As first responders and justice professionals, we often face situations where a child experienced trauma. Often this trauma is on-going and can include physical, sexual or emotional abuse, neglect, exposure to domestic violence and/or an absentee parent, either by divorce, death or incarceration. Once the current situation is stabilized, what happens next? How do these experiences translate into adult behaviors? Looking at the influence of adverse childhood experiences, allows us to address potential negative consequences long before they become an issue and result in more contact with the justice system.
Adverse Childhood Experiences (ACE)
In an on-going collaboration between the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente, co-Principle Investigators Robert F. Anda, MD, and Vincent J. Felitti, MD conducted the largest scientific research study of its kind analyzing the relationship between multiple categories of childhood trauma and health and social outcomes later in life. Utilizing over 17,000 participants in two waves, Drs Anda and Felitti discovered the higher a person’s ACE score, the higher their chances for a myriad of negative behaviors and health problems decades after the events. ACEs include:
- Recurrent physical abuse
- Recurrent emotional abuse
- Contact sexual abuse
- An alcohol or drug abuser in the household
- An incarcerated household member
- Someone who is chronically depressed, mentally ill, institutionalized, or suicidal
- Mother is treated violently
- One or no parents
- Emotional or physical neglect
Many professionals are probably thinking, “This isn’t new. We’ve known for years that childhood trauma impacts a person through their lifetime.” Although this is true qualitatively, the ACE study provides quantitative insight into specific negative behaviors and public health concerns. The study indicates:
- Adverse childhood experiences (ACEs) are common
- ACEs tend to occur in clusters, rather than single experiences
- The cumulative impact of multiple exposures can be captured in an “ACE Score”
- The ACE score likely captures the cumulative (neuro) developmental consequences of traumatic stress
- The ACE score has a strong, graded relationship to numerous health, social, and behavioral problems throughout a person’s lifespan
- These ACE-related problems tend to be co-morbid or co-occurring
ACEs have a cumulative impact on childhood development. In his article, “The Health and Social Impact of Growing up with Adverse Childhood Experiences: The Human and Economic Costs of the Status Quo,” Dr. Anda writes, “As the ACE score increases so does the risk of numerous health and social problems throughout the lifespan.” This information impacts the priorities of a variety of health and social programs.
An important part of the ACE study, especially in light of continually expanding neurobiological advances, is the impact of ACEs on cognitive development. Dr. Anda explains, “ACEs disrupt neurodevelopment and can have lasting effects on brain structure and function.” He goes on to explain,
Early stress is also associated with lasting alterations in stress-responsive neurobiological systems, including the hypothalamic-pituitary-adrenal axis and monoamine neurotransmitter systems; these lasting effects on the developing brain would be expected to affect numerous human functions into adulthood including (but not limited to) emotional regulation, somatic signal processing (body sensations), substance abuse, sexuality, memory, arousal, and aggression.
Changing a child’s cognitive make-up changes that child’s ability to function as a healthy, socially-appropriate adult.
ACEs have a strong influence on:
- Adolescent health
- Teen pregnancy
- Alcohol abuse
- Illicit drug abuse
- Sexual behavior
- Mental health
- Risk of revictimization
- Stability of relationships
- Performance in the workforce