Using Evidence-based Kernels to Create a Response to ACE in My Community
Joe Neigel
Seattle,Washington
November 17, 2015
N...
Our Goals This Morning
Review the Adverse Childhood Experiences Study and how
early life trauma influences behavior, healt...
Adverse Childhood
Experiences Study (ACES)
ACES began as a weight-loss study at Kaiser-Permanente in
Southern California. ...
The Adverse Experiences
• Child physical abuse
• Child sexual abuse
• Child emotional abuse
• Neglect
• Mentally ill, depr...
ACE Score Calculator
ACEs in Snohomish County
0.00%
10.00%
20.00%
30.00%
40.00%
0 1
2
3
4 or
More
35.30%
22.90%
12.60%
9.20%
20.10%
Snohomish
W...
ACE Study Findings
 ACEs are very common.
 They are well-concealed.
 Category exposure determines health
outcomes acros...
The Science Behind ACES
 A child’s environment and experience
shapes their behavior and health.
 Our brain is designed t...
Toxic Stress
Toxic Stress
 Prolonged exposure to Cortisol is toxic,
and makes permanent changes to the
brain.
 This means you may hav...
Do you recognize these signs of
traumatic brain development?
 Hypervigilance - “Always on the ready.”
 Display of trauma...
Other Negative Effects
Prolonged exposure to Cortisol is shown to have
other negative effects, including:
Trauma Induced P...
Graded Relationships in
Health Risk Behaviors
• There is a strong “dose/response” relationship
between a person’s ACE scor...
Dose/Response:
More Gas = More Miles Travelled
0
50
100
150
200
250
300
350
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
NumberofMi...
Smoking
• ACE Score ≥4 = 433% increase from
baseline.
Alcoholism
• ACE Score ≥4 = 433% increase from
baseline.
Intravenous Drug Use
• ACE Score ≥4 = 871% increase from
baseline.
Chronic Depression
• We can see the cause and effect relationship
ACEs create in people and in populations.
0
10
20
30
40
...
Attempted Suicide
• We can see the cause and effect relationship
ACEs create in people and in populations.
ACE lead to risk factors for the 10
most common causes of early
death in the United States
Reframing Our Point of View
• With an ACE score of 0, the majority of adults have few, if any,
risk factors for these dise...
ACE Impact
Washington State Schools
We also know ACE drive :
• Special education needs
• Grade repetition
• Problems at sc...
Meet Mallory
Getting to Know Mallory
• Mallory is in 10th grade at Monroe High School.
• Her counselor knows Mallory’s mother physicall...
Mallory’s Grades
Mallory appears to have trouble paying attention
in class. She doesn’t turn in her homework and
seems to ...
Bullying and Safety at School
Mallory has trouble making lasting friendships
and is frequently the target of bullying beha...
Mallory’s Mental Health
Mallory seems pretty disengaged in class and
always looks tired. She can’t seem to remember
facts ...
Mallory’s Personal Solutions
Mallory was caught bringing a flask of alcohol to school
in 9th grade. She spoke with her Vic...
Mallory’s in every classroom
More than 1 in 4 10th graders in Washington State High Schools indicated
physical abuse by an...
ACE Effects in School
Low School Engagement
Source: National Survey of Children’s Health, Johns Hopkins University (2012)
...
ACE Effects in School
Does Not Finish Tasks Started
Source: National Survey of Children’s Health, Johns Hopkins University...
ACE Effects in School
Highly Externalizing Behavior
Source: National Survey of Children’s Health, Johns Hopkins University...
ACE Effects in School
Household Contacted Due to Problems at School
Source: National Survey of Children’s Health, Johns Ho...
ACE Effects in School
Grade Repetition
Source: National Survey of Children’s Health, Johns Hopkins University (2012)
0%
5%...
Beyond the Hallways
Life-long Negative Outcomes Linked to ACEs
Partial List of ACE Dose/Response Outcomes
Alcoholism & alc...
What Are the Implications?
To put it simply, childhood experiences are the most
powerful determinants of who we become as ...
Population Attributable Risk
 PAR = The difference in rate of a condition
between an exposed population and an
unexposed ...
Population Attributable Risk
Current Smoking
Smoking Not
Attributable to
Ace
Smoking
Attributable to
ACE
78.3%
21.7%
Risk ...
Population Attributable Risk
Ever Using Illicit Drugs
32.1% not
attributable to
ACE
67.9%
attributable to
ACE
Risk data fr...
Population Attributable Risk
Risk data from Felitti, et. Al: PAR analysis: RE Voorhees
Alcoholism
3.2% of self-
reported
a...
Population Attributable Risk
Risk data from Felitti, et. Al: PAR analysis: RE Voorhees
Reporting Having Attempted Suicide
...
How ACES Increase Suicide
Attempts
Less than 1 of 100 people with 0 ACEs attempt suicide
10 of 100 people with 3 ACEs atte...
ACEs Path
“Personal
Solution”
ACEs Impact Mortality
0
10
20
30
40
50
60
0 2 4
PercentinAgeGroup
ACE Score
19-34 35-49
50-64 >=65
Psychological Depletion
• Whether you like it or not, many of you and
your partners are on the ACE frontline.
• The consta...
• Trauma-informed schools and classrooms can create an
environment where students with injured brains have
the best opport...
• Mood is your internal emotional state.
• Affect is how you externalize your emotions through
verbal and non-verbal cues....
• Traumatized students often have difficulty
communicating, so their behaviors may become a
“front” for conveying unmet ne...
• Being predictable by having consistent responses to
student behavior is vital to establishing safety and
reducing a chil...
• Building routines and rituals, particularly around trouble
areas, can make your classroom fun and predictable.
• Researc...
• These four strategies come from the Attachment, Self-
Regulation and Competency research conducted by
Kinniburgh and Bla...
• Kernels are low or no-cost to implement.
• This means we can unleash access to strategies that
support safety, relations...
• A kernel is the smallest unit of scientifically proven
behavioral influence.
• Kernels produce quick easily measured cha...
The alterations in brain chemistry that have resulted from our
changing diet during the last 50 years contributes to trend...
Omega-3 Supplementation
• Omega 3 has no harmful effects
• Well-documented evidence for Reducing aggression,
depression, a...
Why haven’t we heard this before?!
Challenge: Feelings of Safety
• Also known as “handshakes.”
• Frequent friendly physical and
verbal greetings impact social
status and perceptions of sa...
“Turtle Breathing” is a technique for helping
children with controlling anger.
Some elementary teachers use this technique...
Model remaining calm
Teach the child the steps of how to control feelings and
calm down
Step 1: Recognize your feeling(s)
...
Challenge: Praise
When any person receives specific,
spoken recognition for engagement in
a target act or behavior, it is widely
demonstrate...
Verbal Praise As a Social Reinforcer
What are the social reinforcers in your
home or classroom for this behavior?
Paying a...
Verbal Praise As a Social Reinforcer
How about for this behavior?
Showing off.
Peer to Peer Notes
Notes of praise written from one peer to
another, then read aloud or posted on a
public display is wide...
Adult to Child Notes
Notes from adults to children recognizing
them for a specific action or behavior is
demonstrated to h...
Beat the Timer
Beat the timer makes daily routines
run smoother, reduces parent/child
conflict and reduces accidental
atte...
Copy Cat
(Paragraph Shrinking)
• After talking with your student, ask
him to repeat what was said in 8-10
words.
• Repeat ...
Random Calling
This kernel is sometimes referred to as
“Ritalin on a Stick” and is proven effective by
research.
Random ca...
Challenge: Recognition
Positive Note Home for Inhibition
A positive note sent home with a student for
inhibiting an otherwise disruptive behavior...
Principal Lottery
When a status figure sends a note home or calls
a parent about a student’s positive behavior,
research s...
Auditory/Visual Signal for Transition
The attention kernel works for students and
adults. It results in:
• Immediate reduc...
Premack’s Principle
Also known as Contingency Management, the Mystery
Motivator, Granny’s Wacky Prizes, Prize Bowl and the...
Contingency Management by the Numbers
Effects of a randomized contingency management intervention on opiate abstinence and...
Challenge: Meaningful Roles
The Social Development Strategy
Brain on the Ball
Suitable for preschoolers through adults:
• Increases attention and improves academic
achievement
• Redu...
Many Other Kernels
 Graphic/Node Maps
 Choral Responding
 Peer to Peer Tutoring
 Nasal Breathing
 Private Reprimands
...
The Darrington Experience
Good Behavior Game Active Ingredients
• After seeing a presentation like this, a champion
emerged at Darrington Elementary School. With
her help, we identified ...
The Darrington Experience
The effects are even more profound over
the lifetime of a Good Behavior Game
participant:
• Redu...
Good Behavior Game
1. The class defines the “good” to be achieved = PAX
2. The class defines the “bad” to be reduced = Spl...
Our Investment
• The County invested approximately $450
in Good Behavior Game manuals and
materials.
• Teachers noticed im...
Our Investment
• Therapy balls were ordered to each
student’s measurement, and had feet
to prevent rolling or tip-overs.
Our Investment
• Teachers reported:
• The kids like them
• Helps them focus
• Works especially well
partnered with the
“Be...
The Bottom Line
• Understanding ACES gives you the power to significantly
impact the trauma trajectory of youth in your cl...
Johnny
Resources
Presenter: Joe Neigel
Monroe Community Coalition
200 E Fremont
Monroe, WA 98272
(360) 804-2594
neigelj@monroe.we...
Behavioral Vaccines work like
any other vaccine
Prevention on a Shoestring Budget: Responding to ACE in My Community
Prevention on a Shoestring Budget: Responding to ACE in My Community
Prevention on a Shoestring Budget: Responding to ACE in My Community
Prevention on a Shoestring Budget: Responding to ACE in My Community
Prevention on a Shoestring Budget: Responding to ACE in My Community
Prevention on a Shoestring Budget: Responding to ACE in My Community
Prevention on a Shoestring Budget: Responding to ACE in My Community
Prevention on a Shoestring Budget: Responding to ACE in My Community
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Prevention on a Shoestring Budget: Responding to ACE in My Community

An overview of the Adverse Childhood Experiences Study and Evidence-based Prevention Kernels as a response to trauma.
Published on: Mar 4, 2016
Published in: Education      
Source: www.slideshare.net


Transcripts - Prevention on a Shoestring Budget: Responding to ACE in My Community

  • 1. Using Evidence-based Kernels to Create a Response to ACE in My Community Joe Neigel Seattle,Washington November 17, 2015 National Prevention NetworkConference
  • 2. Our Goals This Morning Review the Adverse Childhood Experiences Study and how early life trauma influences behavior, health outcomes and readiness to learn. Discover how ACE impact students and educators in Washington State. Consider simple, evidence-based strategies educators and community members can adopt to mitigate the harm ACE cause to students, their community and the learning environment.
  • 3. Adverse Childhood Experiences Study (ACES) ACES began as a weight-loss study at Kaiser-Permanente in Southern California. It became the largest study ever completed that examined the health and social effects of traumatic childhood experiences over the lifespan.  Middle class, average age of 57  80% white, 10% black, 10% Asian  74% some college  44% graduated college  49.5% men Examines three general forms of abuse and household dysfunction.
  • 4. The Adverse Experiences • Child physical abuse • Child sexual abuse • Child emotional abuse • Neglect • Mentally ill, depressed or suicidal person in the home • Drug addicted or alcoholic family member • Witnessing domestic violence against the mother • Loss of a parent to death or abandonment, including abandonment by divorce • Incarceration of any family member
  • 5. ACE Score Calculator
  • 6. ACEs in Snohomish County 0.00% 10.00% 20.00% 30.00% 40.00% 0 1 2 3 4 or More 35.30% 22.90% 12.60% 9.20% 20.10% Snohomish Washington
  • 7. ACE Study Findings  ACEs are very common.  They are well-concealed.  Category exposure determines health outcomes across the population.  ACEs are strong indicators of what happens later in life, in terms of health risks, diseases and even premature death.
  • 8. The Science Behind ACES  A child’s environment and experience shapes their behavior and health.  Our brain is designed to prioritize survival.  Cortisol is released when our “Fight, Flight, or Freeze” response is triggered.
  • 9. Toxic Stress
  • 10. Toxic Stress  Prolonged exposure to Cortisol is toxic, and makes permanent changes to the brain.  This means you may have students perfectly suited to survive in their home environment, but who cannot turn-off their stress response in the classroom, community or other “normal” situations.
  • 11. Do you recognize these signs of traumatic brain development?  Hypervigilance - “Always on the ready.”  Display of trauma induced ADHD symptoms, including an inability to stay on task or follow directions.  Early onset of sexualized behaviors and activity.  More impulsive, aggressive and disruptive behaviors, including those leading to suspension.  Being less able to tolerate stress.
  • 12. Other Negative Effects Prolonged exposure to Cortisol is shown to have other negative effects, including: Trauma Induced Physiological Outcomes Impaired cognitive performance Weakened immune system Hyperglycemia (fatigue, excessive thirst/urination) Higher blood pressure Slower healing, and other health consequences Decreased bone density Increased risk of physical and mental health problems Decrease in muscle tissue Development of health risk behaviorsff
  • 13. Graded Relationships in Health Risk Behaviors • There is a strong “dose/response” relationship between a person’s ACE score and the likelihood they will adopt personal solutions that lead to serious health problems. • Dose/Response is a direct measure of “cause and effect.”
  • 14. Dose/Response: More Gas = More Miles Travelled 0 50 100 150 200 250 300 350 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 NumberofMilesYouCanDrive (Response) Gallons of Gas (Dose Gets Bigger)
  • 15. Smoking • ACE Score ≥4 = 433% increase from baseline.
  • 16. Alcoholism • ACE Score ≥4 = 433% increase from baseline.
  • 17. Intravenous Drug Use • ACE Score ≥4 = 871% increase from baseline.
  • 18. Chronic Depression • We can see the cause and effect relationship ACEs create in people and in populations. 0 10 20 30 40 50 60 70 80 0 1 2 3 >=4 %WithaLifetimeHistoryof Depression ACE Score Women Men
  • 19. Attempted Suicide • We can see the cause and effect relationship ACEs create in people and in populations.
  • 20. ACE lead to risk factors for the 10 most common causes of early death in the United States
  • 21. Reframing Our Point of View • With an ACE score of 0, the majority of adults have few, if any, risk factors for these diseases leading to early death. • With an ACE score of 4 or more, the majority of adults have multiple risk factors for these diseases or the diseases themselves. Much of what we see as problem behaviors should actually be viewed as a personal solution to an unrecognized prior adversity.
  • 22. ACE Impact Washington State Schools We also know ACE drive : • Special education needs • Grade repetition • Problems at school • Educator burnout
  • 23. Meet Mallory
  • 24. Getting to Know Mallory • Mallory is in 10th grade at Monroe High School. • Her counselor knows Mallory’s mother physically abused the girl in her past. As a result, Mallory’s known ACE Score is “1.” • Keep in mind - ACEs travel in clusters: Among people exposed to physical abuse, 84% report at least 2 additional ACE.
  • 25. Mallory’s Grades Mallory appears to have trouble paying attention in class. She doesn’t turn in her homework and seems to have a hard time following directions - her grades reflect this. • Students like Mallory were nearly twice as likely (1.7x) to report getting C’s, D’s and F’s.
  • 26. Bullying and Safety at School Mallory has trouble making lasting friendships and is frequently the target of bullying behavior. • 10th graders like Mallory were:  Nearly twice as likely (1.9x) to report being the victims of bullying.  2.7x as likely to report missing days of school because they felt unsafe.
  • 27. Mallory’s Mental Health Mallory seems pretty disengaged in class and always looks tired. She can’t seem to remember facts from 10 minutes ago. • Students who report being physically abused by an adult were nearly twice as likely (1.9x) to report being depressed on the most recent HYS. • They were also nearly three times as likely (2.8x) as likely to report contemplating suicide.
  • 28. Mallory’s Personal Solutions Mallory was caught bringing a flask of alcohol to school in 9th grade. She spoke with her Vice Principal and avoided most of her suspension, but she and her family really haven’t engaged with any helping adults since then. • Students like Mallory are 2.2x more likely to report current alcohol use. • They are 2.5x more likely to indicate any other type of current drug use, including Marijuana use.
  • 29. Mallory’s in every classroom More than 1 in 4 10th graders in Washington State High Schools indicated physical abuse by an adult on the most recent Healthy Youth Survey.
  • 30. ACE Effects in School Low School Engagement Source: National Survey of Children’s Health, Johns Hopkins University (2012) 0% 10% 20% 30% 40% 50% 60% 0 ACE 1 ACE 2 ACE 3+ ACEs The student only “sometimes,” “rarely,” or “never” cares about school or does all the required homework.
  • 31. ACE Effects in School Does Not Finish Tasks Started Source: National Survey of Children’s Health, Johns Hopkins University (2012) 0% 10% 20% 30% 40% 50% 60% 0 ACE 1 ACE 2 ACE 3+ ACEs The student “sometimes,” “rarely,” or “never” finishes tasks he starts or follows through with what he says he will do.
  • 32. ACE Effects in School Highly Externalizing Behavior Source: National Survey of Children’s Health, Johns Hopkins University (2012) 0% 5% 10% 15% 20% 25% 30% 35% 40% 0 ACE 1 ACE 2 ACE 3+ ACEs The student “usually” or “always” argues too much or “sometimes,” “usually,” or “always” is cruel, mean to, or bullies others.
  • 33. ACE Effects in School Household Contacted Due to Problems at School Source: National Survey of Children’s Health, Johns Hopkins University (2012) 0% 10% 20% 30% 40% 50% 60% 0 ACE 1 ACE 2 ACE 3+ ACEs
  • 34. ACE Effects in School Grade Repetition Source: National Survey of Children’s Health, Johns Hopkins University (2012) 0% 5% 10% 15% 20% 25% 0 ACE 1 ACE 2 ACE 3+ ACEs
  • 35. Beyond the Hallways Life-long Negative Outcomes Linked to ACEs Partial List of ACE Dose/Response Outcomes Alcoholism & alcohol abuse School Drop-Out Chronic obstructive pulmonary disease & ischemic heart disease Intimate partner violence— perpetration & victimization Depression and other MH issues Sexually transmitted disease Chronic Unemployment Obesity High risk sexual activity Suicide attempts Illicit drug use Unintended pregnancy Intimate partner violence Early Death Three or more marriages Increased Emergency Room Use Increased Pharmacy Use Significant Financial Problems
  • 36. What Are the Implications? To put it simply, childhood experiences are the most powerful determinants of who we become as adults.
  • 37. Population Attributable Risk  PAR = The difference in rate of a condition between an exposed population and an unexposed population.  In this case, it is a calculation used by the CDC to estimate the proportion of a health outcome caused by ACE.  Takes into account: The increased risk due to each level of ACE The prevalence of the number of ACE categories
  • 38. Population Attributable Risk Current Smoking Smoking Not Attributable to Ace Smoking Attributable to ACE 78.3% 21.7% Risk data from Felitti, et. Al: PAR analysis: RE Voorhees
  • 39. Population Attributable Risk Ever Using Illicit Drugs 32.1% not attributable to ACE 67.9% attributable to ACE Risk data from Felitti, et. Al: PAR analysis: RE Voorhees 67.9% 32.1%
  • 40. Population Attributable Risk Risk data from Felitti, et. Al: PAR analysis: RE Voorhees Alcoholism 3.2% of self- reported alcoholism not attributable to ACE 96.8% of self- reported alcoholism attributable to ACE 96.8% 3.2%
  • 41. Population Attributable Risk Risk data from Felitti, et. Al: PAR analysis: RE Voorhees Reporting Having Attempted Suicide 0% of attempted suicide not attributable to ACE 100% of attempted suicide is attributable to ACE 100%
  • 42. How ACES Increase Suicide Attempts Less than 1 of 100 people with 0 ACEs attempt suicide 10 of 100 people with 3 ACEs attempt suicide 20 of 100 people with 7 ACEs attempt suicide
  • 43. ACEs Path “Personal Solution”
  • 44. ACEs Impact Mortality 0 10 20 30 40 50 60 0 2 4 PercentinAgeGroup ACE Score 19-34 35-49 50-64 >=65
  • 45. Psychological Depletion • Whether you like it or not, many of you and your partners are on the ACE frontline. • The constant demand of caring for others as you manage your students and classrooms can lead to burnout: • Illness • Chronic fatigue • Emotional exhaustion • Indifference or detachment • Isolation from colleagues • A lack of personal satisfaction
  • 46. • Trauma-informed schools and classrooms can create an environment where students with injured brains have the best opportunity to learn. • Evidence-based Kernels can lead you from intuitive responses to intentional action.
  • 47. • Mood is your internal emotional state. • Affect is how you externalize your emotions through verbal and non-verbal cues. • Research shows that trauma-impacted youth are particularly aware of changes in affect, which trigger the fight, flight, or freeze response and decreases the capacity to learn. Attachment, Self-Regulation & Competency Kinniburgh, Blaustein, Spinazzola & van der Kolk, 2005, Psychiatric Annals, pp. 424-430. ARC - Managing Affect
  • 48. • Traumatized students often have difficulty communicating, so their behaviors may become a “front” for conveying unmet needs or unregulated affect. • Adults may respond to the most distressing symptom, rather than the underlying emotion or need. • Ask - “What’s happening here?” rather than, “What’s wrong with this child?” Attachment, Self-Regulation & Competency Kinniburgh, Blaustein, Spinazzola & van der Kolk, 2005, Psychiatric Annals, pp. 424-430. ARC - Attunement
  • 49. • Being predictable by having consistent responses to student behavior is vital to establishing safety and reducing a child’s need to exert control. • An intentional focus on building success, rather than establishing limits – which may be associated with powerlessness or vulnerability – should be your priority. • Traumatized children may initially react to both negative or positive responses. Attachment, Self-Regulation & Competency Kinniburgh, Blaustein, Spinazzola & van der Kolk, 2005, Psychiatric Annals, pp. 424-430. ARC - Consistency
  • 50. • Building routines and rituals, particularly around trouble areas, can make your classroom fun and predictable. • Research shows that establishing routines enhances student:  Feelings of safety  Ability to build trust and feelings of reliability within a relationship  Anticipation of an event, which reduces stress Attachment, Self-Regulation & Competency Kinniburgh, Blaustein, Spinazzola & van der Kolk, 2005, Psychiatric Annals, pp. 424-430. ARC - Routines & Rituals
  • 51. • These four strategies come from the Attachment, Self- Regulation and Competency research conducted by Kinniburgh and Blaustein. • You can learn more about ARC framework and training at www.traumacenter.org • The Compassionate Schools Initiative from OSPI also provides a framework for understanding the negative impacts of stress and trauma on learning. ARC & Compassionate Schools
  • 52. • Kernels are low or no-cost to implement. • This means we can unleash access to strategies that support safety, relationship and skill building essential to our student’s readiness to learn. • Kernels give us a way to implement evidence-based practices that will interrupt the ACES trajectory, move us from intuition to intention, and improve classroom outcomes.
  • 53. • A kernel is the smallest unit of scientifically proven behavioral influence. • Kernels produce quick easily measured change that can grow into much bigger change over time. • They can be used alone OR combined with other kernels to create new programs, strategies or policies. • Combinations of Kernels are considered “behavioral vaccines.” • “Planted” Kernels create a culture. What is a Kernel?
  • 54. The alterations in brain chemistry that have resulted from our changing diet during the last 50 years contributes to trends of depression, bipolar disorder, autism, violence and academic problems. Challenge: Brain Nutrient Deficiency
  • 55. Omega-3 Supplementation • Omega 3 has no harmful effects • Well-documented evidence for Reducing aggression, depression, anxiety, bipolar disorder, post partum depression and borderline personality disorder • 2002 Oxford University study and 2009 Dutch Corrections study of found Omega-3 supplementation achieved a 37% reduction in episodes of inmate aggression. • In 2006, the American Psychiatric Association recommend that all psychiatric patients receive at least 1 gram of omega-3 per day to reduce symptoms of mental illness.
  • 56. Why haven’t we heard this before?!
  • 57. Challenge: Feelings of Safety
  • 58. • Also known as “handshakes.” • Frequent friendly physical and verbal greetings impact social status and perceptions of safety and harm. • They also affect behavior streams of aggression, hostility and politeness. Pleasant Greeting with Physical Touch
  • 59. “Turtle Breathing” is a technique for helping children with controlling anger. Some elementary teachers use this technique in conjunction with the scripted story, “Tucker Turtle Takes Time to Tuck and Think.” This technique: • Reduces anxiety • Reduces temper tantrums • Increases resiliency • Increases self-control Turtle Breathing
  • 60. Model remaining calm Teach the child the steps of how to control feelings and calm down Step 1: Recognize your feeling(s) Step 2: Think “stop” Step 3: Go inside your “shell” and take 3 deep breaths Step 4: Come out when calm and think of a “solution” Practice steps frequently Recognize and comment when the child stays calm Involve families: teach them the “Turtle Technique” Turtle Breathing
  • 61. Challenge: Praise
  • 62. When any person receives specific, spoken recognition for engagement in a target act or behavior, it is widely demonstrated to: • Improve school performance • Improve adult/child interactions • Improve organizational functioning • Increase engagement in the noticed behavior Verbal Praise
  • 63. Verbal Praise As a Social Reinforcer What are the social reinforcers in your home or classroom for this behavior? Paying attention.
  • 64. Verbal Praise As a Social Reinforcer How about for this behavior? Showing off.
  • 65. Peer to Peer Notes Notes of praise written from one peer to another, then read aloud or posted on a public display is widely shown to: • Increase positive friendships • Reduce neighborhood disorganization and crime • Increase sense of safety • Increase volunteerism • Increase engagement in the noticed behavior
  • 66. Adult to Child Notes Notes from adults to children recognizing them for a specific action or behavior is demonstrated to help students of all ages to: • Do better at school • Be more socially competent • Reduce ADHD, aggression and problem behaviors • Increase engagement in the noticed behavior
  • 67. Beat the Timer Beat the timer makes daily routines run smoother, reduces parent/child conflict and reduces accidental attention to negative behavior. Research shows that this simple game: • Increases compliance • Increases accuracy and completion of homework • Helps with chores
  • 68. Copy Cat (Paragraph Shrinking) • After talking with your student, ask him to repeat what was said in 8-10 words. • Repeat if summary is poor. • Praise if the summary is good. • Helps with retention and understanding of what is said or read.
  • 69. Random Calling This kernel is sometimes referred to as “Ritalin on a Stick” and is proven effective by research. Random calling results in: • Equality in participation • Increased attention to the lesson • Increased academic performance • Decreased disruptive behavior
  • 70. Challenge: Recognition
  • 71. Positive Note Home for Inhibition A positive note sent home with a student for inhibiting an otherwise disruptive behavior is show to: • Reduce disruptive and aggressive behavior • Reduce problems at home • Increase engagement at school
  • 72. Principal Lottery When a status figure sends a note home or calls a parent about a student’s positive behavior, research shows that action results in: • Increases in academic achievement • Reductions in disruptive behavior • Reductions in aggression
  • 73. Auditory/Visual Signal for Transition The attention kernel works for students and adults. It results in: • Immediate reduction in transition time • Increased academic engagement • Reduced disruptive behavior • Reduced aggression and bullying • Reduced trauma response in traumatized people.
  • 74. Premack’s Principle Also known as Contingency Management, the Mystery Motivator, Granny’s Wacky Prizes, Prize Bowl and the Game of Life. Results in: • Reduction in deviant behavior across the lifespan • Reduction in problem behaviors at school • Increases desirable behavior in all age groups • Reduces addiction. • Motivates youth and adults to do their best and improve • Promotes self-regulation instead of excitement
  • 75. Contingency Management by the Numbers Effects of a randomized contingency management intervention on opiate abstinence and retention in methadone maintenance treatment in China. Hser YI, Li J, Jiang H, Zhang R, Du J, Zhang C, Zhang B, Evans E, Wu F, Chang YJ, Peng C, Huang D, Stitzer ML, Roll J, Zhao M. Addiction. 2011 Oct;106(10):1801-9. doi: 10.1111/j.1360-0443.2011.03490.x. Epub 2011 Jul 27. PMID: 21793958
  • 76. Challenge: Meaningful Roles
  • 77. The Social Development Strategy
  • 78. Brain on the Ball Suitable for preschoolers through adults: • Increases attention and improves academic achievement • Reduces ADHD symptoms without medication and reduces disruptive behavior
  • 79. Many Other Kernels  Graphic/Node Maps  Choral Responding  Peer to Peer Tutoring  Nasal Breathing  Private Reprimands  More!
  • 80. The Darrington Experience
  • 81. Good Behavior Game Active Ingredients
  • 82. • After seeing a presentation like this, a champion emerged at Darrington Elementary School. With her help, we identified the Good Behavior Game and Brain on the Ball as strategies that were a good fit for her classroom. • Research shows the Good Behavior Game implemented in a 1st grade classroom for one school year produces: • 60-90 minutes more time to teach and learn each day. • 75-125 fewer disruptions per hour in classes. • 20%-30% reduction in need for special education The Darrington Experience
  • 83. The Darrington Experience The effects are even more profound over the lifetime of a Good Behavior Game participant: • Reduces lifetime special services needs • Reduces lifetime alcohol addictions • Reduces lifetime antisocial personality disorders • Reduces lifetime smoking • Increases graduation
  • 84. Good Behavior Game 1. The class defines the “good” to be achieved = PAX 2. The class defines the “bad” to be reduced = Spleems 3. The teachers use kernels, like transitions, Beat the Timer and Prize Bowl to create a daily “game.” 4. Teacher forms 3-5 teams in the class (based on a formula). 5. A Spleem (a disturbing, disruptive, destructive or inattentive behavior) is counted against the team. 6. A game is played three (3) times per day for increasing number of minutes as successful. The games are played during demanding times for instruction. 7. Teams have a Win if the score three (3) or fewer Spleems. 8. The wins are reinforced by silly activities for a few seconds or minutes at most, based on Premack’s Principle
  • 85. Our Investment • The County invested approximately $450 in Good Behavior Game manuals and materials. • Teachers noticed immediate reductions in disruptions and increases in teaching time. • Teachers implemented the Good Behavior Game in combination with another kernel – alternative seating strategy. • They replaced all chairs in 1st – 3rd grade with therapy balls.
  • 86. Our Investment • Therapy balls were ordered to each student’s measurement, and had feet to prevent rolling or tip-overs.
  • 87. Our Investment • Teachers reported: • The kids like them • Helps them focus • Works especially well partnered with the “Behavior Game” • Comfortable • Better handwriting • Seems to give the students stamina for writing for longer periods of time • In other classrooms, extra balls are used as a reward. • Rate of disruptions per student per hour: Goheen (74% reduction) and Monte Calvo (86% reduction) teaching Math.
  • 88. The Bottom Line • Understanding ACES gives you the power to significantly impact the trauma trajectory of youth in your classroom. • Remember Kaiser Permanente’s diet and nutrition program dropouts? The researchers learned that their very successful intervention wasn’t just treating nutrition problems, it was treating personal solutions! • If you take away a person’s solution before they discover a better one, and you’re just digging a hole for them to fall back into. • Partner with me. If you need it, I give you my permission to do what’s in your heart.
  • 89. Johnny
  • 90. Resources Presenter: Joe Neigel Monroe Community Coalition 200 E Fremont Monroe, WA 98272 (360) 804-2594 neigelj@monroe.wednet.edu Power Point: http://goo.gl/uPVbSI Kernels: http://promiseneighborhoods.org/kernels/ Or http://bit.ly/embry_kernels ACES: http://www.cdc.gov/ace/index.htm Or http://www.acestudy.org/ Or http://www.fpc.wa.gov/ Or http://www.acestoohigh.com ARC Training: http://www.traumacenter.org/research/ascot.php OSPI Initiative: http://www.k12.wa.us/CompassionateSchools/
  • 91. Behavioral Vaccines work like any other vaccine