Adverse Childhood Experiences (ACEs)
The Question is Not, What’s Wrong with You, the Question is What Happened to You?
- Experiencing violence, abuse, or neglect
- Witnessing violence in the home or community
- Having a family member attempt or die by suicide
- Substance use problems
- Mental health problems
- Instability due to parental separation
- Instability due to incarceration of a parent, sibling, or other members of the household
What are ACEs?
Traumatic experiences in childhood and the teenage years may put children at risk for violence, chronic health problems, mental illness, and substance abuse in adulthood. These traumatic experiences are known as Adverse Childhood Experiences (ACEs). These experiences can affect children for years and impact their potential in life.
Raising Awareness of ACEs
The first step in helping young people at risk for ACEs is for everyone in our communities to gain a better understanding of these experiences. ACEs are far more common than many people realize. About 6 in 10 adults surveyed reported experiencing at least one ACE, and nearly 1 in 6 of them reported experiencing 4 or more different types of ACEs.
It is also important for people to understand the many long-term consequences of ACEs. ACEs put individuals at risk for chronic health problems, mental illness, and substance use problems in adulthood. For example, there is evidence that these childhood stresses can put people at risk for heart disease and depression later in life. ACEs can also negatively impact education and job opportunities.
Fortunately, educating youth-serving and faith-based organizations, coaches, and caregivers and raising awareness of ACEs in communities about how to prevent these experiences and how to help children and youth who have already experienced ACEs, can help children and youth grow up and thrive in a safe and stable environment.
The good news is that ACEs are preventable. There are a number of strategies that involve people from all sectors of society that can prevent ACEs from happening in the first place and lessen the harmful effects of ACEs that have already occurred. The harmful effects of ACEs can affect everyone in our communities, and everyone can be helpful in preventing them. By keeping ACEs from occurring in the first place and taking quick action when an ACE happens, communities can help all children and youth reach their full potential.
Childhood Trauma Has Lifelong Health Consequences for Women
Trauma and adversity in childhood raise the risk of numerous health problems such as diabetes, heart disease, cancer, and mental illness in adulthood. Several recent studies found that women who experienced childhood adversity are more likely to have their first child early or outside of marriage and face a higher risk of cancer than men. Lower-income women are particularly vulnerable to health issues related to adverse childhood experiences (ACEs). And of all ACEs, child abuse may affect adult health more directly than any other.
“Childhood adversity creates a chain of risk that has a lifelong impact on health; preventing adversity and promoting resilience among exposed youth should be a public health priority like obesity and high blood pressure,” argues Kristi Williams, an Ohio State University sociology professor affiliated with their Institute for Population Research.
Researchers are still trying to fully explain how experiences in a person’s early years shape their health decades later.
“There’s physical and biological evidence that toxic stress alters brain development affecting health in later life; our research shows that social processes also play a key role,” explains Williams.
Childhood Adversity Linked to Early First Births or First Child Outside of Marriage
Williams and her collaborator, Brian Karl Finch of the University of Southern California, examined several types of ACEs by analyzing 25 years of data from the nationally representative National Longitudinal Study of Youth.
They found that that the more ACEs women were exposed to as children, the more likely they were to have an early first birth (before age 25) or a first child outside of marriage, which in turn were strongly related to poorer health by around age 40.
Experiencing childhood adversity is as strongly related to early and unmarried childbearing as is being from a socioeconomically disadvantaged household, the researchers report.
- Emotional neglect
- Physical and sexual abuse
- Alcohol abuse or mental illness within the household
- Parental absence due to divorce/separation or incarceration
- Parental death
Preventing adversity and promoting resilience among exposed youth should be a public health priority…
Exposure to trauma affects emotional regulation, impulsivity, and ability to form intimate ties, according to Williams. Earlier studies have linked ACEs to risky sexual behavior, adolescent childbearing, and unintended pregnancy. This new study provides evidence on the relationship among ACEs, early and nonmarital childbearing, and health problems in later life.
Williams suggests that programs targeting teenagers with messages about preventing early pregnancy may be “too little, too late.”
“Interventions that promote the so-called ‘success sequence’ of completing high school, securing employment, and waiting until age 21 to marry and have
children may be ineffective at reducing poverty and improving the well-being of women and children, if, as our results suggest, ACEs are fundamental precursors to nonmarital and early fertility,” the researchers write.
In Williams’ view, reducing children’s exposure to stress and adversity may be
more effective in improving maternal and child health and well-being.
Resilience to ACEs
Adversity is only one part of the equation. Children may also have their own characteristics and experiences that protect them and help them develop resilience despite exposure to ACEs. Resilience is positive adaptation within the context of significant adversity. In the face of adversity, neither resilience nor disease is a certain outcome.
Resilience is the result of a dynamic set of interactions between a person’s adverse experiences and his or her protective factors. This interaction is what determines the developmental path towards health and well–being or towards illness and dysfunction. No child is magically resilient or invulnerable to ACEs, just as no individual child is automatically doomed in the face of ACEs. These protective factors can include a person’s own biological and developmental characteristics. But protective factors can also include characteristics of the family, community, and systems that mitigate the negative impacts of ACEs. Protective factors help explain how some people who have sustained a great deal of adversity as children have fared relatively well in adulthood.
The presence of protective factors, particularly safe, stable, and nurturing relationships, can often mitigate the consequences of ACEs. Individuals, families, and communities can all influence the development of many protective factors throughout a child’s life that can impact his or her development.
How does resilience develop? There are multiple pathways to resilience. Resilience researchers continue to refine understanding about the ingredients and processes involved in supporting resilience. However, there is agreement about a variety of important individual, family and community conditions that support resilience.
- Close relationships with competent caregivers or other caring adults
- Parent resilience
- Caregiver knowledge and application of positive parenting skills
- Identifying and cultivating a sense of purpose (faith, culture, identity)
- Individual developmental competencies (problem solving skills, self–regulation, agency)
- Children’s social and emotional health
- Social connections
- Socioeconomic advantages and concrete support for parents and families
- Communities and social systems that support health and development, and nurture human capital
Protective factors help a child feel safe more quickly after experiencing the toxic stress of ACEs and help to neutralize the physical changes that naturally occur during and after trauma. If the child’s protective networks are in good working order, development is strong even in the face of severe adversity.
If these major systems are impaired, either before or after the ACE, then the risk for developmental problems is much greater. This is particularly true if the environmental hazards are prolonged. In sum, even the negative consequences of toxic stress from ACEs can be buffered with the support of caring, competent adults and appropriate intervention and support.
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