Over the past twenty years several studies have shown that ACEs are common and that there is a strong relationship of these experiences with various health factors. Although these studies have all been very important in helping to establish the frequency of adverse childhood experiences, very little has actually been asked of children themselves. In addition, never before has a direct link been made with what a large, representative group of children (N = 664) say they have experienced in their childhoods, and how fit and healthy they feel.
A study among 11/12-year old children
Our study aimed to change just that. Recently, a nationally representative study has been conducted by the Augeo Youth Task Force in cooperation with TNO, titled ‘I’ve already been through a lot’. This study answers two questions. Firstly: To what extent do 11/12-year-old children in regular primary schools report to having had to deal with, or are still dealing with, issues such as emotional abuse, divorce, or suicide of a parent? The second question is: What are the effects of these adverse experiences on the current, self-reported quality of lives of children?
The results are shocking. Just under half of Dutch eleven and twelve year old children have already experienced an adverse event. Nearly one in nine children (11.4%) have already experienced three or more such events, with some children reporting as many as nine adverse events.
Children most often report divorce, emotional abuse, emotional neglect, physical abuse, and witnessing violence between parents. Another notable conclusion is that physical neglect and divorce are often accompanied by another adverse experience, in 96% and 50% of cases respectively.
Quality of life linked to ACEs
A strong, statistically significant negative relation was found between having experienced any one of these adverse events and the self-reported quality of life. The effect on quality of life proved exponentially stronger when the number of adverse experiences increased.
Aside from these shocking results, the study is especially notable due to the employed research design. Self-report questionnaires in this age bracket and on the topic of adverse experiences is rare, especially in a nationally representative group of children. A translated version of the American ACE study questionnaire was used, with concrete and concise questions in order to create a child-friendly questionnaire.
The Augeo Youth Task Force recommends professionals to ask children themselves about their ACEs more often. This research shows that children are willing to tell, when asked the right questions. It is important to know what children experience, because only then they can get the support they deserve and need.
As a result of their experiences, children often feel unsafe and constantly tense. These emotions extend to the time they spend at school. Teachers can notice it in the classroom, e.g. children may suffer intense emotions, exhibit restless or aggressive behaviour, or conversely become very quiet and withdrawn.
The important role of teachers
Luckily, the damage caused by ACEs is not inevitable or irreversible. We know from research that support from a trusted adult can counterbalance the effects of prolonged stress (Shonkoff 2004, Bernard 2004, Bath 2008). Teachers in particular can play a pivotal role in this; children do, after all, spend several days a week and many hours per day at school, which gives teachers an opportunity to build up a trusting relationship with pupils. By providing security and stability, teachers help children to relax and reinforce their natural resilience (Cole, et al 2005, Downey 2007, Wolpow et al 2009). A teacher can be a supportive figure for these children, so that they can at least feel safe and relaxed at school, thereby contributing to limiting any serious, more permanent (developmental) damage. This helps prevent adverse effects, in both the short term and long term.
It requires a trauma-informed approach, i.e. urging teachers to be aware that many of the children in their classes have experienced traumatic events. Teachers are also encouraged to understand that inappropriate behaviour and complicated emotions may arise as a result of feelings of insecurity and stress, and that they are in a perfect position to help children lower their levels of stress so that they can at least feel safe and relaxed during school hours.
Teach the teachers
Augeo Academy developed the online course ‘Trauma-informed teaching’, to train teachers about providing support to children who have suffered adverse experiences. This course has a broad, international and theoretical basis. In this course, primary school teachers learn what trauma is, how trauma and stress affects the emotions and behaviour of children, how they can help children to lower their stress levels, and how they can help restore these children’s natural resilience to stress.
The course was distributed widely among teachers, and its effect measured through two local research projects. The first involved looking at how the self-efficacy of teachers increased after attending the course, which was done by getting 190 teachers to fill out questionnaires about the extent to which they feel able to offer support to children who have suffered adverse experiences. A pre-test and double post-test (both short-term and long-term) design was used. This research showed that teachers strongly felt to be in a better position to support children after following the course. They were more aware of which supportive actions they could employ to increase children’s sense of safety, foster relationships, and help children cope with strong emotions and inappropriate behaviour.
In addition, the well-being of children whose teachers knew how to incorporate trauma-informed aspects in their lessons was studied in a first explorative research project. In this respect, teachers and children were asked to complete a questionnaire on three occasions, with questions about the social/supportive relationship between pupil and teacher and the social, emotional, cognitive and physical functioning in the classroom of children with adverse experiences. The results showed that being informed about trauma-informed teaching contributes to a slightly improved relationship between teacher and pupil, and that pupils themselves say they experience fewer negative interactions with the teacher, feel physically and mentally better in the classroom, and function better in emotional terms.
More information about these three studies you'll find attached.
We would very much like to hear your responses regarding the research projects we conducted. What are your thoughts regarding the questionnaire we used to measure self-reported ACEs in children and it’s results? The same holds true for our online course and the related two smaller scale studies: we’d love to hear your thoughts!
Kind regards,
Tim Mulder, Marga Haagmans & Edith Geurts – Augeo Foundation, The Netherlands
Augeo is a private, not-for profit foundation based in the Netherlands. Our objective is to ensure that children can grow up healthy in a safe environment. This objective is at the very heart of our online training courses, our online journal and our innovative projects. We believe in collaborating with young people to bridge the gap between them and professionals, which is why participation by young people is fundamental to Augeo and its policies. Therefore Augeo established the Youth Task Force – an independent organisation, consisting of 13 members aged between 14 and 25, that provides a platform for children and young adults in the discussion about effective ways of tackling child abuse and neglect. https://www.augeo.nl/en/
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