I remember where I was when I first heard about adverse childhood experiences (ACEs), or potentially traumatic events that occur in childhood and can impact future violence victimization and perpetration as well as lifelong health. It was the late 1990s, my combat boots were as worn out as my purple hair, and I was working at a sexual assault prevention program on a college campus. I held onto the boots for many more years, but this research helped me to let go of old thinking about healing from sexual harm and talk about the link between childhood trauma and adult health in new ways. It normalized the lives of the survivors that I was working to support. It also made a lot of sense to the general public and sparked a lot of conversation.
You can take a quiz and get a score for goodness sake. So many of us are trying to understand the pain we have experienced in childhood, and ACEs has become a tool for doing just that. This winter, while I gathered with family pre-quarantine, ACEs were the discussion at the dinner table, and for the first time I think my mother-in-law truly understood what I do for work. I’m grateful for the ongoing lessons from this research and work to prevent adverse childhood experiences.
ACEs have informed prevention programs around the U.S. Health care workers use ACEs to screen patients so they can provide more trauma-informed care. Schools use information about ACEs to create more supportive school environments that promote a trauma-informed approach to education. Anyone can learn about risk and protective factors for ACEs, their outcomes, and how to reduce adverse child experiences in the first place through Veto Violence’s free online training.
My purple hair is long gone and COVID-19 has exposed more than roots. There are concerns about using simplified ACEs questions in medical settings since they were designed as part of a complex research process and not meant to diagnose people. Basing treatment only on an ACEs score could also mean that a child with a low score might not get critical care or referrals that they might need. Critics also fear that calls for universal screening could actually harm low income Black and brown communities due to historic racism in our healthcare system and child welfare services. ACEs screening tools are also based on experiences with adults, so children’s experiences of abuse or harassment by peers wouldn’t be discussed.
As we work to create health equity and systems that support racial justice, how can ACEs help us get to the root of these social problems? I have found hope in a new area of research that is extending what we know about ACEs and focusing on how to build community protective factors and resilience for youth, especially Black, Indigenous, and youth of color. I hope you will take the time to listen to Dr. Sabrina Liu, who joined us on our Resource on the Go podcast, to discuss her research on understanding and improving mental health and mental health inequities among children and families from diverse and underrepresented backgrounds, particularly those who have faced trauma and adversity.
My colleague, Casey Keene at the National Resource Center on Domestic Violence, also has a great two-part podcast about how children with adverse childhood experiences can thrive and NSVRC has a whole collection of tools on how to foster resilience in children.
If you aren’t into podcasts, here are some other places to learn more:
- Adverse Childhood Experiences from the Centers for Disease Control and Prevention
- Resources for Supporting Children’s Emotional Well-being during the COVID-19 Pandemic from ChildTrends
- Resources to Support Children’s Emotional Well-Being amid Anti-Black Racism, Racial Violence, and Trauma from ChildTrends
- Information Hub: Adverse Childhood Experiences (ACEs) in Indian Country from the National Indian Health Board
- Trauma and Learning Policy Initiative
- One Caring Adult online course from NSVRC
- How Childhood Trauma Affects Health Across a Lifetime TED Talk with Dr. Nadine Burke Harris
- Offset trauma for students by promoting positive experiences from MultiBriefs
- ACEs and counter-ACEs: How positive and negative childhood experiences influence adult health from Psychology Today