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Holding the Pieces Together: Becoming the Gold in a Child's Life

Dr. Leigh Ann Breckenridge DNP, FNP-C, MSN, BSN

Associate Clinical Professor

Virginia Commonwealth University

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I have no disclosures

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objectives

1. Explain how Adverse Childhood Experiences (ACEs) influence children's behavior, learning, relationships, and emotional regulation.

2. Describe how positive adult relationships serve as protective factors that foster resilience.

3. Apply trauma-informed strategies that promote belonging, empathy, and emotional safety within out-of-school-time programs.

4. Reflect on personal assumptions about children's behavior using the Kintsugi metaphor

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Let’s talk about your dish!

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GIVE YOUR DISH TO YOUR NEIGHBOR!

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Now describe your dish!

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For the remainder of the session, try to put your plate back together.

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What are Adverse Childhood Experiences?

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How does exposure to ACES/Trauma affect an individual?

Physical health

Mental health

Behavioral/social well-being

resilience

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Epigenetic shift-how exposure to toxic stress impacts our genetic translation. This trauma can turn genes on and off.
Size and shape of the brain-smaller brains-the frontal and temporal lobes are smaller
Neural pruning –the brain will disconnect areas that may be important to survive later in life. For example a child who is neglected my not be able to develop those trusting relationships later
Telomeres-like the end of a shoestring-they protect the ends of your DNA so they do not come unraveled
Default mode network-the default mode network is in overdrive. For you and I it can turn on and off depending on what we are doing.
Brain body pathway-HPA and SAM axis. the sympathoadreno-medullary (SAM) axis, which makes the stress hormone adrenaline and hypothalamic-pituitary-adrenal (HPA) axis, which makes the stress hormone cortisol.

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Check in

What feelings are coming to mind as you put your plate together?

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How do we compare?

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ACES Pyramid

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Possible triggers for those affected by ACES

Physical proximity

Yelling/badgering

Lack of information and consent

Power dynamics of relationship

Commonalities of gender, age, race, culture, or physical characteristics of the provider with trauma history

Being touched

A closed room

Having to disrobe or change clothes

Lying or sitting still

Being asked intimate questions

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What is your role when caring for those affected by ACES?

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Back to the bowl one last time!

Tell me about the process of putting the bowl back together
How does this remind you of ACES or Trauma?
What about resilience?
How might this change how you react or treat an individual who has been impacted by ACES/Trauma?

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Words for the Journey

“We must be guardians of a space that allows students to breathe and be curious and explore the world and be who they are without suffocation. They deserve one place where they can rumble with vulnerability and their hearts can exhale…..we should never underestimate the benefit to a child of having a place to belong-even one-where they can take off their armor.. It can and often does change the trajectory of their life.”

Brene Brown

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References

Grafft, N., Lo, B., Easton, S. D., Pineros-Leano, M., & Davison, K. K. (2024). Maternal and Paternal Adverse Childhood Experiences (ACEs) and Offspring Health and Wellbeing: A Scoping Review. Maternal and child health journal, 28(1), 52–66. https://doi.org/10.1007/s10995-023-03825-y

Gupta, R. C., Randell, K. A., & Dowd, M. D. (2021). Addressing Parental Adverse Childhood Experiences in the Pediatric Setting. Advances in pediatrics, 68, 71–88. https://doi.org/10.1016/j.yapd.2021.05.003

Herzog, J. I., & Schmahl, C. (2018). Adverse Childhood Experiences and the Consequences on Neurobiological, Psychosocial, and Somatic Conditions Across the Lifespan. Frontiers in psychiatry, 9, 420. https://doi.org/10.3389/fpsyt.2018.00420

Middleton, J., Edwards, E., Roe-Sepowitz, D., Inman, E., Frey, L. M., & Gattis, M. N. (2022). Adverse Childhood Experiences (ACEs) and Homelessness: A Critical Examination of the Association between Specific ACEs and Sex Trafficking among Homeless Youth in Kentuckiana. Journal of Human Trafficking, 10(1), 121–134. https://doi.org/10.1080/23322705.2021.2020061

Petruccelli, K., Davis, J., & Berman, T. (2019). Adverse childhood experiences and associated health outcomes: A systematic review and meta-analysis. Child abuse & neglect, 97, 104127. https://doi.org/10.1016/j.chiabu.2019.104127

Shimkhada, R., Miller, J., Magnan, E., Miller, M., Coffman, J., & Corbett, G. (2022). Policy Considerations for Routine Screening for Adverse Childhood Events (ACEs). Journal of the American Board of Family Medicine : JABFM, 35(4), 862–866. https://doi.org/10.3122/jabfm.2022.04.210454

Sharma, S. R., Gonda, X., Dome, P., & Tarazi, F. I. (2020). What's Love Got to do with it: Role of oxytocin in trauma, attachment and resilience. Pharmacology & therapeutics, 214, 107602. https://doi.org/10.1016/j.pharmthera.2020.107602

Smith Battle, L., Rariden, C., Cibulka, N., & Loman, D. G. (2022). Adverse Childhood Experiences as Public Health Threat. The American journal of nursing, 122(3), 11. https://doi.org/10.1097/01.NAJ.0000822924.33625.c7

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You are the GOLD in the lives of others!

Thank you for your attention!

Dr. Leigh Ann Breckenridge

breckenril@vcu.edu