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Adverse Childhood Experiences (ACEs)

When a person experiences strong, frequent, or prolonged adversity such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, or the accumulated burdens of family economic hardship, it can have profound negative effects on the mind and body. The stress response to these events has been known to disrupt the development of brain architecture as well as other bodily systems — neuroendocrine, immune, metabolic, and genetic — leading to what is considered toxic levels of stress.

Toxic stress experienced in early childhood (ages 0 – 17 years) — referred to as adverse childhood experiences or ACEs — has been linked to chronic health problems, mental illness, and substance abuse as that child grows to become an adult. ACEs can also negatively impact education and job opportunities. And more recent studies have highlighted how a history of community-level trauma and violence has profound impacts on health in schools.

Health and learning impacts of ACEs

Kaiser Permanente, together with the CDC, conducted the original study on adverse childhood experiences to uncover that:

  • ACEs are common. Approximately two-thirds of Americans have experienced at least one ACE and one in six have experienced four or more ACEs.
  • Experiencing ACEs increases the risk of negative health outcomes later in life, including obesity, diabetes, depression, heart disease, cancer, stroke.
  • ACEs can affect student learning and behavior in the classroom. Children with three or more ACEs are 5x more likely to have attendance issues, 6x times more likely to have behavior problems, and 3x times more likely to experience academic failure.
Mother embracing daughter in front of house

Toxic stress and ACEs are an under-recognized and under-addressed reason that many individuals are unable to achieve their full potential. This impacts them in the classroom, in the clinic, in their relationships, and beyond.

Trauma-informed care in schools

Given just how common childhood adversity and toxic stress are, it’s important that schools develop universal trauma-informed principles in their educational spaces and structures to reduce overall exposure to adversity and enhance resilience for both children and adults. All school personnel can be trained to understand “disruptive” behaviors and school difficulties as possible symptoms of toxic stress and to respond with compassionate, protective interventions rather than punitive actions. Partnerships between pediatric providers and educators can promote shared goal setting, decision making, more optimal treatment, and closer follow-up of those students who are struggling from the effects of toxic stress. Strategies for regulating toxic stress physiology include promoting optimal sleep hygiene, anti-inflammatory nutrition, physical exercise, mindfulness practices, experiencing nature, and supportive relationships.


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