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Adverse Childhood Experience

August 6, 2015

The Adverse Childhood Experience (commonly referred to as the ACE study) was co-authored by Dr.’s Robert Anda and Vincent Felitti from the Centers for Disease Control and Kaiser Permanente, respectively. It was designed to address scientific gaps between certain known risk factors and poor overall health, both physical and mental. The risk factors included five categories of abuse and neglect which were physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect. Five categories of household dysfunction were also examined including mother being treated violently, household substance abuse, household mental illness, parental separation or divorce, and an incarcerated household member. The study found that there is direct, graded correlation between the number of adverse childhood experiences and poor physical and mental health outcomes including substance abuse, depression, smoking, suicide attempts and many other physical and mental health issues.

This work has been foundational in Hillcrest Family Services’ effort to be trauma informed and trauma sensitive in all aspects of our service delivery. While statistics regarding the number of adults and adolescents with mental health concerns who have experienced childhood trauma and adversity varies from roughly 80 to 90 percent, we recommend treating all the adolescents in our group care facilities as if they have had some exposure due to the prevalence of these experiences in the populations that we serve. Doing so encourages us to be sensitive to the neurological, physiological and emotional dysregulation experienced by the vast majority of our clients.

By being sensitive to the effects of trauma and adversity on the lives of the people to whom we provide services, we can see them as individuals who are doing their best to cope with the effects of trauma and adversity, rather than individuals who are simply making “poor behavioral choices”. Thus, on a very basic level, we no longer ask the (wrong) question, “What’s wrong with you?”, but instead ask (the right question), “What’s happened to you?”. This, then, helps guide us in a collaborative, client centered approach to services.

Many states, including Iowa, have done their own ACE studies and made that data available. For more information please visit the CDC’s website. Dr. Felitti’s article “Turning Gold into Lead” is also well worth reading.

– Paul Goldstein, Director of Residential Education, Hillcrest Family Services