Investment in America's Most Important Infrastructure: Promoting the Health and Wellness of Families with Young Children

1. The most important protective resource to enable a child to cope with exposure to violence is a strong relationship with a competent, caring, positive adult, often a parent but doesn’t have to be!

a) True
b) False

2. Stress without the buffering response of a strong adult relationship causes prolonged, brain-controlled secretion and presence of stress hormones, such as cortisol, norepinephrine, epinephrine, and etc

a) True
b) False

3. Behaviors Associated with Early Childhood Trauma in Ages: 0-2 include which of the following:

a) Dysregulated eating, sleeping patterns
b) Developmental regression
c) Irritability, sadness, anger
d) Poor appetite, low weight gain
e) Increased separation anxiety, clinginess
f) All of the above

4. Behaviors associated with Early Childhood Trauma in Ages 3-6 include which of the following:

a) Increased aggression
b) Somatic symptoms
c) Sleep difficulties/nightmares
d) Increased separation anxiety
e) New fears
f) Increased distractibility/high activity level
g) Increased withdrawal/apathy
h) Developmental regression
i) Repetitive talk/play about the event
j) Intrusive thoughts, memories
k) Absenteeism
l) All of the above

5. Stress responses are beneficial in the short term with adult support, but can be damaging to health if they occur over long periods of time with constant physical and emotional wear and tear on the body and potentially permanent changes in gene regulation.

a) True
b) False

6. The ACE study greatly expanded the usual notion of child abuse to include 10 types of CDC defined adverse childhood experiences, with all 10 types now shown to be risk factors of a multitude of later health problems. The 10 ACEs include: physical abuse, sexual abuse, emotional abuse, emotional neglect, physical neglect, witness domestic violence, mental illness in home, family member incarcerated, alcohol/drug problems, and parental separation or divorce.

a) True
b) False

7. Which of the following Epigenetic Changes Affect Stressed Kids:

a) Structural brain changes: Smaller hippocampus (memory), smaller corpus callosum (connections between the hemispheres of the brain), smaller prefrontal cortex (reasoning, emotional control), larger amygdala (anxiety and release of stress hormones from the pituitary)
b) Inflammation/immunological changes: C reactive protein, stress cytokine levels elevated in adults with history of early adversities
c) Endocrine changes: Dysregulation of stress hormones, decreased oxytocin
d) All of the above

8. Moms who are stressed (stressful event famine, increased anxiety, depression) during pregnancy are more likely to have kids with which of the following:

a) Preterm birth
b) Poor emotional coping skills
c) Decreased cognitive abilities
d) Increased fear response to stimuli
e) Increased anxiety
f) Decreased immune function
g) Autism
h) All of the above

9. Which of the following are lifetime costs per victim of nonfatal child maltreatment:

a) $144,360 productivity losses
b) $6,747 criminal justice costs
c) $32,648 childhood health care costs
d) $10,530 adult medical costs
e) $7,999 special education costs
f) $7,728 child welfare costs
g) All of the above