So THAT Explains It! Or, Childhood Trauma's Long-Term Consequences

       Question: What do the following have in common when experienced by children?

1. Physical, sexual and verbal abuse

2. Physical and emotional neglect

3. A family member who is:

       Answer: The onset in adulthood of chronic diseases like heart disease and diabetes, depression and other mental illness, violence, and being a victim of violence.

Discussion

In the 1990s, Kaiser Permanente and the Centers for Disease Control initiated a research study called the Adverse Childhood Experiences Study (ACE Study), which surveyed over 17,000 patient volunteers. The volunteers were asked if they had experienced 10 types of childhood trauma —the same 10 listed in the question above—and have been followed ever since to see how long they live, what diseases they acquire, and what major events take place in their lives. A few of the study’s findings:

        - ACEs are common—almost two-thirds of study participants reported at least one ACE, and more than one of five reported three or more ACEs.

         - ACEs don’t occur alone; if you have one, there’s an 87 percent chance that you have two or more. 

         - Compared to an ACE score of zero, having four adverse childhood experiences was associated with a seven-fold increase in alcoholism, a doubling of risk of being diagnosed with cancer, and a four-fold increase in emphysema.

         - An ACE score above six was associated with a 30-fold increase in attempted suicide.

         - The greater the ACE score, the greater the risk for chronic health diseases such as type 2 (adult onset) diabetes, heart disease, and cancer.

 

The mechanism by which early childhood traumas later manifest as disease, depression, mental illness, and/or violent behaviors is not clearly understood, but researchers generally agree that childhood trauma produces profound and long-lasting effects on children’s brains. Unabated stress caused by traumatic events appears to be toxic. Toxic stress occurs when a child’s brain and body produce an overload of stress hormones that harm the function and structure of the brain, which is developing at a galloping pace from before birth to age three. Toxic stress can come in response to living for months or years with a screaming alcoholic father, a severely depressed and neglectful mother, or a parent who takes out life’s frustrations by whipping a belt across a child’s body. (Of course, there are many other types of childhood trauma—such as witnessing a sibling being abused, witnessing violence outside the home, witnessing a father being abused by a mother, being bullied by a classmate or teacher—but only 10 types were measured in the study.)

ACES in Mendocino County

No one has surveyed local residents with regard to ACES. But a quick look at some Healthy Mendocino indicators suggests we have a problem. First of all, many families are under economic stress, with 28.4 percent of Mendocino County children living below poverty ($23,050 for a family of four) and some areas, such as Anderson Valley and Round Valley, having much higher rates. With widespread poverty and easy access to drugs in Mendocino County, it is not surprising that our rate of confirmed cases of child abuse (17.9 per 1,000) is eighth highest (out of 58 counties) in the State and more than double the statewide average (8.7 per 1,000). Local professionals in the field report that virtually all cases of abuse in Mendocino County involve substance use.

Dealing with ACES

Some of the worst health and social problems in our nation arise as a consequence of ACES. Realizing these connections is the first step toward prevention and recovery. Understanding how to counteract the toxic effects of ACES is the next step. Fortunately, in Mendocino County there are agencies and organizations that are acquainted with ACES research and use a “trauma-informed” approach to services. In a trauma-informed approach, the whole community understands the prevalence and impact of ACEs, the role trauma plays in people’s lives, and the complex and varied paths for healing and recovery. A trauma-informed approach asks: “What happened to you?” instead of “What’s wrong with you?” It is designed to avoid re-traumatizing already traumatized people, with a focus on “safety first” (including emotional safety) and a commitment to do no harm.

Locally, FIRST 5 Mendocino, SPACE, many local schools, foster family agencies, and Mendocino County Health and Human Services take a trauma-informed approach to working with children. As one ACES researcher put it, “it can take just one adult to shield a child from adversity by creating a microenvironment of safety and predictability amid family distress, poverty, discrimination or violence.” And simple acts that anyone can perform, such as responding when a baby cries, playing with a child, and praising good behavior can help counter childhood stress and the biological harm that can come with it.

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Mari Rodin, is a writer for FIRST 5 Mendocino and SPACE. She can be reached at rodin@pacific.net