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good evening ladies and gentlemen I
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believe we are on Algonquin territory
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and I'd like to take this opportunity to
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recognize that and say thank you now I
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am a grandma and the grandmas in this
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audience will understand but that's my
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grandson at about three or four hours
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old now I first became interested in the
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social determinants in that the late 80s
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and early 90s when I was in government
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but I became interested in this topic
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how brains are built more recently after
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attending sessions advanced put on by
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the Norland Alex Foundation and Alberta
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family wellness we listened to hours of
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lectures on how the root causes of adult
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disease begin in childhood and in the
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prenatal environment these advances in
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developmental biology are building a
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very persuasive case for a new way of
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thinking about health promotion and
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disease prevention until now adult
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conditions such as coronary artery
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disease and cancer have been regarded
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largely as products of adult behavior
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and lifestyles but new evidence links
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adult chronic disease to processes and
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experiences such as prolonged toxic
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stress occurring early in life I know
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that many of you in this audience and
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online I'm sure are familiar with this
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work but some of you may not be and it's
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my hope that this will spark your
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interest and encourage you to look
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further into the research in my opinion
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this information is so socially
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politically and medically profound that
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I believe it is incumbent on governments
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to take comprehensive and sustained
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action it is also important that the
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science is shared by everyone who has
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access to it and
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do not have to be an expert or
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specialist I certainly am NOT you just
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need to share it get the information out
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so that communities can then use it the
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adverse childhood experiences study of
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two decades ago revealed a troubling but
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irrefutable phenomenon that the more
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traumatic experiences respondents have
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as children such as physical and
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emotional abuse and neglect the more
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likely they were to develop health
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problems in later life such as cancer
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and heart disease there was also a
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troubling correlation between adverse
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experiences or aces as I will call them
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and the prevalence of drug and alcohol
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abuse unprotected sex and poor diet the
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results of this study brought to light
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the huge price our children are paying
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for growing up in unsafe environments
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and now we also learn that the
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interactions between genes and the
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environment shape human development
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despite the misconception that genes are
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set in stone research shows that early
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experiences can impact gene expression
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experience leaves the chemical signature
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on genes epigenetic modifications if you
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like that can determine whether and how
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genes are turned on and off how genes
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are expressed these modifications
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typically occur in the cells that
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comprise organs such as the brain and
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they influence how the brain develops
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and functions
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therefore early interactions and
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experiences that children have play a
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crucial role in the development of brain
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architecture and negative experiences
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can build weak brain architecture and
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impact physical and mental well-being
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for a lifetime
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the shocking possibility that negative
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epigenetic changes in gene expression
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occurring not only in the child who
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experiences the adversity but being
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transmitted to the next generation is
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why I say this research is so profound
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we need to understand it we need to
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understand early brain and biological
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development and teach it in our schools
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and universities we need to use it to
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inform communities police forces to
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dicier health professionals and all
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levels of policymakers so that this
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knowledge can be put into action if we
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were to reduce aces and create safe
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environments for our children it is an
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investment in society it will help to
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improve the health of our citizens
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productivity of our society reduce crime
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and other social problems and enhance
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the quality of life for children adults
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and families it is important for us to
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understand then how brains are built and
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how they are developed so that we make
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good decisions in our daily lives in
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healthcare and in our schools and
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communities brains are just born they
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are also built the basic architecture of
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the brain is constructed through an
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ongoing process that begins from birth
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and continues begins before birth and
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continues into adulthood and some say as
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long as 30 years old brain architecture
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is comprised of billions of connections
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between individual neurons across
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different areas of the brain the early
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years are the most active period for
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establishing those neural connections
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nurturing experiences with adults are
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critical during this period to build
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sturdy brain architecture as strong
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foundation for later development brains
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are built over time from the bottom up
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simpler circuits are built early in life
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and lay the foundation for more complex
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circuits that allow for the development
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of executive function executive function
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is integrated cognitive social and
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emotional skills such as paying
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attention planning ahead dealing with
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conflict following rules controlling
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emotions and ability to prioritize and
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avoid pilots so if the early
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foundational brain architecture is not
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strong it will impact cognitive social
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and emotional skills abuse and neglect
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will result in more weak brain
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architecture in a more weak brain
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architecture but risk factors can be
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offset by the presence of one dependable
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and caring adult and although parental
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roles are important it doesn't have to
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be a parent more likely than not that
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caring independent adult is a teacher or
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some other caregiver the interactions of
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genes and experience shaped the
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developing brain an important part of
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this development of process is called
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serve and return the serve and return
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interaction between children and the
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caregiver the baby babbles and the
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caregiver responds and this picture it's
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my son grant my grandson and his great
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grandmother who was 102 in that picture
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yes she's still doing pretty good a
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child asks the question or expresses an
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emotion and the caregiver responds serve
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in return interactions between
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caregivers and the child are critical in
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reinforcing circuits responsible for
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cognitive social and emotional skills
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and which later lead to the development
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of more complex skills but simple
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cuddling is not enough that little guy
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was pretty cuddly so I was speaking to
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my son actually who's a philosophy
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professor now about serve
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returned and when my children were
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growing up I had a theory that if I told
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them something once or twice it went in
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one ear and out the other but if I told
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it to them six or seven times or eight
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times something stuck and it would often
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come back you know maybe three or four
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months later so I said to my son Paul
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Paul on the Serban return we did that
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didn't we when you were really young and
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he looked at me and he said mom what I
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remember is you served and you served
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and you served and you served so how is
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brain development negatively affected
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one way is through toxic stress the
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stress system is an adaptive system that
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helps us deal with threats it is
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calibrated in early childhood in
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response to stressors in the environment
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the body responds to stress by releasing
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stress hormones for fight-or-flight but
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if these hormones are elevated too much
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for too long they can disrupt the
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development of brain architecture but
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not all stress is bad there are three
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kinds of stress positive tolerable and
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toxic positive stress is an important
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part of healthy development dealing with
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frustration getting an immunization for
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example are all part of development and
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prepares they they bind in the body to
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cope with stressful situations later in
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life tolerable stress does not have to
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be harmful if there is a caregiver to
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buffer the stress for example an illness
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or death in the family can elevate
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stress hormones but if a caring adult
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helps soothe the stress response teaches
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coping skills and helps the child
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regulate the level of stress the stress
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should not be harmful without this
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support the stress could become toxic
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what is toxic stress it is intense
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repeated and prolonged activation of the
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stress response system
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and there are no caring adults around to
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buffer the stress response or the adults
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are not in a position to buffer the
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stress perhaps due to depression or the
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illness of addiction so the stress
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hormones stay elevated for a significant
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period and can impair the development of
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neural connections especially in the
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areas of the brain dedicated to higher
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order skills toxic stress can disrupt
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brain architecture and increase lifelong
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health risks adverse childhood
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experiences resulting in toxic stress
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are a major pathway to mental illness
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substance abuse and disease they are
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common amongst us poverty
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colonialization racism substance use in
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the family divorce mental illness
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battered parent criminal behavior
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psychological abuse physical and/or
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sexual abuse emotional and/or physical
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neglect and so on aces are progressive
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and pile up over time they also occur in
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groups and they are rarely isolated many
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of us have experienced at least one ace
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maybe two and that's not necessarily a
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problem but the more aces the greater
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likelihood of health and social problems
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the absence of aces and there is almost
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no possibility of problems as I said
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earlier aces can influence gene
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expression in the child experiencing the
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adversity but also these epigenetic
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changes can influence how the next
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generations genes are expressed so
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prevention in one generation is
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prevention in the next positive
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influences can also have a positive
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influence on gene expression in future
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generations what is the old saying an
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ounce of prevention is worth a pound of
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cure well that goes for brain
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development as well
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brain architecture is difficult to
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change as one gets older not impossible
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because children are resilient but
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difficult so early intervention and
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early experiences and environments are
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critical and if society gives this the
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time and attention it demands there will
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be huge paybacks for society such as
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higher education levels increased health
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lower health costs higher incomes and
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more tax revenues many of you will be
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familiar with the children's resilience
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initiative in Walla Walla Washington and
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the amazing positive results the
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community experienced by moving to a
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trauma-informed community the Walla
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Walla initiative provides us with the
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beginnings of a blueprint for creating
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self-healing communities through
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trauma-informed schools and communities
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so beginning to implement pardon me
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since beginning to implement
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trauma-informed practices in 1999 Walla
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Walla has seen a 33% decrease in
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domestic violence a fifty-nine percent
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decrease in youth suicide attempts and a
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sixty-two percent decrease in high
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school dropouts the community
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deliberately tried to put science into
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action and these were some of their
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strategies physicians began to talking
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to parents about aces material was put
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in bags parents took home at birthing
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classes and when they took home their
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new baby information was disseminated
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wherever it made sense to do so
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Head Start staff were trained police
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officers were engaged and began to focus
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on community relations they moved from
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punishment mode to a reward system on a
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child did something right the judiciary
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was informed and judges started to show
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parents going through a divorce that if
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they didn't get along with their partner
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during divorce that their child was at
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risk when a child came to school and was
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getting into trouble instead of
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punishing the child they tried to find
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out what happened to him the night
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before and more often than not the child
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was dealing with a very difficult family
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situation and was actually in need of
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protection so the question they asked
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was not what's wrong with you
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but what has happened to you so what we
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have learned from Walla Walla helps to
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inform our strategies for creating
00:16:05
self-healing communities that are
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working to reduce aces and create safe
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environments for children's early brain
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and biological development we know that
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adults with reducing toxic stress in
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early childhood and adult disease
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prevention rather begins with reducing
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toxic stress in early childhood and
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prenatally we know that when children
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have a solid foundation for brain
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development they are far more likely to
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go on to live healthy productive lives
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free from physical and mental health
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problems including addiction excuse me
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we know that healthy adults are better
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equipped to nurture the next generation
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of children and that informed
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communities that work to reduce aces and
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build safe environments see amazing
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positive results we also know our
00:17:12
efforts to support families now will
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yield benefits for generations to come
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so why aren't we doing more I mean we've
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only been talking about the social
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determinants for some 40 years
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I think governments have a duty to act
00:17:34
the federal government in collaboration
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with the provinces and territories
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should implement a comprehensive early
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child development system with supports
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for families including but not limited
00:17:46
to supports during pregnancy early
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childhood learning opportunities
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high-quality Universal accessible and
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developmentally appropriate childcare
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including for indigenous children living
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on and off reserve but we shouldn't
00:18:03
depend on government to heal everyone
00:18:06
who experiences adversities so families
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and communities also need to understand
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early development and use their own
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ingenuity and resources to mitigate
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adversities and to heal those who suffer
00:18:20
from toxic stress or its results so as I
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mentioned in the beginning I hope you
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are motivated to look into this further
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and share information with your
00:18:31
community and to build those critical
00:18:34
collaborations thank you
00:18:38
[Applause]