Thursday, March 12, 2015

Libraries and the ACE Study: an Iron Fist Joint Post with Anna Donaldson, MSW

Anna Donaldson is a Departmental Analyst with the State of Michigan Division of Continuous Quality Improvement (DCQI) which monitors child welfare compliance and quality across the state. In the near future, she will be joining the clinical research team as Research Coordinator at the Momentous Institute in Dallas, TX as she as recently relocated with her husband to the Dallas/Fort Worth area. This new opportunity at the Momentous Institute will allow Anna to work with the team to gather and analyze data surrounding children's social/emotional growth and how the role of education can positively impact a child's ability to self-regulate, self-aware, and increase educational outcomes for at-risk children. Anna's main areas of interest are child welfare, specifically the impact of trauma on children and families, and improving quality of services provide to this population.

Bryce is Bryce. She's Anna's sister. She obviously did not write Anna's bio.

The following text originally appeared at Storytime Underground as "Considerations for Working with Patrons: What We Can Learn from the ACE Study," February 2015. Reposted with permission.

This summer I went to our city’s annual Learning Summit, where they talked about the Adverse Child Experiences (ACE) Study. The ACE Study is a really interesting ongoing study about the effects of childhood trauma on brain development. It featured a keynote by Jim Sporleder of Walla Walla, WA, a leader in trauma-informed curriculum.

Dr. Dipesh Navsaria, founder of Reach Out and Read, presents on the effects of childhood trauma on literacy; but brain development also affects behavior and the approach children and adults have to the world. I really wanted to write a blog post about this, specifically, having myself spoken before about setting up a library space for successful child interactions. I’m sensitive, however, to what I know well and what others know better than I do. So, I decided to enlist the help of Anna Donaldson, MSW, to talk about the implications of the ACE Study on behavior and patron needs in the library. She’s my younger sister and a super smartypants.

We implore you each to get your ACE score by answering the questionnaire here.[UPDATED LINK]. A high ACE scored is usually defined as 4 or more points. As we discuss the implications, keep in mind that even a single “yes” answer can cause trauma-related effects to the brain. So, chances are we’re not just talking about “problem patrons,” but all patrons, as well as our colleagues and ourselves.

On how the ACE Study has changed the way the social workers work with families, Anna says:
“The recognition of past trauma highly impacts how to interact with clients, both children and parents, as often parents are past victims of trauma as well. Validating this past trauma, or recognizing it at the least, helps us change our approach. If a parent has trauma history, little things like their caseworker’s personality or gender may impact their success.  We cannot interpret avoiding meetings, not giving phone calls back, or not embracing the process as a client not caring. As a social worker, ideally these barriers should lead us to more purposeful approaches with clients and using this information to make appropriate assessments.
Of what we could look for to determine if a patron has a high ACE score (that is, a score of 4+), Anna says:
“I think the most specific fact to remember is there is no set of particular characteristics that a child or parent will exhibit to alert you of an individual with a high ACE score. Everyone’s internal response looks different, and so do the external characteristics. It is more important to remember as you would never judge a book by its cover, never judge a customer by their characteristics. Depending on what trauma an individual experiences, this may make them more introverted or more extroverted than the average person; it may cause their boundaries to be inappropriate (for children this could be behavior such as hugging someone they just met, climbing on the lap of a stranger they were just introduced to); or it may impact their behavior in general (such as increased tantrums, crying, outbursts, or hyperactivity).”

Many of us work with the general public, whether in a public library setting or with families in our school libraries. While we may not know what’s happening in our patron’s lives on a daily basis, it is our duty to create welcoming environments that ensure that the patrons who are most in need of our services are not turned away without significant effort on our part to keep them.  And those who are most in need of our services might be our most “problem patrons.” So what can we do?

I don’t have all the answers, but I do have so much to say that it can’t all be said one post. That’s why I’ve written a series on my own blog about patron behavior in the library (hereand here and here and here) and why I’m teaching a course with all original material this spring, starting March 16. I hope you can join me. Read more about it here.

Even though we may be a small part of our kid patron’s lives, libraries can be an importantpart of a thriving community, which can build resilience. All children need resilience, but it’s critical for children in traumatic and toxic-stress situations to build resilience to survive and succeed.  When working with all patrons, but especially children, we need to ensure that our library spaces are welcoming, structured, and consistent.

Here are some small things you can consider today that can make a huge difference in your library as a part of a thriving community. And if you’ve already given them some deep thought? Give yourself a pat on the back, knowing you can continue more deliberately with your practice of a welcoming, structured, and consistent space!

1. You can’t expect anyone to know anything you haven’t told them yourself:  We can’t scroll down any librarian Facebook group or follow any library list-serv without running into at least one of those “patron gripe” posts. Real talk: I probably would have behaved like the Featured Woefully Ignorant Patron an embarrassingly high percentage of the time under similar circumstances to those mentioned. And you know why? Because there is no such thing as a single shared common sense.  And quite frankly, many library policies are not intuitive. So what do we do about that?

2. Make expectations clear: If some library policies are not intuitive, it stands to reason that the only way to ensure all patrons can use the library space effectively is to make clear expectations. Even adults and kids with low ACE scores can have a difficult time following the directions we give in the library (see the charts below); how, then, can we expect patrons with higher ACE scores to respond?

Adults Unaffected by Trauma
Screen Shot 2015-02-05 at 7.36.36 PM
Children Unaffected by Trauma
Screen Shot 2015-02-05 at 7.36.48 PM

Children with low ACE scores quickly run out of ideas. Not because they have no imagination, but because what they have imagined to do is annoying, or dangerous, or has otherwise elicited a negative response. There’s less and less, in their mind, they can do. At the very least they’re bored, and at the worst the child begins to form anxieties about the library because they’re afraid of breaking the rules by accident. You’re frustrated, and the library is no fun for anybody. You have to tell your patrons what to do. Give them options.

Children and adults with higher ACE scores may be more vulnerable to anxiety. Additionally, people living in toxic stress situations have their brains constantly turned to fight-or-flight mode,  and may have a hard time processing new information effectively. They may act out, their brains relying on their emotions for self-preservation. The shorter and clearer the policy, the more successful all patrons will be.

3. Librarians may be the only healthy adult relationship a child has as a model:  It is so important to consistently provide children with positive interactions with the library. You might be the only adult they converse with all day. We also, however, need to be aware of the physical cues we’re sending kids. You know the 8-year-old who wants to hug you, even though you've just met? As Anna suggests above, this child may be displaying maladaptive boundaries due to a high ACE score. Gently pushing him or her away and offering a high-five or a fist bump instead sends the message that this is the appropriate amount of physical contact he or she should be having with unfamiliar adults.

To wrap up, Anna goes right for the heart. There’s something in my eye:
“The library may be the one place outside a domestic violence shelter that a woman who just left a violent relationship will visit with her children. She may have had the strength to leave, and she wants a break to have normalcy to allow her child to learn something in a family-center environment. It may also be a place that a foster parent wants to bring their foster child to work on reading. It is about changing our own perspectives, based on our own biases of what is right and wrong, to better serve our populations. Half of children in the U.S. will experience an adverse childhood experience in their lifetime – this is our population; these are our children. To assist with resiliency, providing a family-centered, safe environment for children and family should be our top priority to help those with a high ACE score succeed from childhood to adulthood, and to help those adults that have high ACE scores be successful as parents to their children. This prevention can assist parents from repeating the cycle of trauma as this usually appears as generational.”

I want to leave you with one of Anna’s favorite quotes from the Child Welfare Policy & Practice Group, because I think it’s a powerful saying to think about when dealing with all patrons:
‘Do we know what we need to know, to do what we’re about to do?’
 Have thoughts, comments or feelings on this? Let us know in the comments! I'll forward them to my wonderful sister.

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