Browsing by UMass Chan Affiliation "Foster Children Evaluation Services"

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    • Adverse Childhood Experience and Social Risk: Pediatric Practice and Potential
      Conn, Anne-Marie; Szilagyi, Moira; Forkey, Heather (2020-07-01)
      In a landmark study, Felitti et al found 10 Adverse Childhood Experiences (ACEs) to be associated, in a dose-dependent manner, with the leading causes of illness and death in adults decades later. Over the subsequent 20 years, research has confirmed that trauma in early childhood, in the absence of sufficient protective caregiving, causes a frequent or prolonged stress response that is the physiological link between childhood trauma and poor adult outcomes. Schonkoff and Garner termed this “toxic stress.”ACEs harm a child's still-developing immunological system and brain explaining the findings of poor physical, emotional, and developmental health down the road. For pediatric researchers and practitioners, these data have created a 2-fold challenge: How to mitigate exposure to adversity and, critically, how to ameliorate the impacts of adversity on those exposed. In practice, this requires identification of those at risk and responses and tools to impact the trajectory.

    • Putting Your Trauma Lens On
      Forkey, Heather (2019-07-01)
      Trauma in childhood is now understood to cause long-term effects on the brain and body. The pediatric provider, using a "trauma lens," which constitutes observing a child's attachment, resilience, and stress response, is well poised to identify and support children and families at risk. Fortunately, resilience is a dynamic process that can be learned, enhanced, and supported. Familiarity with the most common symptoms of traumatic stress will help the medical provider quickly recognize which children are impacted or FRAYED (Fits, Frets, and Fear; Regulation disorders; Attachment problems; Yawning and Yelling; Educational and developmental delays; Defeat and Dissociation). Once symptoms are identified, the caregiver can "focus" on attachment and resilience skills, the THREADS (Thinking and learning brain, with opportunity for continued growth; cognitive development; Hope, optimism, faith, belief in a future for one's self; Regulation [self-regulation, self-control]; Efficacy, or knowing one can impact their environment and situation; Attachment, secure; Development, or mastery of age-salient developmental tasks; Social context or the larger network of relationships in which one lives and learns) that can be woven together to promote resilience. Guiding families with empathy and positive regard, the medical provider can help the child and family rebuild resilience skills. Organizing practical guidance around the "3 R's"-Reassuring, Restoring routines, and Regulating-is a roadmap to recovery.