Published on 2017/07/05

Who Are Our Students? Now and Into the Future

The EvoLLLution | Who Are Our Students? Now and Into the Future
As higher education’s student demographic evolves, it’s critical that a cultural shift take place in colleges and universities—elite institutions especially—centered around empathy and understanding for challenges and obstacles that stand in the way of student persistence and success.

This article is excerpted from Breakaway Learners: Strategies for Post-Secondary Success with At-Risk Students, published by Columbia University’s Teachers College Press.

The refrain is so commonplace that if I had a nickel for every time I heard it, I would be a wealthy woman. Educators across the pipeline from early childhood through Grade 20 keep articulating some version of this statement to administrators: “Get me better students.” Graduate school professors lament what they perceive to be the absence of quality, well prepared students and they blame inadequacies in undergraduate education for this situation. In turn, college faculty insist that the ability of students to write and think has been in steep decline, and they blame the high schools. The high schools blame the middle schools for student shortcomings; the middle schools blame the elementary schools; the elementary schools blame the preschools and the parents. In short, we have a litany of blame running up and down the educational landscape.[1]

Another frequent lament that gets at the same issues, although through a different lens, sounds something like this: “It was not like this when I was a student.” Or “I always did my homework when asked.” Or “In my generation, things were different; students listened.” Or, finally, “These millennials; they don’t get it. What’s with these students?” These comments are heard across the educational arena and are often uttered with accompanying distain and most often spoken as if the assertions were proven statements of fact.

We also tend to homogenize students and their learning styles. We know that as a matter of both theory and practice, different students learn differently. And, in an ideal world, teachers and professors would adopt a wide array of teaching modalities to ensure that their students find a personalized entry into learning. Sadly, that rarely happens, in part because we tend to teach the way we were taught and we try to replicate in our students the way we ourselves learned and learn even now.

So if current educators had had teachers who fostered auditory learning and they (the current educators) were auditory learners, that is the approach they are likely to take—or have dominate—their own work with students. When a student doesn’t learn the teacher’s way, the teacher in many instances can’t figure out why that student can’t learn the same way the teacher did. To be sure, many students and their teachers are also unaware of the students’ (or their own) precise learning style, although there are diagnostics that help people evaluate how they learn best. This is particularly true at the college level.

Consider the concrete effects and implications of the sentiments and approaches just described. One example involves Concordia University, in St. Paul, Minnesota, which offered summer orientation but explicitly stated that it was mandatory for students of color, forgetting for a moment who “qualifies” as being of color and whether that is an institution or prospective student definition. A not surprising outcry ensued, with one prospective student stating, “Guess this is a class on how us po negroes should act in massas school.” Ouch.[2]

Moraine Valley Community College offers a course designed to facilitate student transition to college-level learning. More recently, the college is piloting two sections of this College 101 course for African American students, noting how important it is that successful students create effective support networks—which they presume means networks of students of one’s same race. Another ouch. Wouldn’t it be wiser to enable students to develop networks among a wide range of students rather than implying that comfort can and only does occur within one’s specific race? Seems to me to be an odd effort with the potential to encourage or reinforce isolation of students.[3]

Finally, at the graduate level, Smith College professors complained that they were teaching minority students who were unprepared for Smith’s School for Social Work. As one letter from a professor said, and I quote intentionally at length, “The core of the problem is that the admissions process of our school has been tainted for a number of years—we have admitted students who did not have a reasonable chance of success in our program. This is very problematic and it is an issue that seems to be somehow displaced onto the field department. Why is that?” Yet another ouch.[4]

These approaches all suffer from the same flaw: They fail to reflect an understanding of our students at every age and stage. And as will be addressed later, there is an implicit challenge to the notion that we really do want to educate, and we care about educating, all students. At the most basic level, the students of today and tomorrow are not the students of yesterday or yesteryear. Full stop. We can complain all we want, but the clock is not moving in reverse. Many of today’s students are the first in their families to attend college, let alone graduate; many are immigrants; many are low income. Many have experienced trauma or toxic stress.[5] Many have attended schools that were not exemplars of excellence. Today, we are not supposed to be segmenting higher education so that it is available only to those who are the landed gentry (or children of that gentry in some instances), who attended elite prep schools or selective public high schools and are White, Protestant, and male for the most part. Ostensibly, that restrictive era is in the past.

The problem, simply stated, is that many educators want to educate (whether consciously or not) their clones, rather than assessing how to educate the students before them. We need to leave aside whether we are doing a good job preparing our teachers across the educational pipeline— not just with respect to the quality and sophistication of how they cover the substantive material they are delivering but also in their pedagogy or andragogy, as the case may be.

Before turning to a more in-depth assessment of who our students are, let’s circle back to the frequent laments about millennials. We can complain about them, but if truth be told, most of the students now entering school are not, in fact, in this category. The last millennials were born circa 1995—meaning the “last” of the millennials are already in middle school. What we have now, whether accurately defined or not, is Generation Z—individuals born from 1995 through 2020 give or take. Some have termed this the “iGen,” given their propensity to use iPhones, iPads, and iPods. They are a tech-savvy generation, even those who are not of upper socioeconomic status. These are our students. Those of us teaching them are largely, but not exclusively, baby boomers.

For its wonderful annual overview of the students entering college (although an elite liberal arts college), Beloit College gathers information and produces lists that would startle even millennials. Here’s the college’s lead-in to the Class of 2020: “Students heading into their first year of college this year are mostly 18 and were born in 1998. Among those who have never been alive in their lifetime are Frank Sinatra, Phil Hartman, Matthew Shepard, Sonny Bono, and Flo-Jo.” Yipes. Another yipes for Beloit and others failing to recognize that at most colleges, entering students are not 18 and many are not at their first higher ed institution.[6]

If our teachers fail to see our students for who they are, we are in trouble. For educators who are not tech savvy and don’t tweet or use Instagram or Snapchat or instant messaging and who perhaps even view these forms of social media with some disdain (or fear), how exactly are they reaching their students? What worked decades ago in delivery of material and attention span and forms of engagement does not work today for most students. And many of today’s teachers (the boomers) were themselves taught by members of the Silent Generation. Sure, there are students who can sit quietly in their seats and do worksheet after worksheet, even if it is busywork. There are students who can listen to professors lecturing from afar, including with PowerPoint slides that often replicate what the professor is saying or that are too dense with text to be read while they are on the screen.

As a participant in a three-leader swap between a college president, the head of a high school, and the head of an elementary school (I went to the high school to be “leader for the day”), I was struck by what we uncovered in the debrief we held. To a person, the three leaders noted that the teachers had not kept pace with the speed of technology and that their use of it in the classroom was not fluid or generally dynamic—except in the elementary school that was involved in project-based learning, and particularly the kindergarten teacher, who was using iPads with her students to teach math.[7]

How good would it be if we lived in a world where such kindergarten teachers received sufficient respect that they could lead workshops for high school teachers and college math professors on how young people are learning and processing math? Imagine workshops where attendees actually used iPads to test out the learning approaches of kindergarteners and perhaps even visited classes or Skyped into classes. Why not enable teacher swaps in addition to offering mixed-level professional development? (I know some readers will be muttering, “Yeah, that will happen when pigs fly.”)

How can you teach well and engage effectively with your students if you do not know who they are?

The answer to that question, on the simplest level, is that you cannot. Consider this example: If a doctor does not know a lot about their patient, how exactly is the doctor going to divine a treatment that will actually work and be adhered to by the patient? The physician gets some information from taking a history. Some information can be garnered by looking at and examining a patient in person or via a computer screen (albeit this is not exactly the same in terms of “feel”). Added information can be garnered by listening to patients and viewing medical-knowledge graphs. Surely we have all experienced physicians who fail to understand what ails us and as a result do not treat us effectively.

Not to be outlandish here but I have always been especially fond of veterinarians. These doctors have patients that cannot speak (although they vocalize, to be sure) and give a history. Yet these doctors can detect what is wrong with their patients with remarkable accuracy. They read expressions. They assess body language. They examine the pet. They ask questions of the owner, if there is one. In short, because of these qualities, I want to go to a vet for my health care.

So teachers across the educational pipeline need to know who their students are—without homogenizing them and without wishing them to be better. Imagine a doctor who said, “I wish I had patients who weren’t sick,” or a lawyer who said, “I’d love the law if it were not for the clients.” The sentiment in “I want better students” has a similar ring and feel to me. It sounds like “I would succeed at and love teaching if I had different (better?) students.”

In an essay that appeared in The Chronicle of Higher Education, a professor tried to explain what the faculty–student relationship was all about. As I read the essay, my blood began to boil. The piece, sadly, also reminded me of some of the things I had said and thought when I was a young professor 4 decades ago. That wee self-reflection wasn’t pretty.[8]

Trying to be hip and help his students, the professor refers to the need to “DTR” (define the relationship), because students do not accurately perceive the role and boundaries of faculty and other “authority” figures. Here are some of the article’s proclamations: “I don’t work for you. You’re not a customer and I am not a clerk. I am not a cable or streaming site. I’m not a high school teacher. I’m not your BFF.” The piece then continues to talk about what the professor “is” as opposed to “is not,” but to be frank, I was so turned off by then that it left me cold to read the remaining statement: “I’d like to be your partner.”

Now, it seems to me that this professor, although explicitly asserting that he was trying to be helpful, misunderstands his role and his relationship with his students. Partnering (his desired end) requires trust, among a host of other essential qualities. The harsh conclusions, such as “I don’t work for you,” when students and their families are paying buckets of money to be educated, seem to be ignoring the financial strain of an education. Yes, the professor is correct that we do risk commodification, but canceling out reality doesn’t change that. In addressing not being a website or its equivalent, the professor added these words in the body of his article: “Consider this official notice that I have opted out of the on-demand world. My office hours are listed on my syllabus. If for some reason I can’t be in my office during those hours, I’ll let you know beforehand if possible or post a note on my door. But I’m usually there.” He then went on to add, “As for email, yes, I have it and I check it often, but not constantly. I do have a life outside this classroom—a wife, kids, hobbies, other professional obligations. That’s why I don’t give out my private cell number. If you need me after hours, email me and I’ll probably see it and respond within 24 to 48 hours.”

How wrong this all is on so many levels! Yet many of the comments in response that were published online were deeply supportive of this professor’s approach. It reminded me of how many people were so supportive of Yale’s husband-and-wife Silliman College house masters Nicolas and Erika Christakis. These individuals were publicly derided by the students for being insensitive to and dismissive of student concerns. But many people agreed with the non-apologetic professors, commenting on how pampered and coddled and fragile the students of today are and demanding, “How dare these students shout and protest given their place of privilege?” After all, they were attending college—in fact, Yale. The argument, taken to its logical extreme, is this: If you go to an elite institution, you park who you are at the door and you need to become the student and person the institution is used to serving and has served for generations. You need to “buck up” and “fly right.” You need to be grittier and more resilient.[9]

The students of today—the ones that I term breakaway students—have had myriad experiences that have shaped who they are, how they feel, and how they respond. Indeed, the brain’s hardwiring for breakaway students is likely changed because of their early life experiences, some of which had unimaginable impacts on their sense of identity and safety. Some of these students live in poverty. Some are homeless. Some go hungry at night. Others can’t get a good night’s sleep. Others are exposed to outbursts or other violence in their home or on the streets of their community. Others have witnessed excesses, including of drugs and alcohol. Some have experienced, and others have witnessed their loved ones experiencing, physical and sexual abuse. Some have a medical condition; others have dealt with the illness of those close to them. They have been yelled at or ignored or both. They have observed and felt the impacts of mental illness, including depression or bipolar disorder. They have seen post-traumatic stress up close, as the result of military service or of lives lived on the ground in their homes and communities.[10]

Here’s an important reminder: While poverty can be a prominent factor in students’ experiences, many of the described issues are not a matter of socioeconomic status (SES). Whether rich or poor or anything in between, young people can be exposed to conditions and people and situations that are damaging, a point recognized by Robert Putnam in his book Our Kids.[11] Often without an outlet through which to escape or respond or even understand, these kids muddle along—some better than others.

For children with curdled childhoods like mine (where SES and race were not directly implicated), the pathway through the educational pipeline is fraught with hurdles. Teachers may not even be aware of the experiences of these children and may assume them away or assume the presence of issues wrongly. But we all know, and Maslow made this abundantly clear, that unless certain basic needs are met, it is tough to teach kids who are tired or homeless or hungry or stressed or physically or psychically damaged. The problem is that these stressors are borne internally, and many teachers and administrators (among others, including even pediatricians) do not see them (or perhaps do not want to see them).

Sadly, the reality is that more and more students entering the educational pipeline have had curdled childhoods. One has only to look at the data in Putnam’s Our Kids to appreciate the level of poverty affecting youth in America. Over 8 million college students receive Pell grants, which were created, as noted earlier, for students in the lowest-income quartiles, and there are students who are eligible for these monies but (unfortunately) do not complete the needed paperwork.

Ponder these data points: In the United States, 15.3 million children live in households with food insecurity. Approximately 2.5 million children were homeless for some part of the past year. Some 8 million children live in a household where at least one parent has an alcohol or drug addiction, and more than 14 percent of these children are under the age of 2. Each year, 5.5 million children are the subjects of reported child abuse, and much abuse goes unreported. More than 400,000 children are in foster care. And we are not counting here students with physical and mental disabilities, whether mainstreamed or not.

One method for reflecting on these data points is to look at the adverse childhood experiences, or ACE, assessment calculator—a “quiz” (although that is something of a misnomer when one realizes what it uncovers) to determine the number of negative experiences one has had as a child. As in golf, one wants a low score; sadly, many children from all walks of life receive a high score, confirming that they have been living with toxic stress and trauma, the impacts of which are without question negative and have a lifelong impact on health, well-being, and success, both academic and personal.[12] (Adverse experiences can also produce a different set of positive attributes that often go unnoticed and unrecognized, as discussed later.)

Two key points before turning to ACE test questions and the meaning of the results: Just because one has a high score does not mean one lives a life that is doomed from the get-go. That’s an important point. Even those with high scores can, with various successful interventions, learn from and experience success in spite of, or perhaps more important, because of, their early years. The key here—and this is critically important from an educational standpoint—is that there is much that can be done by educational institutions to improve the quality of the outcomes for children with high ACE scores. In other words, birth is not destiny. Helping students with high ACE scores is one of the aims of lasticity—the new concept developed in this book. Some people seem to be lastic, but others can be aided if we focus on enhancing their lasticity through our own behavior, actions, interventions, and cultural norms. And we would do well to ferret out and emphasize the positives from the negative experiences, a new way of reflecting on trauma.

The 10 ACE quiz questions focus on whether, before the age of 18, a person was exposed to the mental illness or addiction of a household member, to personal psychological or physical abuse or danger, or to sexual assault within or outside the household or was witness to the abuse of a mother or stepmother or the imprisonment of a household member. In the original quiz, conducted with White middle-class individuals, approximately two-thirds of those questioned ticked off at least one “yes” answer, and of those, 87% ticked off one or more “yes” answers. Those who tick off four or more “yes” answers are at greatest risk. You can include me in that number, sadly. Stated another way, huge percentages of children are exposed to toxic stress, trauma, or abuse, producing the increased risk of many hazards as they mature in terms of well-being.[13]

To put numbers to all this, more than 34.8 million children have at least one “yes” answer on the ACE quiz. Nearly one-third of all children aged 12 to 17 have experienced at least two “yes” events. While the rates do vary according to SES, between one-quarter and one-third of all children under age 6 experience at least one “yes” answer on the ACE quiz.[14]

If there ever were a clarion call to respond to the abuse and toxic stress of our youth in America, this is it. Further, the absence of abundant mental health programming (and funding for it) across the K–6 educational pipeline doesn’t help one bit. Nor, to be sure, are most elementary educators trained to address these issues. Courses and strategies on classroom management are not the answer.[15]

For educators at every level across the pipeline, this means we need to rethink how we address the needs of the students we have. Some faculty and staff and school trustees may even have a deep understanding— because of their own background and experiences, including being first-generation or breakaway students themselves. They, too, may have had low standardized test scores; they may have struggled with “fitting in,” even after getting a PhD. Some may even intuit the challenges. They may have been shown to have high ACE scores had they taken the quiz. Some may be minorities, which can help students identify and form relationships with them; but it is at once an ambitious and a long-range strategy to overhaul the teacher corps across our nation. And such an overhaul would encompass who becomes an educator in the first instance (and we cannot hope or expect that they will all be breakaway kids themselves) and then what information, knowledge, and experience these educators need to have before they enter classrooms unsupervised.

In the absence of a massive revamping of the teaching corps in our nation, we need a different approach. For educators and those working with children within and outside schools now, we need a set of implementable strategies that will help students excel. We need to create environments in which these breakaway students can thrive despite the plethora of “yes” ACE responses.

Breakaway students, then, have a certain set of mental attributes (some that can be very positive and mined for strength) and hurdles that may not be present in other students. Importantly, to repeat an earlier point, it is not poverty per se that distinguishes these students; rather, it is having had a childhood burdened by one or more of these experiences: hunger and exposure to or experience with drugs, alcohol, abandonment, frequent moves, abuse, or self-harm or harm of others. Some students have experienced or watched others suffer from serious health conditions—diabetes and emphysema among them. Some students believe that the world in which they live is “how it is,” and for them, the abnormal is normal. They have experienced gaslighting, a distortion of reality, and hence struggle to know (and normalize) the world beyond their confines.[16]

The need for understanding students’ capacities is vital because breakaway students may not trust those within institutions where they are enrolled, nor may they trust their own capacities, even when these are obvious to others. If you have tattered attachments when you are young, your capacity to trust is weakened, if not broken, and has to be rebuilt. The act of learning requires trust. Learning asks us to change our paradigm: to take risks, to fail, to seek help. Learning environments must have reciprocal trust in actuality; students must trust their teachers and professors, teachers and professors need to trust their students, and eventually, students must trust themselves.[17]

How we build a changed institutional culture for the institution itself and for the individuals within that institution that can understand breakaway students and adapt to them is no small challenge. There is an assumption embedded here: Folks want to accept this challenge and are willing, as people and as members of institutions, to take the time and make the effort, to understand the students they serve. To be candid, although I tend to gloss over this reality, there is not a uniform desire either for cultural change or for understanding breakaway students. Sad but true. For lasticity to embed itself in our approaches, we need a willingness to change institutional culture, and that change is hinged on developing an understanding of the students we serve. A later chapter includes some strategies to address these hurdles, but make no mistake: Educational success can’t and won’t happen if we continue as we currently are. Equally bluntly, the assumption that the flaws rest with the students, not the institutions and teachers, runs deep and is firmly rooted in the psyche of many who work along and engage with the educational pipeline.

To return to and reflect on the importance of culture, keep this phrase in mind, as it highlights how central culture is and how little we do to measure it: “Culture eats strategy for lunch every day.”[18] Stated differently, all the strategy in the world to help students (think multi-page strategic plans as requested by trustees, mandated by accreditors, common in the business sector, and often proffered as a solution to all that ails an institution) will fall short if institutional culture does not support the strategy. Lip service doesn’t work; inauthentic solutions written on pieces of paper don’t have “stickiness,” let alone the needed monetary allocations. It is vastly better and infinitely more effective to spend time creating a quality culture than developing and writing down a long-term strategy, as no strategic plan will trump culture, of that I am sure. For some, this may be a heretical notion, given the emphasis we place on strategic plans (and the time, effort and money expended on them in part because of demands from accreditors).

Consider how the culture surrounding tattoos has changed over time—although some folks in the Silent Generation and among the baby boomers still view them askance. Tattoos were seen as evidence of a person’s instability, of being marginal, of being powerless (but asserting power through a scary symbol on one’s arm). Tattoos were seen as evidence of military service or of an act carried out in a drunken stupor. Tattoos intimated “low rent.”

Today, students and young adults in general have very different views of tattoos and their meaning. They wear them proudly; they wear them to remember something; they wear them to provide inspiration. Look at the movement to create artful tattoos—amazing tattoos—to cover surgical scarring, including for women who have had mastectomies. A museum in Bennington, Vermont, actually had a “live” exhibit of tattoo art.[19]

There are still teachers and professors—usually of a certain age—who misunderstand tattoos. They see the tattoos as signaling trouble, as opposed to being evidence of strength or pride. But perhaps an example—if made known—might alter teacher thinking: There is a new movement centered on Holocaust number tattoos. Holocaust survivors often hid from their families and the general public the numbers tattooed on their left forearms. Those painful reminders of the camps and being objectified were not to be shared. The external symbol was to be hidden (tattooing is also prohibited in Jewish tradition), while the internal memories remained permanent.[20]

However, as this generation of Holocaust survivors is dying, their grandchildren see the need to remember the pain and discrimination that was suffered. So—and note the generation-skipping that is generally happening—these younger people are tattooing their grandparents’ concentration camp numbers on their own arms. And they are not hiding them. Indeed, keeping the exact number matters; some of the numbers have special meaning, as they represent the survivors who were in Auschwitz and suffered the most hardships (they number between 30,000 and 80,000).

So, at least for some, there has been a change in how we perceive and receive tattoos—a change in culture that needs to be recognized and, in many instances, lauded. For breakaway students, tattoos can have profound meaning—they reflect the past but some point forward to hope. Some represent and serve as reminders of loss. Others serve as inspiration—signaling a desire for a better future.

How we change culture in the context of education and throughout the educational landscape is the challenge to which we now turn. Perhaps the change in tattoo culture can alert us to the possibility of change as generations progress; perhaps we can view people and situations through a different lens.

This article is excerpted from Breakaway Learners: Strategies for Post-Secondary Success with At-Risk Students, published by Columbia University’s Teachers College Press. Breakaway Learners explores how higher education institutions can successfully serve “breakaway” students—first-generation, low-income students who are trying to break away from the past in order to create a more secure future.

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References

[1] “A Solution as Obvious as It Is Rare: Making High School Graduates Ready for College,” by Jon Marcus, August 18, 2016, The Hechinger Report, hechinger-report.org/solution-obvious-rare-making-high-school-graduates-ready-college/.

[2] “Mandatory for Minority Students,” by Scott Jaschik, August 5, 2016, Inside Higher Ed, www.insidehighered.com/news/2016/08/05/anger-concordia-st-paul-over-mandatory-orientation-minority-students.

[3] “Course Sections for Black Students Only,” by Andrew Kreighbaum, August 8, 2016, Inside Higher Ed, www.insidehighered.com/news/2016/08/08/community-college-pilots-course-sections-african-american-students.

[4] “Leaked Faculty Letters Expose Racial Fault Lines at Smith’s Social-Work School,” by Steve Kolowich, August 18, 2016, The Chronicle of Higher Education, chronicle.com/article/Leaked-Faculty-Letters-Expose/237491.

[5] “This Chart Debunks Some Common Myths About University Students,” by Joe Myers, July 12, 2016, World Economic Forum, www.weforum.org/agenda/2016/07/this-chart-debunks-some-common-myths-about-university-students/.

[6] “The Mindset List,” 2016, Beloit College, www.beloit.edu/mindset/ “Nontraditional Students Like Me Face Enormous Challenges,” by An Garagiola-Bernier, September 14, 2016, Community College Daily, www.ccdaily.com/Pages/Campus-Issues/Nontraditional-students-like-me-face-enormous-challenges.aspx.

[7] “Swapping Places: Three School Leaders Switch Jobs for a Day—and Learn Valuable Lessons,” by Mary Francis Bisselle, Trudy Hall, and Karen Gross, Fall 2015, Independent School, www.nais.org/Magazines-Newsletters/ISMagazine/Pages/Swapping-Places.aspx.

[8] “Defining the Relationship,” by Rob Jenkins, August 8, 2016, The Chronicle of Higher Education, chronicle.com/article/Defining-the-Relationship/237388.

[9] “Snowflake Totalitarians at Yale” (blog post), by Scott Greer, November 11, 2015, Minding the Campus, www.mindingthecampus.org/2015/11/snowflake-totalitarians-at-yale/; “The Perils of Writing a Provocative Email at Yale,” by Conor Friedersdorf, May 26, 2016, The Atlantic, www.theatlantic.com/politics/ archive/2016/05/the-peril-of-writing-a-provocative-email-at-yale/484418/; “A Dialogue on Race and Speech at Yale,” by Conor Friedersdorf, March 24, 2016, The Atlantic, www.theatlantic.com/politics/archive/2016/03/yale-silliman-race/475152/.

[10] “Toxic Stress,” 2016, Center on the Developing Child, Harvard University, developingchild.harvard.edu/science/key-concepts/toxic-stress/; “Teaching Traumatized Kids,” by James Redford and Karen Pritzker, July 7, 2016, The Atlantic, theatlantic.com/education/archive/2016/07/teaching-traumatized-kids/490214/; “Students Traumatized by Loss and Violence Get a Fighting Chance to Learn,” by Sonali Kohli, August 19, 2016, Los Angeles Times, www.latimes.com/projects/ la-me-edu-share-care/; “How Childhood Trauma Could Be Mistaken for ADHD,” by Rebecca Ruiz, July 7, 2014, The Atlantic, www.theatlantic.com/health/archive/2014/07/how-childhood-trauma-could-be-mistaken-for-adhd/373328/; “Is PTSD Being Misdiagnosed as ADHD?” by David Hosier, April 13, 2015, Childhood Trauma Recovery, childhoodtraumarecovery.com/2015/04/13/is-ptsd-being-misdiagnosed-as-adhd/; “Pediatricians Take On Toxic Stress,” by Carol Gerwin, May 30, 2013, Center on the Developing Child, Harvard University, developingchild.harvard.edu/science/key-concepts/toxic-stress/tackling-toxic-stress/ pediatricians-take-on-toxic-stress/; “Brain Architecture,” 2016, Center on the Developing Child, Harvard University, developingchild.harvard.edu/science/key-concepts/brain-architecture/; “InBrief: The Impact of Early Adversity on Children’s Development,” 2016, Center on the Developing Child, Harvard University, developingchild.harvard.edu/resources/inbrief-the-impact-of-early-adversity-on-childrens-development/; Excessive Stress Disrupts the Architecture of the Developing Brain, by the National Scientific Council on the Developing Child, 2005, updated 2014, Center on the Developing Child, Harvard University, developingchild. harvard.edu/resources/wp3/.

[11] Our Kids: The American Dream in Crisis, by Robert D. Putnam (New York, NY: Simon and Schuster, 2015).

[12] “Take the ACE Quiz—and Learn What It Does and Doesn’t Mean,” by Laura Starecheski, March 2, 2015, Shots, www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean; “Got Your ACE Score?” (blog post) (n.d.), Aces Too High, acestoohigh.com/got-your-ace-score/.

[13] “Adverse Childhood Experiences (ACEs),” April 1, 2016, Injury Prevention and Control: Division of Violence Prevention, CDC, www.cdc.gov/violenceprevention/acestudy/.

[14] “Is PTSD Being Misdiagnosed as ADHD?” by David Hosier, April 13, 2015, Childhood Trauma Recovery, childhoodtraumarecovery.com/2015/04/13/is-ptsd-being-misdiagnosed-as-adhd/.

[15] Toxic Stress: Effects, Prevention, and Treatment, by Hillary A. Franke, 2014, Children, 1(3), 390–402, doi:10.3390/children1030390.

[16] The Glass Castle: A Memoir, by Jeannette Walls (New York, NY: Scribner, 2005); “Top Definition: Gaslighting,” Urban Dictionary, www.urbandictionary.com/define.php?term=Gaslighting.

[17] “Epistemic Trust, Psychopathology, and the Great Psychotherapy Debate,” by Peter Fonagy, Patrick Luyten, Chloe Campbell, and Liz Allison, December 2014, The Society for the Advancement of Psychotherapy, societyforpsychotherapy.org/epistemic-trust-psychopathology-and-the-great-psychotherapy-debate/; The Impact of Trauma and Toxic Stress on Infant and Toddler Development (n.d.), eclkc.ohs. acf.hhs.gov/hslc/tta-system/ehsnrc/docs/000886-impact-trauma-toxic-stress.pdf.

[18] Culture Eats Strategy for Lunch: The Secret of Extraordinary Results, Igniting the Passion Within, by Curt Coffman and Kathie Sorensen Coffman (Denver, CO: Laing Addison Press, 2013).

[19] “Bennington Museum Puts Body Art on Display,” by Derek Carson, August 7, 2015, Bennington Banner, www.benningtonbanner.com/localnews/ci_28605018/ bennington-museum-puts-body-art-display; “Tattoo Psychology: Art or Self Destruction? Modern-Day Social Branding?” by Reef Karim, November 9, 2012, The Huffington Post, www.huffingtonpost.com/reef-karim-do/psychology-of-tattoos b_2017530.html; Cindy Dampier, “Artist’s Mastectomy Tattoos Reveal the Beauty of Survival,” Chicago Tribune, September 30, 2016, www.chicagotribune.com/lifestyles/ct-sun-david-allen-mastectomy-tattoos-20160929-story.html.

[20] “Proudly Bearing Elders’ Scars, Their Skin Says ‘Never Forget,’” by Jodi Rudoren, September 30, 2012, The New York Times, www.nytimes.com/2012/10/01/world/middleeast/with-tattoos-young-israelis-bear-holocaust-scars-of-relatives. html; “Grandchildren of Holocaust Survivors Get Inked Up in Remembrance,” October 1, 2014, CBS DC, washington.cbslocal.com/2012/10/01/grandchildren-of-holocaust-survivors-get-inked-up-in-remembrance/; “Wearing Their Grandparents’ Tattoos: A New Generation Remembers the Holocaust,” by Daniel C. Brouwer and Linda Diane Horwitz, Communication Currents, December 2015, www.natcom.org/CommCurrentsArticle.aspx?id=6740.

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