Adverse Childhood Experiences "Here we are in the 21st century, they were supposed to be there to support me – and what they actually did was bring me to my knees. I could have either committed suicide or had a breakdown." (WAVE focus group attendee, August 2018) What are Adverse Childhood Experiences (ACEs)? Adverse childhood experiences (ACEs) are stressful incidents or environments a child can encounter that have the potential to cause long-lasting trauma to children. Psychological trauma is what happens when a person is overwhelmed by stress and feels they are unable to return to a “safe” state. When this occurs, it can cause lasting harm to their brain’s stress responses, potentially leaving those affected by trauma feeling like they are fighting old dangers years after they’ve passed. See the infographic below to see types of incidents counted as family ACEs and what impact they can have. Why is it important to understand ACEs? Childhood trauma is at the root of many social and personal issues in our society. Studies from the US, UK and elsewhere show clearly that ACEs can significantly raise the likelihood of over 80 negative life outcomes, including suicide attempts, alcoholism, drug addiction, criminality, mental ill health, heart disease, liver disease, obesity and many more. How does this work? Let’s imagine a young girl called Jane. Jane is a seven-year-old whose dad hits her mum regularly. She’s in a constant state of fear. Because there is no adult to protect her and the threat feels as if it’s ever present, her brain “learns” that she’s in danger at all times. It adapts to this by pumping stress hormones regularly and at higher levels during moments of perceived danger. If this happens over a long period the extra stress hormone response becomes her body’s normal way of functioning. This constant stress causes her to develop anxiety issues. As a teenager, she becomes a heavy smoker and drinker, drawn to both substances as coping mechanisms for this over-reactive survival response. Despite having potential, she finds it hard to focus in school and underachieves. When she leaves school and begins working, she finds herself regularly feeling distracted, depressed and unproductive. Her anxiety leads her to develop a meek personality, making her easy prey for partners as violent as her dad was. Over the years, all this stress, smoking, drinking, depression and violence take their toll on her health. She develops heart disease and dies at the relatively young age of 56. As sad as Jane's story is, this is happening in many thousands of homes across the UK. The more ACEs a person experiences, the harder it becomes to develop coping strategies to reduce the impact. The more stress a person undergoes, the higher the risks for things going wrong in that person's life. That's why every ACE in society is important and every one worth tackling. "Imagine you go to your GP, and they know your ACE score, and they treat you with compassion. Because they know what hell you have been through." "I found school my safe place. Out of the house. That was my salvation." "Communities need to have funding, to create long-term solutions." (WAVE focus group attendees, August 2018) Prevention and healing of ACEs It's only by understanding ACEs that we can effectively heal the hurt they cause and give people the power and freedom to transform their lives, breaking the cycle of trauma passing from parent to child as so often happens. As a society, there are a number of steps we can take that will prevent many children from experiencing ACEs in the future, as well as helping those who have been traumatised by them resolve, or at least cope better, with the impacts. We urgently need to: Prevent ACEs before they occur, especially in the crucial first 1,001 days (from conception to age 2). This includes investing in early years measures that will make parents aware of the impact of ACEs, provide support to help them overcome potential risk factors early on, and install programmes that help young children’s brains develop healthily. Train frontline service workers in trauma-informed approaches (see where this has had a significantly positive impact for police, schools and prisons). Create entire communities where knowledge of ACEs and their impact is widespread (The TiC training will show you how you can do this in your area). Of these three aims, the most important is to prevent ACEs before they occur. Only 3-5% of health spending is spent on prevention, yet over 40% of local authority spending is incurred because of issues that could have been prevented upstream. With the enormous cost savings prevention could reap, and the boost to economic productivity that would result, the right measures would pay for themselves many times over in the long run and save taxpayers huge sums. There are no excuses and the longer we wait, the more children and adults there will be unnecessarily suffering as a result. In 2018, WAVE Trust published a 4-year study into the impact of adverse childhood experiences (ACEs) on severe disadvantage throughout childhood. You can read it here.