Traumatic Consequences: A Revolution in Caring for Children

The Deepest Well: Healing the Long-term Effects of Childhood Adversity. By Nadine Burke Harris. Houghton Mifflin Harcourt, 273 pp, January 2018

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In The Deepest Well, pediatrician Nadine Burke Harris writes about her first encounter with the Adverse Childhood Experiences (ACE) Study by Drs. Felitti and Anda. She says that it was like finding “the final puzzle piece that pulled all the others into place.” She had always suspected there was a connection between the difficult life circumstances of her patients and their health problems, but the study provided scientific evidence to prove it.

As a teacher reading Harris’s book, I felt the same sense of excitement. Finally. Perhaps this research will allow educators to have a serious discussion about how adversity in children’s lives impacts their learning at school. During my 20 years of teaching, I have seen time and again teachers’ concerns about trauma in their students’ lives met with criticism. Those things are out of our control. We need to focus on what we can do within the school buildings. Standards. Fidelity to the curriculum. Data. Rigor. If we teach students well enough, they will learn.

It turns out that is not entirely true. Harris explains that neuroscience proves children need to have healthy attachments, stress management, and self-regulation before they can learn anything, regardless of what standard, curriculum, or reform is implemented in the classroom.

After the ACE study helped Dr. Harris understand the why of her patients’ health problems, she dug deeper to learn how to help them. She pored over related research and collaborated with colleagues to understand how trauma affects a child’s biology. She discovered that the main problem is a dysregulated stress response system that causes toxic levels of stress. Our fight, flight, or freeze response was designed to save our lives, but if it is activated too frequently, the stress response system breaks. When that happens in children who are still developing, it can literally change their brains.

Since we can’t always prevent bad things from happening to people, what is the solution? Harris explains that having an adequate adult support system can prevent a child’s stress from becoming toxic, but if a child’s caregivers are also overwhelmed with stress, they often cannot provide that support. Therefore, early detection of ACEs is key, as well as having a multidisciplinary approach to support the child.

Dr. Harris created this type of approach at her clinic. The staff screen all the patients for ACEs and work with therapists, nonprofit organizations, nutritionists, etc., to support the patients’ families. By utilizing the right human resources, the staff are able to develop successful strategies to heal toxic stress, including improving the patients’ sleep, mental health, relationships, nutrition, and exercise.

Harris recognizes that educators needs to be a part of the multidisciplinary approach. When the staff screened the patients for ACEs, they found that those with a score of 4 or higher were 32.6 times more likely to have learning or behavior problems at school.

She turned to Dr. Pamela Cantor for advice. Dr. Cantor is a psychiatrist who worked with New York City schools after 9/11. She asserts that educators tend to embrace one specific thing or another (accountability, data measurement, etc.) as a panacea for fixing problems rather than trying to gain a comprehensive understanding of the problem.

I would suggest it is the reformers and policymakers who think schools can be “fixed” by one specific thing or another, often with encouragement from corporations eager to benefit. The true educators, along with the children, have these “things” forced upon them.

Many policies adopted in the name of improving education—high-stakes testing and elimination of play-based learning, for example—have increased the stress and anxiety levels of children. Additionally, requiring teachers to spend their time implementing these initiatives reduces their ability to be the supportive adult who serves as a buffer for toxic stress. Imagine if all the education funding spent on standardized tests and data coaches over the past decade had been spent on human resources to work directly with children.

The Deepest Well should be on every school’s professional development reading list. Teachers need to share the message of this book with administrators, school boards, state legislatures, and community leaders because the research Harris presents shows that it is a mistake to focus only on performance data.

Finally, Dr. Harris’s strongest warning is that we cannot label ACEs and toxic stress as a problem for just one community or another. If we do, it becomes too easy to pass judgment and ignore the problem. Adversity is present in all communities. It might look different in different zip codes with different levels of violence, poverty, unemployment, addiction, and depression, but no matter where it is present, if preventative measures aren’t taken, it can lead to toxic stress and have devastating consequences on overall health and learning potential. Harris’s message has profound implications for our society and offers a key to improving conditions for children everywhere.


Click a link below to view full book descriptions or purchase.

By (author): Nadine Burke Harris

*A portion of purchases made via the above links benefits Child’s World America.

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