Toxic Stress in the First Three
Years: Understanding and
Mitigating the Lifelong
Impact
January 16, 2014
Summit Conference and Event Center Aurora, CO
Summit Objectives
1. Build shared understanding of:
•
•
•
•
Critical importance of prenatal to age 3
timeframe;
What adverse childhood experiences are &
mean;
How the earliest experiences influence lifelong
health, education, and success; and
Complexities of buffering the impact of toxic
stress.
2. Establish collective responsibility to prevent
adversities and buffer the impact of toxic stress.
2
Early Childhood Colorado Partnership
http://prezi.com/we8tpt_jvcpi/present/?auth_key=xlmdd7x&fol
low=CivicCanopy&kw=present-we8tpt_jvcpi&rc=ref-63011871
Getting to Know Your Clicker
• Press the button that
matches the answer
you want
• The light will flicker
when you vote
• It will register the last
selection pressed
before the poll closes
When the Broncos play the
Patriots, I will be:
A. At the game
B. Watching on TV
C. At the movies
D. Not really sure,
since I don’t even
follow basketball.
65%
12%
19%
Id
o.
..
es
No
tr
ea
l
ly
su
r
At
th
e
e,
sin
ce
m
ov
i
TV
n
go
hi
n
at
c
W
At
th
e
ga
m
e
4%
What region of the state do you
work/live in?
Denver Metro
Front Range
Northeast CO
Southeast CO
Central Mountains
Northwest CO
Southwest CO
Western Slope
San Luis Valley
67%
14%
10%
2%
1%
3%
3%
2%
0%
De
nv
er
M
e
Fr
on tro
t
No Ran
rth
ge
ea
S
s
Ce out t CO
h
nt
ra eas
lM tC
O
o
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rth ain
s
w
es
So
t
ut
hw CO
W
e
es st C
te
O
Sa rn S
l
n
Lu ope
is
Va
lle
y
A.
B.
C.
D.
E.
F.
G.
H.
I.
What is your age?
33%
24%
17%
15%
10%
1%
er
21
ye
ar
21
so
-3
ld
0
ye
31
ar
so
-4
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0y
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rs
41
ol
-5
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51
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-6
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61
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70
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ld
rt
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so
n
71
ld
ye
ar
so
ld
0%
Un
d
A. Under 21 years old
B. 21-30 years old
C. 31 - 40 years old
D. 41-50 years old
E. 51-60 years old
F. 61-70 years old
G. Older than 71 years
old
What best describes the area
you work in?
A. Urban
B. Rural
C. Frontier
D. Statewide
49%
32%
17%
id
e
ew
St
at
nt
ie
r
Fr
o
ra
l
Ru
Ur
b
an
2%
What best describes the
primary focus of your work?
34%
27%
16%
4%
6%
7%
Ot
he
r
7%
Di
re
ct
se
Pr
rv
og
ic e
ra
pr
m
ov
m
isi
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o
ag
e m n ..
Co
en .
Po
or
t/
di
a.
..
na licy
/a
t io
d
n/
vo
co
ca
lla
c
Hi
bo y
gh
ra
er
tio
ed
n
uc
Fu
at
nd
io
n/
in
g
pr
of
es
.. .
A. Direct service provision with
children and/or families
B. Program
management/administrative
C. Policy/advocacy
D. Coordination/collaboration
E. Funding
F. Higher
education/professional
development
G. Other
What sector is the primary
focus of your work?
A. Health
B. Mental/Behavioral
Health
C. Family
Support/Parent
Education
D. Early Learning
E. Other
26% 26%
22%
Fa
m
rly
Ot
he
r
Le
ar
E.
..
Ea
re
nt
Pa
or
t/
ni
n
th
lH
ea
l
ily
Su
pp
eh
av
/B
ta
l
en
M
g
12%
io
ra
He
al
th
13%
What age of children does your
work focus on the most?
A. Prenatal
B. 0-3 years old
C. 3-5 years old
D. 5-8 years old
E. 8+ years of age
52%
32%
9%
4%
ge
ld
fa
so
ye
ar
8+
58
ye
ar
so
ld
so
35
ye
ar
so
ye
ar
03
Pr
en
a
ta
l
ld
3%
What has been your interaction with the topic of
Adverse Early Childhood Experiences (ACES)?
33% 33%
22%
5%
So
m
e
ex
po
su
e
re
ex
to
po
th
su
...
re
M
to
od
th
er
et
at
e
op
e
M
x
ic
p
uc
o
su
h
ex
re
po
to
su
t. .
Yo
re
u
to
co
th
ns
e
id
to
er
pi
yo
c
ur
se
lf
an
.. .
6%
Fir
st
tim
A. First time exposure
to the topic
B. Some exposure to
the topic
C. Moderate exposure
to the topic
D. Much exposure to
the topic
E. You consider yourself
an expert on the
topic
This Revolution Will Be
Twitterized. . .
• Share your reactions, thoughts, responses today’s
discussion on Twitter (#ToxStress)
• We’ll follow the online discussion at breaks through
Twitterfall!
Summit Keynote
Keynote:
Dr. Sarah Enos Watamura, PhD
Moderator:
Lenita Hartman
Early Intervention Colorado, Colorado
Department of Human Services
Perspectives from the Field
Moderators:
Jo Koehn, Colorado Department of Education
Lisa Jansen Thompson, Early Childhood
Partnership of Adams County
_________________________
• What are your initial reactions to what you
are hearing today?
• Why is the topic important to you?
• What are the implications of focusing on
prenatal through the first three years on the
work you do?
Community Perspectives
• Benzel Jimmerson, family member
• Dr. Steve Vogler, health care
• Betsy Rogers, infant mental health
• Brian Conly, child care and preschool
• Stacy Hladek, resource and referral support
• Gail Boekhoff, faith-based community
• Gloria Higgins, business sector
• Bill Jaeger, policy and advocacy
LUNCH
Evidence Base for Prevention
and Intervention
Panelists:
• Dr. Dipesh Navsaria, MPH, MSLIS, MD.
Assistant Professor of Pediatrics, University of Wisconsin
School of Medicine and Public Health
• Dr. Desmond Runyan, MD, DrPH.
Executive Director, Kempe Center
• Sarah Enos Watamura, Ph.D.
Associate Professor of Psychology, University of Denver
Moderator:
Noelle Hause
Project LAUNCH Weld, North Colorado Health Alliance
Building Collective Commitment
This Afternoon:
• Reflect on learning
• Discuss activities that are a given
• Identify how each of us will connect
to those activities
• Capture individual, organization
commitments
• Assess achievement of today’s
objectives
Crafting the Summit
• Acknowledge newness
• Starting point
• Generate momentum
• Recognize opportunity
• Inspire hope
Network as a Vehicle
Early Childhood Colorado
Partnership:
•Open, welcoming table
•Collective impact
•Mutual interdependence
•Learning community
Neural Networks
Social Networks
A Study in Contrasts
Hierarchy
Network
• Centralized
• Useful for stability,
control
• Power derived from
position and
authority
• Ill-suited for
innovation,
adaptation
• Decentralized
• Useful for innovation,
adaptability
• Power derived from
relationships and
connectivity
• Well suited for
innovation,
adaptation
Summit Objective 1:
Build Shared Understanding
• Stand up
• Find 2 people who share your birth month
• Introduce yourself
• Share something you learned today about
Adverse Childhood Experiences and Toxic
Stress
10 minutes
As a result of today, my understanding of the
critical importance of development during the
prenatal to age 3 timeframe was enhanced
A. Greatly
43%
B. Significantly
31%
C. Some
24%
D. Not at all
Si
ta
ll
e
So
m
No
ta
gn
i
fic
a
nt
ly
Gr
ea
tly
2%
g
1%
No
un
d
er
st
an
di
n
ng
nd
i
de
rs
ta
un
ite
d
L im
te
M
od
er
a
Ex
te
ns
ive
un
de
rs
ta
n
un
de
rs
ta
n
di
n
di
n
g
g
Prior to today’s summit, what was your level
of understanding of what adverse childhood
experiences means?
A. Extensive
57%
understanding
B. Moderate
28%
understanding
13%
C. Limited
understanding
D. No understanding
0%
No
un
d
er
st
an
di
n
g
ng
1%
nd
i
de
rs
ta
un
ite
d
L im
te
M
od
er
a
Ex
te
ns
ive
un
de
rs
ta
n
un
de
rs
ta
n
di
n
di
n
g
g
At the end of today’s summit, what is your
level of understanding of what adverse
childhood experiences means?
A. Extensive
58%
understanding
41%
B. Moderate
understanding
C. Limited
understanding
D. No understanding
g
1%
No
un
d
er
st
an
di
n
ng
nd
i
de
rs
ta
un
ite
d
L im
te
M
od
er
a
Ex
te
ns
ive
un
de
rs
ta
n
un
de
rs
ta
n
di
n
di
n
g
g
Prior to today’s summit, what was your level
of understanding of how early adverse
experiences influence lifelong health,
education, and wellbeing outcomes?
48%
A. Extensive
understanding
33%
B. Moderate
18%
understanding
C. Limited
understanding
D. No understanding
g
0%
No
un
d
er
st
an
di
n
ng
nd
i
de
rs
ta
un
ite
d
L im
te
M
od
er
a
Ex
te
ns
ive
un
de
rs
ta
n
un
de
rs
ta
n
di
n
di
n
g
g
At the end of today’s summit, what is your
level of understanding of how early adverse
experiences influence lifelong health,
education, and wellbeing outcomes?
60%
A. Extensive
understanding
39%
B. Moderate
understanding
C. Limited
0%
understanding
D. No understanding
Prior to today’s summit, what was your level
of understanding of toxic stress and its
impact on physiological and brain
development?
51%
35%
11%
No
un
d
er
st
an
di
n
g
ng
nd
i
de
rs
ta
un
ite
d
L im
M
od
er
a
te
un
de
rs
ta
n
un
de
rs
ta
n
di
n
di
n
g
g
4%
Ex
te
ns
ive
A. Extensive
understanding
B. Moderate
understanding
C. Limited
understanding
D. No understanding
As a result of today’s summit, what is your
level of understanding of toxic stress and its
impact on physiological and brain
development?
44%
0%
No
un
d
er
st
an
di
n
g
ng
nd
i
de
rs
ta
un
ite
d
L im
M
od
er
a
te
un
de
rs
ta
n
un
de
rs
ta
n
di
n
di
n
g
g
1%
Ex
te
ns
ive
A. Extensive
understanding
B. Moderate
understanding
C. Limited
understanding
D. No understanding
55%
g
6%
No
un
d
er
st
an
di
n
ng
nd
i
de
rs
ta
un
ite
d
L im
te
M
od
er
a
Ex
te
ns
ive
un
de
rs
ta
n
un
de
rs
ta
n
di
n
di
n
g
g
Prior to today’s summit, what was your level
of understanding of the complexities of
buffering the impact of toxic stress?
50%
A. Extensive
understanding
35%
B. Moderate
understanding
C. Limited
9%
understanding
D. No understanding
g
0%
No
un
d
er
st
an
di
n
ng
nd
i
de
rs
ta
un
ite
d
L im
te
M
od
er
a
Ex
te
ns
ive
un
de
rs
ta
n
un
de
rs
ta
n
di
n
di
n
g
g
As a result of today’s summit, what is your
level of understanding of the complexities of
buffering the impact of toxic stress?
A. Extensive
64%
understanding
B. Moderate
31%
understanding
C. Limited
5%
understanding
D. No understanding
Summit Objective 2:
Establish Collective Responsibility

Early Childhood Colorado Partnership
• Make available relevant resources and research
• Survey network to capture existing , planned
efforts
• Engage TA to develop shared messaging
platform
• Embed prevention and promotion frameworks
• Mobilize and monitor collective will and action
• Facilitate connections
Summit Objective 2:
Establish Collective Responsibility
Individual, organization commitments
Consider:
• next steps you, your organization or community might
take to continue to understand and address toxic stress
• different levels
• personal , professional
• families work with/on behalf of
• service delivery level
• systems level
• what science, research says
Sharing Commitments
NW CO
SW CO
NE CO
SE CO
How committed are you to buffering
the impact of toxic stress in the first
three years?
A. Completely
committed
B. Highly committed
C. Averagely
committed
D. Somewhat
committed
E. Not committed
56%
34%
9%
ed
0%
om
m
itt
it t
ed
m
om
tc
ha
ew
No
tc
ed
itt
m
co
m
So
m
ge
ly
co
hl
y
Hi
g
Av
er
a
Co
m
pl
et
el
y
co
m
m
m
m
itt
itt
ed
ed
1%
What is your sense of urgency to act
to prevent adversities and buffer the
impact of toxic stress?
53%
34%
13%
0%
ur
ge
nc
y
ge
nc
y
of
ur
se
ns
e
of
No
se
ns
e
Lo
w
M
ed
iu
m
se
ns
e
of
u
rg
en
cy
rg
en
cy
of
u
se
ns
e
h
Hi
g
igh
se
ns
e
of
u
rg
en
cy
0%
Ve
ry
h
A. Very high sense of
urgency
B. High sense of
urgency
C. Medium sense of
urgency
D. Low sense of
urgency
E. No sense of urgency
Today’s event increased my sense of
connection with others also supporting
healthy child development.
50%
A. Strongly Agree
B. Agree
C. Neither Agree nor
Disagree
D. Disagree
E. Strongly Disagree
43%
Ne
ith
er
A
0%
gr
ee
ee
gr
ly
Di
sa
Di
sa
gr
ee
Di
sa
2%
St
ro
ng
gr
ee
no
r
St
ro
ng
ly
Ag
r
ee
Ag
re
e
5%
Today’s event was a good use of my
time.
A. Strongly Agree
B. Agree
C. Neither Agree nor
Disagree
D. Disagree
E. Strongly Disagree
64%
35%
Ne
ith
er
A
0%
gr
ee
ee
gr
ly
Di
sa
Di
sa
gr
ee
Di
sa
0%
St
ro
ng
gr
ee
no
r
St
ro
ng
ly
Ag
r
ee
Ag
re
e
1%
Overall, I would rate my satisfaction with
today’s Summit as
A. Completely satisfied
B. Highly satisfied
C. Satisfied
D. Somewhat satisfied
E. Not satisfied
50%
39%
11%
at
is f
ie
d
isf
ie
d
0%
No
ts
ew
ha
ts
at
Sa
t is
fie
d
sa
Hi
g
hl
y
So
m
Co
m
pl
et
el
y
sa
tis
fie
d
tis
fie
d
0%
CLOSING CIRCLE