Early Childhood Interventions

They say “an ounce of prevention is worth a pound of cure.” With total costs of incarceration now estimated at trillions of dollars nationally and no sign of curing recidivism, improving behavioral health, or even deterring crime through incarceration, what is prevention worth?

How do we justify that those in poverty experience more than their share of early childhood traumas and are then repeatedly punished for their responses to those adverse experiences? What is at stake when we fail to acknowledge that our most vulnerable populations, those most likely to be experiencing the behavioral and developmental disabilities that can result from trauma, make up the majority of our jail populations?

Environment, genetics, and the impacts of persistent poverty not only contribute to poor physical health outcomes, but are also associated with behavioral health issues and criminal justice involvement. The ways in which we as a society respond to early childhood trauma and young children’s developing behavioral health needs can support or hinder their opportunities to heal and ultimately determine their likelihood of success—and ours, as a society that aspires to cultivate healthy children and life-long productive citizens.

We now know, thanks to the Adverse Childhood Experiences (ACEs) Study from Kaiser-Permanente, that “toxic stress” changes a child’s brain at a young age. Traumatized brains cause impulsive and undesirable behavior—the sort of behavior that calls negative attention to itself, and sets children up for trouble or even failure in school, as well as suspension, expulsion, or other harsh discipline—even at pre-school age. The consequences of traumatic stress can be much more dramatic than we once thought. In fact, exposure to any of such childhood traumas as divorce, abuse, incarceration of or substance abuse by a family member increases “the risk of psychosis approximately three-fold” with “those who had multiple traumatic experiences…at a much higher risk.”

While eliminating these harmful experiences remains the broader ongoing public health and safety enterprise, interventions to address the needs of traumatized youth have already proven effective in changing outcomes. Young children in New York automatically see a trauma-informed child psychologist during their annual pediatric exams. Students in Philadelphia engage in meditation rather than being held in detention. As a result, suspension rates in Philadelphia have plummeted. In Connecticut, children learn skills to help them cope with negative emotions and teachers are trained to defuse potential disruptions before they happen, dramatically reducing out-of-school suspensions and expulsions. Limiting these harsh punishments measurably improves school performance and reduces the chances youth will later become involved in the justice system and increasing their chances of becoming healthy, capable adults.

When schools have the resources to address childhood trauma appropriately, and share with parents and health providers an awareness that good health and positive social outcomes result from understanding, care, and cultivation and not from penalty and brutality, communities will alter their fate. Structuring child care and education to address behavioral health from a young age and onward, giving everyone the tools to succeed in the face of adversity, will help us achieve the thriving society we all want.  And what we save when we discontinue our failing efforts to rehabilitate through punishment will not only cover the costs of prevention, but will yield a general wellbeing and prosperity that are in better proportion to our unparalleled resources.

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