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March 2022Vol. 23, No. 2Spotlight on Childhood Trauma and Resilience

This issue of CBX features resources about the impact of trauma on children and youth and the importance of building resilience. This month's message from Associate Commissioner Aysha E. Schomburg features an article written by young mothers of the IMPACT initiative, which works to elevate the voices of young mothers and raise awareness of the issues impacting young families. This issue also includes valuable resources for professionals and the families they serve.

Issue Spotlight

  • What the Nation Can Do to Help Children Who Lost a Parent or Caregiver to COVID-19

    What the Nation Can Do to Help Children Who Lost a Parent or Caregiver to COVID-19

    A report from COVID Collaborative and Social Policy Analytics offers a comprehensive blueprint for multidisciplinary outreach and care—in both the public and private sectors—for children who have lost caregivers during the pandemic.

    After providing an estimate of the number of affected children and youth, the report explores the effects that caregiver loss can have regarding child development, the challenges families face to adapt, and the importance of resilience. Its final two sections review potential preventive and clinical interventions to help mitigate some of the negative outcomes from caregiver loss and bolster the resilience of children and families and provide recommendations.

    More than 167,000 children have lost at least one of their caretakers due to COVID-19. Of those, more than 13,000 children lost their only in-home caregiver. For these vulnerable children, the traumatic loss of their caregiver can create a grief that echoes throughout their life and lead to mental health challenges, lower academic achievement, and higher rates of substance and alcohol use—all of which can impact our society as well as those children. 

    Black and Brown children and families have borne the brunt of this type of loss during the COVID-19 pandemic. They have faced greater exposure due to their being more likely to be a frontline worker than White individuals and their greater risk of dying due to racial inequities embedded in the U.S. health-care system. As a result, non-White children lost their caregivers at nearly four times the rate of their White peers.

    Past studies on grief and other forms of trauma act as a basis for the report's guidance and recommendations. It calls out the following types of support and programs:
    • Group peer-support and grief camps
    • Social and emotional learning in schools
    • Evidence-based mentoring programs
    • Family bereavement programs
    • Trauma-informed cognitive behavioral therapy
    The recommendations focus on creating a multidisciplinary strategy to address the needs of this population, including the following:
    • Identifying children who lost a parent to COVID-19
    • Screening for complicated or traumatic grief in settings like schools and pediatric care
    • Enhancing community-based support for children suffering bereavement due to COVID-19 
    • Increasing and expanding clinical care for children suffering bereavement due to COVID-19 
    • Addressing the economic needs of children who lost a caregiver to due to COVID-19
    The report also reveals areas for additional research to support the evidence and better understand the current and future impacts of COVID-19.
     
  • Tips for Building Resilience in Our Children

    Tips for Building Resilience in Our Children

    The Creating a Family website offers tips for building resilience in children and youth in foster care and adoptive families. These children often have experienced trauma before and during their time moving through the child welfare system. Trauma can have a negative impact on how children learn resiliency and other aspects of their current and future lives.

    The webpage spotlights the "Three Rs," which aim to help children manage their response to trauma using the following strategies: 

    • Reassure: Comfort the child both verbally and physically.
    • Return to routine: Encourage the child to continue or return to their familiar routines.
    • Regulate: Teach the child how to identify and regulate their emotions and offer to help them learn these coping skills (also known as coregulation).
    This webpage also emphasizes the importance of consistently utilizing the Three Rs, modeling the regulating behaviors yourself, and recognizing with positive reinforcement when the child is successfully building their resilience.
     
    To learn more about building resilience in children who have experienced trauma, visit Creating a Family's Tips for Building Resilience in Our Children webpage.
     
  • There Is No Age Requirement for Loving Your Children

    There Is No Age Requirement for Loving Your Children

    Written by TK Cross & Madison Iokennoronhawi White, IMPACT steering committee members

    Listen to young mothers. As we continue to learn the value of lived experiences throughout our work with children, youth, and their families, it is important to acknowledge the perspectives and experiences of the young mothers who are often left to struggle without a support system. The writers of the following article are working hard to bolster support for these young women and their families.—Aysha E. Schomburg, Associate Commissioner of the Children's Bureau

    ______________________________________________________________________________

    Over the last 2 years, IMPACT (Invincible Mamas Pushing for Action and Change Together) has been working to elevate the voices of young mothers and raise awareness of the issues impacting young families. IMPACT is boldly advocating for freedom, opportunity, and equity for young families, communities, and the mamas that unite them. Through advocacy and organizing, we are working to change the narrative around young parenthood.

    We are young mamas from across the country, from diverse backgrounds, including various tribal communities all working toward the same goal—raising our children with love and respect for our communities. As mamas of color, we recognize the systemic oppressions we have faced by systems designed to support us, which initially create barriers and contribute to the cycle we are working to dismantle. 

    We have been beaten down, criticized, restricted from adulthood, and shamed for enjoying motherhood. While being stripped of the "rites of passages" into adulthood, we were expected to own a systemic view of parenthood. Being young does not denote a mama's lack of ability to be committed, smart, capable, and/or loving. Being a young mama means we're strong, energized, and full of life. 

    Our IMPACT community rallies to support our children and create a support system for young mamas. This is done in addition to, or in lieu of, the young mama's multigenerational familial/community supports (grandparents, great grandparents, aunts, uncles, and cousins) where elder relations may or may not still be alive, present, or involved. 

    Our lives are at the intersectionality of age, race, and social constructs of "adequate" parenthood. We are here to celebrate our expertise as parents and work on dismantling the barriers (intentional or unintentional) created by systems such as child welfare, health care, housing, and foster care. We are here to tell our stories of intimidation by foster care, to create a platform for young moms who need housing and are turned away, for those who need child care but are presented with barriers, documentation, and endless excuses to get the benefits they need. 

    IMPACT uses a modest approach to parenting in which we collaborate and learn from each other as we grow together. It is ok to not have life figured out just yet as we figure it out together. We are the experts in our lived experiences, and we need you to listen. Young moms are here to show our strength to say we are no longer invisible. Motherhood is not one size fits all. Since when did loving your children have an age requirement? 

  • Understanding the Impact of Trauma on Children's Behavior

    Understanding the Impact of Trauma on Children's Behavior

    A guide from AdoptUSKids aims to help parent group leaders support discussions between parents and caregivers about trauma and its effects. The goal of these discussions is to be able to better respond to the behaviors of children affected by trauma and their needs for attachment and healing. This guide assumes that participants have a basic understanding of trauma and its effects on child development and behavior.

    The guide provides discussion leaders with direction of what to say and activities to complete across four topics:

    • Trauma and behavior
    • Cognitive impact
    • Attachment impact
    • Trauma triggers

    It also includes examples of different scenarios, how they and the participants can prepare for the meetings, and additional resources. 

    To learn more, explore Discussion Guide: The Impact of Trauma on Children's Behavior. 

    Recent Issues

  • March 2023

    Spotlight on Incorporating Youth Engagement and Lived Experience Into Child Welfare Practice

    Spotlight on Incorporating Youth Engagement and Lived Experience Into Child Welfare Practice

  • February 2023

    Spotlight on the Title IV-E Prevention Program and the Family First Prevention Services Act

    Spotlight on the Title IV-E Prevention Program and the Family First Prevention Services Act

News From the Children's Bureau

In this section, find the latest news, resources, and publications from the Administration for Children and Families, the Children's Bureau, and other offices within the U.S. Department of Health and Human Services as well as a listing of the latest additions to the Children's Bureau website.

Training and Technical Assistance Updates

This section features resources and updates from the Children's Bureau's technical assistance partners to support practices and systems that improve the lives of children and families.

Child Welfare Research

In this section, we highlight recent studies, literature reviews, and other research on child welfare topics.  

  • LYGHT Program Enhances Foster Youth Well-Being

    LYGHT Program Enhances Foster Youth Well-Being

    Dougy Center: The National Grief Center for Children and Families recently released findings from a study of the effectiveness of its LYGHT (Listening and Led by Youth in Foster Care: Grief, Hope, and Transitions) program. The research was guided by the question "Does the LYGHT program enhance the well-being of youth in foster care?" Findings suggest that the program is successful in enhancing well-being.

    The researchers analyzed data from 42 youth ages 12 to 16 with foster care experience: 23 youth who were in the LYGHT program and 19 who were on the program's waitlist. The study used quantitative data compiled using questionnaires and qualitative data gathered from focus groups. Youth who participated in the LYGHT program showed increased levels of social support, hopefulness, and self-worth, and their perceived problems became more bearable.

    For more information, read the report, Listening and Led by Youth in Foster Care: Grief, Hope, and Transitions: A Dougy Center Program: Research Findings 2021.

  • Behavioral Health Services Access for Youth in Foster Care

    Behavioral Health Services Access for Youth in Foster Care

    A recent issue brief from the Medicaid and CHIP Payment and Access Commission addresses the access of children and youth in foster care to behavioral health services. Specifically, the authors use data from the National Survey on Drug Use and Health (NSDUH) to analyze the experiences of children and youth ages 12 to 17 who have spent at least 1 day in foster care in the last year, including the prevalence of certain behavioral health conditions and access to services. They also compared experiences of youth with health coverage through Medicaid or the Children's Health Insurance Program (CHIP) to those with private coverage. The authors note that NSDUH data are self-reported, which could impact findings.

    The data revealed that 63.5 percent of youth in foster care were enrolled in Medicaid or CHIP, and many of these youth experience behavioral health conditions and receive treatment. 

    Other major findings reported in the brief include the following: 
    • Most of the sample population reported that they had access to substance use disorder treatment when needed. 
    • Medicaid and CHIP beneficiaries generally received mental health services at slightly lower rates compared with their peers with private coverage. 
    • More than 25 percent of the sample population reported experiencing a major depressive episode at some point in their life. 
    • Nearly 20 percent of the sample population reported having a substance use disorder in the past year. 
    For more information, including data tables, read the full brief, Access in Brief: Behavioral Health Services for Youth in Foster Care. 

Strategies and Tools for Practice

This section of CBX offers publications, articles, reports, toolkits, and other resources that provide evidence-based strategies or other concrete help to child welfare and related professionals.

  • Moving From ACEs to HOPE: The Power of Positive Experiences

    Moving From ACEs to HOPE: The Power of Positive Experiences

    Written by the Capacity Building Center for States

    "A healing-centered approach to addressing trauma requires a different question that moves beyond 'what happened to you' to 'what's right with you' and views those exposed to trauma as agents in the creation of their own well-being rather than victims of traumatic events."—Dr. Shawn Ginwright (2018)

    The landmark Adverse Childhood Experiences Study helped us understand the effects of adverse experiences (ACEs) on health outcomes, but it did not discuss the buffering effect of positive childhood experiences (Bethell, 2019). Research on positive experiences shines a light on the importance of a system that actively supports and cultivates resilience more than identifying past traumas.

    The Healthy Outcomes from Positive Experiences (HOPE) framework provides actionable approaches that focus on family strengths and foster both child and family resilience, in effect building up positive experiences to mitigate the impact of adverse experiences. The framework identifies four building blocks: 
    • Relationships (both within and outside the family)
    • Safe, equitable, and stable environments for living for positive childhood experiences (HOPE, n.d.), playing, and learning
    • Social and civic engagement
    • Emotional growth through playing and interacting with peers
    A collaborative, community approach to using the HOPE framework or a similar protective factor approach can help bridge and coordinate services across systems, such as health, family support, and child welfare, all of which could be facilitators of positive childhood experiences. 

    Supporting Positive Childhood Experiences in Practice  

    By intentionally using a strengths-based approach rooted in the science of resilience, child welfare agencies can help to end longstanding practices of focusing on individual deficits. The following sections outline questions you can explore with your agency as you consider how to better identify and amplify positive childhood experiences. 

    Youth and Family Engagement and Empowerment  

    Consider the importance of engaging youth and families as collaborative partners and how authentic engagement is a positive experience that may mitigate ACEs. Ask yourselves the following:
    • What are we currently doing to engage families and youth in conversations about their individual strengths and needs?
    • How are families and youth receiving child welfare services linked to other families and youth with similar lived experiences?
    • How are we currently gathering input and feedback from those with lived experience to help us implement our agency's approach to supporting strengths and building resilience? 
    • What are we currently doing to strengthen positive childhood experiences as part of our efforts to advance equity and move to a more prevention-oriented system?
    Workforce Development and Casework Practices 

    A diverse, knowledgeable, and skilled workforce supported by leaders and a strong agency culture can operate in partnership with families to identify strengths and nurture positive experiences. Ask yourselves the following: 
    • How are caseworkers currently trained, and what can we do to ensure allyship with families is an expectation throughout the agency?
    • How can we build understanding of unconscious bias (and its impact on identifying family strengths) through training, supervision, and coaching? How does our organizational culture support this approach?
    • How could our hiring practices become more equitable? Is lived experience considered equivalent or comparable to professional experience?
    • What are we currently doing to capture and promote family strengths in our casework? How are we documenting this information? Is our approach aligned with our vision? If not, what needs to change?
    • How does our casework support the building blocks for positive childhood experiences? What steps could we take to make this a reality?
    • How are we engaging the community to support positive childhood experiences?
    Resources 

    As you consider your next steps, take a look at the following resources to learn more about the science behind positive childhood experiences and concrete strategies to support child and family hope and resilience.

    Positive Childhood Experiences 

    The following resources offer approaches and other information to promoting positive experiences:
    Prevention Resources  

    Strengths-based approaches to support positive childhood experiences can align nicely with prevention efforts. The following resources can support a collaborative shift toward prevention:
    Youth and Family Engagement Resources  

    Engaging youth and families is a key strategy for agencies working to build hope and resilience. The following resources can support authentic engagement of youth and families:
    References  

    Bethell, C. J. (2019). Positive childhood experiences and adult mental and relational health in a statewide sample: Associations across adverse childhood experiences levels. JAMA Pediatrics, e1–e10. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2749336

    Ginwright, S. (2018, May 31). The future of healing: Shifting from trauma informed care to healing centered engagement. https://ginwright.medium.com/the-future-of-healing-shifting-from-trauma-informed-care-to-healing-centered-engagement-634f557ce69c

    Healthy Outcomes from Positive Experiences. (n.d.). HOPE: Healthy Outcomes from Positive Experiences. Tufts Medical Center. https://positiveexperience.org/wp-content/uploads/2021/04/HOPE-1-pager.pdf
  • New Book Provides Strategies for Improving Legal Representation of Children in the Child Welfare System

    New Book Provides Strategies for Improving Legal Representation of Children in the Child Welfare System

    A new book by the National Quality Improvement Center on the Representation of Children in the Child Welfare System (QIC-ChildRep), Children's Justice: How to Improve Legal Representation of Children in the Child Welfare System, explores the lack of effective legal representation in child welfare cases.

    The book highlights how the QIC-ChildRep's Best Practice Model of Child Representation improves the way lawyers represent children and leads to improved case outcomes for some children. It also details the QIC Best Practice Model and presents findings of a study on the model. The study took place over the course of 3 years and was based on data from 250 lawyers representing about 4,500 children.

    In addition, the book also explores the following questions related to child representation:

    • Who should represent children, and what characteristics should they possess?
    • What duties should child advocates embrace, and what tasks should they prioritize?
    • How are children represented, and how can states develop and sustain child representation workforces? 
    The book concludes with lessons learned from studying the QIC model and projections for the future of child representation in the child welfare system. 

Resources

This section of CBX presents interesting resources, such as websites, videos, journals, funding or scholarship opportunities, or other materials, that can be used in the field or with families.

  • Supporting the Emotional Well-Being of Children and Youth

    Supporting the Emotional Well-Being of Children and Youth

    The COVID-19 pandemic has been shown to have adverse effects on family stability and well-being. In response to these concerns, the National Academies of Science, Engineering, and Medicine, with funding from the Centers for Disease Control and Prevention, developed a web-based suite of tools to help children and youth manage their feelings of stress, anxiety, and sadness brought on or exacerbated by the pandemic.

    The tools include a collection of comic-book style videos and documents that focus on the specific thoughts, feelings, and behaviors that can cause stress in the lives of children and youth. The goal is to teach children and youth the skills they need to cope with challenges, particularly those associated with the pandemic, including the following: 

    • Changes in routines
    • Breaks in continuity of learning
    • Breaks in continuity of health care
    • Missed significant life events
    • Lost security and safety
    The tools are organized into two age groups—young children (to be explored with their parents) and youth and teens—and are also available in Spanish. A list of frequently asked questions and a page of additional, related resources are also provided. 

    Tools for Supporting Emotional Wellbeing in Children and Youth is available on the National Academies website. 
  • Guide for Foster Parents on Supporting LGBTQ+ Youth

    Guide for Foster Parents on Supporting LGBTQ+ Youth

    Child Welfare Information Gateway created a factsheet to educate foster parents about LGBTQ+ (lesbian, gay, bisexual, transgender, questioning, and other diverse identities and expressions, including Two-Spirit) youth in the child welfare system. The factsheet, Supporting LGBTQ+ Youth: A Guide for Foster Parents, describes the unique challenges this at-risk population of youth face and how foster parents can help reduce those risks and ensure youth feel safe and supported.

    This factsheet was developed to help families understand the complex experiences of LGBTQ+ youth in foster care and the importance of and how to provide a nurturing and affirming home environment. It also provides specific actions that families can take to promote youth health and well-being at home and in the community. 

    To learn more, read Supporting LGBTQ+ Youth: A Guide for Foster Parents on the Information Gateway website. 

Training and Conferences

Find trainings, workshops, webinars, and other opportunities for professionals and families to learn about how to improve the lives of children and youth as well as a listing of upcoming events and conferences.

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