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Arizona Update (2014 – 2015)

Read the beginning of the Arizona story here (2005 – 2013)

Even though the Arizona ACEs Consortium has operated with limited funding since its inception in 2007, it is wielding influence and bearing results. The consortium’s steady outreach means that tens of thousands of Arizonans now know about ACEs. Leaders in social services and education are changing the way they practice. And there’s increased interest in digging deeper into what is often called the unified sciences of childhood adversity – the epidemiology of ACEs, the neurobiology of toxic stress, the long-term biomedical and epigenetic consequences of toxic stress and resilience research.

Over the last year, since we published the story about the first eight years of the initiative, the consortium has continued to develop training workshops and work behind the scenes with organizations and systems that are becoming trauma-informed. It has also laid the groundwork for cities to start their own journeys toward becoming trauma-informed and for the state legislature to pass a resolution to support trauma-informed practices.

The consortium had modeled its strategic plan on the Spectrum of Prevention framework from the Prevention Institute. Now it has adopted a new set of vision, mission and value statements borrowed and modified from the National Collaborative on Adversity and Resilience.

One of the ways the Arizona ACEs Consortium has reached many policymakers and thought leaders across the state is by releasing a report that focuses on some aspect of the consequences of ACEs. In March 2014, they released data from the National Survey of Children’s Health that noted Arizona’s children were suffering a higher level of ACEs than many other states. They plan on releasing two more reports in October that look at the economic impact of ACEs, solutions, and ACE data by county.

TRAINING

After many requests, the consortium sponsored three half-day workshops in the spring, with nearly 100 people in each workshop. The workshops were led by Dr. Robert Rhoton. CEO of the Arizona Trauma Institute. While their train-the-trainer workshop provides an overall understanding of ACEs and resilience, Rhoton’s presentation delves into the biology of stress and epigenetics, and ends with a summary of the first four essential interventions for a better family life: Parental self-regulation, creating an environment of safety, teaching children how to self-regulate, and improving family life and quality.

“People are clamoring for the information,” says Marcia Stanton, co-founder of the

“People are clamoring for the information,” says Marcia Stanton, co-founder of the consortium and a social worker at the Injury Prevention Center at Phoenix Children’s Hospital,

“People are clamoring for the information,” says Marcia Stanton, co-founder of the consortium and a social worker at the Injury Prevention Center at Phoenix Children’s Hospital,consortium  and a social worker at the Injury Prevention Center at Phoenix Children’s Hospital, where she coordinates positive parenting and child abuse prevention programs and promotes primary prevention. The consortium is planning one large workshop for November, with another series in the spring.

The consortium plans on revamping the train-the-trainer program and will have a reunion of ACE ambassadors — the people who’ve gone through the training program — in October to share successes and new resources. Stanton also sees a need for workshops that help organizations become trauma-informed and for specialty toolkits designed for  sectors such as education and the faith-based community.

ORGANIZATIONS AND SYSTEMS

The consortium has worked with its partners to expand the availability of Triple P. It’s now included on several lists of evidence-based programs, including the California Evidence-Based Clearinghouse for Child Welfare and Child Trends. Currently, there are more than 75 Triple P practitioners in more than  a dozen Arizona agencies.

It’s also supporting the efforts of Valley of the Sun United Way to launch Thriving Together, an initiative that focuses on improving educational success for the state’s children.

The consortium plans on partnering with youth organizations to develop a youth ACEs consortium, and is talking with the Mayo Clinic’s Center for Innovation about creating a Destination Imagination Team Challenge for schools, and which has submitted a grant to develop a national campaign to break the cycle of ACEs.

 After a year of working on developing “dos and don’ts” for ACEs screening, the consortium’s clinical practice workgroup stopped what it was doing when people in Washington State published the NEAR@Home toolkit, and adopted that document instead. The work group will continue to share resources and address issues related to ACE screening, as well as develop a comprehensive list of trauma-informed and culturally relevant resources and counseling services in Arizona, and work to support organizations working to become trauma informed.

ACE questions will be added to the Arizona Youth Survey. The state Department of Health Services included the ACE module in its 2014 BRFSS and the consortium is working to support analysis and dissemination of this data.

Several organizations are well on their way to integrating trauma-informed practices. Jewish Family and Children’s Services is taking a comprehensive approach, including educating their staff and changing the physical environment.

At Phoenix Children’s Hospital (PCH), where the state’s introduction to ACEs began in 2006, despite grand rounds by visiting pediatricians who preach the advantages of incorporating ACEs, there’s still lots of interest, but limited action. Plans were made to do ACE histories in outpatient pediatric clinics and conduct a pilot screening for ACEs in children admitted to the hospital for trauma, but both projects have not begun.

CITIES

 The consortium is talking with several people who attended a train-the-trainer workshop in Flagstaff in 2013 about developing a plan for the city to become trauma-informed. In Tucson, where 100 people turned out for a train-the-trainer workshop earlier this year, several are discussing setting up a trauma-informed coalition. Two Indian tribes have also shown interest in developing trauma-informed coalitions on their reservations.

LEGISLATION

The consortium’s policy workgroup supported draft legislation to allocate $330,000 for the state Department of Health Services to develop an ACEs toolkit for medical homes, and a resolution to urge the governor to identify evidence-based solutions to reduce children’s exposure to ACEs, and invest in measures to prevent ACEs.

Dr. Scott Grant, a PCH pediatric resident , and Dr. Sarah Bode, PCH director of community pediatrics, testified about ACEs and trauma before the House health committee.

The draft legislation wasn’t introduced, and the resolution didn’t come up for a vote. The consortium is discussing plans for the next session in January 2016.

Arizona Timeline - Click Year to View Highlights

  • Stanton stumbles on “The Relationship of ACEs to Adult Health: Turning Gold into Lead” article

  • Phoenix Children’s Hospital hosts pediatric grand rounds and community leader luncheon featuring Vincent Felitti, co-author of the CDC’s ACE Study

  • First ACEs presentation at statewide Family Centered Practice Conference; “ACE Think Tank” formed

  • ACEs presentations to professional and other interested groups, including Arizona Academy of Pediatrics and Regional Child Abuse Prevention Councils; ACE Think Tank meets quarterly

  • ACE Think Tank morphs into ACE Consortium; over 200 members statewide. Successful grant awards enable expanded community and media outreach. ACE Consortium develops Strong Communities Raise Strong Kids Tool Kit (logo, brochures, PowerPoint presentation). Inaugural Strong Communities Raise Strong Kids Train the Trainer workshop. First “Ask an Arizona Child Trauma Expert” PBS prime-time/call-in special

  • Consortium holds 2nd annual Strong Communities Train the Trainer workshop; updates training kit.

    “Forgiveness: Ask an Arizona Expert” PBS prime-time special/call-in show.

    Consortium develops mission, vision, values and strategic plan.

  • Consortium continues ACEs community and professional presentations. Child Well-Being Summit draws 125 in-studio and is live-treamed by PBS

  • Consortium takes part in National Summit on ACEs in Philadelphia; four train-the-trainer workshops bring total of Arizona ACE trainers to 400; Arizona supports inclusion of ACE module in 2014 BRFSS

  • More train-the-trainer workshops; release of state report, Overcoming Adverse Childhood Experiences; developing guidelines for using 10-question ACE survey as screening tool; developing state resource list for trauma-informed counselors and peer support. State doing first ACE survey through BRFSS.

  • The Arizona ACEs Consortium policy workgroup supports draft legislation to develop an ACEs toolkit for medical homes, and a resolution to urge the governor to invest in measures to prevent ACEs.

    Arizona ACEs Consortium sponsors train-the-trainer workshop in Tucson on Feb. 9, 2015, for more than 103 participants.

    Dr. Sara Bode, director of community pediatrics at Phoenix Children’s Hospital, and Dr. Scott Grant, a PCH pediatric resident, testify about ACEs and trauma before the Arizona House health committee.

    For people who participated in the train-the-trainer ACEs 101 workshops as well as interested community members, the Arizona ACEs Consortium and the Arizona Trauma Institute sponsor three half-day workshops that delve deeper into the biology of stress and epigenetics.

    At the Second Annual Forum on Adverse Childhood Experiences held on October 22 at Phoenix Children’s Hospital, consortium releases two new reports: “Adverse Childhood Experiences in Arizona” and “The Price of ACEs: Hurting Lives and Our Economy”.

    The consortium and the Arizona School Boards Association co-sponsor the screening of the documentary, Paper Tigers, which is the kick-off to a statewide trauma-informed education initiative.