For 350 stakeholders in attendance at the May 5 State of the Child Forum — held to develop strategies for addressing childhood trauma in Watauga County — Tonier Cain painted a graphic picture of what’s at stake.

Cain served as the afternoon keynote speaker at the forum, planned by the Juvenile Crime Prevention Council and multiple county organizations and held at Boone United Methodist Church. A steering committee will review information gathered at the forum and will make recommendations for more effectively preventing, recognizing, addressing and treating trauma, which has been shown to increase risk of lifelong health and social problems.

Neglected by an addicted mother and sexually abused as a young child in Annapolis, Md., Cain said she believed as early as age 9 that life was how it was always going to be, and that bad things happened to bad people. She began drinking from half-empty cups left over at parties around the same age, learning that the drug helped dull the pain.

At age 11 Cain was separated from her mother and siblings by social services and at age 14 — when her mother regained custody of Cain so she could babysit her new siblings — she attempted suicide. Her mother later arranged for her to marry an older man, in his 20s and who was abusive. By age 19, Cain was addicted to crack.

She recalled almost 20 years of “layers and layers and layers” of untreated trauma and of retraumatization — 83 arrests, 66 convictions, prostitution, a miscarriage while incarcerated due to wrongly prescribed medications, a rape by a drug counselor and her own four children being taken away by social services.

“Because I was on the streets for so long, people came to their own conclusions about me,” Cain explained. “You don’t have the right to deem somebody hopeless.”

Then, 13 years ago, she was pregnant and headed to prison, but this time, her life would change forever. She was invited to a treatment program, and surprisingly, told she could take her baby with her. For the first time, she was asked, “What happened to you?” and told, “We’re glad you’re here.”

Over the years, she had been provided with bits and pieces of information, she said, “but it couldn’t penetrate the trauma.” There, for the first time, she felt safe and she felt believed. She took secure attachment classes to learn how to be a mother, and today, she is drug free, owns a home and makes a career out of being an advocate.

“What this means is the cycle has been broken,” said Cain, to a church sanctuary that erupted in applause. But what if — she asked the forum attendees — what if someone had recognized her trauma at age 9?

This was the focus of the day: recognizing the symptoms of a traumatized child and knowing how to handle it.

When trauma is unresolved in a child’s life, they are more likely to be incarcerated, experience erratic job performance, be homeless, be an addict, an abuser or a victim of domestic violence, said Denise Presnell, the chairperson for the forum planning committee and a Watauga County Schools social worker of 25 years.

The event started with help from the Juvenile Crime Prevention Council and Watauga Children’s Agenda. Presnell, working towards her master’s degree in social work, spearheaded the forum as an internship project with the Western Youth Network. Along with a 22-person planning committee, Presnell said the forum took seven months to plan with help from its biggest sponsor High Country United Way.

In a classroom at Appalachian State University, Presnell said she read, “It’s easier to build a child than to repair an adult.” She said if someone doesn’t heal from a traumatic experience, it would impact them for the rest of their life.

Attendees listed to morning keynote speaker George “Tripp” Ake, a licensed psychologist and professor at Duke University. Ake helped to define trauma and the importance of caregiver involvement.

Ake defined trauma as possibly being “embedded in daily life, chronic or an acute event.” These traumatic exposure types ranged in events such as child abuse and maltreatment, domestic violence, sexual assault, medical trauma, traumatic loss and bereavement, natural disasters and war/political violence.

Representatives from various child networks across the county also spoke to the audience about what their agency does for children and the kind of trauma they see on a day-to-day basis. Agencies who spoke included Blue Ridge Pediatrics, Department of Social Services, Opposing Abuse with Service, Information and Shelter (OASIS), Watauga County Schools, Daymark Recovery, Western Youth Network, the Children’s Council and Southmountain Children and Family Services.

In Watauga County, 62 children are in foster care and 40 are on a waiting list for a mentor, Presnell said. Presnell said she was shocked by a fact presented by OASIS — the organization served 115 children in 2016.

Attendees then split into 20 action planning groups, each with 16 to 20 members. The planning committee intentionally chose the members of each planning group to include members from the school systems, law enforcement, the court system, the medical community and parents.

The action planning groups were given an hour to brainstorm ideas based on the prompt, “in an ideal community, what action steps could we take to prevent, recognize and treat trauma?”

“We didn’t want anybody to deliberate why it wouldn’t work, how there’s no funding, how it’s been tried before or why it didn’t work in their personal experience,” Presnell said. “We just wanted the ideas.”

Ideas were then entered into a spreadsheet and will be given to the leaders of sectors — such as medical, behavioral health and education — and will also be deliberated upon by the Trauma-Informed Community Steering Committee.

The steering committee is having its first meeting from 11 a.m. to 1 p.m. Tuesday, May 30, at the Blue Ridge Energy Community Conference Room, located at 2491 Old U.S. 421 in Boone.

Speaking at the end of the forum, Watauga County Schools Superintendent Scott Elliott said the two themes that had emerged thus far were a need for policies and procedures at agencies and organizations to better focus on this work and a need for more training and education.

“Some people are thinking what happened to Tonier is a foreign experience,” Elliott said. “I’m here to tell you that here in this community, we have the opportunity to change lives.”

For more information on the forum or the steering committee, contact Presnell at presenelld@wataugaschools.org.

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