What are ACEs?


Adverse Childhood Experiences (ACEs) are stressful events occurring in childhood as listed in the study below.

In 1995, a multi-year survey commenced of 17000 middle class patients in a health care plan in California USA which looked at their health and also asked what childhood traumas they had experienced.

Ten childhood traumas were listed in the categories of personal; (abuse and neglect) and family (dysfunction):

Sexual abuse
Verbal abuse
Physical abuse
Emotional neglect
Physical neglect

Parent who is mentally ill
Parent who is an alcoholic
Mother who is a domestic violence victim
Family member who has been jailed
Loss of parent through divorce or abandonment

When the doctor conducting the research first saw the results, he was stunned. “I wept,” he says. “I saw how much people had suffered and I wept.”
As well as suffering, what did the data reveal?

There was a direct link between childhood trauma and a higher risk of adult onset of chronic disease, as well as mental illness, doing time in prison, and work issues, such as absenteeism. This does not mean that these diseases and events will not occur in someone who had experienced a low level of childhood trauma but the risk of this is much lower.

About two-thirds of the adults in the study had experienced one or more types of adverse childhood experiences. Of those, 87 percent had experienced 2 or more types. ACEs usually didn’t happen in isolation.

More adverse childhood experiences resulted in a higher risk of medical, mental and social problems as an adult.

Here is an example: if a person had experienced four adverse experiences, compared with people with zero ACEs, they had a 240 percent greater risk of hepatitis, were 390 percent more likely to have chronic obstructive pulmonary disease (emphysema or chronic bronchitis), and a 240 percent higher risk of a sexually-transmitted disease. They were twice as likely to be smokers, 12 times more likely to have attempted suicide, seven times more likely to be alcoholic, and 10 times more likely to have injected street drugs.
People with high ACE scores are more likely to be violent, to have more marriages, more broken bones, more drug prescriptions, more depression, more auto-immune diseases, and more work absences.
Yet these were average citizens. They were middle-class, middle-aged, and 74 percent were college-educated. They all had jobs and great health care. Their average age was 57.
The ACE Study, which has been replicated many times over, became even more significant with the publication of parallel research that provided the link between why something that happened to you when you were a child could land you in the hospital at age 50. The stress of severe and chronic childhood trauma releases toxic stress hormones that physically damage a child’s developing brain.
Children with toxic stress live much of their lives in fight, flight or fright (freeze) mode. They respond to the world as a place of constant danger. With their brains overloaded with stress hormones and unable to function appropriately, they can’t focus on learning. They fall behind in school or fail to develop healthy relationships with peers or create problems with teachers and principals because they are unable to trust adults. Some kids do all three. With despair, guilt and frustration pecking away at their psyches, they often find solace in food, alcohol, tobacco, methamphetamine, inappropriate sex, high-risk sports, and/or work and over-achievement.
They don’t regard these coping methods as problems. Consciously or unconsciously, they use them as solutions to escape from depression, anxiety, anger, fear and shame.

The cost to individuals and society is huge down the line. A recent report1 in the Lancet estimated these as follows, "Total annual costs attributable to ACEs were estimated to be US$581 billion in Europe and $748 billion in north America. More than 75% of these costs arose in individuals with two or more ACEs. Millions of adults across Europe and north America live with a legacy of ACEs. Our findings suggest that a 10% reduction in ACE prevalence could equate to annual savings of $105 billion."
How do we make sure in our systems of education, criminal justice, etc that we don’t further traumatize someone who’s already traumatized? With the results of all this research, trauma-informed practices are rising in the U.S., Canada, and countries in Europe, Asia, and Central and South America in schools, prisons, mental clinics and hospitals, etc.
The results of the new approach are very encouraging - lives turned around, parents speaking “ACEs” and determined not to pass on their high ACEs to their children, and a significant reduction in costs of health care, social services and criminal justice.

We need to recognise and develop the “resilience” of the developing child—the brain’s and the body’s ability to manage and recover from severe stress, as well as how caring relationships can act as an antidote to stress. People who have experienced trauma should not be “defined” by their trauma. Adversity is not destiny.
Could we influence our institutions to be 'trauma-informed'?
Could we help parents and children locally with this knowledge?

Watch this 3 minute video for further information:

And here is a 5 minute video, made by the NHS, from the perspective of a child exposed to ACEs:

Find out more about how showing a film to the public can help - go to 'Resilience - the film'.

1 https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30145-8/fulltext