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  • InsideTrack
  • July 16, 2019

    Trauma-informed Care and the Role of Guardian ad Litem

    Knowledge of a child's underlying trauma is the first step toward making the most appropriate recommendation regarding the best interest of the child. Kelsey Stefka discusses trauma-informed care and how it can be used by guardians ad litem to better understand their young clients.

    Kelsey L. Stefka

    traumatized girl

    When children find themselves thrust into the court system, whether it is through family court, children’s court, or some other avenue, many times there is underlying trauma that led them there.

    By educating guardians ad litem (GAL) on what childhood trauma is and how best to approach children suffering from high adverse childhood experience (ACE) scores, we can attempt to provide appropriate services and assistance to the child in order to act in their best interest.

    Defining Trauma-informed Care

    According to the Wisconsin Department of Health Services, trauma-informed care is

    an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives.

    In understanding what constitutes as trauma-informed care, it is first important to understand that not everything is trauma. Trauma isn’t parental disciplinary actions like spanking and yelling, or taking away a child’s cellphone.

    Kelsey Stefka Kelsey Stefka, Marquette 2019, is an assistant district attorney in Sheboygan County.

    Trauma is best defined in this context as “extreme stress that overwhelms a person’s ability to cope,” and can be a single event, a series of events, or a set of circumstances that harm a child’s emotional and physical well-being.

    Trauma-informed care is not asking what is wrong with a child, but rather asking “what happened to you?” to get a better understanding of why they are the way that they are.

    By asking what happened instead of what is wrong, a child may be in a better position to explain their past, allowing a GAL to understand how the past may be affecting current behaviors. A dialogue can begin to occur surrounding the five primary principles of trauma-informed care:

    • safety;

    • transparency and trustworthiness;

    • choice;

    • collaboration and mutuality; and

    • empowerment.

    In beginning a conversation with a child about what happened, the child’s true best interest may become much more apparent than from the surface level.

    The Adverse Childhood Experience Test

    The best way for a GAL to begin to understand trauma-informed care is by understanding the basic concepts of Adverse Childhood Experience (ACE) scores, and how the score translates into a child’s current mental, emotional, and physical well-being.

    According to the Centers for Disease Control and Prevention (CDC),

    Adverse Childhood Experiences is the term used to describe all types of abuse, neglect and other potentially traumatic experiences that occur to children under the age of 18.

    The ACE study was initially implemented in 1995 to 1997 by Kaiser Permanente and the CDC to examine the relationship between health risk behavior and disease in adulthood that could be traced back to childhood exposure to trauma.

    The study tests for signs of 10 different categories of trauma:

    • emotional abuse;

    • physical abuse;

    • sexual abuse;

    • emotional neglect;

    • physical neglect;

    • incarcerated household member;

    • parental separation/divorce;

    • domestic violence in the household;

    • household dysfunction involving substance abuse, and

    • household dysfunction involving mental illness.1

    When taking the assessment, children receive one point for each positive answer they have, and the total number of points represents the child’s ACE score. The higher the child’s ACE score, the greater amount of traumatic exposure they have experienced in their life.

    High ACE scores have been linked to negative consequences for a child’s future health and well-being. Of the 9,508 people who participated in the original ACE study, almost two-thirds had at least one ACE, and more than one-fifth had three or more ACEs.

    By studying the effects of ACEs over an individual’s lifetime, it has been discovered that

    persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had a four to twelvefold increased health risk for alcoholism, drug addiction, depression, and suicide attempt in adulthood.2

    It was also revealed that these individuals have “a two to fourfold increase in smoking, poor self-rated health, 50 or more sexual intercourse partners, and sexually transmitted disease, and a 1.4 to 1.6-fold increase in physical inactivity and severe obesity,” in adulthood.3

    These findings are astounding, and should be factors that are considered when making decisions regarding the best interest of a child with an ACE score.

    Gaining Trust and Understanding

    Early identification of children with high ACE scores may help deter future court involvement through both family/children’s court and through the criminal justice system.

    For many children, the interactions they have with the GAL may be their first experience in the court system. A history of traumatic stress may inhibit a child’s ability to form trusting relationships with others. GALs who are educated about trauma-informed care may be able to break down some of those walls and form a more trusting relationship with the child in order to make an appropriate recommendation.

    Children may be more apt to exchange relevant information regarding their history and their home with an attorney who demonstrates an understanding of trauma, who begins a conversation by asking “what happened to you?”

    It is also important for GALs to remember that being trauma-informed may also help to better understand the parents. Many of the traumas the children are experiencing may have affected the parents in their childhood.

    Representing the Best Interests of a Child by Understanding Trauma

    Being trauma-informed can help GALs to have a better understanding not only of the child in front of them, but also of the whole family picture and how they ended up in the court system.

    Understanding a family’s trauma may lead a GAL to make a more appropriate recommendation regarding services for the family, and placement, guardianship, visitation, etc., in relation to the child.

    Ultimately, it is better for all parties involved in a case for a GAL to be trauma-informed in order to make the most appropriate recommendation regarding the best interest of the child, by understanding the trauma that brought the family to their current state.

    Endnotes

    1 Jan Jeske & Mary Louise Klas, “Adverse Childhood Experiences: Implications for Family Law Practice and the Family Court System,” 50 Fam. L.Q. 123 (2016).

    2Id.

    3Id.


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