ACE – Adverse Childhood Experiences

What is the most common adverse childhood experience?

By far, the most common ACEs in all 50 states are economic hardship, and parental divorce or separation (Table 2). Nationally, just over one in four children ages birth through 17 has experienced economic hardship somewhat or very often.

What does an ACE score of 10 mean?

The more ACEs you have, the greater the risk for chronic disease, mental illness, violence, and being a victim of violence. People have an ACE score of 0 to 10. Each type of trauma counts as one, no matter how many times it occurs. You can think of an ACE score as a cholesterol score for childhood trauma.

Adverse Childhood Experiences (ACEs) come in many forms, from physical and mental abuse to neglect and household dysfunction. In 1998, CDC-Kaiser Permanente published a groundbreaking study that investigated the impact of ACEs on physical and mental health problems in over 17,000 adults. During the study, the adults were given a survey asking about 10 different types of ACEs and if they had experienced them prior to the age of 18. The study showed a direct correlation between ACEs and future health complications.

Since this study, we’ve not only learned more about the psychological effects of ACEs on young minds, but also the long-term health complications that can come from recurring exposure to ACEs. Now that we understand how toxic stress affects the minds and bodies of children, we can interrupt these changes by providing safe, stable, nurturing environments, while helping children build social-emotional skills and resilience.

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). For example:

• experiencing violence, abuse, or neglect
• witnessing violence in the home or community
• having a family member attempt or die by suicide

Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding such as growing up in a household with:

• substance misuse
• mental health problems
• instability due to parental separation or household members being in jail or prison

ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. ACEs can also negatively impact education and job opportunities. However, ACEs can be prevented.

ACEs are common. About 61% of adults surveyed across 25 states reported that they had experienced at least one type of ACE, and nearly 1 in 6 reported they had experienced four or more types of ACEs.

Preventing ACEs could potentially reduce a large number of health conditions. For example, up to 1.9 million cases of heart disease and 21 million cases of depression could have been potentially avoided by preventing ACEs.

Some children are at greater risk than others. Women and several racial/ethnic minority groups were at greater risk for having experienced 4 or more types of ACEs.

ACEs are costly. The economic and social costs to families, communities, and society total hundreds of billions of dollars each year.

ACEs can have lasting, negative effects on health, well-being, and opportunity. These experiences can increase the risks of injury, sexually transmitted infections, maternal and child health problems, teen pregnancy, involvement in sex trafficking, and a wide range of chronic diseases and leading causes of death such as cancer, diabetes, heart disease, and suicide.

ACEs and associated conditions, such as living in under-resourced or racially segregated neighborhoods, frequently moving, and experiencing food insecurity, can cause toxic stress (extended or prolonged stress). Toxic stress from ACEs can change brain development and affect such things as attention, decision-making, learning, and response to stress.

Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. These effects can also be passed on to their own children. Some children may face further exposure to toxic stress from historical and ongoing traumas due to systemic racism or the impacts of poverty resulting from limited educational and economic opportunities.

 

Preventing ACEs

Preventing ACEs
Strategy	Approach
Strengthen economic supports to families	Strengthening household financial security Family-friendly work policies
Promote social norms that protect against violence and adversity	Public education campaigns Legislative approaches to reduce corporal punishment Bystander approaches Men and boys as allies in the prevention
Ensure a strong start for children	Early childhood home visitation High-quality child care Preschool enrichment with family engagement
Teach skills	Social-emotional learning Safe dating and healthy relationship skill programs Parenting skills and family relationship approaches
Connect youth to caring adults and activities	Mentoring programs After-school programs
Intervene to lessen immediate and long-term harms	Enhanced primary care Victim-centered services Treatment to lessen the harms of ACEs Treatment to prevent problem behavior and future involvement in violence Family-centered treatment for substance use disorders

Raising awareness of ACEs can help:

• Change how people think about the causes of ACEs and who could help prevent them.
• Shift the focus from individual responsibility to community solutions.
• Reduce stigma around seeking help with parenting challenges or for substance misuse, depression, or suicidal thoughts.
• Promote safe, stable, nurturing relationships and environments where children live, learn, and play.

Let’s help all children reach their full potential and create neighborhoods, communities, and a world in which every child can thrive.

more info at:

Got Your ACE Score?

https://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean

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