As first responders and justice professionals, we often face situations where a child experienced trauma. Often this trauma is on-going and can include physical, sexual or emotional abuse, neglect, exposure to domestic violence and/or an absentee parent, either by divorce, death or incarceration. Once the current situation is stabilized, what happens next? How do these experiences translate into adult behaviors? Looking at the influence of adverse childhood experiences, allows us to address potential negative consequences long before they become an issue and result in more contact with the justice system.
Adverse Childhood Experiences (ACE)
In an on-going collaboration between the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente, co-Principle Investigators Robert F. Anda, MD, and Vincent J. Felitti, MD conducted the largest scientific research study of its kind analyzing the relationship between multiple categories of childhood trauma and health and social outcomes later in life. Utilizing over 17,000 participants in two waves, Drs Anda and Felitti discovered the higher a person’s ACE score, the higher their chances for a myriad of negative behaviors and health problems decades after the events. ACEs include:
- Recurrent physical abuse
- Recurrent emotional abuse
- Contact sexual abuse
- An alcohol or drug abuser in the household
- An incarcerated household member
- Someone who is chronically depressed, mentally ill, institutionalized, or suicidal
- Mother is treated violently
- One or no parents
- Emotional or physical neglect
Conceptual Framework
Many professionals are probably thinking, “This isn’t new. We’ve known for years that childhood trauma impacts a person through their lifetime.” Although this is true qualitatively, the ACE study provides quantitative insight into specific negative behaviors and public health concerns. The study indicates:
- Adverse childhood experiences (ACEs) are common
- ACEs tend to occur in clusters, rather than single experiences
- The cumulative impact of multiple exposures can be captured in an “ACE Score”
- The ACE score likely captures the cumulative (neuro) developmental consequences of traumatic stress
- The ACE score has a strong, graded relationship to numerous health, social, and behavioral problems throughout a person’s lifespan
- These ACE-related problems tend to be co-morbid or co-occurring
ACEs have a cumulative impact on childhood development. In his article, “The Health and Social Impact of Growing up with Adverse Childhood Experiences: The Human and Economic Costs of the Status Quo,” Dr. Anda writes, “As the ACE score increases so does the risk of numerous health and social problems throughout the lifespan.” This information impacts the priorities of a variety of health and social programs.
Neurodevelopment
An important part of the ACE study, especially in light of continually expanding neurobiological advances, is the impact of ACEs on cognitive development. Dr. Anda explains, “ACEs disrupt neurodevelopment and can have lasting effects on brain structure and function.” He goes on to explain,
Early stress is also associated with lasting alterations in stress-responsive neurobiological systems, including the hypothalamic-pituitary-adrenal axis and monoamine neurotransmitter systems; these lasting effects on the developing brain would be expected to affect numerous human functions into adulthood including (but not limited to) emotional regulation, somatic signal processing (body sensations), substance abuse, sexuality, memory, arousal, and aggression.
Changing a child’s cognitive make-up changes that child’s ability to function as a healthy, socially-appropriate adult.
Practical Application
ACEs have a strong influence on:
- Adolescent health
- Teen pregnancy
- Smoking
- Alcohol abuse
- Illicit drug abuse
- Sexual behavior
- Mental health
- Risk of revictimization
- Stability of relationships
- Performance in the workforce
ACEs increase the risk of:
- Heart disease
- Chronic Lung disease
- Liver disease
- Suicide
- Injuries
- HIV and STDs
- Other risks for the leading causes of death
Many public health problems are actually personal solutions. People are treating their symptoms. For professionals to treat the symptoms, as well, it is like trying to put out a house fire by tending only to the smoke. For example, methamphetamine is a psychostimulant used to increase alertness, concentration, energy and can induce euphoria, enhance self-esteem and increase libido. Originally used as an anti-depressant, it is now commonly abused possibly due to being used to self-medicate underlying trauma. Treating only the addictive behavior will do little to heal the reasons why a person needs a destructive coping mechanism to function. Due to this, the ACE study encourages collaboration between physical and social sciences. Reductionist ideology separating biological, psychological and social aspects decreases professionals in every discipline’s ability to tackle public health issues. In his Executive Summary, Dr. Anda writes,
This vast array of problems that arise from ACEs calls for an integrated, rather than separate or categorical perspective of the origins of health and social problems throughout the lifespan. This approach to growing up with ACEs, and to the consequences of exposure to them, may unify and improve our understanding of many seemingly unrelated health and social problems that tend to be identified and treated as categorically separate issues in Western society. Development of more integrated approaches will likely contribute to more meaningful diagnoses, improved treatment of affected personas, and better integration of research priorities, preventive and social services and legal venues.
The ACE study assists criminal justice practitioners with the information to work collaboratively with other professionals in addressing situations in which children are being exposed to ACEs but also to assist adults struggling with past traumatic experiences presenting as criminal justice problems. One of the findings of the on-going study show the positive influence and reduction of public health problems when professionals simply acknowledge a person’s ACEs and allowing them to vocalize and, therefore, reduce the shame, secrecy and stigma of their experiences. With recognition, awareness and collaboration, first responders and others in the criminal justice field can assist with developing and applying practical solutions.
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About The Author:
Michelle Perin has been a freelance writer since 2000. Her credits include Law Enforcement Technology, Police, Law and Order, Police Times, Beyond the Badge, Michigan State Trooper, Michigan Snowmobiler Magazine and Chief of Police. She writes two columns a month for Officer.com. Michelle worked for the Phoenix (AZ) Police Department for almost eight years. In December 2010, she earned her Master’s degree in Criminology and Criminal Justice from Indiana State University. Currently, Michelle works as the Administrative Coordinator at Jasper Mountain a residential psychiatric facility for children. In her spare time, she enjoys being the fundraising coordinator for the Lane Area Ferret Shelter & Rescue, playing her bass, working on her young adult novel Desert Ice and raising her two sons in a small town in Oregon.
