California appointed its first Surgeon General in January 2019, and from the sound of her goals for schoolchildren and personnel, they picked the right person. Dr. Nadine Burke Harris is a pediatrician and research scientist that has focused on childhood trauma. Her ambition for California is for all children to be screened for trauma and toxic stress before they enter school. Furthermore, she wants school employees who might interact with those children to be trained on non-disciplinary methods for helping those children identified as having experienced trauma: from the teachers to the bus drivers to the school's cafeteria employees.
According to NBC News:
"A school nurse would also get a note from a physician that says: 'Here is the care plan for this child's toxic stress. And this is how it shows up,'" said Burke Harris, who was appointed California's first surgeon general in January.
"It could be it shows up in tummy aches. Or it's impulse control and behavior, and we offer a care plan. Instead of reacting harshly and punitively, every educator is trained in recognizing these things. Instead of suspending and expelling or saying, 'What's wrong with you?' we say, 'What happened to you?'"
Can you imagine the transformation this might produce in the lives of children? Screening would be based on the landmark study from 1998 establishing the ACEs measurement: ACE stands for Adverse Childhood Experience. The more adverse experiences, either for the child or the child's caregiver, the higher the chance for toxic stress, physical and mental illness.
Trauma in general leads to a surge in stress hormones. When this trauma goes unchecked and is sustained, it can disrupt a child's brain development, interfering with functions children depend on in school such as memory recall, focus and impulse control.
"When we talk about the effect of ACEs on learning, part of the impact is on the child's ability to sit still in class and ... be able to receive and process information," Burke Harris said.
She found that too often the children she saw at her clinic had been prescribed drugs that actually stimulated parts of the brain that did not need it -- and children did not improve as a result. If the children had been diagnosed with ACEs, Burke Harris said she believes treatment may have been as easy as teaching them how to calm themselves down.
Of course, it's not always that simple. But if the entirety of the school system was educated about this approach, and framed a child's behavior in terms of their needs based on what they know about the child's experiences, imagine the reduction in that child's stress level. If pediatricians screen young children for these signs of trauma from the beginning, it can give the people charged with the sacred duty of caring for them the opportunity to do it with informed, compassion solutions — solutions that might give them the foundation to build a more solid and happy life.