reports that a six-year old recently was handcuffed and arrested because teachers and law enforcement didn’t understand that his behavior was as a result of trauma. A first-grade boy who had been in six foster homes in two weeks was throwing rocks, so his foster mom committed him to a mental hospital, where he was given psychotropic medications.
ACEs science integration also extends to universities. After three attempted suicides by students, FSU administration worked with social work faculty Dr. Karen Oembe, who spearheaded a campus-wide online resiliency program that has quickly become a national model for universities.
FSU’s new 20-hour trauma certification program has also created interest among students as well as postgraduates. The president of Florida State University is the biggest advocate, saying that if it could save even one student from taking her or his life, it will all be worth it. FSU’s innovative trauma efforts were also helpful in improving its national ranking up from 25thto 18thbest public university in the nation.
“It’s amazing what the ‘aha’s’ are when people hear about the science,” says Graham. At recent training with hard-nosed career prosecutors of delinquent youth, one came up to her after the first hour of her ACEs science training and said, “I know we’ve been doing it all wrong. What if we offered trauma treatment to all our teens?”
Florida’s Johnny Appleseed will continue to plant trauma seeds across the Sunshine State to educate and advocate. “In my opinion,” says Graham, “healing trauma is the answer to some of the most intractable problems we face.”