Have you ever wondered why some people just seem to experience more hardship than others? Perhaps you know someone who lost his or her job. Around the same time, they find out they have a major health problem. Is it just a rash of bad luck?
These series of misfortunes may not have to do with luck at all, but rather may be the result of events that occurred years before.
What are adverse childhood experiences?
Adverse Childhood Experiences, or ACEs, are negative experiences that create stress on a child and may lead to other negative health outcomes as they grow. In turn, the negative health outcomes can have a lasting behavioral, emotional and physical impact on a person's life resulting in multiple setbacks.
"The brain pathways are very flexible, so a highly stressful environment impacts the developing brain structure of the child by continued release of stress hormones," explains Sue Schell, Vice President and Clinical Director of Behavioral Health at Children's Health℠. "When the stress is sustained over time, it becomes toxic, impacting their health and emotional development."
Breaking the ACEs cycle
Schell is part of a team of health professionals at Children's Health helping families manage the effects of ACEs through an integrated behavioral health program. Through the program, pediatricians identify children with suspected behavioral health issues and refer them for further screening, which includes an assessment of ACEs to identify needed treatment.
The Children's Health behavioral health team routinely screen for sources of toxic stress in young patients, including:
- Poverty
- Physical, emotional or sexual abuse
- Having a family member in prison
- Drug and/or alcohol abuse in the home
- Losing a caregiver through divorce, death or imprisonment
Through the behavioral health program, licensed professional counselors, social workers, and marriage and family counselors partner with pediatricians across the community to treat, counsel, educate and refer families as needed to break the cycle of ongoing negative health effects caused by ACEs.
ACEs are a family matter
The effects of ACEs are not limited to the child. Many times, there are multiple generations of poverty, stress and trauma, and parents themselves do not have the skills to cope, and so they are unable to help their child.
The original ACEs study focused on adults. It found that the more stressors a person endured as a child, the more likely they were to have serious health problems, such as heart disease.
Now the goal is to address problems as they happen during childhood in order to prevent the negative effects later in life. "We are trying to identify problems in real time, when they're occurring in the child's life, so that we can intervene," says Schell. "We now know that if we can help the child and their adult caregiver to build healthy relationships and reduce environmental stress we can change how their brain is developing and how neural pathways are created, then we can change how their body responds to stress in the future."
A common scenario is a child struggling in school and there is concern that they have ADHD. The pediatrician refers the child to the behavioral health professionals, who assess the situation and find that daily stress or some past traumatic event is impacting their behavior. They then work with the caregiver and the child to understand the situation and create a more stable environment. This might include introducing self-care skills, mindfulness and relaxation techniques, as well as education on nutrition, sleep hygiene and well-being.
"You're teaching the parent at the same time you're teaching the child," says Schell. "Everything's connected; we can help the caregiver find resources to learn how to cope and that in turn helps the child."
For more information about adverse childhood events and the impact they may have on your child or a child you know, speak with your primary care physician.
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