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Overview:

The Adverse Childhood Experiences (ACEs) study was a groundbreaking research project that highlighted the importance of trauma prevention and trauma-informed care. It was the first project of its kind to examine the long-term effects of childhood trauma. The Centers for Disease Control and Prevention (CDC) and Kaiser Permanente created an assessment that determine an individual's ACE score based on the types of traumatic events that they experienced up until the age of 18. Over 17,000 people participated in this assessment from 1995 to 1997, while also providing information on their overall health and well-being as an adult. They found the participants who experienced one or more ACEs during childhood were more likely to struggle later in life. These struggles included poor academic achievement, substance abuse, and health problems. Some of these health problems include diabetes, heart disease, obesity, anxiety, and depression. As educators, it is vital we work with our students to lessen the negative effects of their childhood trauma and promote resiliency.

Examples of ACEs:

Emotional abuse

Physical abuse

Sexual abuse

Emotional neglect

Physical neglect

Incarcerated household member

Mother/sibling treated violently

Mental illness in the household

Parental separation or divorce

Substance abuse in the household

Community violence

Poverty

Racism

Natural disasters

Key findings from the ACEs study:

64% of participants in the study reported experiencing at least one ACE.

About 20% of participants reported experiencing three or more ACEs.

Females, minority groups, and those who are unemployed/unable to work are more likely to have higher ACE scores.

Those with higher ACE scores were expected to have shorter life expectancy than those with less ACE scores.

The study found a connection between higher ACE scores and increased risk for chronic diseases, mental health disorders.

The study found higher substance abuse and risky behaviors (e.g., early sexual activity, smoking) among those with higher ACE scores also.

Health consequences that result from ACEs are estimated to cost the United States $748 billion a year.

Citations:

Bellis, M.A., et al. Life Course Health Consequences and Associated Annual Costs of Adverse Childhood Experiences Across Europe and North America: A Systematic Review and Meta-Analysis. Lancet Public Health 2019.

Felitti, V. J., Anda, R. F., Nordenberg, D., Willamson, D. F., Spitz, A. M., Edwards, V. et al. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventative Medicine, 14, 245-258. https://doi.org/10.1016/S0749-3797(98)00017-8

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Adverse Childhood Experiences (ACEs) can be assessed using a standardized childhood experiences questionnaire. The best resource to assess one's ACE score is the ACEs assessment developed by the original ACEs study researchers. You can find the ACEs questionnaire at the following links:

https://www.acesaware.org/wp-content/uploads/2022/07/ACE-Questionnaire-for-Adults-Identified-English-rev.7.26.22.pdf

https://www.acesaware.org/learn-about-screening/screening-tools/

https://americanspcc.org/take-the-aces-quiz/

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Risk Factors:

Significant and/or frequent abuse, dysfunction in the household, or neglect.

Growing up in an unsafe or unstable environment where there was a lack of caregivers or positive role models.

Economic or social disadvantages, such as being isolated from others, poverty, and limited access to healthcare and education.

Dealing with community violence or natural disasters during childhood.

Genetic predispositions and biological responses to stress.

Protective Factors:

Having good role models, healthy family systems, and a supportive community in the child's life is key. Trusting relationships are important for preventing and combating the effects of childhood trauma.

The child growing up in environments where he or she can access quality education, healthcare, and mental health services, to met their physical needs and build on their own cognitive and emotion regulation skills.

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When one experiences a stressful situation, like an adverse childhood experience (ACE), it causes the individual's stress-response system to work overtime. Long exposure to trauma can cause someone to develop "toxic stress" in their body. This form of stress not only effects the immune system, cardiovascular system, and metabolic regulatory systems, but can have lasting effects on the child's developing brain.

Chronic stress that results from ACEs can cause information to get "stuck" in lower functioning parts of the brain, like the diencephalon and limbic systems, and not be able to reach the higher functioning parts like the cortex. Chronic stress can also alter parts of the brain. It is known that the hippocampus, prefrontal cortex, and amygdala can differ in size and functioning in a traumatized individual compared to an individual free from chronic stress. The hippocampus is responsible for memory, the prefrontal cortex is responsible for logical thought, and the amygdala is responsible for processing emotions.

Unfortunately, not every educator understands that the effects of trauma on the brain is often the reason behind why we see our traumatized students struggle with their attention, learning, executive functioning skills, emotion regulation, and making wise choices. Hence, why it is important for teachers to not take their behaviors personally and focus on providing their students with a safe spaces with an adult they trust to help them cope. Teachers can help students regulate the lower parts of their brains to be able to access the higher parts that will help them make better choices and show more success at school. Social-emotional learning (SEL) is on the rise to address this. Many teachers today model and guide students with how to calm themselves, work through problems, identify their emotions, and reflect.

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Build relationships and become a mentor: Teachers can be positive adult role models for children who have been traumatized. Having someone a child can trust and confide in is needed for those who do not have nurturing adults in their lives. Learning about your students, their interests, and fostering their strengths is a great place to start. Taking time to make check-ins with them and provide them with solutions when they need it will strengthen the relationship as well. After school activities or extracurricular clubs and sports are the perfect opportunity for educators to build healthy relationships with their students, while also helping them to create positive experiences.

Social-emotional learning: Incorporating social-emotional learning (SEL) into your classroom can teach your students empathy and help them improve their decision-making skills, social skills, and coping strategies. Along with teaching these skills, you can model them as well. If children are familiar with a SEL strategy that you use and see the success of using it, they will be more likely to incorporate it into their lives.

Create a safe space in your classroom: Make students feel welcome in your classroom by promoting open communication and respect for diversity. To support students that struggle to get sleep or food at home, consider keeping snacks and comfortable seating in your classroom. Encourage students who are struggling emotionally to utilize safe paces in your school's Guidance center.

Work with other professionals in the students life: Communicating with professionals and other school staff that work with the concerned student is important for providing the best support for that child. Having different perspectives and areas of expertise can give a better understanding of the child and their situation. It is important to have meetings with others to alert them of any changes in the child's life and collaborate on how to best help the child.

Direct your students and their families to resources and career workshops in your community: Consider sharing a handout to families (and older students) during the school year with information on social service agencies, mental health centers, support groups, educational and career workshops, and other aid services in your community. Having a place to start for these families, can alleviate the stress of having to find help on their own.

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Brain Paradigm and ACEs Reflection - EDA 526