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Claire Oakley

Claire Oakley

We know that a rough childhood can affect health as an adult. Those hardships — including abuse, neglect, death of a parent, a parent’s substance abuse or even divorce — are called adverse childhood experiences, or ACEs.

A study of adverse childhood experiences, conducted by the Centers for Disease Control and Prevention and Kaiser Permanente in the 1990s, showed the impact of those experiences on adult health and risk factors. From that study, researchers developed a 10-question ACE quiz as a measure of childhood trauma. The higher the ACE score, the greater the risk for chronic diseases and risky behaviors, including substance abuse, thoughts of suicide, tobacco use and incarceration.

But a high ACE score doesn’t determine your destiny. Establishing trauma-informed schools is one way to help children build resiliency so that they learn how to successfully cope with life’s stress.

Public health focuses on improving the health of communities and the population as a whole. That’s why RiverStone Health, as the local public health agency, has provided teachers training in strategies that help children become more resilient and learn to self-regulate their behavior.

Being able to handle the ups and downs of everyday life is important for every child, but it’s especially important for children who have been exposed to multiple ACEs. RiverStone is working with schools to use trauma-informed approaches that establish safety, trustworthiness, choice, collaboration and empowerment in all students. ACEs are tools for understanding and then empowering families and communities to make changes.

The PAX: Good Behavior Game helps guide children toward positive behavior and learn ways to take charge of their own behavior. “PAX” refers to a classroom culture of peace, in which students are happy, healthy and productive. The students play the Good Behavior Game during normal classroom lessons to reinforce positive behaviors. During the game, students are on teams and learn to work together for common goals. Classmates help guide each other toward productive behavior. Rewards for good behavior could be short, silly games, like a round of “Simon Says,” or getting a few minutes to sit in their chairs backwards.

Nearly all of Lockwood School’s first through third grade teachers learned how to use the PAX game in their classroom during the summer of 2017. This summer, 70 more teachers took the training. Teachers in grades K-3 came from Big Sky, Newman, Orchard and Ponderosa elementary schools, along with teachers from Billings Catholic schools and from as far away as Wibaux and Nashua.

At Saint Francis Catholic School, Principal Deb Hayes has seen the benefits of PAX training.

“I believe that the PAX Good Behavior Game has enabled the teachers to manage classroom behaviors more independently and positively,” she commented.

At St. Francis, first grade teacher Lacey Kuntz noted, “My kids’ faces light up when I recognize they are being good PAX leaders. I’ve noticed some of my most difficult behavior kiddos are responding extremely well to PAX and I have seen big changes in the overall climate of my classroom since we started.”

The training was supported by grants from the Montana Healthcare Foundation and the Montana Department of Public Health and Human Services.

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Claire R. Oakley, PhD, the Director of Health Promotion at RiverStone Health, can be reached at 651.6462 or