1. The Impact of Maltreatment on Relationships Bryan Samuels, Commissioner Administration on Children, Youth and Families

2. A History of Maltreatment Is the Norm among Children and Youth in Many Systems Miller, EA; Green, AE; Fettes, DL; & Aarons, GA., 2011. Data come from a representative sample of 1,715 youths aged 6–18 who received services from one or more of five San Diego County public sectors of care. Apr. 2, 2012 Ntl. Forum on Youth Violence Prevention 2

3. Maltreatment Impacts How Youth Form Relationships with Adults Maltreatment affects a child's health and well-being as well as the quality of his or her relationships. Child maltreatment represents an extreme form of child–parent relationship disruption (Harden, 2004; Milan & Pinderhughes, 2000). Child maltreatment can be considered as a chronic interpersonal trauma, to which the child is exposed on a daily basis within the context of the caregiver-child relationship (Perry, 2008; van der Kolk, 2005). Children’s capacity to adequately cope with stress depends largely on the nature of the stress and on the attachment figure’s capacity to diminish or counter the effects linked to the stressor (Lyons-Ruth et al., 1999). The developmental stage of the child at the onset of the abuse and neglect will influence the type and severity of the consequences (Frederico, Jackson & Black 2005; Perry 1995). For many maltreated children, nurturing and supportive parental behavior was inconsistent or unavailable, resulting in children who lack confidence to explore new environments and relationships (Bretherton, 2000; Sorce & Emde, 1981). Apr. 2, 2012 3 Ntl. Forum on Youth Violence Prevention

4. Student Shootings in Chicago 2007-2009 Demographics 90% of all shootings are male 69% of all shootings are between the ages of 15 to 17 21% are in Special Ed. Misconduct 78% have either no Misconduct Code violation or one that is a 3 or less 48% have never been suspended from school Enrollment 74% have been continuously enrolled in the same school for at least three semesters 97% have been continuously enrolled in CPS for at least three semesters Temporal 70% of all shootings occur outside of Extended Day Hours Attendance Shooting victims had an average attendance rate of 42% for the month prior to the shooting 32% of shooting victims attended school on the day of shooting or on the prior school day if shooting occurred on a weekend. Spatial Shootings happened closer to the victims home address than to the school. – -Median Distance from shooting to victims home: 0.41 miles – -Median Distance from shooting to victims school: 1.41 miles Academic Performance 0.95 grade point average for shooting victims. Apr. 2, 2012 Ntl. Forum on Youth Violence Prevention 4

5. Path of Maltreatment’s Impact on Relationships throughout Life Abusive or Neglectful Parenting Insecure Attachments, Emotional Dysregulation, Negative Internal Working Models Maladaptive Coping Strategies Poor Social Functioning, Disturbed Peer Relationships Psychological Distress Adult Relationship Dysfunction Apr. 2, 2012 Ntl. Forum on Youth Violence Prevention 5

6. Relationship Functioning in Child Welfare 6 Casanueva, Ringeisen, Wilson, Smith, & Dolan, 2011. Apr. 2, 2012 Ntl. Forum on Youth Violence Prevention

7. Relational Functioning as Well-being? Collishaw, Pickles, Messer, Rutter, Shearer, & Maughan, 2007. Apr. 2, 2012 Ntl. Forum on Youth Violence Prevention 7

8. Typical Programs for Youth Yield Poor Outcomes Koball, Heather, et al., 2011. Apr. 2, 2012 Ntl. Forum on Youth Violence Prevention 8

9. Barriers to and Facilitators of Interpersonal Connection Establishing or repairing of a protective, emotionally responsive child–adult relationship for a maltreated child or a child at risk of maltreatment should be the central focus of services. If we choose to intervene on behalf of maltreated children, it is incumbent on us to rehabilitate the capacity of these children to engage in healthy relationships. Barriers to Connection: Fear of the Emotional Risk Fear of indebtedness Fear of being failed Being pushed to bond too quickly Resistance to directive advice Adult lacks understanding of youth’s culture or background Barriers to Connection: Fear of the Emotional Risk Fear of indebtedness Fear of being failed Being pushed to bond too quickly Resistance to directive advice Adult lacks understanding of youth’s culture or background Facilitators of Connection: Adult has persistence/patience Authentic displays of affection by adult Adult opens up/shares their own experiences Adult respects youth/their past experiences Adult goes beyond prescribed relationship Shared characteristics between youth and adult Youth experiencing a period of vulnerability/extreme emotional need Facilitators of Connection: Adult has persistence/patience Authentic displays of affection by adult Adult opens up/shares their own experiences Adult respects youth/their past experiences Adult goes beyond prescribed relationship Shared characteristics between youth and adult Youth experiencing a period of vulnerability/extreme emotional need Apr. 2, 2012 Ntl. Forum on Youth Violence Prevention 9

10. Healthy Adult Functioning Understanding of the value, safety, reliability, and predictability of protective relationships Effective strategies for using relationships Appropriate concepts of normal behavior, roles, and responsibilities Understanding of Relationships Intuitive attunement to others’ feelings; empathy Understanding of pragmatics, nuance, works for feeling, facial expression Effective Verbal and Non-Verbal Communication Good self esteem; coherent life story; healthy identity Awareness of personal strengths and limitations; valued roles and responsibilities; ability to exercise choice Safe personal boundaries Understanding of Self Awareness of danger; ability to judge and manage risk Education; practical independence skills Parenting skills Understanding of the World Safe coping and stress-regulation strategies Tolerance of change; ability to relinquish control Effective executive function: planning, concentration, learning from experience Ability to regulate emotion, anxiety, temper, mood Ability to “reframe,” accept and learn from difficult experiences Ability to use services effectively Adaptability and Resilience (Reese, 2010) Apr. 2, 2012 Ntl. Forum on Youth Violence Prevention 10

11. References Bretherton, I. (2000). Emotional availability: An attachment perspective. Attachment & Human Development 2(2):233. Casanueva, C., Ringeisen, H., Wilson, E., Smith, K., & Dolan, M. (2011). NSCAW II Baseline Report: Child Well-Being. OPRE Report #2011-27b, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Collishaw, S; Pickles, A; Messer, J; Rutter, M; Shearer, C & Maughan, B. (2007). Resilience to adult psychopathology following childhood maltreatment: Evidence from a community sample. Child Abuse and Neglect. 31:211. Crittenden, PM. (1988). Distorted patterns of relationship in maltreating families: The role of internal representation models. Journal of Reproductive and Infant Psychology. 6(3):183. Frederico, MM; Jackson, AL; & Black, CM. (2005). Reflections on Complexity: The 2004 Summary Evaluation of Take Two. Bundoora, Victoria: School of Social Work and Social Policy, La Trobe University. Harden, BJ. (2004). Safety and stability for foster children: A developmental perspective. Future of Children. 14(1):30. Koball, Heather, et al. (2011). Synthesis of Research and Resources to Support At-Risk Youth, OPRE Report # OPRE 2011-22, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Lyons ‐ Ruth, K; Bronfman, E; & Atwood, G. (1999). A relational diathesis model of hostile ‐ helpless states of mind: Expressions in mother ‐ infant interaction. In: Solomon J & George C (Eds.). Attachment disorganization (pp. 33 ‐ 69). New York: Guilford. Milan, SE & Pinderhughes, EE. (2000). Factors influencing maltreated children’s early adjustment in foster care. Development and Psychopathology. 12(1):63. Miller, EA; Green, AE; Fettes, DL; & Aarons, GA. (2011). Prevalence of Maltreatment Among Youths in Public Sectors of Care. Child Maltreatment. 16(3):196. Perry BD; Pollard RA; Blakely TL; Baker WL; & Vigilante D. (1995). Childhood trauma, the neurobiology of adaptation and use ‐ dependent development of the brain: How ‘states’ become ‘traits.’ Infant Mental Health Journal. 16:271 ‐ 291. Perry, BP. (2008). “Child maltreatment: A neurodevelopmental perspective on the role of trauma and neglect in psychopathology.” In Beauchine, TP & Hinshaw, SP. (Eds.). Child and Adolescent Psychopathology (pp. 93 ‐ 128). Hoboken, NJ: John Wiley & Sons. Reese, CA. (2011). All they need is love? Helping children to recover from neglect and abuse. Archives of Disease in Childhood. 96:969. Sorce, JF & Emde, RN. (1981). Mother’s presence is not enough: Effect of emotional availability on infant exploration. Developmental Psychology. 17(6):737. van der Kolk, BA; Roth, S; Pecolvitz, D; Sunday, S; & Spinazolla, J. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress. 18(5):389. Apr. 2, 2012 11 Ntl. Forum on Youth Violence Prevention