When a 14-year-old girl gets pregnant, popular opinion says she's a loser or stupid and deserves whatever happens to her.
"We still live in a world where young moms are bad girls who made bad choices," says Jeannette Pai-Espinosa, president of the National Crittenton Foundation. The foundation and its 27 agencies serve teenage and young women, many who are pregnant or parenting.
For many girls, she says, "Becoming pregnant makes sense in the context of their lives and families."
How's that possible? Some alarming data from a recent pilot study of Crittenton clients show that, compared with a general population, teen and young mothers suffer up to seven times the levels of child abuse and other maltreatment. This explains why they become addicted, pregnant or drop out of school. The good news is that, with a little bit of help and a lot of understanding, they and their kids can live healthier, happier lives. (Details in part two.)
Most of the 253 mothers in the pilot study are teens. Some are as young as 10. Half endured at least four types of severe and chronic childhood trauma. This includes ongoing verbal abuse, neglect, or living with an addicted or depressed parent. Line up any 10 of these mothers and four were sexually or physically abused, saw their own mothers treated violently or lost a parent through abandonment or divorce.
To understand why it's not surprising that these girls and young women couldn't make healthy choices, you have to know a little about the CDC's Adverse Childhood Experiences Study (ACE Study) and how trauma affects children's brains.
The ACE Study -- a groundbreaking epidemiological study that links childhood trauma with adult onset of chronic disease, as well as life-altering social and emotional problems -- looked at 10 types of childhood trauma in 17,000 people in San Diego. Five types were the usual suspects -- sexual, verbal and physical abuse, and emotional and physical neglect. Five were family dysfunctions -- living with a mother who's abused, a parent who's mentally ill or addicted, losing a parent, and having a family member in jail.
Even in this group of mostly white, middle- and upper-middle class, college-educated people with good jobs and great health care (they all belonged to Kaiser Permanente), childhood trauma was surprisingly common. A whopping two-thirds had experienced at least one type of trauma, resulting in an "ACE score" of one -- 87 percent of that group had a two or higher.
You can think of an ACE score as a cholesterol score for childhood toxic stress. You get one point for each type of trauma. The higher your ACE score, the higher your risk for health, emotional and social problems. (What's your ACE score?)
Things start getting serious around an ACE score of four. The risk of emphysema or chronic bronchitis, or depression multiplies by four. Suicide risk rockets to 12 times normal. Teen pregnancy and domestic violence increases. So do lung cancer and heart disease.
What makes the Crittenton study such a big deal? It's the first to look at ACE scores in people already in the social services or criminal justice systems. In this case, the group comprised 916 teenage girls and young women, including 253 mothers.
Compared to the mostly white, middle-class San Diegans, the trauma levels of the young mothers are 1.5 to 7 times higher:
What's even more significant is that a much greater percentage of these young mothers had ACE scores of four or higher:
The data show that these girls and young women aren't bad. They're injured. Their home lives were so destructive, so chaotic and so dangerous that they became too traumatized, too depressed, and too lost to be able or to know how to make healthy choices.
Some say that's so much sob-sister liberal bunk. But research on children's developing brains confirms that trauma produces an overload of stress hormones that are toxic and physically damage a child's developing brain.
With parts of their brains stunted and circuits shorting out, children can't focus. In their minds, the world is a dangerous place; they walk through their lives in traumatic stress mode... flight, fight or freeze (fright). They fall behind in school, have a hard time making friends, or are unable to trust adults. Unrelenting anxiety, depression, hyperactivity, and frustration drive them to find solace in food, alcohol, tobacco, methamphetamines, inappropriate sex, high-risk sports, and/or work and over-achievement. They don't regard these coping methods as problems. Consciously or unconsciously, they use them as solutions to escape.
"This is something we've known intuitively but now can show with the data," says Pai-Espinosa.
The data from the Crittenton study underline what Dr. Robert Anda, one of the co-founders of the ACE Study, has often said: Adverse childhood experiences in this country have led to a "chronic public health disaster" that, without intervention, is passed on from parent to child, from generation to generation. (It's worth noting that Crittenton agencies have served 10 million people since 1883.)
And it's not just the girls and young women with high ACE scores who end up as teen or young parents. Males with an ACE score of five were more likely than males with an ACE score of zero to impregnate a teenager, according to ACE Study results published in Obstetrics and Gynecology in 2002.
The results of the Crittenton ACE survey suggest that the ACE scores of people in prison, on welfare, in rehab, etc., are significantly higher than a general population. This adds more weight to the argument to invest in prevention and early intervention instead of continuing to finance the consequences.
ACEs are an economic disaster and a tragedy of human suffering, noted Kathy Szafran, chief executive officer of Crittenton Services in West Virginia, many of whose 1,200 clients participated in the pilot project, which is being expanded to include all Crittenton clients. "It shows how acute the needs of this population are," she says, "and how important it is to intervene early to stop the long-term effects of ACEs."
Case in point: Take only the abused children who ended up in child welfare services the U.S. in 2008 (the total number of abused children is estimated to be much higher). Add up the total lifetime cost resulting from their maltreatment. It's a whopping $124 billion. Include all the people who were abused each year for just the last 10 years, start including every year from 2012, and the number rolls steadily, but surely, into the trillions.
Images/graphics used with permission.
For the good news that came out of the briefing where the National Crittenton Foundation presented its study, read part two.
Jane Stevens is writing a book about adverse childhood experiences and how organizations, agencies, states, communities and individuals are implementing trauma-informed practices.
For more by Jane Ellen Stevens, click here.
For more on mental health, click here.