Over the past decades, mental health has become more and more of a focus in determining the overall wellbeing of individuals and families. Assessing challenges and experiences that formed a person’s growth, adjustment, and psychological wellness can be instrumental in having a full understanding of their unique outlook. The largest period of a person’s life where these impacts are found is during childhood. This formative time in a human’s life leaves them susceptible to adverse childhood experiences that can have long-lasting effects.
Adverse childhood experiences (ACEs) are traumatic occurrences in a child’s life that can have long-lasting repercussions. The Center for Disease Control (CDC) lists violence, abuse, neglect, witnessing violence either in the home or the community, a family attempting suicide as common examples of adverse childhood experiences. Also, home environments where children are exposed to substance abuse, mental health problems, and separation of parents can constitute ACEs.
Adverse childhood experiences negatively influence both the mental health and physical health of their victims. In the areas of mental health, those suffering through ACEs in life are less likely to succeed in school, more likely to develop substance abuse problems, reduce earning potential, and hinder healthy relationships. From a physical standpoint, ACEs are associated with higher rates of heart disease, cancer, and toxic stress.
The impact of adverse childhood experiences on the individual and on society simply cannot be overstated. The CDC estimates that almost 2 million cases of heart disease and 21 million cases of depression could have been avoided had ACEs been prevented in the lives of those individuals. Millions upon millions of people are dealing with the fallout of these formative experiences on a daily basis.
The Center for Disease Control identifies 10 adverse childhood experiences and grouped them into 3 broader categories.
While certain ACEs are most common amongst various ethnic and socioeconomic grounds, parental separation is the most common adverse childhood experience across all groups of people. Family separation leads to fear and uncertainty about what the future holds and leads to deep feelings of insecurity. Studies have shown that children who are in homes with separated parents experience higher rates of behavioral, psychological, and academic difficulty.
Unfortunately, adverse childhood experiences are extremely common in American society. The Center for Disease Control estimates that 61% of adults report experiencing at least one ACE in their lifetime. Beyond that nearly 1 in 6 reports experiencing four or more. These statistics point to a significant portion of the population who is struggling with the adverse effects of these experiences.
Adverse childhood experiences put children at a higher risk of developing mental health conditions such as depression, anxiety, and substance abuse. These conditions, when left unchecked, can become very serious in future years. The toxic stress of these experiences affects attention span, the ability to constructively respond to daily life stress, the ability to effectively learn, and sound decision making.
Children that have these experiences are also more likely to possess a poorer quality of health. Some studies even show that these individuals are at a higher risk for chronic diseases such as cancer, heart disease, and diabetes. Additionally, ACEs are associated with a higher risk of suicide.
These chronic diseases can have a ripple effect on the lives of those they touch. An individual struggling with depression resulting from an adverse childhood experience is likely to have a difficult time managing their own care and maintaining a much-needed positive outlook when facing a serious health crisis. ACEs not only put individuals at risk for many chronic illnesses, but they can also deprive them of the coping skills they need to fully combat their health issues.
Toxic stress is described as excessive activation of the stress response system. Stress is an expected part of everyone’s life but it becomes toxic when it is excessive and pervasive in a person’s environment. Children who struggle with adverse childhood experiences are much more prone to toxic stress which puts their health and well-being in jeopardy. Toxic stress is extremely damaging to the development of a child’s brain.
Children who experience toxic stress may struggle with stress management, coping skills, unhealthy lifestyle choices, and a variety of other struggles later in life. The sometimes delayed impact of childhood toxic stress is a particularly malicious aspect of the experience.
Children with support structures around them often learn to manage and ward off the effects of toxic stress but, unfortunately, most children struggling with multiple adverse childhood experiences may not have access to such a network.
Combating ACEs generally involves creating a solid support system around a child. Children who are nurtured, feel safe, and have a degree of stability are much more likely to be successful. Here are some strategies for combating ACEs:
Adults who experienced ACEs have many avenues available to them for working through their traumas. First and foremost, seeking out a training therapist to help is the most beneficial. Therapists and case managers are trained to help individuals work through the trauma in their lives and come out stronger on the other side.
Adults can also take the ACE test (as discussed below) to assess how far-reaching their experiences are and just how many ACEs they may have been through. This can be a helpful exercise before entering therapy as a way to jog a memory about experiences that may have been overlooked.
Lastly, self-care experiences such as yoga, exercise, journaling, or joining a support group are a great way to work on treating these experiences day today.
The ACE score is a number derived from a test designed to gauge the degree of difficulty in a person’s childhood. The higher score, the most adverse child experiences someone has endured. This score represents the degree of negative experiences in a person’s life that might influence their health and well-being later on.
The score is derived from a ten-question survey that asks about various types of ACEs a person may have experienced before they were 18. One point is added for each “yes” answer indicating that the test taker did experience that ACE.
The score is meant to be a loose guide and not to be taken as a scientific indicator of the severity of ACE. Positive experiences, individual differences, and external influences that may play a large role in a child’s development are not taken into consideration in this test.
So what does this test look like practically? If a person were to take the test and answered four of the questions yes (indicating that they experienced four of the adverse childhood experiences at some point before their eighteenth birthday) they would have an ACE score of four.
The score of four in and of itself is not inconsequential. Women and racial minorities are at a higher risk than other groups for experiencing four or more ACEs.
The Adverse Childhood Experience International Questionnaire is an internationally utilized standard measure of ACEs. The questionnaire is intended to be administered to individuals aged 18 years and older and consists of 43 items. The results are used to evaluate childhood exposure to trauma. Often the results of this questionnaire are dependent upon the recollections of the individual taking the test.
During childhood development, schools and community organizations are often some of the most influential forces in a person’s life. Counselors and mentors at schools and in the community offer an avenue of hope for those who are currently experiencing or may have experienced trauma.
School counselors are a tremendous resource for children due to their accessibility and network. Counselors can be someone to just listen to or can be a stepping stone to more advanced solutions such as therapy.
Communities also play a significant role in preventing adverse childhood experiences. Access to safe and reliable child care facilitates not only a refuge and sense of belonging for young children but also allows for parents to work and create a firm financial foundation for the family.
Additionally, the social work resources available in a community play a large role. Helping adults who suffered through adverse childhood experiences understand their toxic stress which in turn helps to prevent them from passing on those same experiences to their children. The community helps to stop the cycle of adverse childhood experiences in families.
Technology plays an ever-increasing role in our health care. Mental health and adverse childhood experience therapy are no different.
In recent years, technology has advanced to the point where counselors are able to use artificial intelligence to detect signs of adverse childhood experiences in real-time as data is gathered. The real-time data gathered at in-person consultations helps both the health practitioner and the patient assess the conversation.
The case managers that work with children and adults who are dealing with traumatic experiences resulting from adverse childhood experiences do very important work. They are tasked with understanding the pain and trauma of a person’s formative years and helping them work toward positive solutions. They help children and adults overcome the negative events in their lives that formed much of who they are.
Successful case managers impact not only the immediate lives of those they work with but the next generation in that person’s family who will benefit from the help their parents receive.
Case management software is another way that technology helps in the prevention of adverse childhood experiences by helping case managers working with clients be as effective and successful as they possibly can be. PlanStreet’s unique and user-friendly case management software is designed to be flexible and comprehensive.
Case managers can onboard clients, track confidential information safely and securely, share information with peers and fellow counselors, schedule appointments, and document case progress all in one place. Additionally, with the software being web-based, case managers can access their case files from anywhere.
The ability to work on the go and in virtual workspaces has never been more important. PlanStreet is uniquely positioned to be a one-stop-shop solution for case managers who are ready to take their service to the next level.