Why all the Hype? Understanding Adverse Childhood Experiences

My only experience with poker cards is an annoying game called “52 card pick up” that my grandpa taunted us with as young kids. In case you have yet to experience this joyous game, here is how it works: The said individual will ask you if you want to play “52 card pick up” (HINT say no) and when you get excited, they will hurl the cards into the air and say…pick them up. Yes, so much fun (insert eye roll).

Even though I really do not understand how to play poker, I do understand that the more Ace cards you possess, the higher probability of winning the game. However, in real life possessing a lot of ACEs can mean an entirely different scenario.

Adverse Childhood Experiences, more commonly referred to as ACEs, are currently receiving a lot of well-deserved media focus. ACEs are defined as stressful or traumatic events that children experience before age 18.

Most often when we think of childhood trauma we think of physical abuse, neglect, and sexual abuse. While these are certainly on the list, there are other childhood events that are included.

Some of these events labeled as ACEs may be surprising to many because they have become so commonplace in our society. Yet they can cause long-term psychological and physiological damage. For example, if someone had asked me five years ago if I had experienced trauma in my childhood, I would have said “No way, I had a picture-perfect childhood.”

However, as we look at the ACEs rating scale, growing up in a home with mental illness as I did is considered an ACE… TICK… just like that my scorecard begins to fill.

In addition to living with a mentally-ill family member, events such as divorce, living in poverty, parents with substance dependence, or a parent missing due to death or incarceration also adds to ACEs count.

While no adverse childhood experience is what we would hope for, the reality is that two out of three adults in the US have experienced one ACE.

In addition, one out of eight adults has experienced four or more ACEs. Before we get too deep into the dark forest of the negative impacts of ACEs, let’s explore some good news. Given that many of us have experienced ACEs, I have learned that it is important to present the positive research mixed in with negative as to not overwhelm the reader.

Daily we are learning more about two amazing things…protective factors and the ability of the brain to heal from trauma. Protective factors are conditions in families and communities that serve as buffers thereby increasing the health and well -being of children and families.

These include social and emotional competence, social connections, concrete support, knowledge of parenting and child development and resilience. So, in comic book terms, ACEs are the villains and protective factors are the superheroes! Great news for a child like me growing up with extensive mental illness in the family, these adverse experiences were offset by the presence of many of the protective factors above.

Equally encouraging is the almost daily research coming forth related to neuroplasticity or the ability of the brain to heal from trauma. This is so helpful for people who have experienced trauma who might otherwise believe that the brain is hard-wired and therefore what happened to them cannot be changed. Another wonderful development, as therapists we are learning safer ways (called trauma-informed) to make treatment of traumatic events less stressful for people.

We have long suspected the psychological impacts of trauma leading to increased risk for mental illness and substance use disorders. However, recently the science is revealing concerning connections between childhood trauma and severe health consequences.

Growing bodies of research are demonstrating how traumatic events can literally change our brain and, in some cases, our very DNA! As the number of adverse childhood experiences goes up, so does the risk of not only mental illness and substance abuse but also heart disease, stroke, cancer, diabetes, and COPD.

As we as a nation are swimming upstream to battle an increasing opioid epidemic, here is a jaw-dropping statistic… having an ACE score of 4 or more increases the risk of injectable drug use greater than 10 times those with no ACEs.

You do not have to be a math whiz (whew!) to interpret that this is an insane amount of risk. We can no longer see childhood trauma as just a sad and terrible social justice issue. It’s at the root of many of our public health emergencies.

So, what are these scores I am talking about? An ACE score is calculated by asking questions related to events that occurred prior to your 18th birthday. Each question is answered either YES or NO. For every YES response you receive one point. At the end of the 10-question survey, your score is the total of all your responses. The goal here is a lot like golf, the lower the score the better!

Likewise, a resiliency score is calculated by a questionnaire that asks questions related to your childhood. Remember, like I shared earlier, protective factors can serve as a buffer to counter the impacts of some ACEs. This is great news because knowing what protects children gives us a compass–as families and communities–to guide us.

What do you do with this important information? First, know your own ACE score as well as your resiliency score which can be calculated here.

No matter if your score is high or low, if you feel that you have experienced any trauma or unresolved issues from your past that need to be dealt with now is the time to reach out to a trained professional for help.

The purpose of RCC is to offer education and advocacy, we do not offer professional counseling services. If you are unsure where to turn in your community, contact your primary care physician for direction to begin your healing journey.

Finally, be an advocate for children and families in your community. Think about what you can bring to the table in way of protective factors such as social and emotional competence, social connections, concrete support, knowledge of parenting and child development and resilience. Think about how you can offer this not only in your own family but to your community.

You may be someone’s superhero to counteract their ACEs.  Let’s work together to give kids the winning hand full of protective factors and put ACEs where they belong–in the discard pile.

As always, until next time may you be well, may you be loved, and may you know true peace.