The CDC-Kaiser Permanente Adverse Childhood Experiences Study found that survivors of childhood trauma are up to 5,000 percent more likely to attempt suicide, have eating disorders, or become IV drug users. Dr. Vincent Felitti, the study’s co-founder, details this remarkable and powerful connection in a video produced by Big Think.
When students show up for an appointment at the Elsie Allen Health Center, which is located on the Elsie Allen High School campus in Santa Rosa, CA, one of the first things they do is answer questions about the trauma they’ve experienced during their lives.
That’s because research has shown a direct link between adverse childhood experiences — ACEs – and the adult onset of chronic disease, mental illness, violence and being a victim of violence. The CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study) — which has been replicated by 29 states — also show that ACEs create mental and physical health risks that continue to crop up over a person’s lifetime if not adequately addressed.
The Children’s Clinic, tucked in a busy office park five miles outside downtown Portland, OR, and bustling with noisy babies, boisterous kids and energetic pediatricians, seems ordinary enough. But, for the last two years, a quiet revolution has been brewing in its exam rooms: When parents bring their four-month-old babies in for well-baby checkups, they talk about their own childhood trauma with their kid’s pediatrician.
Wait. What’s Mom or Dad’s childhood got to do with the health of their baby? And aren’t pediatricians supposed to take care of kids? Not kids’ parents?
It turns out that just 14 questions about the childhood experiences of parents provide information critical to the future health of their baby, say Children’s Clinic pediatricians Teri Pettersen and RJ Gillespie. The answer to the questions can help determine not only if the child will succeed in school, but when the child becomes an adult, whether she or he is likely to suffer chronic disease, mental illness, become violent or a victim of violence.
They explain how this is possible.
It’s an understatement to say that raising a kid is a challenge, and not for the faint of heart. The many stressful moments of an infant or a toddler’s life include tantrums, colic, toilet training, sleep problems, colds, hitting and biting, say Pettersen and Gillespie.
“At some point, a toddler is likely to hit or bite Mom and Dad,” says Pettersen. “How will they respond?”
If parents have grown up with a lot of adversity in their lives and little help in understanding how that adversity affects their behavior and how they react to stress, they’re more likely to pass that on to their children, even if they don’t intend to, by reacting without thinking in typical “fight, flight or fright (freeze)” mode. They may hit the child, walk away from the child who’s asking for attention (albeit in a negative way), or freeze, only to be bitten or hit some more. None of that helps grow a healthy child or a healthy relationship between the parent and child.
Long story short: The physicians at the Children’s Clinic believe that asking parents about their own childhood adversity is a good start to preventing their children from experiencing childhood trauma.
If you want to know why you’ve been married three – or more — times. Or why you just can’t stop smoking. Or why the ability to control your drinking is slipping away from you. Or why you have so many physical problems that doctors just can’t seem to help you with. Or why you feel as if there’s no joy in your life even though you’re
Childhood trauma isn’t something you just get over as you grow up. In this 16-minute TED Talk, pediatrician Nadine Burke Harris explains that the repeated stress of abuse, neglect and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain.
This unfolds across a lifetime, to the point where those who’ve experienced high levels of trauma are at triple the risk for heart disease and lung cancer. This is an impassioned plea for pediatric medicine to confront the prevention and treatment of trauma, head-on.
Nearly two-thirds of California adults have experienced at least one type of major childhood trauma, such as physical, verbal or sexual abuse, or living with a family member who abuses alcohol or is depressed, according to a report released today.
The report – “Hidden Crisis: Findings on Adverse Childhood Experiences in California” (HiddenCrisis_Report_1014) – also reveals the effects of those early adversities: a startling and large increased risk of the adult onset of chronic disease, such as heart disease and cancer, mental illness and violence or being a victim of violence.
Ten types of childhood trauma were measured. They include physical, sexual and verbal abuse, and physical and emotional neglect. Five family dysfunctions were also measured: a family member diagnosed with mental illness, addicted to alcohol or other drug, or who has been incarcerated; witnessing a mother being abused, an losing a parent to separation, divorce or other reason.
Sue Mackey Andrews will talk to anyone about adverse childhood experiences, or ACEs: Pediatricians. Early childcare workers. Parent advocacy groups. And those on the front lines who work with kids, like the longtime school bus driver from rural Maine, a gruff and taciturn man who insisted, during a half-day school district inservice, that trauma and resilience had nothing to do with his work.
The driver also told Andrews that he would not start the bus each day until he had made eye contact with every single child and greeted him or her by name. And that, Andrews responded, was exactly the relevance of his work to build resilience.
The tagline of the Maine Resilience Building Network (MRBN), which Andrews co-facilitates, is “Join the Conversation.” The
group, formed in the spring of 2012, brings together practitioners in medical care, education and behavioral health, along with those working in business, law enforcement, the military, juvenile justice and faith communities.
Since its early meetings, comprising a half-dozen people, all of them doing work based on research into childhood adversity, MRBN has grown to include 77 members, with reach into all of Maine’s 16 counties.
From the beginning, said Andrews and MRBN co-facilitator Leslie Forstadt, associate professor with the University of Maine Cooperative Extension, the group agreed that the message should focus on wellness and healing rather than illness and trauma.
The word “resilience” had to be part of the name because, said Andrews, “we talk about how it’s never too late to realize your ACEs and, through support and personal discovery, overcome them.” The term “building” captured the sense of a growing effort, and “network” aptly described how individual sites would function autonomously while sharing their innovations, challenges and questions.
The term “ACEs” has its origins in the CDC-Kaiser Adverse Childhood Experiences Study. The study revealed a direct link between 10 types of childhood adversity and the adult onset of chronic disease (cancer, heart disease, diabetes, autoimmune diseases, etc.), mental illness, violence and being a victim of violence. It showed that childhood trauma was very common — two-thirds of adults have
Many people are happy that the Vikings kicked Adrian Peterson off the team and that Ray Rice can no longer play for the Ravens. Their off-field violence has cascaded into harm and loss for everyone involved – spouses, children, team, league and fans — all because of the consequences of their childhood trauma. And the only way the NFL can stop further abuse, harm and loss is…well…to deal with its players’ childhood trauma.
The severe and toxic stresses in Peterson’s past – or what we in the trauma-informed community count on a scale from one to 10 as adverse childhood experiences or ACEs – aren’t minor. As a child, he lost his father to prison, suffered through his parents’ divorce, saw his brother killed by a drunk driver, and was beaten by his stepfather. Repeating the pattern, he whipped his own four-year-old son with a switch so harshly that he raised welts on the child’s body. And if Peterson is convicted and goes to prison, his son can add another ACE to his trauma-filled life.
Fact #1: People who were abused and neglected when they were kids have poorer physical and mental health. The more types of ACEs (adverse childhood experiences) – physical abuse, an alcoholic father, an abused mother, etc. – the higher the risk of heart disease, depression, diabetes, obesity, being violent or experiencing violence. Got an ACE score of 4 or more? Your risk of heart disease increases 200%. Your risk of suicide increases 1200%.
Fact #2: Mindfulness practices improve people’s physical and mental health.
Now, says Dr. Robert Whitaker, a pediatrician and professor of pediatrics and public health at Temple University, there’s one more important fact: People who are mindful are physically and mentally healthier, no matter what their ACE scores are.
This study, to be published in the October issue of Preventive Medicine, is the first to look at the relationship between ACEs, mindfulness and health. And it has implications for anyone, and especially those who take care of children– teachers, parents, coaches, healthcare and childcare workers.
Many people think of mindfulness as sitting around and saying “Ommmm.” There’s actually more to it, and it’s worth explaining. People who aren’t mindful don’t regulate their own emotions very well. Situations that trigger traumatic memories may cause people who aren’t mindful to lose focus on what’s happening currently, and lead them to make snap judgments and have knee-jerk reactions of anger, frustration, or fear, which can further the spread stress and trauma. They also ruminate on situations they can’t control, and can’t let go. And they may not even be conscious that they’re doing any of this. They just think it’s part of their personality.
Here’s what it’s like not to be mindful:
- “My co-worker’s angry today. I must have done something wrong. She’s JUST like my mother: moody, angry, a screamer. Well, I’d better get my defenses up and give her a piece of my mind before she attacks me.”
When parents bring their four-month-olds to a well-baby checkup at the Children’s Clinic in Portland, OR, Drs. Teri Pettersen, R.J. Gillespie and their 15 other partners ask the parents about their adverse childhood experiences (ACEs).
When parents bring a child who’s bouncing off the walls and having nightmares to the Bayview Child Health Center in San Francisco, Dr. Nadine Burke Harris doesn’t ask: “What’s wrong with this child?” Instead, she asks, “What happened to this child?” and calculates the child’s ACE score.
In rural northern Michigan, a teacher tells a parent that her “problem” child has ADHD and needs drugs. The parent brings the child to see Dr. Tina Marie Hahn, who experienced more childhood trauma than most people. Instead of writing a prescription, Hahn has a heart-to-heart conversation with the parent and the child about what’s happening in their lives that might be leading to the behavior, and figures out the child’s ACE score.
What’s an ACE score? Think of it as a cholesterol score for childhood trauma.
Why is it important? Because childhood trauma can cause the adult onset of chronic disease (including cancer, heart disease and diabetes), mental illness, violence, becoming a victim of violence, divorce, broken bones, obesity, teen and unwanted pregnancies, and work absences.
The CDC’s Adverse Childhood Experiences Study (ACE Study) measured 10 types of childhood adversity: sexual, physical and verbal abuse, and