In 2012, more than 686,000 children in America were victims of abuse or maltreatment. Of those, 1,600 died from abuse and neglect, according to the U.S. Department of Health and Human Services.
The effects of child abuse can linger well beyond childhood. Maltreatment in children can result in adult disorders like anxiety and depression, but also chronic illnesses that harm the lives of millions of adults across the United States each year, according early childhood expert, therapist and author Robin Karr-Morse.
But what if society had a way to identify biomarkers that indicate trauma at an early age, allowing for treatment before illnesses and disorders can be formed?
That’s what Dr. Elaine Bearer, a professor in the Department of Pathology in the University of New Mexico School of Medicine, is trying to discover. Her research on how childhood trauma affects the developing brain has led to a new, non-intrusive method of testing specific biomarkers in children to determine if they have suffered abuse.
She hopes this new test could save their lives.
THE STRESS BRAIN
“I’m a neuropathologist, and one of the inspirations for this project was work I was doing at the office of the medical investigator in New Mexico,” Bearer said. “We saw young children who died from some form of trauma. That’s a major cause of death for children.”
In 2009, Bearer was imaging the brains of mice with post-traumatic stress disorder. She discovered that the emotional brain circuitry in mice were changed when they suffered a trauma, which could be the result of changes in gene expression that doesn’t affect the whole DNA.
“Some of the literature says that early life child abuse is a risk factor for PTSD. So I started thinking, if the brain is changed by early life experience, why and how would that happen,” Bearer said. “What could change in the brain that would change the circuitry in such a permanent way? It could be epigenetics.”
The epigenetic changes in gene expression in brains involve a biochemical process called DNA methylation. According to News Medical, an online, open-access medical information provider for healthcare professionals, DNA methylation is “an epigenetic mechanism used by cells to control gene expression. DNA methylation is a commonly used epigenetic signaling tool that can fix genes in the ‘off’ position.”
Researchers have linked abnormal DNA methylation to several adverse outcomes, including human diseases.
By studying the DNA methylation in children who have experienced traumatic abuse, Bearer and other researchers from UNM and the University of Southern California developed methods to analyze those changes through a strand of hair or through saliva samples.
“People at USC run a laboratory to measure DNA methylation changes, so I hooked up with a woman there who had collected saliva from abused kids for 15 years,” said Bearer. “She was measuring cortisol, because everyone thought it was the stress hormone that was doing this. She has a huge collection of saliva from abused children, so we decided to a pilot program.”
Working with a social worker, Bearer successfully proposed a program to UNM to test DNA methylation in the saliva collected. She analyzed 12 children who had experienced abuse, and of those, three suffered severe physical sexual abuse.
“The three kids who had severe physical sexual abuse all had this pattern,” said Bearer. “We analyzed 850,000 methylation changes [sites] on the DNA sequence, and we found 65,000 changes that were altered in these abused kids, regardless of gender or ethnicity. We compared the sites in each of the three severely-abused kids, and 55,000 were identical [DNA methylation changes].
“The fact that we had 55,000 identical [changes] in three children who suffered abuse, no matter their age, ethnicity or gender, it’s got to be a human response to injury,” Bearer said. “A lot of these sites were related to immune system function, clotting and healing and lots more that we don’t know what they are.”
Bearer hopes that the discovery will lead to tests that could detect biological changes that indicate abuse and use those tests for prevention and therapeutic intervention. Just as vaccination status is determined when children enter kindergarten, so too can psychologists determine children’s stress levels and the biological markers of trauma that may interfere with development and education.
“This is totally new, and my patent is provisional now. We need to sit and brainstorm with stakeholders in child well-being on all the applications this could be used for,” said Bearer. “I would hope we could measure children to see how they are doing in a documentable way. And it’s very non-invasive. They spit in a cup.”
Arlene Drake, a pioneer in the field of childhood abuse and trauma and author of the upcoming book, CAREFRONTATION: Breaking Free from Childhood Trauma, said Bearer’s technology could potentially save thousands of lives.
“This is really exciting. If a test could be developed, it would help social workers, hospitals and others to save children’s lives,” she said. “Children tend to be dismissed when they say they are abused and very few believe adult survivors. I know trauma creates a lot of physical problems that even affect the immune system, so identifying these markers early could mean early intervention.”
James Jimenez, executive director of New Mexico Voices for Children, agreed. The organization works in child well-being, and Jimenez hopes testing for trauma could becoming policy in a state that ranked second in the nation for per capita deaths caused by child abuse in 2010.
“What I’m most interested in is how do we take a tool like this and how do we create public policy around this,” he said. “What are the statewide implications to incorporate this into state law? This question implies that if we have better tools to figure out when abuse is happening, we could potentially have a way that would help us in identification of abuse.”
With a provisional patent filed, Bearer said the technology is still being developed.