Mayoral Musings: Adverse ExperiencesLast Edited:
Screening for Adverse Childhood Experiences can protect our children and ease burdens on society.
While talking with an acquaintance recently, we both came to the conclusion that childhood in today’s world compared to a typical childhood of a couple of generations ago, is a lot tougher, or at least it seems that way. Keep in mind that this conclusion came from two guys who entered the world during the Eisenhower administration. The subject of ACEs came up. I was not really familiar with ACEs, which in this context stands for “Adverse Childhood Experiences.”
In a nutshell, it’s the idea that what happens to children in the first decade or so of their lives continues to impact their physical health for the remainder of their days. As the word “adverse” suggests, these life experiences are negative and can include emotional abuse or neglect, physical or sexual abuse, household substance abuse, household mental illness, parental separation through divorce or death, or an incarcerated household member. It can also include a daily environment filled with fear and danger—poverty, drive-by shootings, or gang violence.
I learned that these adverse experiences may occur as a single traumatic incident, but they just as often encompass an environment where the trauma is slow and cumulative, a sort of death by lesser traumas, perhaps with chaos or loss, expressing itself in a defensive crouch that becomes the resting position each day for years of a child’s life.
The CDC recognizes ACEs as an important public health issue and multiple organizations from the American Academy of Pediatrics (AAP) to the Robert Wood Johnson Foundation have studied the role of ACEs on individuals, families and communities. These a good starting place for information and resources to help understand and deal with ACEs.
Two things stand out to me about Adverse Childhood Experiences. The first is that overwhelming stress in childhood leaves physical impacts due to the psychological effects. Secondly, ACEs and the resulting stress is not confined to any one ethnic, racial, or income group, though the incidences are higher for those living in poverty.
We’re not talking about normal stress, meaning the stress that generally makes us more resilient and stronger as people, but the type of stress that the AAP calls “toxic stress,” described as a “strong, frequent, or prolonged activation of the body’s stress response systems.”
As I think about this description, I conjure up that cocktail of adrenaline and cortisol that surges through us in times of fear, trauma, or danger. To imagine it, I tried to recall the moment I locked up the brakes and swerved to avoid oncoming traffic or those hours in the patient lounge waiting to find out if my loved one made it off the operating table. For you, it might be something that put your heart in your throat and those “butterflies” in your gut while pushing your blood pressure off the charts.
Imagine this level of stress in a developing child that never eases or stops. Researchers know that the genes involved with the neuroendocrine system that regulates eating, drinking, metabolism, blood pressure and certain behaviors are strongly influenced by our experiences. When a child’s body grows and develops under conditions of toxic stress, changes to these genes can occur and cause changes in the developing brain. Researchers are connecting those dots between these changes in childhood and adult heart disease, alcoholism, obesity, mental health, and drug use.
This matters because while most parents and families intuitively understand the damage and destruction that occur from physical and sexual abuse, it can be easy to underestimate or simply ignore so many other factors, especially if daily life is consumed with simply surviving. Sometimes it takes a herculean effort to keep our worries, fears, hurts, resentments, bitterness, or bad habits from becoming our children’s burden, but that too is part of protecting them and breaking the generational cycle of health and other problems that run in too many families.
In New Jersey, Cape May and Cumberland counties were ranked lowest in safety and well-being, according to the AAP. To make progress, we’ll need our schools and healthcare organizations to focus us more on identification and early intervention of ACEs through screenings and assessments, both to protect children and ease burdens on the healthcare system and our public assistance safety net.
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