Adverse Childhood Experiences certainly can last a lifetime. But they don’t have to.

 

Adverse Childhood Experiences certainly can last a lifetime. But they don’t have to.

An Adverse Childhood Experiences (ACE) is growing up with one or more of the following in the household prior to turning 18:

Recurrent physical abuse

Recurrent emotional abuse

Contact sexual abuse

An alcohol and/or drug abuser in the household

An incarcerated household member

Someone who is chronically depressed, mentally ill, institutionalized, or suicidal

Domestic violence

One or no parents

Emotional or physical neglect

The health impacts of ACE first came to light during a ground-breaking study conducted by the Centre for Disease Control and Kaiser Permanente between 1995 and 1997. This study identified relationships between the breadth of the exposure to abuse or household challenges during childhood and multiple risk factors for several of the leading causes of death in adults. This study is known as the Adverse Childhood Experiences study.

Maria grew up one of three children. Her father was an alcoholic and her mother suffered from depression. Both parents struggled with finding and keeping employment and the family was very poor. Sometimes, there was not enough money to buy food. Because both her parents were sick, they sometimes did not take adequate care of the children.

Shanta grew up with a maid, who was sexually abusing her for six years of her life and parents were absolute unaware of the situation. As a consequence, Shanta had trouble paying attention in school so she often earned poor grades and got into fights, and during her adolescence she was scared of being in relationships.

Shyam was in a confused state of insecurity, because her mother remarried but did not get along with her stepfather. Eventually, he became a very stubborn and arrogant child. When he got in trouble at school, his father sometimes even hit him.

When Aman was in middle school, her mother attempted suicide. Fortunately, she recovered, but Aman’s family was deeply affected and his dad left the house. Aman shared his story while he was in a de-addiction Centre.

These stories are fictional examples, which reflects realities which we come across as professionals, working with children of different socio-economic Background.

How many children have been affected by suicide? Divorce? Violence at home? Substance abuse? Poverty? Lack of opportunities? These experiences are commonly described as ACE, or Adverse Childhood Experiences.

Child abuse and trauma in the household leave a child incredibly vulnerable which has the potential, in early years, to disrupt the normal development of the brain. Adverse Childhood Experiences appear to be associated with a predictable path towards disease and disability. Recognizing this path and tackling it at the earliest possible opportunity is crucial to give children the chance to develop as they ought to so that they can play as full a role in society in the future, in the healthiest possible state, that they deserve to.

People who have experienced ACE should be aware of their effects so they can seek appropriate health care when needed. They can also get professional and social support to improve their lives and avoid allowing ACE to impact their children, families, and futures. Some ACE survivors find they understand themselves better after learning about ACE and considering their own experiences.

Everyone should know about ACE!  Its impact on individuals and on our communities is important.

Healthcare Providers

Healthcare providers of all types including traditional practitioners, physicians, therapists, midwives, nurses, and others-should understand ACE and  it’s impact on physical and mental health. This information can help them understand and help their patients efficiently and make appropriate referrals and screenings.

Teachers and Others Working with Children

Teachers and others who work with children are sometimes the first and only individuals outside of a family to recognize when children are currently experiencing ACE. They can provide initial support and referrals to help the children and their families. Understanding ACE can also help teachers and others better understand their children's challenges, behaviors, and needs.

Recommended strategies to reduce ACE in localized area and to build stronger communities:

Increasing public understanding of ACE and its impact on health and well-being.

Enhancing the capacity of families and healthcare providers to prevent and respond to ACE.

Improving the effectiveness of public-health campaigns by refining their messages regarding ACE.

Promoting identification and early intervention of ACE through universal screening or assessment within child and family health systems.

Early childhood intervention is arguably one of the best ways to improve the chances of children growing up to succeed as best they can and to have the best possible chances in life.

By

Dr. Mona Shah

Occupational Therapist, Clinical Psychologist