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Adverse Childhood Experiences

AN EXPLORATION BY DANIELLE ARE,


ALISHA DRABEK, AND VIOLET BROOKS
What is an ACE?

Adverse childhood Experiences


(ACEs) are potentially
traumatic events that can have
negative, lasting effects on
health and well-being. These
experiences range from
physical, emotional, or sexual
abuse to parental divorce or
the incarceration of a parent or
guardian. It can be a single
event, or an ongoing chronic
issue.
Types of Trauma

Acute: Toxic: Complex:


Trauma resulting from Prolonged trauma, Varied and multiple
a single incident. like domestic traumatic events.
violence or abuse. Ongoing abuse,
This could be to the parents struggling
child or parent. with mental
disorders or
addictions
One in Four Students Has Experienced a
Traumatic Event
Type of ACEs –
Trauma & Toxic Stress

 Physical abuse
 Sexual abuse
 Emotional abuse
 Physical neglect
 Emotional neglect
 Mother treated violently
 Substance misuse within household
 Household mental illness
 Parental separation or divorce
 Incarcerated household member
Averse Childhood Experience Study and ACE
score:

• Felitti- Obesity clinic drop out rates


• Vince Felitti- Kaiser and Bob Anda- CDC began study an
ongoing study started in 1995
• Examined 10 major points that they identified as traumatic
to children
• Interviewed 17,500 adults
• Assigned one point for each event (Ace Score)
• Noticed a correlation
So, what’s your ACE score?

http://www.npr.org/sections/health-
shots/2015/03/02/387007941/take-the-ace-quiz-
and-learn-what-it-does-and-doesnt-mean
Results of the 1995 study:

ACEs are common:


67% had 1 ACE 12.6% had 4 or more

Dose/Response relationship between ACE and health outcomes


as compared to a score of 0.
4 or more:
COPD: 2.5X
Hepatitis: 2.5X
Depression: 4.5X
Suicidality: 12X
7 or more:
Triple the lifetime risk of lung cancer
3.5X the risk of Ischemic Heart Disease

“Adverse Childhood Experiences are the single greatest unaddressed public health threat
facing our nation today.”
-Robert Block PhD, American Academy of Pediatrics
Bottom Line:

Those with an ACEs score of four or more are three


times as likely to experience heart disease and are
more likely to experience a 20 year difference in
life expectancy. Even those that DO NOT
participate in high risk behaviors.
How Does It Effect the Child?

 Flight or Fight Response


 Inhibits the growth of the pleasure/reward section of the
brain
 Inhibits prefrontal cortex (learning center of the brain/
impulse control)
 MRI’s show differences in the amygdale (anger/fear)
 Growth of the immune system
 Hormonal System
 DNA replication
Healthy Vs. ACEs Brain
High Risk Behaviors

Students who have higher ACEs scores are more likely to


experience:
Alcoholism and  Ischemic heart Suicide attempts
alcohol abuse disease (IHD) Unintended
Chronic obstructive  Liver disease pregnancies
pulmonary disease  Risk for intimate Early initiation of
(COPD) partner violence smoking
Depression  Multiple sexual Early initiation of
Fetal death partners sexual activity
Health-related  Sexually Adolescent
quality of life transmitted pregnancy
Illicit drug use diseases (STDs) Lung cancer
 Smoking
What Does This Look Like in the Classroom?

 Difficulty trusting and benefiting from relationships


 Disrupted cognitive processes, such as memory, attention
and thinking
 Increased risk of chronic health conditions
 Inability to cope with normal stresses and strains of daily
living
 Inability to regulate behavior or control the expression of
emotions
How Teachers Help Students Who’ve Survived
Trauma

• Listen
• Create Opportunities to be Successful
• Routines
• Incorporate Downtime
• Champion for a Trauma-Informed approach in
schools.
• Make resources available to students and parents
• Make expectations for violations clear
• Let the student be part of the process
Trauma-Informed Approach

 Realization
 Understanding the prevalence of trauma within our schools,
communities and within ourselves.
 Recognition
 Education on spotting it, assessing trauma, and helping to
indentify when individuals are experiencing prolonged
elevation. This means knowing before the student even
reaches the classroom.
Continued:

 Response: Build
relationships
 Create a safe environment
 Be trustworthy and transparent
 Offer peer supports
 Find out what works best for that
student, give mutual respect.
 Empower the child, provide
choices
Resist Re-traumatization

 Be mindful of student stressors


 Let the student know “In this
place, with these people, I am
safe.”
 Offer opportunities for children to
express concerns.
 Help students find ways to enter
their community in ways that will
help them grow their skills.
Mandatory Reporting Laws:
“It isn’t our place.”

 Educators are required by law in the state of Alaska to


report suspected abuse and neglect.
 It is not your job to determine if your suspicions are
correct or investigate them at all.
 Reports made in good faith keep you free of legal
liability.
 You can make claims anonymously.
 You should report if you are aware or have reasonable
suspicion that abuse or neglect has occurred.
 A 2011 survey found that 25% of children reported being
abused at some time. Professional estimates are 1/5 girls
and 1/20 boys will be sexually abused by 18.
“We are all responsible for the welfare of the children in our communities.” -State of Alaska Mandatory Reporting website
Alaska State Definitions of Abuse or Neglect:

 Physical injury that harms or threatens a child’s health or


welfare;
 Failure to care for a child, including neglect of the necessary
physical (food, shelter, clothing, and medical attention), emotional,
mental and social needs;
 Sexual abuse, including molestation or incest;
 Sexual exploitation, including permitting or encouraging
prostitution;
 Mental injury--An injury to the emotional well-being, or
intellectual or psychological capacity of a child, as evidenced by an
observable and substantial impairment in the child’s ability to
function in a developmentally appropriate manner; or
 Maltreatment--A child has suffered substantial harm as a result
of child abuse or neglect due to an act or omission not necessarily
committed by the child’s parent, custodian or guardian.
Who are the Abusers? The Abused?

Abused: Abusers:

• Children of all ages,


•ANYONE can be a child
from infancy through abuser.
the late teens; •People in all walks of
life
• Children from families
•People in all income
of all income levels; brackets
• Children of all cultural •People of all cultural
and social backgrounds. and social backgrounds.
More About Abusers:

Some parents may have emotional problems that


increase their potential to abuse children. Generally,
abusers look just like everybody else. Abusers are
often people whose stress levels have pushed them to
a crisis point.
Indicators of Abusers

 Ignore child’s basic needs


 Socially Isolated parents
 Are indifferent or annoyed by
 Parents with unrealistic
a child’s injury, illness, or
expectations of
developmental delay
themselves and their
 Seem concerned with
children
punishment, rather than
helping the child  Those who express fear
they may harm a child
 They express how
uncomfortable their child  Those who struggle to
makes them relate to the child in your
 Favor one child while calling
presence
the other different or ‘bad’.  Those with very low self-
 Anger is disproportionate to
esteem.
the situation
Family Indicators of Abuse

 Previous sexual abuse in the family


 Previous violence in the home
 Excessive interest in child’s activities with the
opposite sex and peers.
 Paternal Dominance/ abused or passive mother
 Role Reversal between parent and child
 Unusual amounts of physical contact between family
members
 Complaints of “seductive children”.
Indications of Abuse or Neglect in Children:

 Children who are chronically late or absent.


 Children who arrive early and are reluctant to leave.
 Children ill-equipped for the weather
 Children with welts, bruises, blisters (should be seen by a
nurse immediately)
 Children who are hyperactive, destructive, or aggressive.
(may be acting out home life.)
 Children who are withdrawn, passive or overly-compliant.
 Children with obviously unattended medical needs.
 Children who routinely go without breakfast or lunch (often
due to poverty, considered neglect)
 Tired, lethargic, listless children, ones who’s parents may not
regulate their sleep patterns.
Child Sexual Abuse Indicators:
(I know, I don’t like to talk about it either.)
 Regression (going to an inner safe space)
 Acting out sexually and abusing others, unusual rubbing of genitals
(theirs or others), excessive and inappropriate physical contact
 Promiscuity
 Poor self-esteem and image
 Poor peer relations
 Sudden problems in school
 Depression
 Sudden eating/sleeping problems
 Fear of going home, clinginess to teachers
 Unusual phobias, such as being left alone
 Self-destructive behaviors (suicidal gestures, drugs, smoking)
 Knowing about sexual behaviors above their level of development.
 Confiding partially in someone “What if I have a secret I can’t tell.”
 Running away.
Organizations and Resources that can help:

 http://dhss.alaska.gov/ocs/Pages/Publications/Rep
ortingChildAbuse.aspx
 https://www.cdc.gov/violenceprevention/acestudy/i
ndex.html
 https://www.nationalregister.org/pub/the-national-
register-report-pub/nr-issue-spring/the-assessment-
of-childhood-trauma/
 http://www.naasca.org/2016-Articles/011116-
OvercomingACE.htm
 http://www.parentsanonymous.org
How this works
• Take out a piece of paper or use your computer

• You will get a true or false question or a multi-question


question .

• Answer the best you can (you will have time)

• We will then go over answer as group

• Remember this is for fun and we are all winners!


I hate doing review games.

Haha just testing you


What does ACE Stand for?

A. Another Caribou Explodes


B. Another Confusing Explanation
C. Adverse Childhood Experiences
D. Alternating Color expressions

C is the correct answer!


ACEs are experiences that are only emotional issues that have a
lasting effects on health and well-being

False-ACES are potentially traumatic events that have negative,


lasting effects that range from physical, emotional, or sexual abuse.
It can be a single event or an ongoing chronic issue
There are four types of trauma and toxic
stress.

False. There are three types. Acute,


toxic and complex.
Which of the following is considered a
household dysfunction?

A. Mental illness
B. Incarcerated relative
C. Divorce
D. Emotional neglect

A, B, C are considered household dysfunction Emotional neglect is


considered neglect with emotional neglect.
ACEs does effect the learning and thinking
part of the brain.

True. IT causes the brain to go into


survival mode. Causing the brain to go
into Flight/Flight/Freeze mode.
People with high ACES are 3x more likely
to experience heart disease.

True. They are also more likely to


experience a 20 year difference in life
expectancy as well.
A Child that has ACE could show…

A. Inability to regulate behavior control


B. Inability to read
C. Emotional expressions
D. Does not participate in PE

A, C There are many ways a child can look like if ACE effects them.
A teacher should ignore the signs of ACEs.
They will get over it

False. A teacher should take steps such


as, listen, create opportunities to
succeed, make clear expectations for
violations clear.
Only certain people can be abusers.

Anyone can be a child abuser no


matter what walk of life, income or
background.
What are some indicators of abusers?

A. Favor one child while calling the other


child different or ‘bad’
B. Socially isolated parents
C. People who don’t kiss their kids
D. Those with very low self-esteem

A, B, D There are many other indicators as well.


I learned something new!

Hopefully this is true! I know I learned something new.

If you got most of them right give yourself a high five!

If you got all of them right give yourself a pat on the


back!
Bibliography

 Felitti, V. J., MD, FACP, Anda, R. F., MD, MS, Nordenburge, D., MD, Williamson, D. F., MS, PhD, Spitz, A. M., MS. MPH, Edwards, V., BA,
. . . Marks, J. S., MPH. (n.d.). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in
Adults. Retrieved July 24, 2017, from http://www.ajpmonline.org/article/S0749-3797(98)00017-8/fulltext
 T. (2016, May 17). A Call to Connection: Making Childhood Trauma Personal | Dr. Allison Jackson | TEDxRVA. Retrieved July 25, 2017,
from https://www.youtube.com/watch?v=-HG8H4n2j9I
 Adverse Childhood Experiences. (n.d.). Retrieved July 25, 2017, from https://www.samhsa.gov/capt/practicing-effective-
prevention/prevention-behavioral-health/adverse-childhood-experiences
 Beers, L. S., MD. (2016, August 4). Adverse Childhood Experiences- Impact on Education and Learning. Lecture.
 Burke Harris, C. N. (2014, November 21). Adverse Childhood Experiences: A Conversation with Dr. Nadine Burke Harris. Retrieved July
25, 2017, from https://www.youtube.com/watch?v=bOrMMy41i6Y
 Burke Harris, T. N. (2015, February 17). Retrieved July 25, 2017, from https://www.youtube.com/watch?v=95ovIJ3dsNk
 Home. (n.d.). Retrieved July 25, 2017, from http://parentsanonymous.org/
 T. (2015, March 06). How Do We Stop Childhood Adversity from Becoming a Life Sentence. | Benjamin Perks | TEDxPodgorica. Retrieved
July 25, 2017, from https://www.youtube.com/watch?v=qp0kV7JtWiE
 Injury Prevention & Control : Division of Violence Prevention. (2014, May 13). Retrieved July 25, 2017, from
https://web.archive.org/web/20151227092712/http://www.cdc.gov/violenceprevention/acestudy/index.html
 Lahey, J. (2014, December 02). How Teachers Help Students Who've Survived Trauma. Retrieved July 25, 2017, from
https://www.theatlantic.com/education/archive/2014/12/how-teachers-help-kids-heal/383325/
 Mandatory Reporting Laws: Child Abuse and Neglect. (n.d.). Retrieved July 25, 2017, from http://criminal.findlaw.com/criminal-
charges/mandatory-reporting-laws-child-abuse-and-neglect.html
 Nakazawa, D. J. (2016, September 14). 7 ways childhood adversity changes a child’s brain. Retrieved July 25, 2017, from
https://acestoohigh.com/2016/09/08/7-ways-childhood-adversity-changes-a-childs-brain/
 Reporting Child Abuse & Neglect in Alaska. (n.d.). Retrieved July 25, 2017, from
http://dhss.alaska.gov/ocs/Pages/publications/reportingchildabuse.aspx
 Starecheski, L. (2015, March 02). Take The ACE Quiz - And Learn What It Does And Doesn't Mean. Retrieved July 25, 2017, from
http://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean
 Stevens, J. E. (2012, October 08). The Adverse Childhood Experiences Study -- the Largest Public Health Study You Never Heard Of.
Retrieved July 25, 2017, from http://www.huffingtonpost.com/jane-ellen-stevens/the-adverse-childhood-exp_1_b_1943647.html
 Tomer, J. F. (2016). Adverse Childhood Experiences, Poverty, and Inequality. Integrating Human Capital with Human Development,83-
107. doi:10.1057/9781137456748_5
 Violence Prevention. (2016, April 01). Retrieved July 25, 2017, from https://www.cdc.gov/violenceprevention/acestudy/index.html
 Violence Prevention. (2016, June 14). Retrieved July 25, 2017, from https://www.cdc.gov/violenceprevention/acestudy/about.html
 Who must report? (n.d.). Retrieved July 25, 2017, from http://dhss.alaska.gov/ocs/Pages/childrensjustice/reporting/who_mr.aspx

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