Addressing ACEs through P-3 Partnerships

This past summer I did a presentation at the National Academies of Medicine on how P-3 Partnerships can serve as ideal platforms for preventing and addressing Adverse Childhood Experiences (ACEs). This two-day workshop on the Neurocognitive and Psychosocial Impacts of Violence included presentations by researchers from the health, behavioral science, criminal justice, and education fields. You can find the workshop agenda and a number of the presentations at the meeting webpage.  The National Academies has also made audio of all the presentations available at the bottom of the page (the audio requires a large download of each day’s sessions).

For easy reference, you can find my slides here, and I’m posting the audio from my session below (I pick up the pace as I get rolling a few minutes in). You will see a small square of video in the top right corner. Unfortunately there is no way to make the video larger.

New Evidence: The Impact of Community Partnerships

Liberals and conservatives often disagree about the causes of poverty and other social ills. Broadly speaking, liberals point the finger at structural factors and advocate for policy changes, while conservatives look to individuals and families and favor behavior changes. Clearly, both points of view have validity. But what’s often overlooked is what lies between these two poles — communities and neighborhoods — and the value of focusing on this middle zone. (David Bornstein, How Community Networks Stem Childhood Traumas)

In the early 1990s, Washington State created a state-wide Family Policy Council to address a spike in youth violence. The Council in turn funded local community networks to develop integrated approaches to violence prevention. David Bornstein, a reporter for the New York Times, describes the thinking behind the approach in ways that will sound very familiar to those working on P-3 initiatives:

Policy makers analyzed the problem and recognized the inter-connectedness of issues usually handled separately: child abuse, domestic violence, dropping out of high school, teen pregnancy, youth substance abuse, and youth suicide.

The separation made little sense. Youths who commit violence or drug-related crimes at 17, or drop out of school at 15, often have received a first suspension in second grade and have experienced abuse or neglect as toddlers or infants. It is now understood that the best hope of interrupting this downward spiral requires years-long collaboration between child welfare specialists, parents, educators, health workers, police officers, legal advocates and community members. [Italics added.] (Tapping a Neighborhood’s Inner Strength)

Over time the Family Policy Council began sharing research with the community networks regarding the impact of adverse childhood experiences (ACEs) on young children. ACEs refer to 10 types of abuse, neglect, and family exposure to toxic stress. One in four adults report having three or more ACEs, which are closely linked to a range of problematic outcomes for adults, including drug use, physical and mental health challenges, and early onset of disease.

Washington’s community networks followed the lead of the Family Policy Council and focused their work on addressing ACEs. They launched community outreach campaigns, organized neighborhood associations to address the underlying causes of ACEs, and developed programs in schools and social service agencies. Communities chose to work on a variety of issues, including prenatal smoking and drinking, truancy, youth drinking, domestic violence, foster care, mentoring, and improving playgrounds and parks.

In recent years several evaluations have found that community networks have been highly effective in reducing ACEs, capped off by a recently-published Mathematica study that found that several communities had successfully reduced the “long-term social, emotional, and physical problems related to abuse, neglect and other adverse childhood experiences.”

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