ACEs: What They Are and How They Relate to Toxic Stress

A survey across 25 states reported that about 61% of adults had experienced at least one type of adverse childhood experience (ACE)(1).

Exposure to ACEs can have lasting and adverse effects on health, well-being, and opportunity. ACEs can increase the risks of injury, transmitted infections, maternal and child health problems, and leading causes of death, like heart diseases, diabetes, and suicide.

ACEs and associated conditions can also cause toxic stress, altering an individual’s brain development and affecting concentration, learning, decision-making, and stress response. Thus, many people look into some of the best alternatives to reduce stress, like ACEs initiatives, to reduce the effects.

What Are ACEs?

Adverse childhood experiences (ACEs) refer to traumatic events that occur before the age of 18.  These experiences include witnessing or experiencing violence or abuse in the home or community, having a family member attempt or die by suicide, and growing in a household with family members having issues with mental health, substance abuse, parental separation, or incarceration(2).

The Centers for Disease Control and Prevention (CDC) and the Kaiser Permanente health clinic conducted the first ACE study from 1995 to 1997(3).

Results from the surveys showed that ACEs affect people from all walks of life. More than two-thirds of the middle-class population had at least one ACE case, and nearly a quarter experienced three or more ACE types.

The study also noted a strong correlation between the breadth of exposure to ACEs and multiple risk factors for leading causes of death in adults, such as heart disease, cancer, chronic lung disease, and liver disease.

Moreover, findings revealed that the more ACEs experienced, the greater the risk for depression, substance abuse, smoking, and marital or job-related problems.

How Do ACEs Relate to Toxic Stress?

Toxic stress refers to severe repetitive adversity resulting from prolonged activation of the stress response, with the body’s failure to recover fully(4).

ACEs may trigger a prolonged activation of the stress response systems, disrupting the development of a child’s brain and other organ systems(5).

Children who experienced ACEs are at risk of long-term adverse health effects that may not manifest until adulthood(6). These include poor stress management, unhealthy lifestyles, and physical and mental illnesses.

Reducing the Effects of ACEs and Toxic Stress

While prevention is the best way to solve ACEs, everyone, especially parents and teachers, can mitigate ACEs’ effects. Steps to reduce stress and ACEs include the following(7):

• Practice meditation and breathing and other physical exercises.
• Focus on handling your own stress. Parents should identify the source of their stress and stay calm to understand, protect, and support their children.
• Stick to daily routines and allow children to know what will happen next. Having a clear schedule to follow can help reduce stress.
• Maintain a healthy diet. Caregivers, teachers, parents, and children must eat well to maintain a healthy mind and body.
• Get enough sleep. A good night’s sleep allows the body to recharge and help children and parents to handle stress well.
• Turn to supportive relationships within the community. A healthy support system helps children and parents manage the effects of ACEs well.
• Seek professional help to know how to handle toxic stress coming from ACEs.

How Local ACEs Initiatives Can Help

While ACEs can have long-lasting negative impacts on one’s health and quality of life, they are preventable.

Statewide and local initiatives can help prevent or mitigate the impacts of ACEs.

For instance, Tennessee has an initiative called “Building Strong Brains Tennessee(8).” It aims to inform the public about ACEs and early childhood brain development through a series of public service announcements, educational videos, and other materials.

According to the CDC, prevention strategies also include the following(9):

• Strengthen economic support to families. Policies such as providing tax credits, childcare subsidies, paid leaves, and flexible and consistent work schedules, should be promoted. Increasing economic stability improves parents’ capacity to satisfy their children’s basic needs.
• Promote social norms that protect against violence and adversity. Local initiatives may include supporting parents and positive parenting and fostering healthy and positive perspectives around gender and masculinity to safeguard against violence toward intimate partners, children, and peers.
• Ensure a strong start for children. This initiative includes early childhood home visitation, high-quality child care, and preschool enrichment with family engagement.
• Teach skills related to communication, problem-solving, alcohol and drug resistance, empathy, conflict management, and safe dating through social-emotional learning approaches and healthy relationship skill programs.
• Connect youth to caring adults and activities through mentoring and establishing after-school programs. These initiatives can foster relationships that will contribute to young people’s growth opportunities, academic success, and positive employment outcomes.
• Intervene to lessen immediate and long-term harms by providing enhanced primary care, victim-centered services, and family-centered treatment for substance use disorders.

Raising awareness of ACEs can help educate people about the causes of ACEs and who could help prevent them. Initiatives such as the ones mentioned above can shift the focus from individual responsibility to community solutions.

References:

1. Centers for Disease Control and Prevention. Preventing Adverse Childhood Experiences. Retrieved from https://www.cdc.gov/violencepr...n/aces/fastfact.html
2. Ibid.
3. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American journal of preventive medicine, 14(4), 245–258. doi.org/10.1016/s0749-3797(98)00017-8. https://www.ajpmonline.org/art...(98)00017-8/fulltext
4. Franke H. A. (2014). Toxic Stress: Effects, Prevention and Treatment. Children (Basel, Switzerland), 1(3), 390–402. doi.org/10.3390/children1030390. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928741/
5. American Academy of Pediatrics. Adverse Childhood Experiences and the Lifelong Consequences of Trauma. Retrieved from https://www.aap.org/en-us/docu...ces_consequences.pdf
6. Franke H. A. (2014). Op Cit.
7. Center for Youth Wellness and ZERO TO THREE. How to Reduce the Effects of ACEs and Toxic Stress. Retrieved from https://www.acesaware.org/wp-c...c-Stress-English.pdf
8. Tennessee Commission on Children and Youth. Building Strong Brains Tennessee. Retrieved from https://www.tn.gov/tccy/ace/tc...g-strong-brains.html
9. Centers for Disease Control and Prevention. Preventing Adverse Childhood Experiences (ACEs): Leveraging the Best Available Evidence. Retrieved from https://wvde.us/wp-content/upl...C_preventingACES.pdf