Healing Childhood Trauma From Gun Violence in Watts

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At just two square miles, Watts is one of Los Angeles’ smallest neighborhoods – showing up as a blip on the sprawling 500 square mile footprint of the city. Yet with a median annual income of $25,000 and five large housing developments, Watts is a small community dealing with large issues when it comes to violence and trauma.

Watts has dealt with decades of high crime rates and frequent gun violence. Multiple generations have grown up in a neighborhood where the rattling bang of a gunshot has been a regular occurrence and the risk of a family member or friend being targeted or hit by a stray bullet is a real threat. During the span of one week in late March 2019, a total of 26 shootings with 10 fatalities took place across Los Angeles, with multiple incidents in Watts.

Minimizing the impact of gun violence is what a new initiative at Children’s Institute is working toward. Known as The REACH TEAM, CII is partnering with the LA City Attorney’s Office and LAPD to respond to gun violence by expanding access to crucial intervention and counseling services for children in Watts.

“Gun violence is so present in these neighborhoods,” said Eztli Herrera, Care Coordinator on The REACH TEAM. “We don’t want to minimize how traumatic this is and act like it’s normal.”

Residents in Watts have endured decades of gun violence that has caused generational trauma and toxic stress.

Prior to joining CII, Herrera worked in schools around South LA. She said she saw a lot of nervousness and anxiety tied to gun violence whenever the topic came up around students.

At one point, she remembers a group of students swapping details about a time they had a gun pulled on them after school. Other times they talked about having few options for walking home safely where there would be a lower potential of encountering somebody with a gun.

Deputy City Attorney Lara Drino said that in environments where gun violence is prevalent, children are likelier to intersect with violent crimes as adults. After hearing about these outcomes at the Watts Gang Task Force meetings in and around Watts, Drino said she saw an opportunity to increase mental health resources as a way to help children in Watts heal from trauma.

Without counseling services, exposure to gun violence can have damaging results that last throughout adulthood. Viewed as a toxic stress, children can develop symptoms like post-traumatic stress disorder that impact brain development and physical health. Academic achievement, professional success and family stability are all negatively impacted as well.

Watch the Spectrum News story on The REACH TEAM

It is essential that children who have already experienced gun violence have access to counseling and support services. These services can help them heal from past trauma and give them the tools and resources to navigate future dangers. Drino said she also sees The REACH TEAM connecting kids with other community-based initiatives like after-school programs that keep children away from gang activity.

“If we can intervene in these kids’ lives early and get them on a different trajectory with positive mental health, hopefully we can keep them out of the criminal justice system as either a victim or a suspect,” Drino said.

The REACH TEAM wouldn’t be complete without LAPD who provides background on neighborhood dynamics around housing developments while also sharing immediate updates whenever there are reports of shots being fired in Watts. This work is overseen by Lieutenant Gena Brooks of LAPD, who is also on CII’s Board of Trustees.

CII’s Clinical Program Manager Ginger Lavender-Wilkerson with The REACH TEAM members Deputy City Attorney Lara Drino and LAPD Lieutenant Gena Brooks.

“Normally when we respond, we’re looking for the victim to take care of, for the suspect, to take them in to custody, and we’re walking by all these little casualties of war who have seen it, and what we realize now is that hurt people hurt others,” Lt. Brooks said.

While Herrera handles the day-to-day work of implementing the strategies of the program, Clinical Program Manager Ginger Lavender-Wilkerson, LMFT, oversees the team along with Maria Reyes, who provides counseling and therapy and helps with outreach.

Based out of CII’s Watts Campus, The REACH TEAM goes out into the community and responds when shots are fired. Whenever LAPD informs The REACH TEAM of a shooting, the group moves into the area to find kids who may have seen or heard the gun shots. They talk to community leaders and neighbors to understand who exactly has been affected.

When they learn about a child who has witnessed gun violence, they reach out to the family with a care package that includes a teddy bear and other items designed to help a child relax. The team then works with the family to set up short-term counseling. As children access services, assessments are made around longer-term therapy and support groups. In some cases, it may take more than a month for the signs of trauma to appear so the team checks back in with families who may have initially declined services.

If we can intervene in these kids’ lives early and get them on a different trajectory with positive mental health, hopefully we can keep them out of the criminal justice system as either a victim or a suspect.

–  Lara Drino, Deputy City Attorney

Reyes said children have shared with her that it feels good to know they now have a place to go if they need support.

“The REACH TEAM has helped kids understand it’s okay to talk about how they’re feeling or what they’re going through,” Reyes said. “This work is going to dictate the health of the next generation in Watts.”

When designing The REACH TEAM, Lavender-Wilkerson said it was crucial for them to go out and meet residents to better understand their needs. She said mental health resources can carry a stigma in Watts where people most likely won’t utilize these services unless the team was knocking at their door and following up with them. She said this is a unique and proactive approach that is time-intensive, but will likely determine the initiative’s eventual success.

CII's initiative to prevent trauma from gun violenceThe REACH TEAM at CII includes Maria Reyes, Yvette Martinez, Eztli Herrera, and Ginger Lavender-Wilkerson.

“While counseling is focused on children, she said the team’s outreach is geared toward helping the whole family. In most cases, she said parents and other family members have also grown up around gun violence and deal with these dangers on a daily basis. They too have experienced trauma and need outlets to heal.

“Parents are affected by this as well,” she said. “Many don’t recognize their own trauma, because they’ve accepted gun violence as a regular thing.”

The REACH TEAM is focused on partnership at all levels of the community and refers adults to free mental health counselors or support groups like Mothers of Murdered Children. Lavender-Wilkerson said it is essential that the whole family heals from gun violence, not just the children.

The REACH TEAM has helped kids understand it’s okay to talk about how they’re feeling or what they’re going through. This work is going to dictate the health of the next generation in Watts.

– Maria Reyes, Therapist

When The REACH TEAM isn’t working directly with families affected by a recent shooting, they are out in the community educating groups on the importance of counseling and ways to stay safe in their neighborhood.

Herrera estimates the team attended upwards of 30 meetings in the last few months with different community groups at housing developments, schools and churches. She is frequently picking up the phone or meeting in-person with community leaders.

She said it is important for The REACH TEAM to be an active part of the Watts community. She wants residents to know she and her team members are a resource, whether it is a question about the best route home from school or the benefits of accessing counseling after a traumatic event.

Herrera said it is important to let people know they aren’t alone. They have a whole network of people here to help them.

While the program has only been in place since September 2018, Drino said she is already seeing results that point to this being an essential program to helping Watts heal from decades of gun violence. If this program is successful, Drino said she can see it expanding to other parts of South LA that face similar challenges.

Last month, The REACH TEAM held the first workshop in what will be a series of courses designed to give kids important tools for avoiding gun-related traumas. A group of 20-plus kids listened intently as the team went over the long-term effects of trauma and how counseling can help. The kids were appreciative and optimistic about the guidance they were receiving.

For Herrera, this was another reminder that The REACH TEAM is approaching gun violence in a unique way. Classes like these, in addition to the other work being implemented, highlight the evolution of community support and trauma that differed from when she first started in the neighborhood. The last few months have been a positive first step in what will hopefully be a successful campaign to heal Watts after decades of struggling against gun violence.

“We want to continue a dialogue and start the healing process,” Herrera said. “We’re reaching out and we’re really trying to make a difference.”

CII is working to help children affected by gun violence

Promoting Healthy Alternatives to LA’s Food Deserts

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In early February, Children’s Institute held a Family Health Fair in South Los Angeles with the goal of promoting simple ways to live a healthier life to the children and families CII serves. The event sought to expand access to preventative health care while making activities like visiting the dentist or eating plant-based meals more palatable.

Held at CII’s Figueroa Center and sponsored by the Herbalife Nutrition Foundation, the fair brought together 21 community organizations that spanned different health and wellness fields. Community partners like UCLA Mobile Eye Clinic, Benevolence Health Center Inc., and Dignity Health, offered free screenings for dental, vision and blood pressure. Zumba and yoga courses were held throughout the day and wellness tools like electric tooth brushes and fitness trackers were raffled off.

As the day progressed, the importance of regular medical and dental checkups was discussed, but many attendees, volunteers and community organizers kept coming back to one area that was crucial to preventative health and wellness – a balanced diet.

CII works to reduce food deserts in South LAVegan tamales were served by Claudia Lopez and her restaurant Mama’s International Tamales.

Justine Lawrence, Vice President of Head Start at CII, said South LA offers few options when it comes to healthy eating. She said fast food restaurants are often the only option in these neighborhoods and the impact takes a toll on families living in food deserts.

“If you drive around this community, you are going to be hard pressed to find a grocery store that has fresh food,” she said. “We have a lot of children coming into our program struggling with obesity.”

Large swaths of South LA are considered food deserts. The term, created in the 1990s, describes urban areas that lack grocery stores where residents can buy fresh foods like fruits and vegetables. The United States Department of Agriculture has released multiple studies showing that there are large parts of South LA where fast food or processed food are the only available options.

Ongoing studies by the Centers for Disease Control and Prevention point to a clear connection between negative long-term health effects in areas where fresh food is limited. As a result, higher rates of obesity, diabetes and high blood pressure have been reported in these areas.

If you drive around this community, you are going to be hard pressed to find a grocery store that has fresh food.

– Justin Lawrence, Vice President of Head Start at CII

Angel Gaines, Site Supervisor for Compton Early Head Start, said she personally struggled with high blood pressure. She grew up in South LA food deserts and didn’t start eating healthy until after join CII and learning about maintaining a balanced diet.

Gaines said an important part of working with children and families is encouraging a healthy lifestyle that includes fresh food. As Gaines promoted physical activity by leading Zumba and yoga courses at the Family Health Fair, she said families are often unaware of the potential negative consequences when they eat only processed foods.

“When we have high blood pressure or diabetes, it is usually caused by what we are eating,” she said.

Olga, who has been attending CII programs since her daughter Sophia was 3 months old, said she appreciated how CII promotes cost-effective ways to make healthy meals while living in food deserts. She said she was able to cook food that is healthy without abandoning family recipes tied to her own Hispanic heritage.

“It opens up a door for people who may not want just raw vegetables,” she said. “Tamales are part of our culture, but they can be vegetarian or vegan.”

Claudia Lopez took this philosophy and turned it into a business. Her restaurant, Mama’s International Tamales, was at the Family Health Fair serving vegan tamales with vegetarian sides.

CII shares alternatives to food deserts in South LAStaff from CII’s Early Childhood Education display healthy alternatives to chips and candy as after school snacks. 

“I felt our community needed more health-based food options,” she said. “It is easy to substitute healthier ingredients like jack fruit or stop cooking with lard.”

Lopez views her restaurant, located in MacArthur Park, as an opportunity to educate people on how cultural foods like tamales can stay delicious while also being healthy. She said people often try her tamales and say they are shocked it was vegan.

Edgar, a parent visiting the Family Health Fair with his three children, said he would have never guessed the food from Mama’s International Tamales were vegan. He said he was drawn to the tamales aroma at the food booth after only being at the fair for a few minutes.

As a parent, Aguila has noticed a positive shift toward healthier eating. He said it is easy as a parent in South LA to get into a routine of eating too much fast food. He was thankful to see cost effective balanced eating promoted by CII and other community organizations.

“We raised our kids on McDonald’s for years, but now we’re more into cooking at home with kale, arugula and cauliflower,” he said. “Eating well is a big factor in growing up healthy and not getting sick.”

As many pointed out at the event, long-term success for South LA is continuing to expand the number of healthy food options while keeping costs low.

The average household income for neighborhoods in this area range between $33,000-$45,000 according to data published by the LA Times. Spending $10-$15 for a quick and healthy meal, which is often the cost in Santa Monica or West Hollywood, is not within the budgets of most residents in South LA.

Lakisha May, a field marketer for fast food startup Everytable, was offering up an example on how businesses can better serve residents of South LA food deserts and stay profitable. May said Everytable has a sliding scale for menu items. In South LA, Everytable items cost less than at their restaurants in other parts of the city where average incomes are higher.

For South LA to eat healthier, having affordable options will be crucial.

“It is different for people with less resources,” May said.

Thank you to event support from: Herbalife Nutrition Foundation; Mama’s International Tamales; CII Intensive Programs; LA Public Library; CII PowerUp!; CII Project Fatherhood; Herman Ostrow School of Dentistry of USC; CII PABC; CII PFF, P&A; UCLA Mobile Eye Clinic; Eyeglass Store of OC; CII ERSEA; Benevolence Health Centers, Inc.; CII ECS; Dignity Health; Susan G. Komen; California WIC; Fun Dental 4 Kids; AltaMed.

Children’s Institute’s Top Moments of 2018

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This month, we took a moment to pause and look back at a few highlights from Children’s Institute this past year. In 2018, we adopted an ambitious strategic plan that will double the number of children and families we serve over the next 10 years. As part of this strategic plan, we spent last year expanding services focused on supporting children and families facing adversity across Los Angeles. This included launching a new initiative in Watts supporting children and families exposed to gun violence. We also looked for ways to bring new experiences to kids in our programs like attending a theatre performance, camping or building their first bike.

Like previous years, our successes in 2018 were powered by the strong support of our greater LA community. Events were supported, attended and hosted by amazing volunteers and in-kind items were donated by local CII friends and businesses. The donors who fund crucial CII services continued to support our organization with a record number of gifts. We ended the year on a high note by raising almost $1 million at our inaugural Cape & Gown Gala on November 14 when we honored child advocates Beth & Bob Lowe along with Frank, Berta and Sam Gehry.

We’ve already started working to make an even bigger impact in 2019, and we’ll keep you updated along the way.

Supplied for Success

We celebrated our four year-old Head Start graduates with a back-to-school event ensuring a successful transition to kindergarten. The children received backpacks filled with school supplies provided by Age of Learning.

“It has always been our goal to achieve school readiness for our children and their families. The backpack donation ensures our children starting kindergarten have all the essentials,” says Justine Lawrence, Vice President of Head Start, CII.

The Healing Power of the Arts

Youth from our Individualized Transitional Skills Program  and Santee Education Complex were treated to a performance of Daniel Beaty’s “emergency” at the Wallis Annenberg Center for the Performing Arts. The one-man show featured poetry, music and humor as Beaty played an array of characters coping with the effects of trauma. Read more about the event.

Supporting Children Exposed to Gun Violence

We launched a new initiative in partnership with the LA City Attorney’s Office and LAPD to support children in Watts who have been exposed to gun violence. The REACH TEAM ensures children and families in Watts receive appropriate and timely crisis intervention and support services through Children’s Institute and partner organizations. Read more about the partnership.

Gears for Kids

Our annual Gears for Kids event went off without a hitch thanks to our partners at Haworth.  Partners from 24 major design firms built bikes with kids from our Power-Up after-school program. Each kid got to take their bike home at the end of the day. In-N-Out Burger sent a food truck keeping our kids and volunteers energized.

Happy Campers

We held our 8th annual Camp Booth retreat at Booth Ranches in Fresno where kids got to spend time in nature and build camaraderie. Youth got to see a movie under the stars, interact with horses and make s’mores. Camp Booth was hosted by former board member and longtime supporter Loren Booth.

UCLA Career Day Opens Horizons for Youth

Our Power Up after-school program youth joined us for our first College & Career Day. The event was hosted by the UCLA Latino Alumni Association. Kids created resumes and figured out the skills they will need to make their dream jobs a reality. UCLA students and alumni also spoke to the kids about their unique college and career paths.

Cape & Gown Gala Raises $1.3 million for Services

Children’s Institute welcomed 400 guests to the Fairmont Miramar Hotel & Bungalows in Santa Monica to honor Beth & Bob Lowe and Frank, Berta and Sam Gehry at the first ever Cape & Gown Gala. The event raised close to $1 million for Children’s Institute’s programs. Read more about this successful event.

Early Head Start Expands to Compton

CII opened its first Early Head Start Program in Compton. Serving 140 infants and toddlers, the program provides crucial services to set kids up for future success. To celebrate the grand opening, CII invited kids, families and community members to an event with food and music.

A New Home in Long Beach

The day after we celebrated the new Compton Early Head Start, CII headed further south to celebrate the grand opening of our Long Beach center. The award-winning 20,000 square foot hub was designed by DSH // architecture.

Winter Family Festival Spreads Holiday Cheer

In December, we hosted our annual Winter Family Festival. The event opened our Otis Booth Campus to more than 2,500 children and families. The day included special holiday moments for kids including storytelling, arts and crafts and cupcake decorating. There was also an obstacle course and lots of giveaways for children and families who take part in CII’s programs.

Working as a Team

More than 30 CII staff members finished up the year by completing in the rigorous LASpartan Race. With several stunning displays of teamwork, the group pushed the limits as they climbed over barriers and swung through rope courses to finish as a team. Those who compete in Spartan races demonstrate a camaraderie towards other participants, embrace the challenge of the unknown and set out to prove they can accomplish difficult things. Mission accomplished.

Want to learn more about CII?

Read our 2018 Annual Report and Impact Report.

Make a difference in the lives of children and families exposed to adversity and poverty by making an end-of-year donation this holiday season.

 

The Gift of Possibilities

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My name is LaRae and I’m a working mother of four children. I survived years of living in a violent household, as a child and into my adulthood. I have fought to keep my children safe, because they are the most precious and important people in my life. Our family has experienced significant trauma, including multiple incidents of gun violence, personal injury, murder and homelessness.

I grew up in the projects in South LA where I learned very fast that I had to get tough, even though I was a child who didn’t like violence. One day, my dad sat me in a folding chair and invited all the neighborhood kids to hit and kick me. Afterwards, he said, “Now are you mad enough to go and fight?”

Throughout my life, I was also struggling with my own internal battle. I was constantly under the pressure of thoughts that the world and I just didn’t fit. I lived over 20 years of my life suicidal and it reached a point where I couldn’t take care of my children. This is when I was introduced to Children’s Institute. I didn’t know much about myself at that time. The therapist would say, “We are going to explore how to identify our feelings,” and I would start to release every secret I’d been holding throughout my life that I’d been ashamed of, or had weighed me down. I told it all — I got free.

Children’s Institute has been a part of my journey from contemplating the worst to accomplishing the best. From teaching me how to create a new vision for my life that is centered on purposeful living and stability, to attending conferences to help me transition back into work.

All four of my children benefited from Children’s Institute’s therapeutic programs teaching us to work together as a family, learning how to build healthy relationships with ourselves, with one another, and also with our community.

Today, my family is doing great, and we are exactly where we are supposed to be — happy, healthy and safe.

Happy Holidays,

 

 

Make a difference in the lives of children and families with an end-of-year donation this holiday season.

 

Dr. Todd Sosna Named Chief Program Officer at Children’s Institute

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We’re pleased to announce that Todd Sosna, Ph.D. has been named Children’s Institute’s Chief Program Officer effective today.

In this new role, Dr. Sosna will lead all Early Education, Behavioral Health, Family Strengthening and Community Innovations programs for the agency, overseeing a budget of more than $70 million and a staff of 800.

Dr. Sosna has served as Interim Senior Vice President of Clinical Services at Children’s Institute since April 2018 and held the role of Senior VP for Program Evaluation and Improvement from 2012 to 2014.

“Over the past eight months, Dr. Sosna has demonstrated strong leadership, collaboration and accountability, and has fostered strong morale throughout the reorganization of our clinical and community programs. We currently have the unique opportunity to unify our broad array of services to achieve lasting impact for the children and families we serve, and I am confident Dr. Sosna is the best suited candidate for this crucial role,” said Martine Singer, President & CEO, Children’s Institute.

“As Chief Program Officer, I look forward to strengthening CII’s position as a leader in child trauma, behavioral health and early education, and deepening partnerships with other community-based organizations, funders and policymakers,” said Dr. Sosna, Chief Program Officer, Children’s Institute.

Dr. Sosna’s prior positions have included Senior VP of Operations for Jewish Family Service of Los Angeles, Deputy Director for the California Institute for Mental Health and Assistant Director for Santa Barbara County Alcohol, Drug and Mental Health Services. He is known for developing Santa Barbara County’s nationally recognized multi-agency Integrated Children’s System of Care, advancing California’s large scale dissemination of evidence-based practices, leading child welfare and juvenile justice reforms, and establishing early childhood mental health programs in partnership with Head Start agencies.

Dr. Sosna earned his doctorate in clinical psychology from Washington State University in 1991, and is a member of the National Association for the Education of Young Children (NAEYC).

Support for Children Exposed to Gun Violence

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With orange balloons flanking the stage at our Watts campus, Los Angeles City Attorney Mike Feuer, Children’s Institute and the Los Angeles Police Department announced the REACH TEAM, a new program to support children exposed to gun violence in the Watts community.

In 2017, there were approximately 110 calls made to LAPD in Watts reporting shots fired, with over 40% of the calls coming from local housing developments.

When gun violence occurs in a community, children are often witnesses to the event and its aftermath. The impact of gun violence exposure is associated with learning, health, emotional and behavioral issues, as well as substance abuse later in life. Early intervention and emotional and social support are key in preventing and healing the symptoms of trauma.

Setting the tone for the announcement, actor/poet/activist and Watts native Kyland Turner performed one of his original pieces of poetry.

Following his performance, Turner commented, “I’m 23 and I’ve lost more friends than I can count on both of my hands to violence and I don’t think that’s normal. I don’t think it’s normal to experience this thing of literally living in a war zone, and I had to find a way out. For me it was poetry, it was art, it was spoken word, it was writing.”

L to R: Kyland Turner, Actor/Poet/Activist; Yvette Martinez, Children’s Institute Administrative Assistant; Dennis Kato, Deputy Chief Operations-South Bureau, LAPD 

“Children deserve safe and secure childhoods, and when violence erupts into their lives, we have to step in and act, and that’s just what we are going to do,” said Feuer. “I have put Deputy City Attorney Lara Drino, who has years of experience working with abused children, in charge of our efforts to work with our partners to intervene quickly and effectively to reduce the long-term trauma children exposed to violence suffer.”

The REACH TEAM aims to ensure children and families exposed to gun violence receive appropriate and timely crisis intervention and support services through Children’s Institute and partner organizations.

“Children’s Institute is so pleased to be partnering with the City Attorney’s office and LAPD on this important initiative that is a natural extension of our work offering trauma-informed services and support to children and families in the Watts community and throughout Los Angeles. In addition to providing early intervention and follow up care through our REACH TEAM, we also hope to increase community awareness around the possible long-term effects of gun violence exposure and encourage outreach for support,” said Martine Singer, President & CEO, Children’s Institute.

“Shots fired in our community tear at the very fabric of our emotional security, especially for our children,” said Michel Moore, LAPD Chief of Police. “There is no excuse for a child in our city to be exposed to gun violence, and the Los Angeles Police Department will work diligently to ensure our most vulnerable residents are safe and supported.”

When a gunshot is reported in the Watts community, LAPD will assess the scene and notify the REACH TEAM, comprised of Children’s Institute staff, who will provide an initial crisis response to the families involved as soon as possible. From there, children identified for follow-up support will be referred to Children’s Institute to receive trauma-informed health services, as well as other family services and support.

Children’s Institute staff member Yvette Martinez closed the event with her personal account of growing up in South Los Angeles in the midst of gun violence. “Once you are connected to the effects of one bullet whether by sight, sound or because you knew the individual’s family, you are never the same. The support of my family has always kept me going. But once again I ask, ‘should we have to cope without professional help?'”

As a part of the program, the LA City Attorney’s office and Children’s Institute will regularly conduct community outreach within Watts schools, housing developments, community organizations and nonprofits. Children and families in Watts who have been exposed to gun violence in the past can also reach out for support.

This initiative has received guidance and support from the Watts Gang Task Force and The Housing Authority of the City of Los Angeles.

Back to School Week

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It is Back to School Week at CII, and it is great to see the early childhood services programs moving ahead at ‘full speed’.

As you know, the CII ECS division offers parents a number of early childhood program options. They include part day/part year center based services, full day/full year center based services, full year home based services (children up to 3 years of age), and full day/full year services in family child care homes under contract to CII. Our overall goal is to ensure that all children in our care and their parents, regardless of program option, are ready for a successful school experience by the time the children enter kindergarten.

So what are we looking like this year? ECS projects will serve nearly 2,500 children up to 5 years of age in the current year. Approximately 500 of these children are in our home based program, including First 5LA funded Select Home Visitation in SPA’s 6 and 8, almost 200 are receiving services in contracted family child care homes, and the rest are placed in one of CII’s 30 early education centers. We are excited this year to have added two new preschool buildings:  Our Compton Blvd. facility will serve 30 children: 6 infants and 24 toddler age children; our Western Avenue facility will serve 8 toddlers and 20 Head Start age children. Both centers recently began operations.

Summer months are important to ECS program operations, and this year was no exception. A number of key events took place:  recruitment and enrollment of new children and families, hiring of new staff – over 40 new staff were hired in the last four months, restocking classroom supplies, refurbishing playgrounds and classrooms, and finally, comprehensive training for classroom and non-classroom staff. Thank you all for your contributions to all of these efforts. They are not only very much appreciated, they are essential to our success.

This year ECS, in line with “One CII” strategic initiative, is already working on two key program efforts that will involve collaboration with CII’s Early Childhood Behavioral Health Services and Project Fatherhood.  Our goal for the current program year is to assess, refer and serve 100 children/families through our mental health services and to initiate a series of program activities with Project Fatherhood staff that will engage fathers currently enrolled in ECS.  We look forward to two very successful collaborations that will benefit the children and families that we serve.

Stay tuned! We are always working on something!!

– Manny Castellanos, Jr., Ed.D., LCSW, Senior Vice President Programs

Doctor’s Notes: At this Preschool for Traumatized Kids, Emotional Care Comes First, Then Academics

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This article was originally published on California Health Report on 7/10/2018.

Reggie, now 5, was exposed to methamphetamines in utero and, after he was born, his biological mother wasn’t able to care for him. When he was 4-weeks-old, I was his doctor in the foster-care clinic at Harbor-UCLA Medical Center. He was adopted by one of my pediatric colleagues, Amy Huang, and her husband, Daniel. Because Reggie is a minor, his and his parents’ names have been changed.

“He was the best baby, no withdrawals, no terrible twos,” Amy Huang said. “We thought he had escaped the meth-effects.”

But, unfortunately, that wasn’t the case.

In January, when Reggie returned to preschool after winter vacation, he started having extreme behaviors. He became defiant and aggressive. He was biting, hitting strangers and at times getting on all fours and acting like an animal. His parents were frustrated and worried that the problems were related to his drug exposure.

The effects of methamphetamines on infants in the womb run a wide spectrum, from mild learning problems to significant impairment of brain function. These infants may be born premature, have low birth weight or suffer withdrawals causing jitteriness, irritability and poor feeding. In addition, meth-addicted mothers often have poor health and may use other substances such as marijuana, tobacco, alcohol and cocaine. All of these can have negative effects on the infant’s development, as well as the mother’s ability to parent.

ChrisAnna Mink is a pediatrician who practices in South Los Angeles.

Researchers have shown that children who were meth-exposed in utero have difficulties with their brain’s executive function, which is the central command for organizing thoughts, planning and learning. These children also have an increased risk of disruptive behaviors and attention deficit/hyperactivity disorder (ADHD), as well as depression, anxiety and other mental illnesses, when compared to non-exposed peers. Some of these problems don’t become obvious until the cognitive and behavioral demands of a classroom.

By spring, Reggie’s behavior was spiraling out of control and his preschool teachers couldn’t cope with him. The Huangs took him out of that school but didn’t know where to turn.

I recommended Children’s Institute Inc, as did some other friends with an adopted child who had also been exposed to drugs. I was familiar with the Institute’s therapeutic preschool called Day Treatment Intensive, DTI. Over the past 12 years, I have referred many children with behavioral difficulties due to drug exposure, abuse, neglect and other psychological traumas.

DTI “looks like a regular preschool,” said Nicole Fauscette, a licensed family therapist and supervisor of the program, but it offers real-time, individual therapy. First, DTI focuses on mental health, in a supportive and developmentally appropriate preschool setting. The school adds in academics as the children are ready.

The Children’s Institute building on Harbor-UCLA’s campus is surrounded by playgrounds. The inside is decorated in lively colors, and it’s neatly cluttered with toys and children. It looks like Crayola designed a home inviting visitors to come play.

Children ages 2½ to 5 are eligible. Many have been expelled from regular preschool. DTI has space for 12 children and classrooms have, on average, one staff member for every two kids. Referrals come from child protective services, pediatricians, Head Start, internal mental health programs and community mental health agencies.

DTI is one of less than a dozen such specialized programs in Los Angeles County, which is home to nearly 330,000 children younger than five. About 20 percent of those kids live in poverty and most have experienced adversity. The need far exceeds the slots available.

“Therapeutic preschool uses the neuro-sequential model,” said Jesus Parra, the regional director for clinical services for Children’s Institute. This approach provides a framework for helping a child, keeping in mind his or her trauma history, developmental stage and current ability to function.

“We help the kids get to a place where they can regulate their behaviors, increase their attention (and) their tolerance of frustration, and better navigate peer and adult relationships,” said Fauscette. The goal is to help the children achieve emotional stability, so they’ll be ready for a traditional learning environment.

The staff and volunteers at DTI are chosen in part because of their temperament and ability to regulate their own emotions. These qualities are as valued as their education, though most have backgrounds in child development, psychology or mental health.

“An adult in control of their emotions helps children who are not in control of theirs,” said Parra, who leads some of the staff trainings.

The program aims, Parra said, for “the parents to fall in love with their child again.”

Reggie started at DTI in early May. The teachers observed that when he behaves like a dinosaur or other animal, it is because he is feeling anxious and frightened. In this way, they reason, he is attempting to defend himself against the danger he perceives. So, instead of punishing him for disobeying, Reggie’s teachers approach him calmly and help him address his anxiety.

In the last few months, Reggie has made progress learning to use words—and not aggression—to express his emotions.

The Huangs have already noticed a change. The teachers “were able to describe to us how Reggie interprets his world,” Daniel Huang said. “It’s helping—him and me.”

Pediatrician ChrisAnna Mink writes the bimonthly Doctor’s Notes column on Cal Health Report’s children’s health.

Doctor’s Notes: Head Start Offers Better Beginnings for School, Resilience for Life

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This article was originally published on California Health Report on 6/22/2018.

Colleen Kraft was in preschool when she heard something that helped chart the course of her life.

“I remember that my Head Start teacher told me that I was so smart I should be a doctor,” Kraft told me in a recent conversation. She’s now a pediatrician and current president of the American Academy of Pediatrics. Kraft is also a graduate of the 1965 inaugural Head Start class, which she proudly proclaims in the first line of her bio.

Head Start and Early Head Start programs provide services to poor children and their families in three core areas: learning, health and family wellbeing. Early Head Start provides services for infants from pregnancy until age 3 and Head Start is for children ages 3 and 4. Both programs were established as part of the War on Poverty under President Lyndon Johnson, with the goal of preparing low-income preschoolers for kindergarten.

Children from families that qualify for public assistance, foster children and homeless children are eligible for the programs. Some children with family incomes above the poverty level, including some disabled children, also qualify for Head Start. The programs even offer assistance to disadvantaged pregnant women through Early Head Start programs that emphasize the importance of a healthy pregnancy, parenting skills, child development and early learning.

ChrisAnna Mink is a pediatrician who practices in South Los Angeles.

The annual federal budget for Head Start programs is just above $9.5 billion and a significant portion of that funding – about 11 percent – goes to California, which serves nearly 100,000 children and pregnant women.

Poverty is associated with lower academic performance for reasons related to the child, the household and the community. Low-income parents often have attained less education, are less involved with learning activities with their children and preoccupied with the ongoing stress of meeting their family’s basic needs for food and shelter. As a result, their children hear fewer words, have poorer health and nutrition, miss more school days, and face more struggles with attention and impulsivity compared to more affluent peers. Impoverished children are also more likely to live in neighborhoods with fewer resources such as libraries and grocery stores.

Research has shown the benefits of the Head Start programs for learning, behavior, health and parenting skills. Head Start students scored better than a control group for cognitive and social-emotional development, had higher rates of immunizations, healthier weights and less problematic behaviors. A 2016 study showed that Head Start children were more likely to graduate from high school, attend college and get a post-secondary degree, license or certification.

“I went to Head Start by Watts Tower,” said Nancy Munoz, mother of Armando, “I always knew Head Start was important and I wanted Armando to go.” Now 3, Armando just completed his first year in Early Head Start.

Munoz is a single mother who works full-time as a bail bond agent, but she couldn’t afford most preschools. She learned about the Head Start classes at Children’s Institute, Inc., in her neighborhood in Watts, an impoverished area in Los Angeles. As a pediatrician in South Los Angeles, I work closely with the organization’s child development and mental health experts, who introduced me to Munoz and Armando at their Watts center.

Children’s Institute serves nearly 2,000 children in its Early Childhood Education programs, including Head Start, Early Head Start and home-based programs, throughout the poorest communities in Los Angeles. Almost 90 percent of the participants are Latino and African American.

“We can do all we want in the classroom, but if the kids still have health or mental health issues or the families aren’t ready, then the kids aren’t ready.”  said Justine Lawrence, vice president of early childhood programs at the organization.

Kids growing up in poverty are also at risk for adverse childhood experiences, called ACEs. ACEs include traumatic events such as abuse, homelessness, hunger, witnessing violence and separation from a parent. Children who are hungry, frightened or anxious can’t learn as well.

As part of school readiness, Head Start programs help nurture resilience for disadvantaged kids with a history of ACEs. Resilience is defined as good mental and physical health despite adversity—in other words, the ability to withstand and recover from adversities.

After years of working with low-income families, I’ve come to believe that combating ACEs contributes as much to a child’s academic success as learning the ABCs.

Munoz contended with multiple ACEs, including time in the foster care system, because her mother struggled with mental illness and her father with substance abuse. At 16, she and her siblings were taken in by their aunt. She is grateful to Head Start and her tia for her survival.

Munoz reads to Armando’s class once a week and credits Head Start for helping her be a “more present” parent. Munoz and Armando haven’t had an easy beginning, but “having him in Head Start is one thing to make his life easier,” she said.

“I refer families to Head Start all the time,” said Kraft. “I use it as a mechanism to support kids in unstable situations.”

Like Kraft, I also refer children to Head Start. Most of my patients are low-income and many have had ACEs. I know their parents need better coping skills. Overweight toddlers need more activity and their parents may need to learn about nutrition. I turn to the program to help children who are smart and others who are struggling because they all need the stimulation. Low-income families need more resources and the programs provide key supports. That’s why Head Start is one of my weapons in the War on Poverty. It changes lives, one kid at a time.

What Are Children Telling Us?

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It’s National Mental Health Awareness month, and I keep thinking about Antoine because I may have broken his heart.

Years ago I volunteered at a residential treatment center for foster children, in a cottage that housed ten young boys. They were “seriously emotionally disturbed,” the threshold classification for placement in that center. Most had survived multiple foster homes, sometimes punctuated by stays in psych hospitals, only to become “unplaceable” and almost certainly unadoptable.

During my weekly visits, some boys avoided me while others checked out the Pokémon cards or Legos I brought, only to wander off within minutes, endlessly distracted. But Antoine, 11, always sat by me, rapt and loyal. He built plastic cities, or painted his arms in Wonder bread polka dots, or listened to Harry Potter by the hour. Clever, powerful and entirely winning, Antoine had a monk-like focus, even when all hell broke loose in the cottage. He particularly loved an oversized book on the Titanic; we imagined life on every deck, the sound of the ocean, the smells of the boiler room (but never the ending). Antoine and I hung out in a corner of the common room every Tuesday, week after week. In that chaotic place, it was one thing we both could count on.

And then one day he wasn’t there: he had to spend the day in court. Before this third birthday he’d been taken from the custody of his grandmother because she extinguished cigarettes on his body and sexually abused him, but I didn’t know anything about his current status.

Meanwhile, emboldened by Antoine’s absence, 9-year old Shawn grabbed the Titanic book, sat with me for a while and soon lost interest.

The following week Antoine was back, but he refused to speak to me. I asked him why, I joked, I begged, and then gave up. The next week, same thing: wouldn’t look at me, wouldn’t answer, wouldn’t touch anything I left behind for the boys to use. I asked his counselor what was going on, but he was calming a crying boy, inconsolable after losing a basketball game. I finally got Antoine’s attention long enough to apologize for sharing the Titanic book with another kid, but he never, ever spoke to me again. By April, he was gone, transferred to another group home.

What became of that extraordinary child, so keen, so persistent? His stubborn silence told me he was nothing like the other boys, that he was proud, vigilant, in control. Perhaps by sharing my time and his book with the other boy I had betrayed him, like so many others with whom he’d felt just a little bit safe. Who knows how many adults broke him, even after his physical scars healed.

How do children communicate their pain? And are we listening?

One out of five children has a diagnosable mental disorder, and it’s estimated that 80 percent of foster children have significant mental health issues. Quiet kids like Antoine may not advertise their trauma history with antisocial behavior, but former foster youth in general are five times more likely to suffer from post-traumatic stress disorder (PTSD) than the general population, and even exceed the rate for American war veterans.

The effects of trauma, especially complex and repeated trauma experienced by so many young people in foster care, are varied: dissociation, depression, anger and anxiety. Children may lack self-regulation and appear to overreact or underreact. Chronic stress affects cognition and executive functioning, and is a predictor for long-term physical health, as well as substance abuse and other suffering.

In celebration of National Mental Health Awareness month, let’s listen to children, without judgment, and remember how many are exposed to violence, in their homes and in their streets and schools. They are longing to trust, no matter what they say or do.

The National Child Traumatic Stress Network has excellent information and resources. To commemorate national Mental Health Awareness Month, let’s mend hearts, not break them.

 

This article was originally posted to The Huffington Post on 5/15/2017