Adverse childhood experiences
The experiences chosen were based upon prior research that has shown to them to have significant negative health or social implications, and for which substantial efforts are being made in the public and private sector to reduce their frequency of occurrence.
[6][7] The concept of adverse childhood experiences refers to various traumatic events or circumstances affecting children before the age of 18 and causing mental or physical harm.
[30] Additionally behavioral challenges can arise in children who have been exposed to ACEs including juvenile recidivism,[31] reduced resiliency,[32] and lower academic performance.
[33][34] Adults with ACE exposure report having worse mental and physical health, more serious symptoms related to illnesses, and poorer life outcomes.
[35][36] Across numerous studies these effects go beyond behavioral and medical issues, and include damage to DNA,[36] higher levels of stress hormones,[37] and reduced immune function.
[49] ACEs have been linked to numerous negative health and lifestyle issues into adulthood across multiple countries and regions including the United States,[50] the European Union,[51] South Africa,[52] and Asia.
[53] Across all these groups researchers have reported seeing the adoption of higher rates of unhealthy lifestyle behavior including sexual risk taking,[54] smoking,[55] heavy drinking,[56] and obesity.
[54] Chronic illnesses such as asthma,[63] arthritis,[54] cardiovascular disease,[64] cancer,[65] diabetes,[66] stroke,[67] and migraines[68] show increased symptom severity in step with exposure to ACEs.
According to a large study conducted in 21 countries nearly one in three mental health conditions in adulthood are directly related to an adverse childhood experience.
[24][80] Globally knowledge about the prevalence and consequences of adverse childhood experiences has shifted policy makers and mental health practitioners towards increasing, trauma-informed and resilience-building practices.
[81][82][83] This work has been over 20 years in the making, bringing together research that is implemented in communities, education settings,[84] public health departments, social services, faith-based organizations and criminal justice.
[88] Interventions have been developed in American Indian tribal communities and have demonstrated that social support and cultural involvement can ameliorate the negative physical health effects of ACEs.
[89] There is a paucity of empirical research documenting the experiences of communities who have attempted to implement information about ACEs and trauma-informed practice into widespread public action.
Over the course of the two-year study, over 230 individuals from nearly 100 organizations attended one training offered by the PTICC, raising the number of engaged public sectors from 2 to 14.
These barriers included availability of resources over time, competition for power within the group, and the lack of systemic change needed to support long-term goals.
[91][92] Trauma-informed initiatives in Tarpon Springs include trauma-awareness training for the local housing authority, changes in programs for ex-offenders, and new approaches to educating students with learning difficulties.
[101] In a national survey conducted for the American Association of University Women Educational Foundation in 2000, it was found that roughly 290,000 students experienced some sort of physical sexual abuse by a public school employee between 1991 and 2000.
Young people who are refugees experience trauma whether they were part of the immigration process or were born in the country (where they currently attend school) where the family settled[citation needed].
[106] Early-childhood literacy education includes explicit teaching of reading and writing skills, building phonological awareness, and academic vocabulary.
[106] Resettlement affects children's phonemic awareness and exposure to academic vocabulary since many families are unable to fully provide these out of school experiences.
Social service providers—including welfare systems, housing authorities, homeless shelters, and domestic violence centers – are adopting trauma-informed approaches that help to prevent ACEs or minimize their impact.
Utilizing tools that screen for trauma can help a social service worker direct their clients to interventions that meet their specific needs.
Some doctors have questioned whether some behaviors resulting in attention deficit hyperactivity disorder (ADHD) diagnoses are in fact reactions to trauma.
[122][123] Other obstacles to adoption include that the technique is not taught in medical schools, is not billable, and the nature of the conversation makes some doctors personally uncomfortable.
Resilience is the ability to adapt or cope in the face of significant adversity and threats such as health problems, stress experienced in the workplace or home.
An underlying thesis of the ACE Study is that stressful or traumatic childhood experiences have negative neurodevelopmental impacts that persist over the lifespan and increase the risk of a variety of health and social problems.
[79] The medical history is completed by a health care provider who also performs a general physical examination and reviews laboratory test results with the patient.
[135] Felitti and Robert Anda from the Centers for Disease Control and Prevention (CDC) went on to survey childhood trauma experiences of over 17,000 Kaiser Permanente patient volunteers.
[137] This article incorporates text from this source, which is by David W Brown, Robert F Anda, Vincent J Felitti, Valerie J Edwards, Ann Marie Malarcher, Janet B Croft, and Wayne H Giles available under the CC BY 2.0 license.
The Behavioral Risk Factor Surveillance System (BRFSS) which is run by the CDC,[152] is an annual survey conducted in waves by groups of individual state and territory health departments.
