Advice for Parents

Why Aren’t We Preparing Kids for Disaster

~ debvilasconsult ~ 2 Comments

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Beal_Photo_sm Guest Blogger Heather Beal is a military veteran with 23 years of crisis management and operational planning experience that she draws upon daily in her battle to raise two well-prepared, happy, curious, and intelligent children. As a trained emergency manager and parent, she saw the need to provide age-appropriate disaster preparedness information to young children in a way that empowered rather than frightened them. She is currently writing additional books to cover a greater spectrum of potential disasters children may face.

“Generally speaking, we do not prepare our children for disaster. We make them hold our hand in the parking lot and talk about the dangers of getting burned by the stove, but we stop short of this really big “disaster” word. When I think about it, I can come up with a few excuses we call reasons as to why we don’t give this topic the attention that we should.

First, like our children, (but usually without donning the superhero capes and masks), we believe that we are invincible. It (the disaster) can’t happen to ‘us,’ it only happens to ‘others.’ Folks – look at Hurricane Harvey, Superstorm Sandy, Hurricane Katrina, the Indian Ocean Tsunami, and any other number of disasters. With that many people affected – the ‘us’ and the ‘others’ are the same people. We need to look at disaster as a probability, not a possibility.

Second, we think talking about disaster will be too scary. I get it. No one wants to tell children anything bad could happen. We all know our children could get terribly hurt running if hit by a car in the parking lot, but we don’t get into explicit details about injury and death. We do however, talk to them about being safe, making good choices, and not doing things that could more likely result in their getting hurt.

We should approach talking about disaster in the same way we approach other learning topics or the consequences of actions or inaction. We don’t need to focus on the destruction a tornado can cause, how their lives could be uprooted, or what other things could dramatically change. We can however, talk about what children need to do to stay as safe as possible.

There are no guarantees in life for anything. We can’t guarantee that a car in the parking lot won’t do something stupid, just as we can’t guarantee the tornado will miss a child’s house, school, or childcare. But we, as parents, as childcare providers, as educators, as caregivers, as emergency managers, and as community members, can arm our children with the tools to succeed. We owe them that.

Sounds good – but how would I know, right? Fair question. A few years ago I tried to explain to my then 4-year old daughter that she and her brother might be woken up in the middle of the night to go into the basement if there was a tornado warning. Of course, it was already dark and stormy (thunder and lightning and everything). Needless to say, I did a very poor job, ultimately scaring her and beating myself up about my failed attempt to mitigate later fear through a botched explanation. Never again I vowed.

That was when I discovered that almost no one was having the conversation with young kids (toddler, preschool, or kindergarten) about disaster. At the same time, I realized that disaster was not going to sit by patiently and wait until my children could calmly and rationally discuss everything at a grown up level. I decided I could develop a way to talk with them in a way that didn’t scare them, but instead empowered them by teaching them what to do and giving them back a little control in a typically uncontrollable situation. They might not be able to stop the disaster, but they could do something to increase their safety within it.

I started Train 4 Safety Press to develop picture books that would teach children what to do “if.” As I conducted research, I discovered a few books out there on the science of disaster, but almost none that taught young children what to do when the disaster was happening. Our first book Elephant Wind tackles what to do during a tornado. Tummy Rumble Quake teaches children about the Great ShakeOut™ and earthquake safety.

Children have a great capacity for building their own resilience. Teaching them how to protect themselves can have an exponential effect. Children could not only help themselves, they could help their classmates, their teachers, their family and their community. Isn’t anything that increases the odds we bring our children home after a disaster worth it? Can we afford not to talk about it?”

And here is a great resource: National Child Traumatic Stress Network

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Bilingual Book for Pediatric Cancer Patients

~ debvilasconsult ~ 1 Comment

My thanks to Marifer Busqueta for connecting me to this wonderful bilingual children’s book for children and families facing cancer:

 

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The information below is copied directly from the book’s website benito books. Marifer herself has written a children’s book in Spanish to address children’s questions about loss and death, “I want to know what is death?”. It is wonderful to have access to books for Spanish speaking and bilingual children facing illness and loss.

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Overview

Benito, You Can Do It! Volume 1 is the first in a series of bilingual picture books for children diagnosed with cancer. This 80-page (40 in English and 40 in Spanish) picture book depicts a Latino family facing childhood cancer and uses a soccer analogy to explain the roles of the medical team.

Pages from the book

Written and illustrated by Alan Quinonez, this book helps parents find strength and hope when one of their little ones has been diagnosed with cancer.

Our Goals

The picture book series Benito, You Can Do It! has been inspired by the testimonials from the families in the Latinas Contra Cancer Parent Support Group as well as the expert knowledge and input of the medical team at Stanford’s Lucille Packard Children’s Hospital.

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Our goals in developing this first-of-its-kind book series reflecting the Latino experience are:

  • To the affected families to share the resources, advice, and best practices learned from the cancer journey with their child.
  • To show the cancer survivors that this is an opportunity for them to step into the limelight and reach out to those who might lose faith.

The book series

Our first volume The News, helps children and their families cope with a recent diagnosis by providing a better understanding of the disease, and the medical team that will be helping them.

Upcoming volumes in the series are:

  • Vol.2 The Awareness (working title) Will explain how the immediate family of a child with cancer faces twice the risk of developing the disease, and what steps the family can take to reduce the risk.
  • Vol. 3 The Treatment will explain the different types of treatment and life at the hospital.
  • Vol. 4 The Siblings will help brothers and sisters process their own feelings of being set aside and neglected.
  • Vol. 5 The Return to School will explore the anxiety that children face when they go back to school before their hair has regrown.

Our fundraising on Kickstarer

From Sep 6th to Oct 6th 2013, we ran a kickstarter fundraising campaign.

Thanks to the generous donations from 171 backers, we were able to raise over $12,000, which allowed us to cover the costs of print, as well as set aside 110 books and make them available for free to families in need!

At our campaign page you can:

About the author/illustrator
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Alan Quiñonez is a writer and illustrator working on his dream of telling stories that cross language barriers and foster a message of hope and strength in children and families around the world. He lives with his partner in North Hollywood. His personal website is alanrq.com

About Latinas Contra Cancer

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Latinas Contra Cancer is a decade old nonprofit based in San Jose, California. Founded by Ysabel Duron, a cancer survivor, this agency, one of the few of its kind in the country, works to improve outcomes for Latino families affected by cancer by increasing awareness and knowledge, access to care, and psychosocial support.
Learn more at latinascontracancer.org

Prescription for Play: How Pediatric Play Promotes Health and Healing

~ debvilasconsult ~ 3 Comments

I was honored and so excited to be interviewed by Photographer & Guest Writer, Marj Kleinman for her article at TocaBoca.com. She and I have much in common, including a deep passion for child life and play in hospitals, and the fact that we are both alums from Saint Ann’s School in Brooklyn, NY. She is a talented artist and used her creativity to write a photo journal of child life and play at Maimonides Hospital. I will publish that here next week. The Toca Boca article is reprinted here in full below.

Child life specialists support kids and families in a hospital environment, reducing stress and increasing joy.

Marj Kleinman
BY
Marj Kleinman, Toca Magazine Guest Writer

When I tell someone that I volunteer in pediatric hospitals, I usually spot a sad face across from me. That response is understandable, given that hospitals can be scary and sometimes painful and upsetting. But in fact, there’s no greater place to see joy and resilience on display, all through kids’ natural passion for play.

Whether at their doctor’s office or in the ER, kids find a way to play, particularly with encouragement. Most children’s hospitals today come equipped with a playroom and a bevy of materials and activities, so kids can be kids while hospitalized. Once they see a playroom full of toys, messy finger paints and a silly guy blowing bubbles, they know this place is made for them and they will probably feel safe there. There’s even a team of people whose job is to play with your child: the child life specialists. They become parents’ partners in health and healing.

Meet the child life team: Your play partners

Many parents are surprised to learn that there’s a person solely focused on your child’s emotional health during a hospital stay — and they do it mainly through play. Child life specialists (CLSs) help kids and families adapt to the hospital environment and support them in understanding what’s taking place, thereby reducing the stress of a hospitalization. CLSs are trained in child development and play theory, as well anatomy, research methodology, sociocultural issues, ethics, family systems and bereavement, among other things. They also act as a bridge and advocate with your medical team. Child life departments often include art and music therapists, and are visited by yoga and mindfulness teachers, clowns and other practitioners.

Language of play

Play is the universal language of childhood — in fact, when CLSs assess their patients, they’re watching how kids communicate via play. I spoke to Deborah B. Vilas, a CLS and social worker who teaches child life graduate students at Bank Street College of Education. Vilas says, “Young children won’t sit down and say, ‘I felt sad today and I think I’m anxious about the medical treatment I’m getting.’ When children are playing, they act out scenarios and show us what they’re feeling; they show us what they understand, what they’re capable of and what their coping mechanisms are.” This may seem obvious, but in some hospitals, there’s a misconception that play is frivolous or low on the priority totem pole.

Young children won’t sit down and say, ‘I felt sad today and I think I’m anxious about the medical treatment I’m getting.’

Vilas reminds us, “It’s been proven that when children have play opportunities that they need less medicine, less anesthesia, are more compliant and get better faster. The benefits of play reach beyond the child to assist medical personnel and influence the hospital’s bottom line.”

Benefits of play

According to the American Academy of Pediatrics (AAP), “Play is essential to development because it contributes to the cognitive, physical, social, and emotional well-being of children and youth. Play also offers an ideal opportunity for parents to engage fully with their children.” Why would all that stop at the hospital? The AAP goes on to state that hospital play is a necessity that helps kids cope with treatment and stay on track, developmentally. The uses and benefits of play in medical settings are varied and significant.

At its essence, play provides a safe space for kids to experiment with unfamiliar and often scary experiences. Through open-ended play, kids can take in new information at their own pace, re-create situations and play out fears until they are familiar enough to gain a sense of mastery over the situation. When supported by an empathetic parent or CLS, this process is deepened and they can better process and release feelings.

At its essence, play provides a safe space for kids to experiment with unfamiliar and often scary experiences.

Open-ended and child-centered play, in particular, are highly beneficial, as they provide opportunities for kids to immerse themselves more deeply in play and lead from a sense of agency. Unfortunately, free play has been on the decline due to our hurried and jam-packed, overscheduled and tech-filled lifestyles, yet it is necessary for skill development, self-regulation, independent thinking and creative problem solving. In the hospital, where kids lack choices, it’s even more crucial to let kids be in charge.

Medical play

One of the roles of the CLS is to normalize the hospital experience through play. They might do familiarization activities, for example, building a robot using a bedpan, tongue depressors and IV tubing, all taped together with bandages. Suddenly medical supplies aren’t scary, cold, weird objects that only doctors and nurses use, and kids can “hack” the hospital.

Going a step further, medical play with a toy doctor’s kit and/or real medical supplies can 1.) educate children about an upcoming procedure, 2.) let them process their experience, before, during or after a procedure, and 3.) put the child back in the driver’s seat.

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Meghan Amorosa, CLS, engages Jan, age 4, in medical play at Brooklyn Hospital Center, Brooklyn, N.Y. Photo by Marj Kleinman.
 

Children experience a strong sense of helplessness, vulnerability and anxiety when faced with uncertainty and misconceptions (let’s face it, so do grownups). Procedural support helps educate, greatly reducing feelings of unpredictability, and increases a level of mastery.

Meghan Amorosa, child life specialist at Brooklyn Hospital Center in Brooklyn, N.Y., says, “A really big part of medical play is about giving patients choice and control over their own hospital experience. Instead of being the patient, they become the doctor and play on their own little patient.” She observed that Jan (pictured above) gave the doll a lot of shots, which is typical in patients who’ve been poked a lot. In fact, “If a kid gives a doll a million shots, they’re showing you how painful that was for him,” says Vilas.

A really big part of medical play is about giving patients choice and control over their own hospital experience.

Movement plays a key role in healing.

Movement also plays a key role in healing, which is why doctors want patients up and walking almost right after surgery. If kids can get out of bed and step on bubble wrap or a floor piano, ride a hospital wagon around the unit, or skate down the hallway on their IV pole, they get the blood circulating, feel more energized and also empowered at the same time.

Play is powerful and can be tailored towards your child’s individual age, temperament and tastes. Read on to find out 10 ways to support kids going to the hospital, as patients or visitors.

Marj Kleinman is a Brooklyn based photographer and children’s media producer with a master’s in educational psychology.

Medical Play: Modeling Empathy for your Child

~ Deb Vilas ~ 3 Comments

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Colleague and friend, Teresa Schoell, is a child life specialist in upstate New York. She is featured in  “That’s Child Life!” , a video published by the Child  Life Council. She is also, first and foremost, a mother to Malcolm. She posted this story on FaceBook today, and with her permission (and Malcolm’s), I wanted to share it with all of you.

I just finished performing surgery on one of Malcolm’s beloved stuffies (a gift from the dear Justinn Walker). Apparently, JC the Lobster was quite anxious about the procedure, hiding in Malcolm’s arms while I threaded my needle.

“I’m scared it’s going to hurt,” came JC’s voice (with a marked similarity to Malcolm’s falsetto).

Then I heard Malcolm’s reassuring voice “Don’t worry, JC, we’ll give you sleep medicine so you don’t feel anything. Would a hug help you feel brave?”

A few hugs and and some invisible anesthesia later, the lobster was open on my table (prepped and draped in the usual sterile fashion….which is to say, laying on a couch cushion on my lap) Today’s procedure was to repair the distal fracture to the bendy wire in the patient’s left antenna, which supports movement and pose-ability.

Under general anesthesia I opened and peeled back the fabric, revealing the damaged wire. The sharp wire bits were realigned and repaired use med-surg duct tape, reinserted into the fabric, and sealed with a running subcuticular suture (sewed on the inside for a near-invisible scar). Procedure complete in 15 minutes with minimal stuffing loss. Patient resting comfortably.

 

I commend how Teresa invested in Malcolm’s powers of imagination and attachment by treating JC the Lobster with the respect one would give a live patient. When parents take their child’s attachments and emotional needs seriously, they model empathy, the glue that holds our society together.

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Preventing Pediatric Pain: A Longterm Win Win

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Amy Baxter, MD, the queen bee of pediatric pain prevention

“I believe established medicine is courting a public health disaster, not because of costs or lawsuits or one dumb publication from a scientist gone bad, but because of a national Pavlovian failure of empathy.” — Amy Baxter

Who is Amy?

“Emergency pediatrician Amy Baxter noticed a disconnect in health care: caregivers often cause pain to solve a problem, but for many patients, pain is the problem. While researching the causes and consequences of untreated pain, she invented Buzzy, a bee-shaped device that physiologically takes the sting out of shots using high frequency vibrations and cold. Amy is the director of Emergency Research for Pediatric Emergency Medicine Associates at Children’s Healthcare of Atlanta, Scottish Rite. In the academic world, she is known for creating and validating the BARF nausea scale for children, and an algorithm to measure the timing of child abuse. Honors include a 2011 Medical Design Excellence Award, Georgia Bio Innovative CEO of the Year, and a Wall Street Journal “Idea Person.”” (TEDMED, retrieved November 7, 2016)

In a recent conversation with Dr. Baxter, I asked her about her war on pain, and her appreciation for the field of Child Life.

What are your beliefs about pediatric pain and the need to prevent it?

I take seriously the oath to First Do No Harm.  When iatrogenic procedural pain causes people to fear healthcare later in life, we have done harm.  When we withhold pain management in the trauma bay, we do harm. I have always been suspicious when we do something without pain management to someone small enough to hold down, but we sedate or give analgesics when they’re big enough to fight back.

What do you believe children need most in the medical setting? 

Children need to know they’re safe.  Therefore, parents need to know we’re doing everything we can to make them not hurt.  Something may happen that isn’t comfortable, but kids need to trust that they’ll be warned.  If there isn’t any way to make it more comfortable, they need to know that their care team and parents are all agreeing and supporting what is best for the child. Even very young children know crap happens; what is scary is when the people who keep their world stable are visibly angry, confused or afraid.  Pain isn’t the worst thing that happens, it’s pain when their parents seem unable to protect them. When I fix a nursemaid’s elbow or a patella, I offer analgesics, but let parent and child know I can make them feel better FAST right now but it is going to be uncomfortable for 5 seconds or less.  Or they can wait, but it will still be a little uncomfortable.  Most opt for fast, but that control and honestly let them know I’m thinking about not hurting them first and foremost.

Why is pain prevention important for very young children?

Kids who are persistently afraid of needles have healthcare consequences. They grow up to be adults who don’t get flu shots, or start insulin when they need it, or donate blood.

What motivates you in uphill battles with sensitizing other medical professionals to the necessity of pain control for infants and children? 

I really believe that truth carries its own coercion.  If people who want to heal see the truth of the importance of pain relief, they eventually will align their behaviors with that belief.  No one wants to be an outlier in medicine.  Once one person sees the truth, that pain relief matters, they can’t unsee that.  Eventually the obvious will become apparent to everyone – we can make the entire system work better when we don’t hurt children.

How did you learn about Child Life?

I know this is hard to believe, but I can’t remember not knowing about Child Life.  I’m sure we didn’t have Child Life in pediatrics when I was training, but perhaps because it always seemed such an obvious need when I first began seeing Child Life specialists, perhaps I assumed they always been someplace, just perhaps not in my department.  I carried distraction toys on my stethoscope and in pockets since I began training, it just seemed logical.  My oldest was born my first year of residency, so I had a natural connection to what worked for different ages from the beginning of my training.

Resources for doctors, parents, nurses, and child life specialists

In this TEDMED Talk, Amy speaks to the increase in vaccinations in early childhood, and the impact it has in increasing needle fears later in life.  Visit her  Buzzy website to find out more about the most cost effective way to prevent needle pain in infants and children.
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The Child Life Maker Movement: Loose Parts Impacting Healthcare

~ Deb Vilas ~ 1 Comment

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What happens when you cross a child life specialist with loose parts? Creativity, to say the very least. Specialists have been using loose parts to make the medical world more accessible and friendly for children and families since the beginning of our profession. They combine medical supplies (tubing, gauze, rubber gloves) and household items (paper towel rolls, pipe cleaners, paper clips, felt) to create everything from customized dolls that reflect a child’s medical situation, to a glove-o-phone to help children pass breathing tests. Simple and complex inventions have aided children in making meaning out of their medical experiences.

 

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Now, with the Maker Movement, child life specialists have invaluable opportunities to join brains with other disciplines seeking to improve patient experience and speed recovery.   Bank Street College Child Life alumnae Jon Luongo and Kelly Segar, and children’s book author Anastasia Higginbotham rolled up their sleeves to join the Maker Faire at The New York Hall of Science this past weekend. They joined nurses, doctors, medical technicians and fellow inventors in the Health Maker tent on this brisk and cloudy autumn day.

As children and caregivers meandered through the exhibits, .the specialists shared information about how to make pediatric hospital stays more manageable, less stressful, and more fun. As Jon demonstrated the glove-o-phone, kids jumped at the unexpectedly loud honk it made.

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Exclamations of “Ewww gross!” were followed by attentive curiosity as Jon explained the purpose of the vial of “blood soup” on the table.

 

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Families spontaneously grabbed colorful neon strings and engaged in string play, a simple game that crosses generations, culture and language around the world.

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Kelly demonstrated her Barium Bear, “Barry”, developed to support children receiving barium enemas and scans. She used simple circuitry that she learned from a Hospital Play Specialist in Japan to illuminate the pretend scan.

 

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At nearby tables, radiation techs and doctors showcased how legos can be used to build mini MRI, CT-Scan, and linear accelerator machines. When they are doll sized, they aren’t quite so scary. And when children aren’t as frightened, doctors can administer less anesthesia to their tiny patients, a win-win for everyone.

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Did you know that a A three-D printer can be used to make prosthetic hands for children who have lost theirs to birth defects, disease or accidents? And for a fraction of the cost of traditional prosthetics. And they aren’t just your run of the mill hands either. They are superhero hands! As I observed a three-D printer humming away at one exhibit, I wondered about what kind of mind came up with the idea of this machine. And then who had the amazing idea about the possible application of it in the medical world?

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Wonderful ideas start somewhere, and when we encourage children to explore and create, even in the medical environment, we are investing in their healing and in their future. The Maker Faire was an extraordinary celebration of the possibilities of the human brain. From low-tech to high-tech, creative minds came together in the Health Lab tent to hack medical problems and make the healing process more fun. If you want to get your maker on, I encourage you to find maker spaces near you Challenge your child life staff to a loose parts contest at the next departmental meeting. Jumpstart a health maker group in your hospital and invite staff from throughout the institution to collaborate. And don’t forget your best assets. Find every opportunity to include children in creative problem solving with loose parts. In and out of the healthcare field, children and adults all benefit when we connect with what Eleanor Duckworth called “wonderful ideas.”

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Bombings & Shootings & Stabbings, OH MY!

~ debvilasconsult ~ 2 Comments

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We all might be feeling on edge these days. I know I am after the bombings in my hometown of NYC this week. But I have coping skills as an adult. How hard must it to be to be a kid and see this stuff on TV? How do we help our children feel safe as we do our best to keep our own fears in check? We know that children need help to process these unfathomable occurrences. The bad news doesn’t just go over their heads, and they will draw their own conclusions and suffer inner fears alone without adult support. The trouble is, what do we do when we don’t know what to say? When we don’t have answers?

Thank goodness, there is some great expert advice out there to guide adults in helping kids process  disasters, both natural and manmade.  Here are some links to get you started.

Discussing Tragic Events in the News

Addressing Extremism

Talking to Children about Shootings

Stay safe out there, and help children in your care to feel safe by monitoring their exposure to news on TV and the internet. Whether you are a parent, caregiver, or if you work in a hospital or school setting, gently encourage adults to keep TV/radio news off in the presence of children, and to be aware of children’s listening ears when discussing events with one another. And then, begin the tough discussions.

 

Rabbit Ray – Helping Kids with Needle Fears

~ debvilasconsult ~ Leave a comment

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Esther Wang has a vision. As an entrepreneur, designer and inventor, she has learned first hand what it means to use creative skills to make the world a better place. Esther took up the challenge of “How can we help kids be less afraid of needles?” in Singapore, her native country.  She designed Rabbit Ray, an interactive, virtually unbreakable, washable patient interactive device that empowers even more than it teaches. Continue reading →

Death may be stupid, but kids aren’t.

~ Deb Vilas ~ 5 Comments

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This week, Shani Thornton (aka Child Life Mommy) and I brought Child Life services beyond hospital walls into our community. Via a referral from Jen Holahan, CCLS, a parent invited Shani to do some bereavement work at a girls and boys club.  A staff member and former member of the club had recently died unexpectedly, and the kids and staff  needed support. Shani reached out to me and asked if I would join her. How could I say no?

We armed ourselves with Anastasia Higginbotham’s book Death is Stupid, 3 rolls of toilet paper and Shani’s years of experience volunteering with bereaved children at Center for Hope. Our plan of action included a read aloud, followed by a group mural where  the school-aged children could express any of their many feelings about their beloved mentor’s death. The club supplied a huge roll of white butcher paper, paint, crayons, markers, glue, yarn, glitter, pompons, and googly eyes. The kids supplied their hearts.

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In addition to the mural, we set up a toilet paper target station in a corner away from the art activity.  Kids could draw what was making them sad, angry or afraid, and then wail away at the target with sopping wads of water-logged toilet paper.

What did we discover? Well, first, the children joined us in a circle of chairs for the reading of the book. Some teared up while others got silly. We staid our course and refrained from redirecting any of it. We were surprised when almost all of them raised their hands when asked if they knew others who had died. Many relatives and pets had already paved the way for this loss.

Then we set them loose on the mural. They dug deep quickly, drawing and writing about their feelings and memories about the young man who had died at the tender age of 21. They told us stories of things they had done with him, what he enjoyed, how he had helped them with their homework. They talked openly about feeling sad and angry. One tween drew a heart, wrote “Death is Stupid” in the middle of the heart, and then crossed out ‘Stupid’ and added the words scary, mean, weird, confusing and heartbreaking.

Those who weren’t quite ready to join in the mural found solace in the target game, something that allowed for a more physical, visceral release of emotions. “I hate death” they wrote on the target. “Come Back!” One child drew a picture of himself crying, and then decided to cut the drawing off of the target, so that it would not be ruined by the wet toilet paper. Their bodies danced in anticipation as they lined up to take their turns spooling toilet paper around their fists. The toilet paper flew, splatting with satisfying force again and again, as emotion propelled major league-worthy arms.

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When the smoke cleared, every child had contributed to both the mural and the target practice. We regathered in the circle, where Shani reminded them who they can speak to about their feelings as time goes on. The kids named their parents, counsellors, teachers and one another. We held hands and shouted their friend’s name as a final ritual.

Kids know what they need. When adults provide them with space, time, materials and a listening ear, kids know exactly what to do. They need to talk about the person they lost. They need to know that the adults in their lives can hear them without turning away or handing out platitudes. They need to know that they are normal, that their thoughts and feelings aren’t bad or wrong. And they need to know that the feelings will come and go, and that it’s okay to play and have fun anyway, even amidst the sadness.

After the room had emptied, as we scraped wet toilet paper off the cinder block walls, Shani said, “Isn’t this exactly where child life belongs?!”

Yes, my dear friend. This is exactly where it belongs, in the community where the children live day in and day out, and where death is stupid, scary, mean, weird, confusing and heartbreaking.

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Paper Tigers

~ Deb Vilas ~ 4 Comments

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What are paper tigers? Well, they refer to a byproduct of trauma. When kids grow up in environments where toxic stress is an everyday occurrence, their brains wire to keep them in a constant state of fight or flight. They are perpetually on edge, vigilant in assessing their surroundings for dangers, real or imagined. The imagined dangers are paper tigers, not real but emanating from traumatic experiences and just as threatening as a raised fist or an unwanted touch.

The documentary Paper Tigers depicts a school in Walla Walla Washington where teachers and leaders have found a new way to reach and teach kids who see paper tigers around every corner. Instead of responding to acting out teens with punishing discipline, they seek to understand the adverse childhood experiences or ACEs that effect their students and get in the way of their learning.

More than two decades ago, two respected researchers, clinical physician Dr. Vincent Felitti and CDC epidemiologist Robert Anda, published the game-changing Adverse Childhood Experiences Study. It revealed a troubling but irrefutable phenomenon: the more traumatic experiences the respondents had as children (such as physical and emotional abuse and neglect), the more likely they were to develop health problems later in life—problems such as cancer, heart disease, and high blood pressure. To complicate matters, there was also a troubling correlation between adverse childhood experiences and prevalence of drug and alcohol abuse, unprotected sex, and poor diet. Combined, the results of the study painted a staggering portrait of the price our children are paying for growing up in unsafe environments, all the while adding fuel to the fire of some of society’s greatest challenges.    (http://kpjrfilms.co/paper-tigers/about-the-film/)

Adverse Childhood Experiences include eight experiences that impact future health and longevity of children. They fall into three categories: Abuse, Neglect and Household Dysfunction. The eight ACEs are physical, emotional or sexual abuse, physical or emotional neglect, and whether mental illness, the incarceration of a relative, domestic violence, substance abuse or divorce are present in the home environment. The more ACEs present, the worse the outcome.

That’s the bad news.

The good news is that something can be done. Trauma informed therapy and emotionally responsive teaching are two interventions that can buld resiliency in children facing traumatic stress.

Last night I had the pleasure of sitting on a panel made up of policy makers and practitioners  who work tirelessly to address the inequities that perpetuate toxic environments for large numbers of our country’s children. The US rates number two in developed countries for  how many children live in poverty, second only to Romania. In my eyes that is nothing short of a crime. Poverty is the single highest variable coralated with ACEs.

We screened the movie for a standing room only audience at the Grace Church School in Cooper Square in lower Manhattan. Moderator Andrew Solomon, the Pulitzer Prize finalist and author of Far From the Tree: Parents, Children, and the Search for Identity, led us in a lively discussion of the film, fielding questions from an audience of parents, teachers and community leaders.The event was sponsored by many schools and community organizations, including The First Presbyterian Church, Go Project, St. Francis Xavier Catholic Church, NIP Professional Association, Academy of St. Joseph, Prevent Child Abuse New York and the Corlears School. The room was filled with caring citizens who want to see change. Teachers spoke about their own trauma in working with troubled children in broken schools with no resources or administrative support.

Joy Farina Foskett, the organizer of this important event, reminded us all that ACEs cross all socioeconomic boundaries and exist in every culture. Some of the panelists themselves spoke to the ACE of divorce in their own families. We listed some valuable resources in the program: community organizations, websites and books. Included in the list are “Divorce is the Worst” and “Death is Stupid”, two great books by Anastasia Higginbotham, that help adults open up important conversations with children who may suffer alone through painful ACEs. Kathleen McCue’s “How to help Children Through a Parent’s serious Illness” is another great resource to assist parents and teachers.

Trauma informed, emotionally responsive teaching seems like a no brainer. It doesn’t cost more money, and it prevents costly medical care, incarceration and strengthens our country’s most valuable asset, our children. If it worked with teens who’d already been labeled as unreachable and no good, how much more could it do within early childhood settings? In Early Intervention?

We were all left with one question on our minds. Why isn’t every school in the country following in the footsteps of Lincoln Alternative High School? What are we waiting for?

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