April is child abuse prevention month. We urge everyone in the community to step back, and to consider this issue in the context of Adverse Childhood Experiences, or ACEs. Take some time to learn about this issue and the short- and long-term impacts that ACEs have on our children and their lives, and help do something about it.

ACEs were first assessed in a longitudinal study conducted by the Centers for Disease Control and Prevention and Kaiser Permanente. The study, which recruited participants in 1995 and 1997, asked 17,500 adults about their exposure to 10 types of ACEs as children. The study found that people who were exposed to four of more ACEs were two and one half times more likely to have chronic obstructive pulmonary disease than persons who had zero ACEs, were four times more likely to suffer from depression, were 12 times more likely to commit suicide. A person with seven or more ACEs was three times more likely to incur lung cancer and ischemic heart disease, a leading cause of death.

There have been many other studies which use slightly different variations of the ACEs. One recent study used these ACEs: experienced extreme economic hardship; parents divorced or separated; lived with someone with an alcohol or drug problem; witnessed or was the victim of neighborhood violence; lived with someone who was mentally ill or suicidal; witnessed domestic violence; parent served time in jail; was treated or judged unfairly due to race/ethnicity; and death of a parent.

Everyone experiences adversity and stress. Experiencing moderate, short-lived stress is a normal part of life, and learning how to adjust to it is an essential feature of healthy development. But there is a dose effect. At some point, adversity and stress becomes toxic, where it is strong, frequent, and triggers prolonged activation of the body’s stress management system. 

One example given is if you see a bear in the woods, your brain sends a signal to release stress hormones, adrenaline, and cortisol. That prepares you to fight the bear or run (neither of which may be the smart move). It is a defensive response. The problem is if your body activates this system repeatedly every day, it goes from being an adaptive life-saving mechanism to something that is toxic.

A child who is exposed to toxic stressors such as recurrent child abuse or neglect, severe maternal depression, parental substance abuse, or family violence can suffer adverse effects. These early experiences “can have adverse effects on developing brain architecture, which weakens the foundation upon which future learning, behavior, and health are built,” says the Scientific Council on the Developing Child. 

One study of children in an urban setting found that 51% of the children who were exposed to four ACEs had learning/behavioral problems, compared to 2.3% of the children who had one ACE.

Another study found that students who were exposed to three ACEs are three times as likely to experience academic failure, six times as likely to have behavioral problems, and five times as likely to have attendance problems.

The reason given is that children with toxic stress live much of their lives in a defensive mode, and their brains develop to cope or survive in a stressful environment. This impacts their ability to concentrate in a classroom and to focus on learning. They may fall behind in school, they may fail to develop healthy relationships with peers, or they may create discipline problems.

Many communities are addressing childhood ACEs and trauma in ways that build resiliency, and, importantly, in ways that do not simply magnify the problem. This requires new ways to address children’s needs in schools, in health facilities, in social service programs, and in the criminal justice program.

School Districts 65 and 202 are on top of this and are attempting to address students’ needs in a holistic manner. They are partnering with agencies in the community to do so. The Evanston Cradle to Career initiative is considering overarching three-year goals, one of which focuses on childhood trauma and trauma-informed care. This is also on the radar of many social service agencies and health providers in the City.

It is something, though, we should all be concerned about.