The Other 60 Percent

Research traces impact of childhood adversity

The stress of a spelling bee or a challenging science project can enhance a student’s focus and promote learning. But the stress of a dysfunctional or unstable home life can poison a child’s cognitive ability for a lifetime, according to new research.

Dr. Jack Shonkoff, director of Harvard University’s Center on the Developing Child, spoke last month to Colorado policymakers and children’s advocates. Photo courtesy of <em>Solutions</em>.

While educators and psychologists have said for decades that the effects of poverty interfere with students’ academic achievement, new evidence from cognitive and neuroscience is showing exactly how adversity in childhood damages students’ long-term learning and health.

Those studies show that stress forms the link between childhood adversity and poor academic achievement, but that not all adversity — or all stress — is bad for students.

“Children from their earliest life need to learn how to manage adversity,” such as dealing with the first day of school, said Dr. Jack P. Shonkoff, the director of Harvard University’s Center on the Developing Child, in Cambridge, Mass.

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Research from Dr. Shonkoff’s center and from other experts finds that positive stress — the kind that comes from telling a toddler he can’t have a cookie or a teenager that she’s about to take a pop quiz — causes a brief rise in heart rate and stress hormones. A jolt can focus a student’s attention and is generally considered healthy.

Similarly, a child can tolerate stress that is severe but may be relatively short-term — from the death of a loved one, for example — as long as he or she has support.

“Adults help children develop strategies to help cope with these stressors,” Dr. Shonkoff said. “Whether it’s reading or managing stress, adults provide the scaffolding for children to build those skills themselves.”

‘Toxic’ recipe

By contrast, so-called “toxic stress” is severe, sustained, and not buffered by supportive relationships.

The same brain flexibility, called plasticity, that makes children open to learning in their early years also makes them particularly vulnerable to damage from the toxic stressors that often accompany poverty: high mobility and homelessness; hunger and food instability; parents who are in jail or absent; domestic violence; drug abuse; and other problems, according to Pat Levitt, a developmental neuroscientist at the University of Southern California and the director of the neuroscience graduate program at the Keck School of Medicine in Los Angeles.

Both Mr. Levitt and Dr. Shonkoff are part of the National Scientific Council on the Developing Child, which is studying the effects of environment on children’s health and cognitive development.

Good experiences, like nurturing parents and rich early-child-care environments, help build and reinforce neural connections in areas such as language development and self-control, while adversity weakens those connections.

Over time, the connections, good or bad, stabilize, “and you can’t go back and rewire; you have to adapt,” Dr. Shonkoff said. “If you’ve built on strong foundations, that’s good, and if you have weak foundations, the brain has to work harder, and it costs more to the brain and society.”

For example, a study in the October issue of the peer-reviewed journal Child Development found that out of more than 26,000 students in the Minneapolis public schools, those who moved more than three times a year had significantly lower mathematics achievement and academic growth than students with more stable homes.

In a separate study, Richard P. Barth, the dean and a professor of social work at the University of Maryland College Park, found children with six or more adverse experiences before age 3 were overwhelmingly likely to be identified as needing special education for developmental delay.

Self-control or trust?

Moreover, a child’s ability to delay gratification and control him- or herself — often seen as a personality trait critical for academic success — can be hugely dependent on the child’s sense of stability in the environment and trust in surrounding adults.

In a twist on the classic Stanford University “marshmallow experiment,” in which young children’s ability to resist eating a marshmallow was tested to show their self-control, researchers led by Celeste Kidd, a professor of brain and cognitive sciences at the University of Rochester in New York, recently found children who trusted the word of the adult tester and felt their environment was more stable waited four times as long for a treat as those who felt more insecure.

The effects of early stress can linger for decades and go well beyond learning difficulties.

“What happens in childhood, like a child’s footprint in wet cement, leaves its mark forever,” said Dr. Vincent J. Felitti, the director of the Adverse Childhood Experiences Study at the health-care provider Kaiser Permanente’s department of preventive medicine in San Diego.

Known as the ACE study and done in collaboration with Dr. Robert F. Anda at the federal Centers for Disease Control and Prevention in Atlanta, the project analyzed longitudinal data on more than 17,400 middle-class adults in the Kaiser Permanente system.

Participants reported whether, as children, they had experienced repeated physical, sexual or severe emotional abuse, and whether they had grown up with any of five types of “household dysfunction”: a family member in prison; domestic violence; an alcoholic or drug abuser in the home; someone in the home who was depressed, mentally ill, or suicidal; or loss of at least one biological parent during childhood for any reason.

Adversity, decades later

As it turned out, more than half the adults had had at least one type of severe abuse or home dysfunction in childhood, and one in 16 had experienced four or more. The number of traumatic childhood experiences, Dr. Felitti found, was directly proportional to a person’s risk of a wide variety of major medical and social problems, from teenage pregnancy and drug abuse to adult heart disease and hepatitis.

“These results are almost unique in their magnitude,” Dr. Felitti said. A boy with six indicators of abuse and home dysfunction was 4,600 percent more likely than a boy with no risk factors to become an intravenous-drug user, according to the study.

Such findings mean that teachers and doctors are left trying to fix late symptoms, like poor reading skills or boredom in school, rather than underlying issues that occur much earlier in life.

“The science [on the effects of poverty and stress] has exploded in the last 25 years, but the policy on the delivery of child care has stalled, without anything close to similar progress,” Dr. Shonkoff said.

While federal and state education programs typically focus on academic remediation and nutrition for disadvantaged students, “for some kids, no matter how well you do that, it’s not enough, because the amount of adversity in their lives overwhelms,” he said.

“It’s asking too much,” Dr. Shonkoff said, “to require parent education and an enriched preschool program to counteract the effects of the level of adversity in some kids’ lives that is whipping up their stress-response systems.”

Researchers, including Mr. Levitt of USC and Dr. Felitti, are starting to explore new interventions, both medical and cognitive, that might protect children’s developing brains from damage caused by stress and improve their ability to cope.

So far, there are no classroom-ready techniques beyond developing supportive relationships between teachers and parents and their children, Mr. Levitt said. “Helping people after the fact is really nibbling at the edges of the problems,” Dr. Felitti said during a presentation on the research at the Society for Neuroscience conference in New Orleans last month. “We need a polio vaccine, as opposed to buying bigger and better iron lungs.”

“Stress is not something you get a lot of sympathy for,” Dr. Shonkoff said in a separate interview at the Society for Research in Educational Effectiveness meeting in Washington. “This is a culture that says suck it up and get over it.”

But in reality, Dr. Felitti concluded, “the [ACE] study makes it clear that time does not heal some of the adverse experiences we found so common. … One does not ‘just get over’ some things, not even 50 years later.”

Coverage of school climate and student behavior and engagement is supported in part by grants from the Atlantic Philanthropies, the NoVo Foundation, the Raikes Foundation, and the California Endowment. Read this story on the EdWeek site, including links to videos.

Chilling effect

Five ways a proposed immigration rule could impact Colorado students and schools

PHOTO: JGI/Jamie Grill | Getty Images

Advocates for immigrant families fear that a proposed federal rule governing green card decisions could lead to more children going hungry and losing housing and health care. That, in turn, could pose challenges for educators and schools.

The proposed rule would allow the government to penalize some legal immigrants who have used public benefits by denying them permanent residency — a possibility that could prompt families to forgo any kind of government help. For children in those families, many of them citizens, the result could be hunger pangs, untreated illness, or outsized worry that their parents won’t be able to stay in the U.S. Inside schools, the new rule could mean more time and energy spent addressing students’ basic needs and the loss of funding from some public programs.

Fear that immigrants will shy away from benefit programs is nothing new. Stricter immigration rules since President Trump took office — stepped-up raids, efforts to discontinue the DACA program, and family separations at the U.S.-Mexico border — have already led to a chilling effect on the legal use of public benefits by immigrants. Advocates say changes to the so-called “public charge” rule will only exacerbate the problem.

The rationale behind the proposed rule, a stricter version of one that’s been in place for years, is to prevent immigration by people who will end up dependent on government help. Opponents of the rule say it punishes working-class immigrants who may need short-term aid, but contribute much more to the country’s economy over the long term.

The existing public charge rule penalizes immigrants for using programs such as Temporary Assistance for Needy Families or long-term care. The proposed version adds several more to the list, including Medicaid, food stamps, and housing vouchers. Free and reduced-price school meals aren’t included in the existing or proposed rule.

Mónica Parra, program manager of the Denver school district’s migrant education program, said families she works with are reluctant to sign up for any kind of help, even assistance heating their homes during the winter.

“They’d rather struggle or find other ways to get support,” she said. “It’s going to be very challenging to keep students motivated, but also safe. Maybe they’re going to be cold. Maybe they’re going to get sick.”

The proposed public charge rule doesn’t apply to refugees and asylum-seekers, and doesn’t penalize immigrants for public benefits used by their children. Still, like other advocates, Parra said she hears anxiety about the proposed rule from all kinds of immigrants, including citizens and those who already hold green cards.

They worry that using public benefits could get their own legal status revoked or hurt their chances to sponsor family members who want to immigrate to the U.S.

“The fear has always been there in these communities,” she said. “Now, people are even more afraid.”

The new public charge rule likely won’t take effect for months. First, there will be a 60-day public comment period, scheduled to start Wednesday, and then Trump administration officials will consider the comments and decide whether to make any adjustments.

Here’s a look at some of the ways the proposed rule could affect Colorado schools and students.

More kids come to school hungry

There are at least two ways schools could see more hungry students walking through their doors due to the public charge rule. First, families may be afraid to take advantage of food stamps — either by deciding not to enroll, or by dis-enrolling current recipients, such as citizen children.

Both Denver and Adams counties have seen dips in the number of people participating in the program over the last couple years. In Denver, about 2,000 fewer children receive the benefit now than in November 2016 when President Trump was elected. However, city officials caution that it’s hard to make a direct connection between falling participation and federal immigration policies since historically low unemployment rates may also be contributing to the trend.

While free and discounted school lunches are not part of the public charge rule, some advocates report that immigrant parents have been wary of enrolling their kids since Trump’s election. By law, public schools must serve students regardless of their immigration status and can’t ask for information regarding a family’s or student’s status.

A week after the Department of Homeland Security released a draft of the new public charge rule on its website, the Eagle County school district emailed parents asking them to help squash the rumor that signing children up for free or reduced-lunches “will inform ICE,” a reference to the U.S. Immigration and Customs Enforcement agency.

The letter concluded, “There is NO RISK in applying for free and reduced lunch, help us spread the word.”

So, what happens when kids go to school hungry? They may have trouble paying attention, misbehave more easily, or suffer from headaches or stomach aches. In short, less learning.

More children without health insurance, more student absences

The public charge rule’s chilling effect could have a major impact on child health, according to a recent Colorado Health Institute analysis. An estimated 48,000 Colorado children — the vast majority of them citizens — could be disenrolled from one of two public health insurance programs, Medicaid or Child Health Plan Plus. That would double the state’s rate of uninsured children from 3 percent to 6.7 percent, according to the institute.

The reason for so much dropoff is that health insurance is typically a family affair. So even when different rules govern adults and children in the same family, they tend to be enrolled as a group or not at all.

When students don’t have health insurance, school attendance and performance can suffer. For example, children may be absent more if they lack help managing chronic conditions like asthma, or if they’re not getting treatment for acute illnesses or painful dental problems.

Loss of health-related funding for schools and school-based clinics

School districts stand to lose two health-related funding streams if the number of uninsured children swells. The first would impact the state’s 62 school-based health clinics, which would likely see a drop in Medicaid and Child Health Plan Plus reimbursements if fewer students enroll in those programs.

Such an enrollment decline, which some clinic leaders have already reported, could make it harder for school-based clinics to stay afloat financially, said Bridget Beatty, executive director of the Colorado Association for School-Based Health Care.

With more uninsured students, “The need will go up,” she said, “but conversely the ability to financially sustain them will get more challenging.” 

In addition, 53 Colorado school districts receive funding through a program that could be affected by the proposed public charge rule. It’s called the School Health Services Program and allows districts to seek Medicaid reimbursements for services provided to low-income students with disabilities. That money can be used for health-related efforts that benefit all students, such as the addition of school nurses, wellness coordinators, or suicide prevention programs.

Funding received through the program ranges from a couple thousand dollars in small districts to a few million in large districts.

High-poverty schools have a harder time offering universal free meals

Nearly 40,000 students in 20 Colorado school districts can eat school meals for free because their schools participate in a federal program designed to make breakfast and lunch easily accessible to low-income students. But that number could drop if the public charge rule decreases food stamp participation.

The special meal program, called Community Eligibility Provision, is open to schools or districts where at least 40 percent of students come from families that use certain public benefits, including food stamps or Temporary Assistance for Needy Families. Unlike in traditional school lunch programs, parents don’t have to fill out applications for free or reduced-price meals.

“Any time when you have eligible families not participating in SNAP, it does have a negative impact on community eligibility,” said Crystal FitzSimons, director of school programs at the national nonprofit Food Research and Action Center.

Even if schools or districts remain eligible for the program, a drop in students getting public benefits could mean a change in how schools are reimbursed for the free meals, she said. That, in turn, could make the program less financially viable for schools or districts to participate.

Immigrants could turn away from publicly funded early childhood programs

Crystal Munoz, who heads the nonprofit Roots Family Center in southwest Denver, worries that the Spanish-speaking families her program serves will stop using programs like Head Start, state child care subsidies, and the Denver Preschool Program, which provides tuition assistance to the city’s 4-year-olds.

Even though those programs aren’t part of the proposed rule, there’s still trepidation, she said. It’s because of the constant flurry of rule changes and the generally negative tone around immigration right now.

“We find ourselves very afraid to even give out resources or referrals to certain programs because we’re not sure,” she said. “For us, it’s waiting and seeing.”

She said if families do drop out of Head Start or other child care programs, it could push children — many of them citizens — into unlicensed care with relatives or neighbors, or force parents to cut back work hours to stay at home with them.

The Other 60 Percent

Too young to vote, Memphis teens lead voter-engagement campaign in advance of midterms

PHOTO: Caroline Bauman
Caitlin Brinson (left), Christian Fuentes, and Aaliyah James lead a breakout session with fellow students on youth and education.

At 17, Caitlin Brinson isn’t yet old enough to vote, but she’s working hard to get other Memphis residents to the polls in November.

The Cordova High School school senior is active in a new youth initiative called Engage Memphis, which aims to increase voter turnout and to educate young future voters on issues that affect their lives, such as school discipline, sexual assault and harassment policies, and diversity in schools.

“It’s difficult not to have input on decisions that affect us directly,” Caitlin said. “It can feel powerless, like you can’t change things at your school or in local government, but I’m a pretty optimistic person. I really believe we can make an impact if we come together and help people around us see why who they vote for directly impacts us.”

Caitlin was one of more than 300 Memphis students from 40 schools who gathered earlier this month at a forum held by BRIDGES and Facing History and Ourselves. Those two local student leadership groups joined forces to create Engage Memphis.

One of the goals of the youth forum was to grow Engage Memphis into a citywide effort, said Marti Tippens Murphy, the Memphis executive director for Facing History. Ahead of the November midterm elections, students involved with BRIDGES and Facing History gathered for a series of lectures and breakout sessions. One of the goals was to help teens decide what they wanted their initiative to look like.

“Students came up with the strategy to focus on re-engaging people who can vote but haven’t yet,” Tippens Murphy said. “That often looks like a parent, grandparent or older sibling. They’re now having conversations with those people and connecting voting to issues that affect them.”

When it comes to voter participation, Tennessee has a long way to go. More than 838,000 adult Tennesseans are not registered to vote. The state ranks 40th in the nation in voter registration and last in voter turnout, according to The Tennessean. So the teenagers of Engage Memphis are trying to correct course.

“We’ll hear students say, ‘I’m only 16 and hadn’t thought issues around voting applied to me,” Tippens Murphy said. “We see this as leading students to prioritize voting when they become old enough. We know the youngest demographic is the lowest in voter turnout. But it doesn’t have to be that way.”

PHOTO: Caroline Bauman
A recent Harvard Institute of Politics poll of America’s 18- to 29-year-olds found a spike in the number of young Americans who said they will “definitely be voting’ in the upcoming midterm Congressional elections.”

Caitlin said she’s seen a large amount of excitement around voting among her peers. That’s reflected nationally, too. A recent Harvard Institute of Politics poll of America’s 18- to 29-year-olds found a spike in the number of young Americans who said they will “definitely be voting’ in the upcoming midterm Congressional elections.”

Morgan Fentress, a 10th grader at Immaculate Conception Cathedral School, said that while she originally attended last week’s forum because it meant a day off from school, the gathering inspired her to get involved in earnest.

“I hear people talk about voting in terms of getting out to the polls and making sure your voice is heard, but we’re not told or taught what we should be voting for, what the issues are we should care about,” Morgan said. “I wish modern politics were taught more in school. But coming here and hearing what issues other students are passionate about, it’s been really good.”