Adverse Childhood Experiences (ACES): What you need to know for both you and your children.
Often, stressors in our children’s lives go unnoticed and unaddressed. Divorce, parental separation, emotional abuse, and substance abuse in the household are some factors that can contribute to a stressful childhood. Recent research has revealed that these Adverse Childhood Experiences (ACES) can cause a lifetime of health consequences; from not being able to sleep soundly as an adult, to difficulty concentrating, anxiety, depression, and physical health problems in adulthood such as heart disease. Historically, the impact of “stressful childhoods” has gone unnoticed and researchers are beginning to understand how chronic stressful events in childhood impact physical and mental health in adulthood. The evidence is clear: The more risk factors in childhood, the higher the likelihood of problems in adulthood. Although children are indeed resilient, too many ACES events cause be overwhelming. In fact, too many events can cause changes in the brain which affect healthy childhood development and last into adulthood. For this reason, exposure to ACES has been called the greatest public health concern because of the long-lasting effects in adulthood. Often, emotional trauma can lead to adult mental health and physical health problems.
“Children’s exposure to Adverse Childhood Experiences is the greatest unaddressed public health threat of our time”– Robert Block, American Academy of Pediatrics.
There are two main reasons why it is important to understand the impact of stressful childhoods, risk factors, and protective factors. First, it is helpful to examine your own childhood experiences. For example, if you find yourself struggling with mental health issues as an adult, it may be helpful to recognize how many childhood stressors were present in your own upbringing. Adults often wonder “Why do I suffer from lifetime depression?” or “Why do I have problems in relationships?” or “Why do I struggle with addictions or drugs or eating disorders?” Often, these issues may be correlated with childhood events and specific therapy such as EMDR can help address these issues. Second, it is important to understand this for your own children because identifying these experiences and intervening early is crucial for reducing adult mental health problems and behaviors. Untreated Adverse Childhood Experiences (ACES) can develop into toxic stress and can invariably disturb healthy childhood development. For example, your child may be at risk for adult health problems such as COPD, liver disease, alcohol or drug dependency, problems with relationships, depressive episodes, suicide attempts, or even sleep disturbances (Baldwin, 2018). Further, emerging research in neuroscience supports that early maltreatment has effects on brain development (VanDer Kolk, 2014). Yes, too much stress in childhood can affect your brain, and this can change your life.
The Impact on your Brain
Stressful childhoods can cause potential structural changes that occur within the brain. The field of neuroscience helps us explore brain dysregulation in childhood. For example, when there is consistent brain dysregulation in childhood, the ability to move through adversity, otherwise known as resilience, decreases. This is because stressful childhood events (ACES) impact the development of the brain. Those individuals with impaired brain development may have issues in relationships due to disrupted attachment or struggle with the ability to calm and regulate their emotions appropriately. Further, research supports that there are changes in the prefrontal cortices and the amygdala which can impair both how a person reacts to an event and their executive functioning.
What are Adverse Childhood Experiences (ACES)? There is some level of stress in every household or upbringing. However, there may be higher incidences of risk factors in some households than in others. The higher the incidence of these issues in childhood, the higher the risk for chronic stress, long-term disease, and adult mental health issues.
The following are ACES risk factors:
- Emotional Abuse
- Parental separation or divorce
- Substance misuse within the household
- Mental Illness in the Household (including a Narcissistic parent)
- Intimate partner violence
- Mother treated violently
- Physical abuse/neglect
- Sexual abuse
SAMHSA identifies the negative consequences that may result from higher ACES scores:
- Early alcohol or tobacco use
- Self-reported addiction issues
- Suicide attempts
- Sleep disturbance in adults
- Prescription drug use
- High-risk sexual behavior
- Anxiety and depression in adulthood
The Good News…
According to the Center for Disease Control protective factors include:
- Supportive family including extended family such as grandparents
- Social support, friendships
- Stable family relationship(s)
- Parental employment and education
- Access to health care
- Adults outside the family that can serve as role models or mentors (like a teacher, spiritual leaders, etc.)
In my practice, I find that if children have some stable family support this can help immensely. These factors help promote adulthood resilience, the ability to “bounce back” from adversity. Additionally, engaging children in other activities such as community involvement, sports, and/or clubs can help increase self-esteem and connect them with friends and other support systems. They can learn how to reach out when in distress and learn positive coping skills from their social supports, role models, and stable family members.
What do I do now? How Counseling Can Help
If you feel that you are your children have been at risk, counseling can help. Childhood maltreatment is not something you can just “get over”. As research shows that early maltreatment has chronic negative effects on brain development, early intervention is key. This early intervention is also a protective factor because counseling can teach children different ways to regulate their emotions. For example, therapists can teach effective coping skills to help deal with childhood stress. These may include positive self-talk (CBT), mindfulness, or techniques to help self-soothe when distressed. EMDR can help process stressful events from your past in a quicker way compared to conventional counseling. Additionally, adults can learn ways to cope by changing their thoughts (CBT) or (DBT) which includes a mindfulness component that helps you stay in the present versus staying in the past. There is no one size fits all approach to addressing ACES but a trauma counselor or therapist can tailor a treatment plan that is right for you based on your individual needs and experiences.
References
Baldwin, D. (2018). Neurocounseling: Bridging Brain and Behavior. American Counseling Association.
Van der Kolk, Bessel A (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking.
