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Butte-Silver Bow Health Department

The Butte-Silver Bow Health Department is located at 25 W. Front St.

If you are a parent, you are likely hyper-aware of and concerned about the stresses in your children’s lives.

Stress in children is normal — in order to develop properly, children actually require stress — stress being defined as a mental, physical or biochemical response to a perceived threat or demand. Childhood stress is actually natural and inevitable.

What we parents and adults actually need to look for are the “types” of stress being experienced by our kids and other children, because some types can affect a child’s brain and body with potential lifetime impacts.

There are three types of stress in childhood — positive stress, tolerable stress and toxic stress. Positive stress is comprised of normal, typical childhood experiences, such as being dropped off at daycare, sustaining an injury on the playground, or losing a game. Though experiences such as these lead to a temporary and mild elevation in stress hormones and a brief increase in heart rate and blood pressure, no buffering support from an adult is really necessary. These positive stressors actually lead to long-term resilience and confidence and the development of coping skills.

Tolerable stress is more complicated, scary, challenging and long-lasting. Examples of tolerable stress include natural or man-made disasters, poverty, parents divorcing or the death of a loved one. A caring adult could most certainly buffer this type of stress. The cardiovascular and hormonal responses are more severe and continuing with a potential for lasting physical or emotional damage. But in the long term, adaptation and recovery are likely.

And then there’s toxic stress, which is severe, long-lasting, uncontrollable and frequent stress. This type of stress could be caused by emotional, physical or sexual abuse, emotional or physical neglect, or household dysfunction such as substance abuse, mental illness, exposure to violence (particularly domestic abuse of a mother), criminal behavior or severe economic hardship. No adult is available to buffer the child from these stressors. This kicks in a prolonged activation of the stress response system, disrupts development of brain circuits and depresses the immune system. In the long term, impacts can be lifelong. These impacts include alcoholism, heart disease, learning difficulties, anxiety, depression and cancer.

Research into childhood stress is deep — agencies and organizations such as the National Institutes of Health, the National Institute of Mental Health, the U.S. Centers for Disease Control and Prevention and Harvard University have conducted such research with organizations such as the U.S. Department of Health and Human Services’ Office of Family Assistance and its Healthy Marriage & Responsible Fatherhood initiative helping to educate about the research.

Here in Montana, the Helena-based ChildWise Institute is also attempting to educate through its Elevate Montana initiative. The Butte-Silver Bow Community Action Team (CAT), which has focused for more than four years on suicide prevention and putting into place a variety of interventions aimed at youth, recently became an Elevate Montana affiliate. In December, 14 people were trained by Elevate Montana leaders on how to present in Butte and the region about Adverse Childhood Experiences (ACEs), those toxic stresses that impact children, sometimes into adulthood.

All of us have encountered children who seem disconnected, out of control, acting out of context — that child may be consumed by toxic stress and we just don’t know it. But not every child enduring toxic stress acts out in obvious ways — kids affected by toxic stress may not always be the ones swearing at the teacher. According to the Elevate Montana training, toxic stress can actually block a child’s ability to communicate or engage with anyone — it can cause a child to shut down completely.

The Elevate Montana training talks about all of this, and the provision of this training — we’ll come to you and it’s free! — is part of CAT’s effort to make Butte more trauma-informed. The training includes information on the CDC’s huge national epidemiological ACE Study, designed by physicians and health researchers Robert Anda, M.D., and Vincent Felitti, M.D. CAT particularly wants to bring this presentation to the business community, as we believe workplaces are greatly impacted by employees who may have sustained toxic stress and adverse childhood experiences.

The training illustrates how people can score themselves on a scale of one to 10 ACEs (toxic stressors sustained in childhood), with a score of four ACEs appearing to be a tipping point for many prospective negative health and social outcomes. ACEs are common, including in Montana, which conducted its own ACE Study in 2011 and released the results in 2013. About 40 percent of Montana adults have no ACEs, and 43 percent have one to three ACEs. About 17 percent of Montana adults have four or more ACEs.

The good news: Just because a person has a high ACE score does not mean that person is destined for negative health and social outcomes. Resilience is key. (Conversely, people with an ACE score of 0 or a low ACE score may not be the best at careers that require one to be edgy, hypervigilant or emotionally detached.)

Much of what we’re seeing today in our communities — drug abuse, crime, families in upheaval — could be related to generational childhood toxic stress, those adverse childhood experiences. It’s important for us to know that we can intervene, that we can be adult buffers, that we can have a better understanding of how what occurs in childhood can have lasting impact on lives and communities. We can understand that not every ACE kid needs to be predestined to poor health and social outcomes.

If this training interests you, your group, organization or business, please call me at 406-497-5003 or email me at ksullivan@bsb.mt.gov — the training lasts about one hour. I’d be happy to come present, or ask one of my trained co-presenters to be available to you.

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Karen Sullivan is Butte-Silver Bow Health Officer and Director of the Health Department. Her column, The Public's Health, appears weekly on The Montana Standard's health page.

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