Today, many children across the UK get off to a very difficult start. Adverse Childhood Experiences (ACEs) during the early years, like abuse and neglect, can do lifelong harm. Until we succeed in preventing ACEs, we cannot hope to seriously reduce entrenched social problems such as violence, mental illness and homelessness.


What prevention of adverse childhood experiences means

Adverse childhood experiences (ACEs) can affect children at any point in their young lives, while trauma can affect adults at any age. However, a child is most likely to experience adversity during their earliest years. Because of the way the brain develops, harm caused during this time is also more likely to be severe and long-lasting.

If an infant is raised in a safe, nurturing environment which is free from persistent stress, they will likely become a healthy, resilient person. Yet an infant raised in a dysfunctional, stressful or dangerous environment will likely see their social and emotional growth severely impaired. As such, this period carries both enormous opportunity and risk for the later life chances of each child.

To prevent ACEs in these crucial early years, we must:

  • Identify where risk factors exist in the household (primarily mental illness, domestic violence, addiction and parents’ histories of trauma) and work with parents to mitigate and resolve them as soon as possible during the perinatal period.

  • Implement programmes and systems that assess children’s development during their early years, particularly for attunement and attachment, and provide evidence-based support to parents where helpful.

Other factors that would be beneficial to this preventive approach include spreading awareness about ACEs and trauma among parents, including through parenting classes; discussing parents’ own histories of trauma with them; a trauma-informed early years’ workforce; and establishing a trauma-informed community.


Why is prevention crucial?

Any attempt to avoid children experiencing trauma is a worthy goal in its own right, particularly during the earliest years. But there are other more strategic reasons why focusing on prevention during this period is a wise move. Damage caused during this period is more likely to be severe, long-lasting and harder to resolve later on than if it occurred at any other time. This period also provides an opportunity to build strong emotional foundations, strengthening the child’s ability to withstand traumatic incidents later in life.

The evidence shows a strong economic case for prevention, especially for the local authorities who would fund and lead such an initiative. Only c.3% of public spending on children is spent on prevention of child harm. The result is that c.£23 billion is spent every year on the social problems arising from early childhood adversity. 

The Christie Commission on local government spending stated in 2011 that up to 40% of local government expenditure is incurred because of 'failure demand' – in other words, because of a failure to prevent issues further upstream.

Our 2018 report into severe and multiple disadvantage showed that ACEs lie at the root of many problems that local authorities have to deal with, including homelessness, school exclusions, juvenile crime, drug-taking and so on. They are contributing significantly to ever increasing demand which is costing councils, health bodies, police and other services far too much. Budgets are dwindling, many local services are no longer affordable, and councils are going into the red.

Prevention saves money. Prevention saves lives. UK and US economic analyses show that for every £1 spent on prevention, the savings will be between £5-10. We must prevent ACEs during the earliest years. We must help children develop healthily and help them become pro-social citizens. 

When residents and services understand the impact of trauma and adapt their approaches to handle trauma effectively  then we will make lasting social transformation. We need to start now.