Inspire! Topic: ACES (Adverse Childhood Experiences)- Part 1

Inspire! Topic: ACES (Adverse Childhood Experiences)
Saturday April, 20, 2019

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So just what are ACES? Adverse Childhood Experiences (ACEs) are stressful or traumatic experiences that can have a huge impact on children and teenagers throughout their lives. ACEs can create harmful levels of stress, which impact healthy brain development. This can result in long-term effects on learning, behavior and health. Evidence from ACE surveys found that ACEs can exert a significant influence throughout life and have been found to be associated with a range of poorer health and social outcomes in adulthood.

My ACES score is 4. That means I had quite a bit of trauma during my childhood.

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I’m not alone. 53% of people living in Ottawa County have at least one adverse childhood experience. 14% have 4 or more. That puts me at greater risk of health problems – both mental and physical. But it doesn’t mean that I will definitely have health problems.

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Because along the way, I also developed resiliency. I found adults who cared about me. I developed my own internal systems of coping and growing. Today, I’m actually doing quite well. And I have much greater insight into my own functioning, the family systems in which I continue to operate, and the needs of a community I seek to serve. 

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According to Dr. Nadine Burke Harris, author of The Deepest Well, our ACES score is recorded in our nervous system and DNA which affects every aspect of our body's functions. What’s more important to know is that there are simple, non-medical methods of counteracting much of these effects through mindfulness, relationships, sleep, exercise, stress buffering, caregivers and so on. Simple lifestyle changes can make a big difference in our entire lives. And knowing this information can help prevent ACES from happening in the lives of young people who are just starting their journey.

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This awareness also helps us move beyond shame and blame to deeper empathy. My husband is fortunate enough to have 0 ACES. His awareness of that, and mine, helped to explain why he used to look at things like depression and alcoholism very differently than me.

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So let’s think about that. 47% of people in this county have 0 ACES. It is often said that Grand Haven lacks resources because of a perception that it doesn’t have “those problems” and if someone IS struggling, all they have to do is pull themselves up by their bootstraps. What awareness of ACES can help do is explain why some people have no boots. And it can spur us on to develop what we are calling Trauma Informed Care in ways that help people build their own resourcefulness and resiliency.

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 When we take the judgment out of disease (mental and physical), I am hopeful that we can rally more people around the idea that we all have a shared responsibility to care for everyone in our society in a way that builds health and strength for all of us. ACES can be a tool for creating empathy and compassion.

For our reflective time today, I want you to think of something from  your childhood that was hard to overcome and I want you to think about how you got through it. Then I want to invite you to come get a candle. The candle represents your struggle. And I want you to light that candle. The candle represents what got you through it. Then put the lit candle in the sand to represent you burning bright, claiming your own resiliency!

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Following our reflective moment, we heard from our three panelists. First up was Leigh Moerdyke, the Community Youth Development Program Manager from the Stop Child Abuse & Neglect Council. You will find Leigh’s presentation below.

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The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being. The study is a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente's Health Appraisal Clinic in San Diego.

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Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, et al JS. The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine. 1998;14:245-258.
www.acestudy.org

Adverse childhood experiences are the most basic and long-lasting cause of health risk behaviors, mental illness, social malfunction, disease, disability, premature death, and healthcare costs.

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Almost two-thirds of adults surveyed reported at least one Adverse Childhood Experience – and the majority of respondents who reported at least one ACE reported more than one.

Can think of ACE score as “cholesterol score for childhood stress” – acestoohigh.com

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To frame my discussion….
1) Nationally, and in Michigan, Approximately 58% of kids 3 and under.  70% of children that die from abuse are under the age of 4. US HHS.  This age group is a third of all children entering foster care and who are likely to stay the longest.

2) Architecture: 0-5, when family stability, skills and knowledge have the greatest impact on development. 

“We want to build brains well.” – Dr. Navsaria, Prof. of Pediatrics at University of WI

  The brain’s primary architecture is  developing in years 0-5, when family stability, skills and knowledge have the greatest impact on development.

Connections form by experience.  Dr. Segee.  Positive neural connections don’t just happen because of a lack of negative connections.  Good, positive experiences build.  (E.g., attachment and bonding imprinted on brain (emot. Regulation), reading, play, mentoring)

3) Adverse experiences at an early age create lifelong risk for multiple problems; mitigating these traumas early is most effective.  But also being aware of impact, e.g., trauma-informed perspective, can impact interactions with parents and children/youth who have experienced ACEs or other trauma.

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This brief uses data from the second cohort of National Survey of Child and Adolescent Well-Being (NSCAW II) to examine the prevalence of adverse childhood experiences in a nationally representative study of children reported for maltreatment to the CWS. In addition, the brief compares the number of adverse childhood experiences among children in the CWS with the number of adverse childhood experiences reported in the CDC ACES.

More than half of all children reported for child maltreatment had experienced four or more adverse childhood experiences by the time of contact with the CWS. These levels of adverse events are extremely high. As a point of comparison, almost two thirds of the adult population of the ACES reported one or no adverse childhood experiences. Even the youngest children in the NSCAW population have already accrued more adverse childhood experiences than many of the adults interviewed for the ACES

36% (HMO population): zero ACEs

100% (Substantiated abuse victims): 1 or more ACEs

21% (HMO population): 3 or more ACEs

73% (Substantiated abuse victims): 3 or more ACEs

Think about the different kinds of harmful stress to which a small child is being exposed.  The increase in heart rate, blood pressure, serum glucose, stress hormones, adrenaline – whatever – cannot be good for a developing brain, heart, immune system.  I think about this almost as the kind of post traumatic stress syndrome we see in soldiers, but a child witnessing his mother being beaten has no physical or emotional training for that, no weapon to fight back with, and, unlike a soldier, his or her organs are still developing.

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Tend to think about ACE’s and their consequences for Criminal Justice, Child Welfare, Special Ed., and Health Care. By far the biggest economic consequence is the productivity loss as evidenced by the Yellow above.

Tend to think about ACE’s and their consequences for Criminal Justice, Child Welfare, Special Ed., and Health Care. By far the biggest economic consequence is the productivity loss as evidenced by the Yellow above.

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Empower others by educating and encouraging them to use protective factors

Local: Taken off at grassroots, local level.  Very organic movement.  1) it makes sense, 2) is relatable, and 3) provides a research-based platform for many systems to come together.

Possible Application: Screening of ACEs, screening/assessment of Protective Factors (e.g., PFS), increased attention to increasing PFs as well as decreasing RFs, targeted referrals and interventions, education within field, teaching and modeling for students and parents, conflict resolution, early ID of children displaying symptoms of ADHD and behavior problems that may not be a primary condition by the effects of ACEs

Transition

While this is compelling data, if we do not use the information than it is merely a lot of distressing data.  It can feel like a lot of “bad.”  And that is not where we want to be left.  So what is good, and what is hopeful?

ACE research and protective factors research are both really underlying our approach to prevention and intervention.

Can use the data to 1) think about ways to “buffer against” or prevent ACEs altogether. 2) mitigate where it has happened (for both adults and children) and 3) treat.

TODAY focus on Prevention and Mitigation
Number of ACEs do NOT determine your fate.

Stay tuned for the rest of our community conversation on ACES. We’ll see the presentation that Jodi Spicer from Department of Health & Human Servies showed regarding ACES at the State [of Michigan] level.