Empowered to end the epidemic of childhood trauma.


In the interest of keeping a dialogue about ACEs on track, let’s be clear that all of us collectively allow unsafe childhoods, filled with adversity, to remain a standard feature of these United States. We do not control the actions of one broken person doing harm to one child, but we do influence the surrounding environment that is the single biggest predictor of whether the harm will come. Change will arrive only when we who are ultimately responsible for the situation demand it.

What on earth would that change look like? We barely have a picture of that, despite living in a society obsessed with numerical metrics that fancies itself as forward thinking. With kids, we tend to measure what’s going right, like satisfactory math scores, school attendance, graduation rates, and college admissions percentages. These numbers are great to have, but they don’t tell the full story. What’s missing is the information about the people who ended up on the other side of the hoped-for outcome. Were they safe from violence and assault? Did they live in homes that prominently featured substance abuse, untreated mental illness, or neglect and malnutrition? We need to measure success, to be sure, but to do so correctly we must also measure failure.

A Turning Point Arrives

As most of the readers of this blog know, we published our book Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment a year ago. After we received an email from a New Mexican social worker who asked us to make the book as widely available as possible to people of all income levels—we made it free-of charge to download at www.AnnaAgeEight.org.  (This is not something most authors do but to us it made perfect sense.)

A year later, the book has served as the catalyst for the proposal to develop the Anna, Age Eight Institute. This will be a technical assistance center focused on the data-driven prevention of childhood trauma and maltreatment. For twenty years since the publication of the ACEs Study, our nation has failed to develop a strategic plan for the data-driven, cross-sector and systemic prevention and treatment of ACEs. Not one state has a transparent and sustainable plan to significantly address our epidemic of childhood trauma.

We intend to change the course of the epidemic. To learn more about our plans for the Anna, Age Eight Institute, please visit www.AnnaAgeEight.org/institute.

We currently have a bill with non-partisan support to fund the Institute. The bill being presented to New Mexican lawmakers is the result of a state senator reading the book and seeing ACEs prevention as a vital part of school reform. The senator understands that traumatized students do not focus on their math homework when they worry about what awaits them at home in an unstable and unsafe household.  


Our work to generate dialogue about ACEs started by sending each state lawmaker a copy of Anna, Age Eight. We have been using the book as a catalyst for community dialogue and debate, and we formed book clubs in all the counties we did forums on ACEs prevention. I am including our key questions that are part of each chapter. We strongly encourage all those involved in the health, safety and education of children to begin conversations with lawmakers and stakeholders on the state, county and local levels. We are close to a tipping point when measurable and meaningful progress toward ending ACEs is possible. We are nearing the time when every state will have their own technical assistance center to make ACEs prevention possible. Your willingness to ask the tough questions are all part of the process.

Questions to ask, ponder, and debate

 The following questions can serve as a catalyst for work study groups or book clubs. We recommend taking on one chapter per week or month and exploring attitudes, ideas, and steps for getting to meaningful solutions, whether one is within an institution like child welfare or public health, a nonprofit with limited funds to focus on youth development, the mayor’s office staff, or a software company with a book club of socially-engaged designers.

CHAPTER ONE: Comfortably Numb

  • How numb are we to news about childhood trauma and fatalities?
  • What can we do to reduce the numbing influence of the mass media on all our screens?
  • Who is doing any work related to advocating for the safety and health of children and families in your community?


CHAPTER TWO: An epidemic we prefer not to see

  • How are ACEs like a virus? How are they different?
  • Why are some people able to shrug off childhood adversity as “no big deal” while others are traumatized by it?
  • What are the financial costs of childhood trauma that you can see in your everyday life?

CHAPTER THREE: Software, eggshells, and minefields: Illustrating the problem in all its glorious shame

  • What do you think of the ACEs survey? Had you taken it before or even heard of it?
  • Do you think it would be useful to have all late elementary, middle, and high school students take the ACEs survey? Why or why not?
  • How useful are ACEs scores from middle school students versus a random sample of adults across your state?


CHAPTER FOUR: Our inheritance of horrors: The complex, chaotic, and invisible root causes of trauma

  • How is brainstorming root causes for bad coffee in an office different from brainstorming the root causes of ACEs?
  • If a root cause of ACEs is untreated mental health challenges, what data and research tell a story of the availability of your county’s mental health services? (For both children and parents.)
  • How do you think community norms are related to how parents can treat their children?
  • What do you think are the root causes of childhood trauma in your community?


CHAPTER FIVE: An infant, a motel room, and a pile of needles: The impossible work of child welfare pros

  • What do you know about your local child welfare office?
  • Where can you easily access data on local maltreatment?
  • Does your state or local child welfare office have a robust quality and planning department with the capacity to promote a framework and process like continuous quality improvement?
  • Do people who work on the prevention of ACEs see themselves differently from those who work in child welfare preventing maltreatment? If so, how?

CHAPTER SIX: Trauma’s fuel tank: The ongoing crisis in mental healthcare

  • What are the challenges to providing behavioral health care to children and families?
  • What are the benefits of having behavioral health care based in a school setting?
  • What are attitudes about accessing “talk therapy” in all your communities? Is there any stigma discussing trauma-related problem with a counselor?
  • How can we better promote the benefits of mental health care and treating ACEs?


CHAPTER SEVEN: Because this is America: Why your zip code should not determine your destiny

  • What are the benefits of home visitation for parents in your community and county?
  • What are the benefits of early childhood programs? What are the challenges to accessing such programs?
  • What are the benefits of having youth mentors? What strategies are used to recruit mentors?
  • How can organizations that serve families become data-driven, cross-sector, and adopt a systematic approach to preventing childhood trauma?
  • Which groups are tackling the long term work of creating access to safe housing, medical/dental care, transport, job training and family-centric schools?


CHAPTER EIGHT: There’s an app for that (maybe): Healthy kids and the promises and perils of technology

  • What would be the benefits of an app or site that published information about family-centric services available in your area?
  • What are the benefits of having services rated by clients? (The way people rate hotels on Trip Advisor.)
  • What are the benefits of creating an online environment that would tell us if the needs of our most vulnerable families were being met?
  • How can you easily access data and research online related to ACEs and maltreatment?
  • How do you start or strengthen an organization to ensure that we address risk factors in our most vulnerable communities?


CHAPTER NINE: Get the Data and Make a Plan: Why we all live in Santa Fe, New Mexico

  • What do you need to strengthen ACEs prevention work and resiliency promotion work?
  • How data-driven, cross-sector and systemic is the current ACEs prevention work? How do we strengthen it?
  • What can be done to ensure that each state has dedicated staff positions and the resources to implement the data-driven prevention of childhood trauma and maltreatment?
  • How can you train people in continuous quality improvement at your place of work?
  • How do we use data to disrupt dysfunctional systems?
  • What can you do about the lack of urgency for addressing childhood trauma and maltreatment?
  • Why will some people and agencies fear using data?


CHAPTER TEN: Experience being courageous preferred, but not essential

  • Why would it take courage to work on ACEs prevention?
  • What other large social problems required courage and risk to solve?
  • What is one social problem you see as solved that can serve as a model for addressing ACEs?
  • What is your role in ending the epidemic of childhood trauma and maltreatment?



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