Adverse Childhood Experience Study (ACES)

The Segments of the Pyramid

Generational Trauma and Historical Trauma: Historical trauma and generational trauma describes how the cumulative and psychological wounding over a lifespan and across generations can influence our genetics to lead to disparate ACEs scores. Historical trauma occurs typically in people whose culture has a history of oppression and whose families over generations experienced the individual effects of trauma as well as trauma experiences by their ancestors. Infants born to women who have experienced ACEs are more likely to have poor physical and emotional health outcomes, partly because toxic stress experienced by women during pregnancy can negatively affect fetal development. Children who have previously experienced abuse are also more likely to commit violence, including abusing or neglecting their own children, creating a victimization cycle. 

 

Social Conditions/Local Context: ACEs research shows a correlation between children with low socioeconomic status and a greater risk of experiencing ACEs.  Community environments, such as a lack of economic opportunities, poor education, discrimination, community violence, systematic racism, inacessability of health care, low income, and other risk factors increase the likelihood of additional challenges for the family, adding stress for parents and children.

 

Adverse Childhood Experiences: The disparities experienced at a social and local level, combined with the effects of generational and historical trauma lead to toxic levels of stress in parents. This intense environment can lead to abusive or trauma experiences for children before the age of 18. 

 

Disrupted Neurodevelopment: As mentioned above, adverse childhood experiences trigger toxic stress, creating disruption in the neurodevelopment of a child's brain. 

 

Social Emotional Cognitive Impairment

• Greater difficulty learning, memorizing and processing information. 
• Increased internalizing and externalizing depending on the adversity encountered.
• Poorer mental health across the life course 
• Difficulties forming social attachment

 

Adoption of Health Risk Behavior: ACEs scores are predictive of greater risk behaviors in extremely vulnerable early adolescents. In an attempt to cope with the trauma can result in unhealthy behaviors such as drinking, drugs, risky sexual behaviors, etc., being used as behavioral coping mechanisms.

 

Early Death Statistic: People with six or more ACEs died nearly 20 years earlier on average than those without ACEs. ACEs are associated with an increased risk of premature death due to ACE-related health and social problems. 

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Applying ACES to the Foster Youth Population

The original ACEs study focused on adults. Researchers have been interested in learning more about childhood adverse experiences among children who have been reported to the child welfare system. This comparison provides perspective on the future challenges foster children may face, as well as preventive services and treatment services.

In order to apply ACEs to foster children, researchers at the Administration for Children and Families used NSCAW II, a national longitudinal study of the well-being of 5,873 children who had contact with the CWS within a 14-month period starting in February 2008. 

The researchers found that more than half of all children reported to CPS had experienced four or more adverse childhood experiences BEFORE they even came into contact with CPS. “The levels of adverse events foster children are experiencing 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.”

U.S. Department of Health and Human Services- Administration for Children and Families: National Survey of Child and Adolescent Well-being

A more recent study conducted in 2017, “Adverse Childhood Experiences Among Children Placed in and Adopted from Foster Care,” revealed that, compared to children from other complex family structures, children in foster care are disproportionately exposed to ACEs.

 

Protecting Children in the Child Welfare System:

As foster youth are uniquely vulnerable to experiencing adverse childhood experiences, it is important that the child welfare system consider thoroughly the implications of its policies and practices. A study examining the psychosocial well being of women who were in foster care as children recommends several policies to address the developmental needs of children.

1. Policies should recognize that although separation may be protecting a child, it is also a confusing and stressful experience, as a child is removed from their familiar lives. 
2. Efforts should be made to reduce the number of foster care placements and to protect children who must enter foster care from subsequent abuse.
3. Programs should be implemented to address the emotional burdens of children in foster care, with specific efforts to help children interpret life events to ensure that adversity and trauma experienced do not distort or impair their mental health.
4. Social workers, health care workers, and responders should be trained to recognize ACEs and to address the developmental needs of foster youth. 

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The Impact of Resilience on ACES Resources

ACEs and adversity is only one part of the equation. Children have their own characteristics and experiences that help them develop resilience despite exposure to ACEs. Children are not born magically resilient nor susceptible to ACEs. 

Resilience can come in the form of many different protective factors, such as: