Reminder: She Doesn’t Owe Anyone a Hug. Not Even at the Holidays.

GirlScouts.Org

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Holidays and family get-togethers are a time for yummy food, sweet traditions, funny stories, and lots and lots of love. But they could, without you even realizing it, also be a time when your daughter gets the wrong idea about consent and physical affection.

Have you ever insisted, “Uncle just got here—go give him a big hug!” or “Auntie gave you that nice toy, go give her a kiss,” when you were worried your child might not offer affection on her own? If yes, you might want to reconsider the urge to do that in the future.

Think of it this way, telling your child that she owes someone a hug either just because she hasn’t seen this person in a while or because they gave her a gift can set the stage for her questioning whether she “owes” another person any type of physical affection when they’ve bought her dinner or done something else seemingly nice for her later in life.

“The notion of consent may seem very grown-up and like something that doesn’t pertain to children,” says Girl Scouts’ developmental psychologist Dr. Andrea Bastiani Archibald, “but the lessons girls learn when they’re young about setting physical boundaries and expecting them to be respected last a lifetime, and can influence how she feels about herself and her body as she gets older. Plus, sadly, we know that some adults prey on children, and teaching your daughter about consent early on can help her understand her rights, know when lines are being crossed, and when to go to you for help.”

Give your girl the space to decide when and how she wants to show affection. Of course, many children may naturally want to hug and kiss family members, friends, and neighbors, and that’s lovely—but if your daughter is reticent, consider letting her choose what to do. Of course, this doesn’t give her license to be rude! There are many other ways to show appreciation, thankfulness, and love that don’t require physical contact. Saying how much she’s missed someone or thank you with a smile, a high-five, or even an air kiss are all ways she can express herself, and it’s important that she knows she gets to choose which feels most comfortable to her.

Child Sexual Abuse Among Boys

 Many boys, too, are sexually abused. Most don't feel comfortable speaking up about it

Many boys, too, are sexually abused. Most don't feel comfortable speaking up about it

UNDOUBTEDLY, SEXUAL abuse is one of the most underreported crimes in our nation.

According to the U.S. Department of Health and Human Services, in 2016 more than 57,000 children reported being sexually abused, and that’s on the low end since only about a third of cases are reported. What's more, males are even less likely to report sexual abuse than females. Research indicates that about 1 in 6 boys will be sexually abused by the age of 18, and most of them aren’t saying a thing.

The Crimes Against Children Research Center at the University of New Hampshire reports that 90 percent of these boys will likely know the person who is sexually abusing them. According to RAINN, or the Rape, Abuse & Incest National Network, about a third of the sexual perpetrators are family members, and about 60 percent are acquaintances.

Another potential reason males may not report being victims of sexual abuse is stereotypes that exist in our culture pertaining to how they are supposed to be strong and independent. As a society, we have done a huge disservice to our boys by instilling stereotypes, like that big boys don’t cry, and sending the message they should just suck it up and be strong, or even worse, that they need to “man up." According to these false beliefs, men are supposed to be tough and brave, and they're supposed to have a strong sex drive. Media, literature, schools, community establishments like places of worship and even family members can reinforce stereotypical messages and paint a fictitious picture of how boys are supposed to behave. Research indicates that male sex abuse survivors not only have few resources available to them, but they also face greater stigma than female survivors.

[Read: Sexually Abused Children Face a Long Road to Recovery.]

In a study published last year in the Journal of Adolescent Health, researchers show that gender stereotypes have been associated with high levels of stressanxiety and depression. It's not just an American problem, either. According to research done as part of the Global Early Adolescent Study, a collaborative effort of Johns Hopkins Bloomberg School of Public Health, the World Health Organization and other research partners, children studied from 15 different countries began to accept gender stereotypes well before the age of 10. So it appears that many of these misconceptions are universal. When boys are taught that they aren’t supposed to show emotion because that is a sign of weakness, they learn to suppress and not express their feelings.

In a society full of erroneous stereotypes, is it any wonder that boys are less likely to report having been sexually abused than girls? With most of the research on sex abuse focusing on male perpetrators and female survivors, it’s past time that we shed some light on the devastating effects of male sexual abuse. Here are some things to keep in mind:

  • One in 25 boys will be sexually abused before they turn 18, according to a review of child sex abuse prevalence studies.

  • 10 percent of rape survivors are male, according to RAINN.

  • 27 percent of male rape survivors were sexually abused before they were 10 years old, according to the Centers for Disease Control and Prevention.

  • 7 percent of boys in the juvenile justice system have been sexually abused.

  • 50 percent of the children who are sex trafficked in the U.S. are male; and according to the National Coalition to Prevent Child Sexual Abuse and Exploitation, the average age at which boys first become victims of prostitution is 11 to 13.

Unquestionably, when boys or men are sexually abused, it has a profound impact on their psychological and emotional well-being. According to the American Psychological Association's Division of Trauma Psychology, this horrific crime has been associated with:

  • Alcoholism and drug use

  • Anger and aggression

  • Anxiety

  • Depression

  • Intimate relationship problems

  • Poor school and work performance

  • Post-traumatic stress disorder

  • Sleep disturbances

  • Suicidal thoughts and attempts

Despite all of the information that we have on sex abuse, we still have a long way to go. It’s hard to turn on the TV and see that another person, such as a coach, teacher, priest or physician has taken indecent liberties with a minor. As we continue to urge survivors to come forward, more survivors may begin to tell their stories.

[Read: The Silent Epidemic: Child Sexual Abuse.]

As parents, we need to make sure that we don't endorse damaging societal stereotypes about boys at home. First, we have to challenge our own biases and preconceived notions. Next, we can teach our children from an early age to question what they hear and see on television and social media. We can teach them that it's perfectly normal for boys to cry, to be afraid and to express how they feel. Furthermore, we should teach them that it’s OK to tell others when someone has wronged them; and sadly, we have to tell them that person may even be someone they respect and trust.

If you believe that your child may have been victimized, watch out for these signs that kids who have been abused may exhibit:

  • Avoiding or appearing uncomfortable in the presence of a family member, family friend or acquaintance

  • Becoming secretive and shy

  • Engaging in self-harm, such as cutting or burning themselves

  • Sleeping problems and nightmares

  • Expressing suicidal thoughts

  • Running away

  • Experiencing mood swings, anger or depression

  • Receiving money or gifts frequently from another adult (often used as a source of bribery for not telling)

  • Eating less or more than usual

  • Taking less care of appearance or hygiene

  • Acting out in sexually inappropriate ways

  • Using sexually explicit vocabulary, especially when younger children, who wouldn’t otherwise know the meaning of the words, are doing this

  • Declining school performance

  • Pulling away from hobbies and interests

  • Pulling back from others, or becoming isolated

If you suspect child abuse in any form, please report it and make sure your child receives professional help immediately. As parents, we should monitor anyone who wants to spend excessive amounts of time with our kids. Also, children should be taught at an early age to speak out if anyone ever touches them or does anything to them that makes them feel uncomfortable.

Although we have made strides in reaching our youth, we have a lot more work to do. Sexual abuse is a serious crime plaguing our nation, and we need to make sure that both girls and boys feel loved and supported, and that they have the resources they need to heal.

We also need to do more to understand the devastating impact this horrific crime has on male survivors. We need more trained professionals to support male survivors. Doctors treating sexual abuse survivors have fewer guidelines available to treat males in comparison to females.

According to the World Health Organization, male rape is often not treated as an equal offense with female rape. That needs to change. We need to break the taboo that keeps many boys from coming forward to disclose they've been sexually abused, and begin to train, conduct research and increase awareness, so male survivors can heal, not remain silent. Keep in mind that the prevalence of falsely reporting sexual abuse is very low – between 2 and 10 percent, according to a review of research – so it’s unlikely a child will report something untrue.

[See: 10 Concerns Parents Have About Their Kids' Health.]

Sadly, many kids are sexually abused, and any child can be a victim, regardless of gender, sexuality, sexual orientation, race, ethnicity or religion. It’s time we teach our children to speak out when someone abuses them, for their voice is one of power, strength and truth.

Location and Date Announced: 2019 Guilty Girls Warehouse Sale

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The Guilty Girls Giving Group has chosen Prevent Child Abuse Delaware as the beneficiary of the 7th annual 2019 Warehouse Sale. The event will take place at the DuPont Country Club on Friday, February 1 and Saturday, February 2. Tickets will go on sale in December.

The Guilty Girls Giving Group is a committee of local women, committed to the betterment of the community through fun and social events. Their mission is to help charities that serve Women & Children in the Delaware community.

Pediatricians strengthen stance against spanking kids

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Jacqueline Howard | CNN

The American Academy of Pediatrics has hardened its stance against spanking children as a form of parental discipline.

In a new policy statement, published in the journal Pediatrics on Monday, the pediatricians' group recommends that adults caring for children use "healthy forms of discipline" -- such as positive reinforcement of appropriate behaviors, setting limits and setting expectations -- and not use spanking, hitting, slapping, threatening, insulting, humiliating or shaming.

The policy statement updates guidance published in 1998 that recommended "parents be encouraged and assisted in developing methods other than spanking in response to undesired behavior."

"In the 20 years since that policy was first published, there's been a great deal of additional research, and we're now much stronger in saying that parents should never hit their child and never use verbal insults that would humiliate or shame the child," said Dr. Robert Sege, first author of the policy statement and a pediatrician at the Floating Hospital for Children at Tufts Medical Center in Boston.

"This is much stronger than the previous advice," he said. "The new policy encourages pediatricians to discuss the data about different kinds of discipline with parents so, of course, they can make their own decisions in how they chose to raise their children."

The policy statement describes corporal punishment as "noninjurious, open-handed hitting with the intention of modifying child behavior" and indicates that spanking is considered a form of such physical punishment.

The statement goes on to describe how several studies have found associations between spanking and aggressive child behavior, depressive symptoms in adolescence and less gray matter in children's brains, among other outcomes.

How to discipline without spanking

The statement encourages pediatricians to counsel the parents of their patients when they may want guidance about the use of spanking. Sege said there are other forms of discipline that parents can employ, no matter their child's age.

For instance, for children younger than 1 who might be misbehaving, "the best thing to do is just pick them up and move them somewhere else, distract them, change the subject -- and that's usually all they need and they can handle it," he said. "Your average 6-month-old child doesn't have the ability to learn the rules. They will eventually."

For toddlers and preschoolers, Sege recommended using the time-out method, which involves a child sitting quietly by him- or herself.

"What we talk to parents about is paying attention to your child's good behavior and paying less attention when they're misbehaving," Sege said.

"Kids like attention, they crave that, and if they misbehave, we recommend something called a time-out," he said. "If they're 2 years old, you have to ignore them for two entire minutes."

For older children, Sege said, typically allowing the natural consequence of misbehavior play out can be effective.

"So if they run out in the street, you don't want the natural consequence to be that they get run over by a car. But a natural consequence might be that they have to hold your hand when they're in the street or they can't go out on their own past a busy street until you've observed them always looking both ways," Sege said.

In other words, holding Mom's or Dad's hand becomes the consequence.

All in all, "the loving relationship between a child and their parents is the most important relationship that there is," Sege said.

"Parents can use that relationship to teach their children right from wrong without inserting violence, shame and humiliation into that relationship," he said. "As a result, children are more likely to grow up feeling secure and positive, knowing how to regulate their own behavior."

The science on spanking and child development

The policy statement is consistent with what research has found on the relationship between corporal punishment and adverse outcomes among children, said Rebecca Ryan, a developmental psychologist and associate professor at Georgetown University who was not involved in the statement.

Yet Ryan, who has studied the use of corporal punishment, noted that only a correlational relationship has been found, not a causal one.

"Nobody has randomly assigned children to receive different types of parenting or different types of discipline strategies, per se. ... So it's difficult for anybody to say spanking a child causes that child later on to be more aggressive, even though there are theories to suggest that could be why the correlation exists," Ryan said.

"Although all the evidence is correlational, there's little correlational evidence that it's an effective strategy, and if it were effective, you should see correlational evidence," she said.

"If it were an effective strategy, you would either see no correlation between spanking and child behavior, or you would see a correlation that's the opposite of what you do see," she said. "What you see is a positive correlation between spanking and higher levels of behavior problems. If it were effective you should see the opposite."

Since research shows only a correlational relationship, some question whether children who are more aggressive or misbehave more are subsequently spanked more -- and could that be why corporal punishment has been linked with higher levels of behavioral problems among children?

"There probably is reverse causation, but one of the things that some of the longitudinal research suggests is that when you look at kids over time -- so controlling for baseline rates of misbehavior -- children who are disciplined with corporal punishment versus those who are not, who have the same kinds of behavior problems, show increases in behavior problems over time in a way that children who aren't disciplined that way don't," Ryan said.

"So yes, there is probably some truth to the idea that kids who are predisposed to misbehavior for whatever reason are more likely to be spanked by parents who use that form of discipline than kids who are less likely to misbehave for whatever reason," she said. "But it's also true that spanking is correlated with an increase in behavior problems over time among children with similar levels of misbehavior relative to nonphysical forms of discipline."

Governor Carney Signs Executive Order Making Delaware a Trauma-Informed State

News.Delaware.Gov

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Order will mitigate the impact of adverse childhood experiences, build resilience

WILMINGTON, Del. – Governor Carney on Wednesday signed Executive Order #24 making Delaware a trauma-informed state. This Order provides direction for the Family Services Cabinet Council to help mitigate the impact of adverse childhood experiences (ACEs) and build resilience in children, adults and communities.

ACEs can include physical, emotional, or sexual abuse; physical or emotional neglect; household dysfunction, including substance abuse, untreated mental illness, or incarceration of a household member; domestic violence; and separation/divorce involving household members.

“We have children and families in Delaware who are affected by trauma in their lives, and we need to do everything we can to support them,” said Governor John Carney. “Addressing these issues as a community will help Delaware become a stronger and healthier state. The Family Services Cabinet Council will remain vigilant about this issue and work with many partners across the state to create trauma-responsive communities.”

The Executive Order was motivated by the work of the Family Services Cabinet Council – a cabinet-level group reestablished by Governor Carney in February 2017 that coordinates public and private services for Delaware families. This Executive Order will direct the Family Services Cabinet Council to develop tools for training state employees and community partners on the impact of exposure to ACEs, to promote ACE awareness, and to improve services and interventions for children and families exposed to trauma.

The Family Services Cabinet Council will work to identify gaps in available services, or service capacity, along the prevention and early intervention-treatment continuum for children and their caregivers statewide. The members also are charged with developing a comprehensive plan focused on early intervention for children and their caregivers exposed to adverse childhood experiences in order to help prevent abuse and neglect, and remedy the impact of it.

First Lady Tracey Quillen Carney is also committed to creating an environment that gives Delaware children a chance to succeed, and was present for the signing.

“You know, the word ‘trauma’ sounds like bad news, but what we’ve learned about brain science, about the impacts of childhood experiences, is actually very good news – because now, we can do something about it,” said First Lady Tracey Quillen Carney. “We can act on what we know – to prevent and mitigate the effects of trauma, and to build on the strengths of every child, every family, and every community. Trauma-informed care is a pre-requisite, to any effective strength-based strategy.”

The Executive Order also will direct state agencies that provide services for children and adults to integrate trauma-informed best practices, including trauma-specific language in requests for proposals and in service contracts with the state, when appropriate.

“The executive order signed today by Governor Carney demonstrates his commitment to making Delaware a trauma informed state,” said Josette Manning, Secretary of the Delaware Department of Services for Children, Youth and their Families. “I, along with my fellow agency heads who serve on the Family Services Cabinet Council, welcome this opportunity to improve the quality of services we provide to all Delawareans. We know that many of the children and families in Delaware have experienced trauma and toxic stress in their lives. We also know, based on years of research, that exposure to toxic stress can actually impact a child’s brain development and has been linked to higher rates of physical, social and emotional issues in adulthood. By focusing, as a state, on minimizing trauma and by helping people who have experienced trauma build resilience, we will improve the physical, social and emotional health of our children and families.”

Teens, Anxiety, and Depression

Lynn Lyons

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Causes, Connections, and What Parents Can Do to Help

Teen depression is on the rise, and a parent’s best strategy to help a child is to promote the development of key skills.

One of the most important aspects of healing and recovering, be it from an injury, depression or a broken heart, is the belief that change is possible. Researchers call this “positive expectancy,” and when we look at the success of therapy, it figures prominently.

In order to do the hard work of changing or healing, we have to believe that change is actually an option. Recently I’ve been bumping into more and more information about depression and anxiety disorders that is saying the exact opposite of this.

In an effort to promote mental health awareness and prompt children, teens and adults to seek help for mental health issues, the messages that depression and anxiety disorders are diseases of the brain that “just happen” and –more disturbingly–are “how you are wired” or “are like diabetes and heart disease” have been showing up again and again. Drug ads are major offenders, but not the only ones. (Note: I am not talking about bipolar disorder or schizophrenia…these are viewed and treated differently.)

Seeing Teen Depression For What It Is

I understand the intent: we want to prevent kids and teens from feeling guilty or ashamed when they are struggling.

We want them to understand that mental health issues like these are common and treatable. We don’t want them to feel alone. But it’s also critical they know that their brains are malleable and changeable.

The way we think, develop, relate to others, and handle challenges are critical to good mental health and are components of our human experience that CAN be learned, unlearned, and adapted.

What you believe about yourself and how you view the world are significant factors in both the development and recovery from anxiety, depression, stress, chaotic relationships, and many other issues.

Parents can learn how to help a teen with depression when the family takes a skill-building approach.

Teens are hearing– so they tell me when I ask them–that depression and anxiety are permanent, based on hard wiring and/or genetics. While there may be some genetic contribution to anxiety and depression in teens, there is no known anxiety gene or depression gene nor ANY solid scientific proof that fully explains what causes depression.

We do know that the malleability of our brains, our chemistry, and even the genetic expression of our DNA is far broader and influential than researchers believed even 10 or 15 years ago, and we know about risk factors, like trauma, isolation, and social disconnection, to name a few.

Depression is not who you are

Rather than promoting healthy changes in thinking, acting, decision-making, and connection, we are hindering the positive expectancy and motivation that is critical to the treatment of these problems. And we are inhibiting an important discussion about risk factors, prevention, and recovery.

When we give teens the message that “this is who they are,” that their brains are imbalanced, and that depression is a disease that “just shows up,” our attempts to help are possibly doing the exact opposite.

Depression and anxiety in teenagers are very real and very destructive when left alone, but treatment that focuses on building resources and skills is very successful.

Connecting Teen Depression and Anxiety

As an anxiety expert, I often talk to teens who are also depressed. Why?

Because an untreated anxiety disorder in a child is one of the top predictors of developing depression as a teen or young adult, a fact that most teens and parents are unaware of. And because anxiety is the chief mental health complaint of young people, it’s not surprising that rates of depression in teens is increasing.

Adolescence is often the time when longer term issues with anxiety and worry become more intense and isolating. The challenges of social life and increased academic pressures push kids toward brand new experiences and responsibilities, along with the shadow side of hesitation and insecurity.

Specific learning difficulties can surface as students take on more complicated tasks or have to speak up in class. Sports become more demanding, and hormones can wreak havoc with appearance. Whether social, intellectual or physical, anything can serve as a source of worry.

Teens are caught between wanting to achieve and being afraid of failing, of wanting to belong and fearing rejection.

When teens believe they won’t measure up or when they expect rejection, they withdraw.

To make matters worse, teens are developmentally more likely to reject adult input as they strive to be independent and find their own answers. At the very time when they are faced with huge changes– graduating from high school, waiting to hear from colleges, moving away from home or deciding on a career path—your advice and desire to help are met with resistance.

No degree of reassurance or encouragement seems to be enough, because you can’t give your teen what she’s looking for: a guarantee that everything will turn out perfectly.

The Desire for Certainty

And it’s this desire for certainty that allows anxiety to grab your teen and hold on tight. Add to that a conflicting desire to be a part of a complicated and uncertain social world, and it’s no wonder that the withdrawal, hopelessness, and sadness of depression can take hold.

This means that helping children and teens understand and normalize the challenges of relationships, problem solving, disappointment, and uncertainty is critical for prevention and recovery. These are skills that can and should be taught.

Your anxious teen is looking for a guarantee that everything will turn out perfectly. Since you cannot control that, the family goal is acceptance with uncertainty.

Shifting Thought Patterns

When we talk about permanence and disease, we miss an opportunity. We must help our children notice the patterns of thinking and responding that can be most helpful and most hurtful.

For example, most teens understand that life can be unpredictable. But during this time of flux, they sometimes lose their ability to tolerate such big uncertainties.

Most anxious teens get trapped by the following rigid patterns when making plans and thinking about the future:

  1. Perfectionism: “Everything must—and can– be done perfectly” (also known as all or nothing thinking)

  2. Catastrophic thinking: “If one thing goes wrong, everything will fall apart and I won’t be successful in life.”

  3. The One Path Myth: “There is ONE PATH to a successful life. I have to find it or stay on it, no matter what!”

How to Help a Teen With Depression

These ways of thinking create anxiety and stress in teens, so what can you as a parent do to help? You can start by paying attention to how you and your family handle failure and mistakes.

Research tells us convincingly that your own relationship with anxiety and uncertainty—and how you role model this to your child—significantly impacts how she sees the world.

When is something good enough? How do you move on to your next task? What does your family say about screw-ups?

Now may be the time to notice and change your own response to mistakes, to sprinkle family conversation with phrases that normalize screw-ups, struggles, and imperfection.

Teens also need to hear that they aren’t expected to know everything, and that they can’t see into the future.

The goal is NOT to make all good decisions. The goal is to have the problem solving skills needed to adjust from the inevitable bad ones.

Flexibility is key, and this means knowing when to push harder and when to be satisfied with a less-than-perfect result. As you see your teen becoming anxious, look for opportunities to let her know that this IS a time of uncertainty, but you have confidence in her ability to problem solve along the way.

Giving advice about how you would handle things might not be as valuable as instilling a sense of autonomy in your teen—and this may mean backing off the lectures and letting her know that you are there to support her as she makes HER choices.

Worry is Normal

Finally, teens need to hear that they are supposed to be anxious! Expecting to be calm and relaxed during such a time of change is unrealistic.

In fact, moving toward the anxiety and learning how to manage it is the skill I most strongly promote.

If a teen believes that staying calm is the goal, she’ll avoid taking risks, stay where she’s most comfortable, and never build up her own sense of confidence.

Let her feel her feelings, but then support taking action and courageously moving into uncertainty. Although your first instinct may be to step in and make it okay, know that you are equipping your teen with valuable skills when you model and support a more flexible—and independent– path into adulthood.

Remember how girls used to be told that boys were better in math and science? And then they lived up to those limited expectations? We don’t do that anymore.

Sadly, however, we have seemingly replaced those outdated myths about brains with some new ones. With the rates of depression and anxiety in college students at an all time high, we need to start paying attention to the power and (in)accuracy of our language about change, brains, and the future of our children’s mental health.

Learning how to help a teenager with anxiety and depression means teaching problem solving skills needed to respond to the tough choices and bad decisions they all make.

Help teens to step back from their rigid expectations and permanent mindset, and instead support them through this time of struggle, discomfort, discovery, and growth with the language of change, possibility, and movement.

Most importantly, stay connected to your teens, even when they are being clear about how annoying you are.

Small gestures go a long way: offer a compliment, ask question or two that conveys genuine interest, and be that steady stream of messages that let them know you are there when needed as they trip, fall, regroup, and find their path.

Childhood Trauma And Its Lifelong Health Effects More Prevalent Among Minorities

Tara Haelle | NPR

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When researchers first discovered a link in the late 1990s between childhood adversity and chronic health problems later in life, the real revelation was how common those experiences were across all socioeconomic groups.

But the first major study to focus on adverse childhood experiences (ACEs) was limited to a single healthcare system in San Diego. A study published Monday in JAMA Pediatrics — the largest nationally representative study to date on ACEs — confirms that these experiences are universal, yet highlights some disparities among socioeconomic groups. People with low-income and educational attainment, people of color and people who identified as gay, lesbian or bisexual had significantly higher chance of having experienced adversity in childhood.

The study finds three out of five adults across the U.S. had at least one adverse experience in their childhood, such as divorce, a parent's death, physical or emotional abuse, or a family member's incarceration or substance abuse problem. A quarter of adults have at least three such experiences in childhood, which – according to other research — increases their risk for most common chronic diseases, from heart disease and cancer to depression and substance abuse.

"This is the first study of this kind that allows us to talk about adverse childhood experience as a public health problem in the same way we talk about obesity or hypertension or any other highly prevalent population risk factor," says Adam Schickedanz, an assistant professor of pediatrics at the David Geffen School of Medicine at UCLA, who was not involved in the research. "Up until now, we haven't really had a study that takes a national look."

The study researchers, led by Centers for Disease Control and Prevention researcher Melissa T. Merrick, analyzed data from 214,157 adults in 23 states between 2011 and 2014. The participants answered 11 questions about whether they'd experienced what have now become well recognized as ACEs: parental separation or divorce, child abuse (physical, emotional and sexual), domestic violence and living with someone who has been incarcerated or has a mental illness or a substance use disorder.

Nearly 62 percent of respondents had at least one ACE and a quarter reported three or more. The remaining respondents had at least two ACEs, including 16 percent with four or more such experiences.

Those identifying as black or Latino and those with less than a high school education or an annual income below $15,000 were more likely to have more ACEs. But a relatively new finding was that multiracial and gay, lesbian and bisexual individuals carried the greatest burden.

Multiracial participants reported roughly 2.5 ACEs, and bisexual adults reported 3.1, both the highest scores reported. Women, younger adults, unemployed people and those unable to work also tended to have higher scores.

But Schickedanz cautions that, while the disparities are real, it's important to recognize how common these experiences are among all people, including white and middle class families.

"This [study] shows that ACEs affect people from all walks of life everywhere," he says.

The link between trauma and health

The original ACE study, published in 1998, analyzed data from more than 9,000 primarily middle class adults in the San Diego area, starting in 1995-1997. Its publication opened people's eyes to how common adverse experiences are even among children in seemingly more privileged homes. Nearly 40 percent of participants had at least a college degree, and 75 percent were white.

More than a quarter of those original participants reported physical abuse in childhood, and one in five reported sexual abuse. And the study identified the link between adverse childhood experiences and poor physical and mental health decades later.

Since that study, an increasing number of states have begun collecting data on ACEs with the Behavioral Risk Factor Surveillance System, the database used by the new study's researchers. All states use the system, and 32 states since 2009 have collected ACEs data.

The CDC tracks the many ACE-related studies published on a website section specifically about ACEs. Studies have linked a greater number of ACEs with greater risk of heart disease, cancer, bone fractures and chronic lung or liver diseases, diabetes and stroke. Those with the most ACEs, four to six or more, tend to have higher rates of mental illness.

Scientists have just begun understanding the social and biological mechanisms that might explain how highly stressful experiences in childhood could translate to greater risks for heart disease or diabetes. One way has to do with the stress response itself: the body produces and releases the hormones cortisol and adrenaline while increasing blood sugar and blood pressure — all of which help with the body's need for fight or flight.

But chronic stress means chronically high levels of these substances, which isn't healthy in the long term. Consistently high blood sugar, for example, increases the risk of diabetes, and high blood pressure is linked to heart disease.

Opportunities for intervention

This new study suggests a need to target prevention resources where they can help most, says Jack Shonkoff, a professor of child health and development at the Harvard T.H. Chan School of Public Health. This also requires identifying what makes some people more susceptible than others to the effects of adversity.

"Nobody is immune to adverse experiences in childhood but for some population groups, they're a larger burden of childhood adversity than others," he says. "We need to focus on targeting limited resources to the people at greatest risk and making sure those resources go into programs that reduce or mitigate adversity."

Doing that will require developing tools to screen for people's sensitivity to adversity, he says. He also notes that ACEs alone don't account for health disparities. Genetics play a key role in health outcomes as well, he explains.

"Environmental risk factors are only part of the story. You can't separate genetics from environment," Shonkoff says.

To address the consequences of childhood adversity, it will be important to develop programs that help children learn healthy coping mechanisms and strengthen families and communities overall, says Andrew Garner, a clinical professor of pediatrics at Case Western Reserve University School of Medicine in Cleveland.

"Our objective is not to put kids in a bubble but teach kids how to deal with adversity in a healthy manner," Garner says. "If parents are in survival mode, their kids are in survival mode too, and they're not going to learn as well and learn coping mechanisms. Those poor coping mechanisms are what we think links adversity to poor health outcomes."

For example, youth who cope by using drugs, alcohol, sex or other risky behaviors are increasing their risk of substance abuse problems, teen pregnancy and sexually transmitted infections, all of which increase risk of other chronic diseases later on.

Garner and Schickedanz both pointed to increasing levels of social isolation documented by other researchers as a substantial likely contributor to the health outcomes linked to ACEs.

"If you look the very highest risk group, it's bisexuals, and we know they may feel isolated. The second highest is multiracial people who may not necessary feel they belong in any particular group," Garner says. "We know from biology that it's really bad to be socially isolated and we're seeing that disparities in adversity are mirrored in health outcomes later on."

But Garner emphasizes that an ACE score is "not destiny." In addition to social programs that address underlying income and racial disparities, it's vital to teach kids resilience.

"Resilience reflects using skills, and the beauty of that is that skills can be learned, taught, modeled, practiced and reinforced, and kids learn better when they're in relationships," he says. "We need to do better job of primary prevention by focusing on emotional learning and promoting safe, stable, nurturing relationships."

Talking to Children About Bullying

Parenting Tips | Prevent Child Abuse America

Back-to-School season is an exciting time for kids. A new year means new classrooms, teachers, friends and possibilities. Unfortunately, it can also mean new and different ways for kids to experience bullying. As a parent, you can help prevent bullying by having open communication with your children about school. The more you are able to talk with your children about what’s going on at school, the better you can help them understand what bullying looks like and some appropriate ways that they can react when they witness or hear about bullying.

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Communication is essential to preventing bullying

Begin by asking the right questions. Rather than asking, “How was your day” which usually leads to “good” or “ok,” consider asking questions that encourage a longer conversation. Some examples include:

  • What did you do at recess today? Who did you play with?

  • What was the best thing that happened today?

  • Does anyone in your class seem to be having a hard time?

  • Did anyone make you feel good / bad today? How?

Knowing the right time and place to talk is also important. For young children, after school snack or dinnertime offers a chance for meaningful communication and gives children an opportunity to share while they are also focused on eating. As they get older, car rides offer a great opportunity for talking with your child, as teens feel less threatened having personal conversations when their parents are not looking directly at them.

For some other ideas on how to talk to your kids about bullying, check out this page from StopBullying.gov.

What to do if your child tells you they’re being bullied…

If your child discloses that they are being bullied, make sure they understand that it is NOT their fault. Reassure them that they did the right thing by telling you. Help them find ways to handle it by confirming the circumstances:

  • Has your child experienced problems with those involved before?

  • Did those involved have power over your child either in strength, popularity or perception?

  • Did other children observe the conflict or did it happen in private?

Once you understand the facts, tell the teacher or principal who can monitor the situation and prevent further incidents.

If your child discloses that there is someone else they know who is being bullied, once again be sure to tell a teacher or principal about the situation. If your child wants to do something to help, you can encourage them to become an “upstander” and follow some of these tips to safely and appropriately intervene in a bullying situation.

How to Raise Optimistic Kids in Pessimistic Times

Time.com | KJ Dell’Antonia

Wanted: Optimists. Must enjoy challenges, appreciate possibilities and possess a deep belief in your ability to master a situation. Hope for the future a must, and confidence in that hope a strong plus. If your motto is “try, try again” and your glass is always half-full, you’re perfectly set to make the most of this — or any — opportunity.

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There are excellent reasons for anyone — nations, businesses, schools — to seek out the optimistic. And it’s even truer for parents who wish to see their children succeed both as kids and as adults. Optimists are more resilient. They make better entrepreneursexperience better health outcomeslive longer and are more satisfied with their relationships. Optimism enables people to continue to strive in the face of difficulty, while pessimism leaves them depressed and resigned to failure — even expecting it.

I want that hopeful, optimistic outlook for my children. I think most of us do. But when it seems like everything from our headlines to our entertainment options suggests a dystopic society careening towards catastrophe, I’m finding it tough to set a positive example — even as I think it’s more important than ever.

We live in especially pessimistic times. We’re pessimistic about the environment, pessimistic about America, pessimistic about the government and education. The resulting stew of negativity makes me worry that the future — my kids’ future — will be even more grim than the present. Pessimism, here I come — and yet, how can I expect my kids to practice what I don’t preach?

Fortunately, research suggests things we can do help our children grow up with the resilient “can-do” attitude that’s the mark of the optimist — and maintain a happier outlook ourselves. Here’s what I’ve learned, and what I’m trying.

Pay more attention to the positive, and help your kids do the same.

There’s one problem with the pessimist’s perspective: it’s wrong.

That negative dystopian soup is an illusion, the result of an unfortunate collision between a 24/7 news cycle and the brain’s tendency to hone in on any possible danger and ignore everything else. Overall, things on planet Earth are pretty good — or at least, in many ways, they’ve never been better. No country in the world has a lower life expectancy now than the countries with the highest life expectancies in 1800. More people around the world believe in gender equality than ever before, and more value religious freedomPoverty, malnutrition, illiteracy, child labor and infant mortality are all on the decline.

Humanity has made enormous progress by almost every measure, but that progress has become the water in which we swim, and like fish, we take the water for granted. We focus on the beasts that are still out there in the deep rather than on those we have tamed because that’s what we’re designed to do. As neuropsychologist Rick Hanson described in his 2013 book Hardwiring Happiness, our brains naturally put greater emphasis on the negative. “Just a handful of painful experiences of futility can rapidly become a sense of helplessness,” he writes, while “most good news has little or no effect on lasting memory systems in the brain.”

In other words, it’s natural to let the bad news overwhelm us. Fortunately, with practice, we can help our brains to give the good stuff equal weight. Dr. Hanson’s advice: when you hear a great story, achieve something in your own life or just find yourself in a beautiful place with those you love, deliberately rest your mind on that experience and stay with it. Sink into that feeling, he writes, “as it sinks into you.” Describe what you’re doing to your kids, and encourage them to dwell on their joys and pleasures as well.

Change the language you use to describe current events.

Optimism can be developed. Researchers found that when even people with a more pessimistic outlook use positive language to describe situations they find traumatic, their feelings about the situation become more positive, and their more generalized sense of optimism increases. That’s something we can try at home.

Stuck for some ways to approach depressing current events with a more hopeful tone? Consider this: what we call “hate speech” today was just “speech” not very long ago. Bad behavior by corporations was rewarded with higher profits; hunting animals to extinction was sport; dumping pollutants into rivers was an efficient way to get rid of a mess. The event that’s driving the news may be bad, I tell my kids, but listen to all these people trying to do something about it. That’s a change for the better. Our pessimism, ironically enough, derives in large part from our collective expectation that we can do better.

Moderate your news intake.

On any given day, ugly things have been said and done, violence has ended lives and, somewhere, justice has not been served — and in our 24/7 media cycle, there are vast forces aligned to ensure that we don’t miss a minute of it. When Paris was attacked in 2015, I couldn’t hold back my gasp when my phone started to ping. With events still unfolding, it was hard to reassure my kids that it was all “a long way away” when the chance that it could come closer was at the top of my mind.

Those moments, however short, of fear and anxiety were pointless. It didn’t serve anyone for me to ignore my family to click and refresh to learn more. I may need and want to know what’s going on in the world, but news delivered in that manner evokes fear rather than informs — including for our kids. I’ve found that it’s difficult for our children to feel secure when they see us reacting constantly to outside events that are often invisible to them. I turned my news notifications off, and I’ve never brought them back.

Involve yourself in your community.

Passionately following the “big scary” news can not only leave us feeling helpless and distraught, it can distract us from the smaller issues where knowing the facts, and then acting, voting or volunteering as a result might make a difference. Instead, put your energy towards making sure you and your family are a part of the world immediately around you. That might mean volunteering, but it might also mean simply joining and being part of local institutions and clubs that feed our natural human need for connection (not of the digital kind). Find something in your area that makes you feel hopeful, and make it a part of your family life.

Raising optimistic kids is hard, in part, because it demands that parents relinquish the cynical perspective that’s the easiest response to pessimistic times. It’s tempting to dismiss the challenges that bombard us daily with a hopeless shrug. It’s even reasonable. I don’t know what I, or you, or our kids, can do to make any of that better.

But I do know that we need to find ways to try — and that means answering the “optimists wanted” call, and raising our children to do the same. Hopeful, resilient problem solvers needed. No application necessary. Just show up, and make the best of it.

Which is Better, Rewards or Punishments? Neither

NY Times | Heather Turgeon

Rewards and punishments are conditional, but our love and positive regard for our kids should be unconditional. Here’s how to change the conversation and the behavior.

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“I feel a sense of dread as bedtime rolls around. Here we go again.”

A dad said this in our family therapy office one day, describing his son’s pre-bed antics. The child would go wild as bedtime approached, stubbornly ignoring his parents’ directions and melting down at the mention of pajamas. The parents felt frustrated and stumped.

They asked us a question we hear a lot: Should they sternly send him to time out and take away his screen time when he acted this way (punishments)? Or set up a system to entice him with stickers and prizes for good behavior (rewards)?

Many parents grew up with punishments, and it’s understandable that they rely on them. But punishments tend to escalate conflict and shut down learning. They elicit a fight or flight response, which means that sophisticated thinking in the frontal cortex goes dark and basic defense mechanisms kick in. Punishments make us either rebel, feel shamed or angry, repress our feelings, or figure out how not to get caught. In this case, full-fledged 4-year-old resistance would be at its peak.

So rewards are the positive choice then, right?

Not so fast. Rewards are more like punishment’s sneaky twin. Families find them alluring (understandably), because rewards can control a child momentarily. But the effect can wear off, or even backfire: “How much do I get?” a client told us her daughter said one day when asked to pick up her room.

Over decades, psychologists have suggested that rewards can decrease our natural motivation and enjoyment. For example, kids who like to draw and are, under experimental conditions, paid to do so, draw less than those who aren’t paid. Kids who are rewarded for sharing do so less, and so forth. This is what psychologists call the “overjustification effect” — the external reward overshadows the child’s internal motivation.

Rewards have also been associated with lowering creativity. In one classic series of studies, people were given a set of materials (a box of thumbtacks, a candle and book of matches) and asked to figure out how to attach the candle to the wall. The solution requires innovative thinking — seeing the materials in a way unrelated to their purpose (the box as a candle holder). People who were told they’d be rewarded to solve this dilemma took longer, on average, to figure it out. Rewards narrow our field of view. Our brains stop puzzling freely. We stop thinking deeply and seeing the possibilities.

The whole concept of punishments and rewards is based on negative assumptions about children — that they need to be controlled and shaped by us, and that they don’t have good intentions. But we can flip this around to see kids as capable, wired for empathy, cooperation, team spirit and hard work. That perspective changes how we talk to children in powerful ways.

Rewards and punishments are conditional, but our love and positive regard for our kids should be unconditional. In fact, when we lead with empathy and truly listen to our kids, they’re more likely to listen to us. Following are suggestions for how to change the conversation and change the behavior.

Look Underneath

Kids don’t hit their siblings, ignore their parents or have tantrums in the grocery store for no reason. When we address what’s really going on, our help is meaningful and longer lasting. Even trying to see what’s underneath makes kids less defensive, more open to listening to limits and rules, and more creative in solving problems.

Instead of saying: Be nice to your friend and share, or no screen time later.

Say: Hmm, you’re still working on sharing your new building set. I get it. Sharing is hard at first, and you’re feeling a little angry. Can you think of a plan for how to play with them together? Let me know if you need help.

Crying, resistance and physical aggression may be the tip of the iceberg. Underneath could be hunger, sleep deprivation, overstimulation, having big feelings, working on a developmental skill or being in a new environment. If you think this way, it makes you a partner there to guide, rather than an adversary there to control.

Motivate Instead of Reward

Motivation is great, when it has the underlying message: “I trust you and believe you want to cooperate and help. We are a team.” This is a subtle difference from dangling rewards, but it’s a powerful one.

Instead of saying: If you clean your room we can go to the park. You better do it, though, or no park.

Say: When your room is clean, we’ll go to the park. I can’t wait. Let me know if you need some help.

Help Instead of Punish

The idea of a punishment conveys the message: “I need to make you suffer for what you did.” Many parents don’t really want to communicate this, but they also don’t want to come off as permissive. The good news is that you can hold limits and guide children, without punishments.

Instead of saying: You’re not playing nicely on this slide so you’re going to time out. How many times do I have to tell you?

Say: You’re feeling kind of wild, I can see that! I’m going to lift you off this slide because it’s not safe to play this way. Let’s calm down somewhere.

Instead of saying: You were rude to me and used swear words. That’s unacceptable. I’m taking your phone away.

Say: Wow, you’re really angry. I hear that. It’s not O.K. with me that you use those words. We’re putting your phone away for now so you can have some space in your mind. When you’re ready, tell me more about what’s bothering you. We’ll figure out what to do together.

Engage the Natural Hard Worker

Humans are not naturally lazy (it’s not an adaptive trait), and especially not kids. We like to work hard, if we feel like we’re part of a team. Little kids want to be capable members of the family, and they like to help if they know their contribution matters and isn’t just for show. Let them help in a real way from the time they are toddlers, rather than assuming they need to be otherwise distracted while we do the work.

Have a family meeting to brainstorm all the daily tasks the family needs to get done. Ask for ideas from each family member. Make a chart for the kids (or have them make their own), with a place to note when tasks are completed.

In the case of the bedtime-averse child, when the parents looked under the surface, they made progress. It turned out that he was overtired, so they let go of some scheduled activities and protected more wind-down time in the evenings. When he started to get wound up, his mom wrapped him in his bath towel and said he was her favorite burrito. She acknowledged that it was hard for him when she had to work late: “Maybe you’ve felt sad I missed bedtime the last few weeks — I know I have. Hey, can we read our favorite book tonight?” They made a chart listing each step of his routine and asked for his input. Over time, he stopped resisting, and the tone at bedtime went from dread to true connection and enjoyment.

No matter how irrational or difficult a moment might seem, we can respond in a way that says: “I see you. I’m here to understand and help. I’m on your side. We’ll figure this out together.”