Ryther - Healthy Children, Stronger Families

Interview with Ryther Psychologist, Dr. Rochelle Coffey, PsyD

What types of psychological assessments do you most frequently do? Most often we do assessments for the purpose of diagnostic clarification and recommendations for treatment. This may include questions about whether a child has ADHD, post-traumatic stress disorder, autism spectrum disorder, a learning disability, depression, anxiety or other psychological disorders.

How is the decision made as to which type would be most beneficial? We determine which tests to administer based on the question the parent or referring professional is asking about the child. If in the course of the assessment other questions arise we discuss that with the parent to determine whether additional assessment is desired.

Why would parents consider having their child tested? Simply put, an evaluation is an investigation to answer questions. When parents have concerns about their child’s behavior in school, with friends, or in the home, they may consult their child’s teacher or pediatrician, a therapist or others. If subsequent interventions do not resolve concerns, parents may request an assessment to provide further information. Is the high activity ADHD, anxiety or opposition? Are the learning problems due to a developmental disability, inattention, or a specific learning disability? Is the delay in language development and socialization indicative of an autism spectrum disorder? Is a child underperforming in school because the material is too difficult for them or because they are not being challenged? Our psychologists can help you determine whether an evaluation might be helpful.

What should parents and caregivers expect during and after an assessment at Ryther? Initially, the psychologist will meet with parents or caregivers to determine whether their questions or concerns may be addressed with an evaluation. She will attain a thorough description of their concerns as well as a developmental history. If an evaluation is appropriate, she will discuss what types of assessments will be used and who will need to provide further information. Releases to speak with teachers, coaches or other caregivers may be sought or the parent may be asked to deliver standardized questionnaires for these people. After that an appointment will be scheduled for the child to come in for the assessment. This is typically done in two sessions depending on the child’s age and the number of tests to be administered. With only rare exception, the assessment must be completed without parental presence. After the assessment, a report will be prepared and the caregivers will return for a feedback session. The report will include recommendations for various domains including academics, home, and community.

Do we have any specialized assessments that go beyond general psychological evaluations? At Ryther we have the ability to do a broad range of evaluations. We use cognitive, academic achievement, objective and projective personality tests as well as neuropsychological instruments. We also do autism spectrum disorder assessments, which in addition to those tools mentioned above, includes the Autism Diagnostic Observation Schedule II, specialized structured interviews, as well as parent, teacher and child reports.

Call Ryther at 206.517.0234 for information or to make an appointment.

There was a column in the Seattle Times recently about the state budget issues possibly pitting children’s needs versus children’s needs.  The source of this conflict is the State Supreme Court’s decision to order the State of Washington to improve its funding of the public schools. Some estimates exceed $1 billion to comply with the order. I don’t have any qualifications to speak to what ails the system of public education in Washington. I do know that a few weeks ago it was decided in Olympia that Ryther would not be receiving some of the dollars that had been unspent by the Behavioral Rehabilitation Services (BRS) component of the Children’s Administration.  These dollars were unspent because the State has sent fewer kids to residential care and those that have been sent are more acutely disturbed and therefore more costly to care for, especially when they are concentrated in the remaining facilities like Ryther. This has resulted in the closure of at least 70 such beds in the State hence the savings.  Ryther loses $120 per day per BRS child placed in its care.  That translates to under-funding Ryther to the tune of more than $1.5 million per year.  While unspent funds in the BRS account from 2012 and anticipated under-spending in the current year total approximately $5 million each year, budget demands facing the State have served as an excuse for doing nothing.  The State Supreme Court didn’t create an atmosphere of competition of needs, but you can bet that some government officials have.

- Lee E. Grogg

Executive Director/CEO

Everybody is chiming in on the recent swath of death created by Ian Stawicki, so I guess I will too.

Most disturbing, but not surprising, is the fact that his family believed he needed help, knew he wouldn’t seek it voluntarily, and knew that if they tried to secure involuntary help, he wouldn’t get it. His family is right; our system in Washington would not have detained him involuntarily in a psychiatric unit for evaluation and treatment. In the State of Washington, for instance, it is not a physician or psychiatrist who makes the call on involuntary treatment, but a master’s qualified “Mental Health Professional” who has criteria for commitment that are more politically correct than they are clinically correct. I have been told that Washington is a “high autonomy” state in terms of its public policy on involuntary mental health care. I am not sure how that justifies a law that says a child at the age of 13 can refuse treatment even if his/her parents seek it and the child needs it. High autonomy is an interesting way of describing a policy of avoiding responsibility. Washington has among the fewest psychiatric hospital beds per capita of any State in the country (ranked 47th out of 50), so it’s not like there is a huge risk of masses of people being herded inappropriately into institutions. There just isn’t enough room. Whatever else the policy wonks are doing, they are not serving the interests of the mentally ill, their families, or the public. Don’t be surprised if this turns out to be more about money than good public policy. So much for leading the country in progressive and humane public policy leadership.

From Lee Grogg, Ryther Executive Director & CEO

DXM is a dangerous new drug that teenagers are abusing found in common household cold medicines. Below is an interview with Kelliegh Kinst BA, CDP, Assistant Program Supervisor at Ryther’s Inpatient Substance Abuse program for teen boys. Parents and school administrators may be surprised about what they learn.

Where does DXM come from and what does it do?

DXM (Dextaramorphine) is added into cold medicines for suppressing a cough. Coricidin, Robitussen DM and Mucinex are the cold medications that reportedly have the highest concentration of DXM. Teenagers use DXM by swallowing higher than recommended amounts. In the past decade it has increasingly been consumed by teenagers to produce a feeling of intoxication similar to alcohol and ecstasy (MDMA).  In very high doses DXM can produce hallucinations and dissociation similar to PCP or Ketamine, (Inaba and Cohen, 2007). The impact that DXM use has on a teenage life is profoundly negative. The temporary high may be desirable, but in the long run, their lives are suppressed from the quick pull of this readily available new drug.

Why do kids start to abuse DXM?

I recently interviewed a client named “Steve” at Ryther’s Inpatient Substance Abuse program about the dangers of DXM abuse. I was astounded by what I learned.

Apparently, the cold medications are being stolen by teens so much more often than bought that the manufacturers have decreased their distribution of the products. Steve said, “Because it’s so readily available, it’s really hard to quit. I get triggered to use whenever I go into a Walgreens or a Safeway because it’s right there, waiting for me to put it in my pocket.” As a result, Steve feels that DXM has the potential to “ruin lives almost as fast as heroine.”

The real danger is that though the drug is widely used, there is a stigma against it in teenage social circles. Teenagers do not share that they’re using DXM because it’s seen as pathetic by experienced drug users—Steve compared it to a thief “stealing scrap metal.” When they don’t admit it to their friends, they don’t learn how to use it “safely.” They’re experimenting alone with doses way beyond what they need to get high. Without asking questions on how to use the drug “safely,” overdoses are occurring at a rampant rate.

Steve reported having this experience the first time he tried it: “I found out I had taken 3 times the amount that I needed to get high. I only discovered this after the fact, in my outpatient treatment class from a kid who shared about his own DXM use.”

What are the signs that a teenager is abusing DXM?

From: Inaba and Cohen, 2007

- Nausea
- Vomiting
- Blurred vision
- Bloodshot eyes
- Fever
- Diarrhea
- Urinary retention
- Sweating
- Dilated pupils
- Shallow respiration

What can parents do?

If you suspect that your child is using DXM, getting them an Alcohol and Other Drug assessment will determine if they are and what type of treatment they may need. Talking to your kids about the dangers of alcohol and other drug use may produce eye rolls and “OMG” Facebook posts, but it will also show them that you are invested. Turning to alcohol and other drugs as a result of peer pressure often stems from teenagers feeling invalidated or insecure. With regular check-ins and sound parental guidance, your teenager will have the assurance that they are cared for and loved. Which in turn can decrease the likelihood of them feeling  the need to seek fulfillment from alcohol and other drugs.

Things to keep in mind:

- This drug can be found in anyone’s medicine cabinet and is often stolen instead of purchased. Therefore, a lack of financial difficulties does not rule out the possibility of your child using the drug.

- Kids most at risk are ones who are isolated or kids who are already experienced with drugs as they will turn to DXM if they do not have access to their D.O.C. or, “Drug of Choice.”

- Other street names for this drug are: “CCC,” “tussin,” “orange crush,” and “dex.” (Inaba and Cohen, 2007)

Inaba, Darryl and Cohen, William, (2007), Uppers Downers All Arounders, Physical and Mental Effects of Psychoactive Drugs, Sixth Edition, CNS Publications, Inc. Medford, Oregon

In recognition of Child Abuse Prevention Month, Ryther Therapist Lindsey Beaky MA, LMHCA offers some insights on how you can do your part to protect children. She explains the often daunting and ambiguous task of when and how to involve Child Protective Services.

Who should report child abuse and neglect?

Professionals who work with children regularly, such as teachers, health care professionals and therapists, are certainly an important part of the recognition and prevention of child abuse. These groups are considered “mandated reporters,” which means they are bound by law to report any signs or suspicion of abuse or neglect of child. While this is April Child Abuse Prevention Month, it’s important to note that most intakes (about 63%) by Child Protection Services are for neglect while 27% are for physical abuse. Whatever the reason, it’s important for all members of our community to understand and take part in this process in order to keep children safe.

You may be a close friend or family member of a child who you suspect is being abused. It’s important to learn to recognize the signs of child abuse and how to approach the child, the parent or both. No matter what, the bottom line is that if you suspect a child is being abused or neglected, it’s vital to call Child Protective Services. Calling CPS does not necessarily mean that a child will be removed from the home. It simply starts a process and creates a record of reports that could, in the end, help the child and family.

How can you recognize child abuse?

In order to recognize potential child abuse, it’s important to understand the different behaviors both parents and children display when abuse is occurring in the family.

Some warning signs that a child is being abused or neglected:

- Her behavior or school performance changes suddenly
- She comes to school early or late, is absent frequently, or does not want to go home
- Medical needs brought to a parent’s attention are not met
- She is watchful or anxious around adults
- She has bruises or injuries that cannot be explained
- She has consistently poor hygiene
- She begs for or steals food or money

Some warning signs that are unique to child sexual abuse include:

- He has difficulty walking or sitting
- He refuses to change for gym
- He reports bedwetting, having nightmares or a sudden change in appetite
- He displays sexual knowledge that is unusual when compared to other kids in his age group

Parents who may be physically or emotionally abusing a child may have these behaviors:

- They offer no explanation, or conflicting explanations, for injuries
- They describe their child in a negative way
- They use harsh physical discipline or are indifferent toward their child
- They abuse alcohol or other drugs
- They refuse offers of help for the child’s problems

Parents who are sexually abusing their child may have the following behaviors:

- They limit the child’s contact with others and are extremely protective
- They are jealous or controlling of other family members
- They are secretive and isolated

Most importantly, if a child reports that they are being physically, emotionally, or sexually abused, or neglected, it is critical that you assume they are telling the truth and that they picked to tell you, as a person who can help them. 

How do you approach the child?

If you believe you have reason to suspect any form of child abuse or neglect, make time to talk to the child about this right away. Find a confidential location and point out what you’ve noticed about their appearance or demeanor. Ask them to tell you about home. Who do they live with? Who are they close to? Are they afraid of anyone? Be aware that if a child is experiencing sexual abuse, he or she may not recognize it as “bad.” When you call Child Protective Services, they will ask for specific information, including: the child’s and parents’ names, birthdate, address, and when an event occurred. CPS and the local police will then take steps to protect the child if he or she is in immediate danger.

How do you approach the child’s parent?

Depending on your relationship with a child’s parent and the nature of the abuse suspected, it may be most helpful for you to assume that the parent is struggling and would accept assistance or support if given to them. Many parents lack the skills, resources, and knowledge to do better, even when they really want to. Approach the parent with care and concern. Find out what the family needs. Provide some resources such as information about parenting classes or counseling, and if you are a family member or friend, offer to take the child for a weekend so that the parents can have a break.

While you do not have to tell them that you are calling CPS, it’s extremely important that you do call CPS, even if you speak to the parents and provide resources and support. If abuse is occurring in a home, Child Protective Services will take additional steps to ensure that parents are connected with services and that children are protected.

What happens next?

Once child abuse or neglect is reported, you may begin to witness serious changes in the family, such as a child being removed from the home or a parent going to jail. Things may get worse for the family before they get better due to separation or sudden involvement with the legal system. Remember, safety for a child is the number one priority, and if your actions meet that goal, the child is ultimately better off than before. Also, if a family is willing and able to change, they will take the steps to do so and may eventually feel thankful for being given the opportunity.

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Notes from Lee Grogg, Ryther Executive Director: Washington’s Children’s Administration periodically sends out reports with data about its activities. You might be interested in what some of that data is.

In the State’s fiscal year 2011 (ending last July 1) there were 77,882 referrals received by CPS reporting alleged abuse or neglect. 37,992 were “screened in” for investigation while 35,772 were deemed for some reason not meeting a standard for further involvement of the agency. In short, about half of all reports made get investigated. If you total the “screened in” and “screened out” figures there is a gap of some 4,118 referrals that is unexplained.

On June 30, 2011, there were nearly 10,000 children in the care of the Children’s Administration. This figure has remained surprisingly stable over the years. Of the 9,987 children in care, 90% (8,966) were in out-of-home care of some kind. A little over a thousand of the children were in State Dependent In-Home care. 3,174 of the children in out-of-home care were placed with relatives. This figure has increased via policy emphasis in recent years. 5,819 (65%) were in foster care or group homes.

The most common reasons for intakes were Negligence or Maltreatment (62.7%), Physical Abuse (27.3%) and Sexual Abuse (4.8%). Assuming that intakes equal the number of children in care in 2011, that means there were approximately 6,562 neglected children, 2,726 physically abused children and 479 sexually abused children in the system.

There were 18 child fatalities in open Children’s Administration (CA) cases of which 11 were due to abuse. At this point the published report seems a bit obtuse. In breaking down the 18 fatalities of kids in open cases they report a line “the number related to child abuse” as being 11 while in the next line they report “abuse-related fatalities in open CA cases” being 7. The wording suggests that, in fact, all 18 fatalities in open CA cases were due to abuse.

This morning the local news is reporting that the State Senate passed a budget bill and sent it to the Governor for signature in the wee hours of the morning. For organizations like Ryther that serve the State’s Child Welfare System, this news may come as some relief in that catastrophic cuts were not made to relevant funding sources within the government, but this is not a time for self-congratulatory backslapping. The Children’s Administration’s Behavioral Rehabilitation Services prorams still pays less than two-thirds the cost of care for kids at Ryther. Ryther loses $115 per day per child on kids referred from DSHS. Since 2009, Western Washington has seen its residential bed capacity shrink by 72 beds as a result of grossly inadequate reimbursement. The State has already used residential care at a much lower rate than nearly every other State. It is very hard to avoid inflammatory rhetoric when discussing this subject. Ryther is hanging on for now, but this situation cannot go on forever. Any celebration over a new budget that does not address some needed tax reforms should be modest.

Lee Grogg, MSW, MBA

Executive Director / CEO

Thoughts on Policy Development and Child Development

In the news recently there has been a spate of sensational headlines involving children with firearms with some of those stories having tragic endings (see here and here). While I suppose it’s possible (though far fetched) for someone to argue that children have a Second Amendment right to bear arms, what is indisputable is they should not be allowed to carry firearms to school. When they do, someone is inevitably injured or killed. This concept is not a particularly controversial topic for discussion. Most people would agree that we should not allow first graders to carry guns. At the same time, in the face of compelling scientific evidence about adolescent brain development, we in Washington have a policy that allows thirteen-year-olds to make decisions about their mental health treatment, including Chemical Dependency treatment.

Given that we know that adolescent brains are not capable of making decisions that carry this kind of risk, it’s hard to imagine how anyone could justify it. While I object to this policy as a provider of care, my principle objection is that it too often paralyzes parents.

One rationale that I have often heard is that many times, parents use confinement in treatment facilities to bully and incarcerate argumentative youth. Indeed, I have seen such things happen. At the same time I have seen people driving on the highway clearly intoxicated, but I don’t conclude that we should not stop and arrest such people.

The fact is, we are the adults and are supposed to know better. I find it interesting that in the Child Welfare field, there are ardent advocates that believe that the children’s parents always know better. If that is true, maybe we ought to give all parents the same presumption of competence in all things relating to their children. In fact, we do most of the time, so it makes the State’s policy about children having the adult competence to accept or reject mental health or addiction treatment all the more curious. To allow a cocaine-addicted sixteen-year-old to check out of treatment  is the same as allowing the nine-year-old to carry a 9mm pistol in his or her backpack. Look for deadly outcomes from such a policy.

Contributed by Lee E. Grogg, Ryther’s Executive Director/CEO

This month for Women’s History Month, Ryther is celebrating the legacy of founder “Mother” Olive Ryther, who in 1885 took in her dying neighbor’s four children and raised them as her own. By the time she passed in 1934, she had “mothered” over 3,000 Seattle-area children in three different orphanages as well as her own home, which she opened up to “urchins,” female drug addicts, and prostitutes and their children.

Olive Ryther’s first charity work in the frontier town of Seattle included the downtown City Mission for men, where her husband Noble was a frequent volunteer, as well as working with “fallen women,” or prostitutes. Ignoring social expectations for respectable women such as herself, Ollie and her supporters visited the “red light” district often, meeting women for tea in the brothels.

The Rythers soon established (in their own home) the City Mission Foundling Home for unwed mothers and their children. It was during this time that Ollie became known as “Mother Ryther.” Many accounts tell of Ollie’s tenacity when soliciting donations for the children in her home. As reported in The Seattle Times, when the children were in need of new shoes, Ollie brought over 20 kids to a downtown shoe store and firmly informed the proprietor that they would not leave without new shoes for every child. Another account tells when the Home had come up short on its finances for the month. Olive spent the afternoon soliciting donations and reportedly sat on the stoop of a business for hours until its owner relented and wrote her a check.

All children in Ollie’s care attended the Seattle Public Schools at a young age and continued to vocational school as they entered their teens. Ollie’s relationships with local businesses provided her with a network through which many of her charges could find work. Olive Ryther provided by herself services to children that today require many trained workers.

Mother Ryther toiled in the care of children through three moves from their family home in what is now Kirkland to a home on Alder Street in Seattle, and then into an old mansion on Denny Way. Olive’s last move in 1920 was spearheaded by prominent Seattle businessman Laurence Colman who helped Mother Ryther get funding from other community leaders. Olive published this appeal in The Orphan, a periodical she produced:

“We have burdened mothers…with one, two, three, four and seven (children)- we want to make this home a haven of rest and comfort, and are planning to start a building fund so as to be ready soon to have a better place.”

The unique fundraising approach of small donations by many private citizens had proved successful. It was publicized in Seattle papers with headlines like, “Have You Bought a Brick for the Ryther Child’s Home?” On Thanksgiving Day, 1919, the cornerstone of the new Ryther Home was set, inscribed: “Dedicated to the life work of Mrs. Ollie H. Ryther.” In May of the following year, Mother Ryther and seventy-five children were moved by a parade of volunteers to their new home on Stone Way. The new building would comfortably and safely house the multitude of children under her care.

In her later years, an account tells of her unflagging dedication to daily life at the Ryther Child Home. “Mother Ryther is seventy-one years old.

Although she now has assistance with the cooking and housework, she oversees everything. She maintains an excellent discipline, and punishment is almost unknown, so effective is her influence. She says, ‘The essential thing is to love the children and understand them.’”

Mother Ryther carried on her duties without interruption until she fell ill in 1934. After a short period of illness, she passed on October 4th, 1934 at the age of 85. Seattle newspapers printed the news of her death the next day with headlines: “Mother Ryther’s Loving Work Ended by Death,” “Mother Ryther Goes to Rest as City Mourns,” and “Her Task is Ended.”

Olive Ryther’s steadfast love and understanding for children over her 50 year’s life work set the foundation and guiding principles that governed Ryther through the 20th century and today. Ryther continues to follow the spirit of Mother Ryther and her successor Lillian Johnson (stay tuned for her story) and have since refocused our mission to treat children, teens and families facing complex challenges using innovative and proven therapeutic techniques.

Thoughts involved in “wrong thinking” are called “thinking errors.” We all make “thinking errors” every now and then (justifying, blaming, lying and excuse making) so that we don’t have to feel too bad when we make a mistake that causes some degree of harm. Ryther takes careful steps to recognize them in our children and teenagers to decrease the chances of hurting others and empower them to take responsibility for their actions.

Of the many types of thinking errors, one comes to mind on President’s Day: lying. Remember the story of George Washington and the cherry tree? Young George received a hatchet and went hacking about in the family garden, ultimately chopping the bark of a cherry tree enough so that it died. When his father discovered that the cherry tree had been chopped, he became enraged and directly questioned his son. George considered potential responses for several moments and said, “I cannot tell a lie, father, you know I cannot tell a lie! I did cut it with my little hatchet.”The anger drained from his father’s face and he said, “My son, that you should not be afraid to tell the truth is more to me than a thousand trees!”

What a gift George’s father gave to him when he showed that he valued the truth more than he valued a prized possession? How did he muster the emotional strength to do that?

Why do Children & Teenagers Lie?

Whether you’re working with kids or raising kids, you must consider the problem of lying within the context that a child has learned to lie. Some kids lie because it’s a natural part of being young (forging a doctor’s note to skip high school classes). Others lie because they have learned that their parents, teachers, and other adults are uncomfortable with the truth (consider teens who are afraid to tell their parents they’re gay for fear of not being accepted). Some kids lie to protect themselves and others, maybe fearful of further abuse, of feeling shame or embarrassment, or of the consequences from an angry parent.

At Ryther, we teach children that lying about wrong behavior is worse than the behavior itself. We do this by maintaining a calm, neutral stance in response to disclosures and discoveries. We hold groups in which kids learn about how different “thinking errors” such as lying apply to different situations and engage them in role playing to identify where a person is using errors to justify their behaviors. Individually, our staff are trained to recognize and point out “thinking errors” when kids use them, then prompt them to describe their thought process and put into words the thoughts and feelings they had when they made a mistake.

Tools for Parents

Of all the thinking errors, lying is the most difficult to verify. Kids can lie by telling partial truths, by denying or giving false information and by faking agreement with something. As adults, we might suspect a lie is being told but not have the evidence that this is so. In this case, it is most helpful to state your suspicions and the evidence that backs them up. Don’t ask questions like, “Did you take the money out of my wallet?” This opens up the opportunity for more lies. Rather, state, “Some money is missing from my wallet, and I saw you near my purse this morning. I am wondering if you know where my money went.” It’s important not to be accusatory, as this breeds resistance and conflict. Remain calm and don’t get angry. Focus on your own feelings and how the act you think your child has committed has affected something important. Offer the opportunity for your child to talk to you about the problem later, and if you say you won’t be mad when the truth is told, follow through with that promise. However, don’t avoid giving a consequence for wrong behavior. If you know for sure that a lie has been told, give your child the opportunity to tell the truth within a set amount of time, and let him or her know that consequences for the behavior will be more severe if the truth does not come out.

Like George’s father, as parents and caregivers we should show our children that we value the truth more than the loss of possessions or harm that is caused by mistakes they make. We should also be talking with our children about the importance of telling the truth when a lie protects someone who should experience consequences for wrong behavior that hurts others. Perhaps most importantly, we should recognize that kids often communicate through their behavior, and lying is a behavior kids use to meet a need to feel worthy, successful and good. Find ways to help meet this need in your child every day, and you should be able to notice a gradual elimination of a child’s need to cover up the truth. Dealing with lying in children and teens is not an easy process, but a patient, thoughtful approach on the part of a parent will make it easier for all.

Contributed by Ryther Therapist Lindsey Beaky, MA, LMHCA

If you’re concerned about your child and would like to seek professional help, please call 206.517.0234 or visit this page.

Considerations during American Heart Health Month

Ever since the dawn of the modern age of psychology, there has been a debate about how we become the adults we are. The short-hand description of this debate was “Nature or Nurture”. Are we born

with innate traits that make some people criminals and other people humanitarians? Interestingly, as the science and technology of brain research and genetics has advanced, some have thought these advancements would help clarify or settle the argument. While newer science has clarified some issues, the best that can be said is that we are who and what we are as a result of both nature and nurture.

Whatever else we have learned, we know that one’s adult health status is very strongly affected by the experiences one has as a child. This is something to consider especially in February which is American Heart Health Month. The pioneering research of Dr. V. J. Felitti and Dr. R. F. Anda has given us ample evidence that if you experience a number of traumatic and highly stressful events in childhood, your entire health status will definitely be affected. We are, of course, referring to Adverse Childhood Experiences.

Perhaps one of the more surprising things this study funded by Kaiser Permanente revealed was that Adverse Childhood Experiences were not all that uncommon. It has been estimated that as much as 25% of the adult population has had some of these experiences which include absent parents, alcohol or drug abuse by a parent, violence, some manner of neglect and emotional abuse as well as physical and sexual abuse. People who have enough of these experiences are likely to develop high risk and unhealthy coping mechanisms including smoking, over eating, drug and alcohol abuse and lack of exercise. Hence, morbid obesity, addiction, depression and even Chronic Obstructive Pulmonary Disease occur with much greater frequency with these people. Those who advocate hands-off methods to struggling families should know that not only will the specific families and their children be victims, but we will all pay a higher price for health and mental health care as well as for the criminal justice system.

To learn more about Adverse Childhood Experiences (ACE), visit www.acestudy.org.

- Lee E. Grogg

Ryther’s CEO/Executive Director