The following information was adapted from Harvard University’s Center on the Developing Child.
What are ACEs?
ACEs, or Adverse Childhood Experiences, was a term coined by researchers during the 1995 study conducted by the Centers for Disease Control and the Kaiser Permanente health care organization. According to the CDC, ACES are “stressful or traumatic events that occur in the first 18 years of a person’s life.” These events are categorized into three groups: abuse, neglect and household dysfunction.
The more ACES a child is exposed to during adolescence, the greater the chance the person has of developing social, emotional or health problems in adulthood. The higher the ACES score, the bigger the risk the individual has of developing outcomes such as heart disease, diabetes, obesity, depression, etc.
Surprisingly, research found that ACEs are quite common among middle-class populations with two-thirds of the population reporting at least one adverse childhood experience. In Indiana in 2016, 47.3% of children, age 0-17, reported an ACES score of 1. This is higher than the United States percentage of 46.3. Indiana ranks 28th in the country for reporting any ACE exposure and 32nd for reporting two or more (ISDH, 2016).
What is trauma, and how does it connect to ACEs and toxic stress?
While trauma has many definitions, typically in psychology it refers to an experience of serious adversity or terror—or the emotional or psychological response to that experience.
There are three main types of stress: positive, tolerable and toxic. Stress can serve the valuable purpose of teaching us how to respond in certain situations. This stress is fleeting and has no long-term effect. Toxic stress, however, can have a lasting effect on the body and/or brain.
Trauma-informed care or services build an understanding that problematic behaviors may need to be treated as a result of the ACEs or other traumatic experiences someone has had, as opposed to addressing them as simply willful or punishable actions.
What can we do to help lessen the effects of ACEs and create a self-healing community?
People who have experienced significant adversity (or many ACEs) are not irreparably damaged. Research has shown that individuals with strong support networks are more capable of handling long-term stressors. Helping individuals who have experienced ACES is imperative for recovery and can be addressed in multiple ways.
- At the most intensive end of the spectrum are therapeutic interventions, ranging from inpatient treatment to regular sessions with a mental health professional, which are designed specifically to deal with serious trauma.
- Trauma-informed care or practice is less intensive, but affects how practitioners in a range of fields—such as social work, medicine and education—work with people who have experienced toxic stress and reflects an awareness of the harm that has occurred and takes that into account. The goal of trauma-informed care is to identify trauma and actively resist re-traumatize.
- ACEs-based screening and referral is an increasingly common approach in which individuals are given an ACE score based on a brief 10 question survey of their own personal history of ACEs. This information can provide insights on increased risk based on population-level probabilities, but it cannot tell you what specifically your specific risk is or how to reduce it. This isn’t to say that all individuals with identified ACEs will end up with the same outcomes.
- There are many types of trauma that may result in ACEs. If anyone reading this feels that you need support please refer to resources mentioned on this page and feel free to contact Beacon Community Impact.
The ideal approach to ACEs is one that prevents the need for all levels of services: by reducing the sources of stress in people’s lives—from basic needs like food, housing, and diapers, to more entrenched sources of stress, like substance abuse, mental illness, violent relationships, community crime, discrimination or poverty.
System of Care
Supporting responsive relationships with a parent or caregiver can also help to buffer a child from the effects of stress. Helping children and adults build their core life skills—such as planning, focus and self-control—can strengthen the building blocks of resilience. These three principles—reducing stress, building responsive relationships and strengthening life skills—are the best way to prevent the long-term effects of ACEs.
For more information on ACE Interface trainings, contact Communityimpact@beaconhealthsystem.org
For information on local and national resources that support the emotional health and well-being of youth and families, please reach out to your county’s System of Care organization.
Elkhart County System of Care: The Source, https://thesourceelkhartcounty.org/