Glass Half Full: The Bright Side of ACEs Research

Parents swear, and children sufferIn recent months, it seems as if the public, and policymakers, have caught on to the science on adverse childhood experiences (ACEs, aka “toxic stress”) in a big way. The list of prestigious organizations and government entities collecting and reporting on ACEs data, providing summaries of the science, and implementing trauma-informed interventions include the World Health Organization, the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Office of Juvenile Justice and Delinquency Prevention, the American Academy of Pediatrics, the Robert Wood Johnson Foundation, Harvard University, at least18 states, the city of Philadelphia—and Child Trends.*

Why is this new research about ACEs important?

1. It bridges the divide between the biological and the psychological.

Many of the old (and often stigmatizing) distinctions between “mental” and “physical” health just don’t make sense here. The research on toxic stress, particularly as it affects children, reveals how experience modifies the brain and other body systems (immune response, hormone activity). Chronic early stress alters children’s emotional responses, their impulse control, and their attentional and decision-making processes. It puts them at risk, in adulthood, for cardiovascular disease, obesity, substance abuse, and depression, as well as early death. Thanks to this research, we’re poised to take a more holistic view of wellness.

2. It reinforces the importance of child-caregiver relationships.

The ray of hope in this new knowledge is that a child’s safe, stable, and nurturing relationship with a caregiver plays a buffering role against these toxic effects. Good parenting (or, when that’s lacking, sensitive care from another adult) can protect children from the harms they might otherwise incur from overwhelming stress, or even, in some cases, can help undo the effects of prior trauma. Relationships matter.

3. It recasts much of the old debate about poverty.

Do you explain poverty as mainly the result of a number of unfavorable circumstances beyond one’s control, or do you ascribe it primarily to personal failings of one sort or another? The research on ACEs and the toxic stress they can create doesn’t resolve that debate, but it most certainly offers a different and potentially more productive frame for thinking about poverty. Living in poverty, we know now, frequently causes an accumulation of stress that becomes toxic. As surely as smoking or obesity, chronic poverty damages health—now, and in the future. Moreover, when it also handicaps cognitive and emotional functions, it becomes harder for the poor to escape poverty.

4. It puts a new spotlight on the toll violence takes on our society.

The ACEs research makes it clear that violence—both directly experienced, and witnessed—is both pernicious in its effects, and is a too-common experience of children. Violence is toxic. Children are wired to recoil from it and, when they cannot, they respond in ways that damage their health and blunt their capacities. It is the responsibility of adults to protect children from violence wherever it may occur, starting at home. It’s a need on a par with their needs for adequate food, clothing, shelter, education, and medical care.

Fortunately, as we learn more about toxic stress, research is also progressing about how to mend the damage it wreaks on children. However, that’s not always reversible. The clearest message here is prevention.

-David Murphey, Senior Research Scientist

*Don’t miss our new report comparing the prevalence of adverse experiences for children nationwide and by state. Our new fact sheet examines the association between teenagers’ well-being and their history of adverse experiences. 

Comments

I like that you have that poverty is a potent ACE. It is. I know in a video on the resource page, Dr. Felitti, suggests ACEs as a means to poverty, but in the AVA Vimeo video by Dr. Frank Putman, he has a section near the end of that video that discusses the potentiating effect of poverty on other forms of adversity. Poverty is a strong ACE. Thanks

Fantastic that so many are focusing now on this topic–one so many know of but now our science, policy and lived experience converging to promote a more serious dialogue.

For more state by state information on ACES by subgroups of children see:

http://www.childhealthdata.org/browse/allstates?q=2257

Readers may want to also see a series of 2013-2014 articles and newsletters from the CAHMI’s Data Resource Center on ACES and Resilience (links below) and based on the 2011-2012 National Survey of Children’s Health data.

http://acestoohigh.com/2013/05/13/nearly-35-million-u-s-children-have-experienced-one-or-more-types-of-childhood-trauma/

http://archive.constantcontact.com/fs154/1101849134265/archive/1113181502498.html

http://archive.constantcontact.com/fs154/1101849134265/archive/1112761772958.html

In addition, we are working in collaboration with AcademyHealth to develop a child health services research and policy agenda related to ACES and Resilience and invite all to participate and join the conversation!

Write us at info@cahmi.org to learn more! Collective action, research, translation and synergy across all sectors is needed. Thank you for this piece.

For more state by state comparisons of ACES prevalence by subgroups of children click here:

http://www.childhealthdata.org/browse/allstates?q=2257

Thank you for this clear summary and framing for this critical issue—one pediatrics and most have known about, but now our policy and science and live experience are converging to promote real action and focus!

Readers may want to also see a series of 2013-2014 articles and newsletters from the CAHMI’s Data Resource Center on ACES and Resilience (links below) and based on the 2011-2012 National Survey of Children’s Health data.

http://acestoohigh.com/2013/05/13/nearly-35-million-u-s-children-have-experienced-one-or-more-types-of-childhood-trauma/

http://archive.constantcontact.com/fs154/1101849134265/archive/1113181502498.html

http://archive.constantcontact.com/fs154/1101849134265/archive/1112761772958.html

In addition, we are working in collaboration with AcademyHealth to develop a child health services research and policy agenda related to ACES and Resilience and invite all to participate and join the conversation!

Write us at info@cahmi.org to learn more! Collective action, research, translation and synergy across all sectors is needed. Thank you for this piece.

Christy

We are inspired by the many communities across the U.S. are using the ACEs framework to bring together multiple partners – schools, health care, law enforcement, early childcare, community agencies- to address violence and trauma and promote health and wellbeing. Thanks for the shout out!
Martha Davis
Senior Program Officer, Strengthening Vulnerable Children and Families Team
Robert Wood Johnson Foundation

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