Misuse of ACE assessment

I've commented on this issue previously. Having worked in health services, I have felt that ACEs screening as part of medical services are protected information under HIPPA. However, to what extent are school records or human service records protected? Can they be easily accessed for criminal, civil and child custody cases, for example? 

My concern is that using information from a minor for other purposes can be very damaging. Hearing "the family's in trouble 'cause you squealed," whether true or not, could make them more distrustful of adults and less willing to disclose personal information. Some circumstance should and must be reported by law, but I am concerned about third parties using the data, for example, to question the fitness of parents or guardians.  I would love to hear from others with experience in this area, and from legal experts on whether my concerns are reasonable or not.

I personally believe taking the ACE questionnaire initiates healing.  Not screening the kids keeps them from healing. I speak in schools about ACEs. This morning I passed out the questionnaire to a few classrooms in a highschool and asked them to fill it out anonymously and then shared with them what percentage of the classroom had atleast one ACE. The results were consistent with all other studies I've seen. 65%-75% of students had atleast one ACE.  The best thing about it is that I was able to show them that they are not alone in this journey. Their peers have ACEs too. Sometimes that is all we want to know.  I didn't have the names on any of the results so I don't know which ones were really high, but they all now know who they can turn to for help and they understand the impact of ACEs. 

I totally agree that realizing that you are not alone can be a powerful healing experience, and using it anonymously is very different than having in in your official record. My concern is not about giving people information about themselves, but about that information then being used by others for purposes for which the owner never imagined. (Gee, where have we heard about that before?)

I too have some reservations about screening for ACES.  First, we already know more than half of our students have at least one or more.  So it's not like we need to "see" if any of our students are affected.  You don't need an ACE score to tell students they are not alone in their difficulties.  The biggest message is where and how to get help. That's for the students.

My second concern is that we educators (I'm a retired elementary principal) need to take a deep and systemic look at our practices in the classroom, school-wide, and in our response to challenging behaviors.  Our standard (problem-solving) practice with everything in school is to screen, identify, label, and provide some ad hoc service to those "identified".  We educators even with the best intentions, separate, isolate kids and make them feel that they are different and inadequate. If we think screening needs to be done, it's because this is our usual practice.  Unfortunately, our usual practices are inadequate when it comes to helping kids with ACES better function at school.

ACES research strongly indicates strong positive relationships and fostering a feeling of belonging is essential to healing.  Yes, inform kids that they are not alone in their difficulties.  By all means have these conversations.  But beware of using the data gathered as yet another "screening" tool to provide an ad hoc service - and fail to make systemic changes within the classroom, the school and the policies around challenging behaviors.  Habits, beliefs, and practices of teachers & principals are difficult to break.  Let's not treat ACES as yet another way to sort and label.  That's why I discourage my workshop participants and school clients from using a screening tool - we have to retrain and rethink, not identify who has ACES.  Screening students it's not relevant to us educators since our task is make positive changes that affect every student.  And by the way - ACES can change - maybe you have none now, but when one is living in it, the experiences could change overnight.  A score last month means nothing - anyone at any time could go from zero ACES to have multiple ones due to changes in ones life circumstances.  So it's not even practical for educators to screen.  Leave the screening tool for what it was intended - medical and mental health use.  We educators need to instead change OUR game and change our practices.

I hope this helps you Margo!  Good luck.

http://whitewaveseducation.com

I think routine screening for ACEs and other traumatic experiences is potentially harmful and is not a trauma-informed practice. Discussion about traumatic experiences is best done within a trusting relationship, not by a stranger or through a written instrument. And Margo is right that it was developed as a research tool, and not intended as a screening instrument.

I think an important element to consider is how ACEs could be used as a reflective tool for the teachersand administrators themselves, though I'm not advocating for screening teachers. How do teachers' own adverse experiences (or lack thereof) affect their teaching practices, attitudes and responses to students' classroom behaviors? In the social services contexts I work in, the question I hear raised is "How do we do this work when we may have our own trauma to deal with?" If that's not coming up for teachers, perhaps the starting point is different, ie. How do you relate to and have empathy for children without problematizing or pathologizing them based on assumptions or implicit biases you may hold? How is it different to be affected by vicarious trauma vs. one's own lived adverse experiences? How do we balance the need to support the teachers' needs with the students' needs without making ACEs all about the adults? 

I'll bring in the pragmatics, because believe it or not we have already observed it happening.  When dollars are squeezed, we can't allow ACEs to be misunderstood to be predictors and triage out patients. I was at an ACE summit two years ago where we actually heard  accounts in two separate workshops about a hospital system who was doing this.  The higher number of ACEs actually demoted quality of care and receiving certain scarce medicines.  This is why we organizationally do not advocate yet for mandatory screenings.  We need to be clear that the people who gather the data are using it properly, and it is never to be used in a derogatory fashion.

To Angela's question, in my trainings, I teach teachers how to incorporate coping strategies and imbed them in their daily instruction and routines.  By doing this, teachers learn that those same strategies - breathing, mindful activities, etc. are just a beneficial for them.  In fact, once they start doing these with their students, the teachers find themselves in a better place - because they are getting a double benefit.  The teacher benefits from doing the coping skills daily, and benefits from her students' improvement in emotional well-being.  My training goes deeper than the coping skills - so when they apply the other strategies I share, they improve students social interactions, relationships with the teacher and see academic success.  Which leads to a huge improvement in both students and teacher's anxiety.  It all goes together.

Should read  "Just as beneficial for them (the teachers) as for their students."

My biggest concern is when ACEs are discussed without including the topic of resiliency factors. On their own, ACEs operate from a deficit perspective. We run the risk of pathologizing our students/clients if we don't also talk about personal strengths.

Being no expert in this arena - I'll simply rely on one. Dr. Felitti has commented about the power of acknowledging and responding to ACEs in a non-judgemental and empathetic way itself being a powerful intervention. When screening is done so infrequently on an issue that is seen as an epidemic possibly for our systems and health particularly later in life - not doing so out of "fear" feels quite overblown. In the same writing - Chapter 10 of "The lifelong effects of adverse childhood experiences" where Felitti says this about it being an intervention, it is related to asking simple follow up in a medical evaluation - and in seeing reductions in ER and office visits from those patients after follow up. I realize that is in a sense a relationship and it involves follow up - but we are not talking therapy in that context. Being careful is appropriate. Not moving out of fear - and without strong data to support the status quo - is baffling.

Susan J Ciminelli posted:

I too have some reservations about screening for ACES.  First, we already know more than half of our students have at least one or more.  So it's not like we need to "see" if any of our students are affected.  You don't need an ACE score to tell students they are not alone in their difficulties.  The biggest message is where and how to get help. That's for the students.

My second concern is that we educators (I'm a retired elementary principal) need to take a deep and systemic look at our practices in the classroom, school-wide, and in our response to challenging behaviors.  Our standard (problem-solving) practice with everything in school is to screen, identify, label, and provide some ad hoc service to those "identified".  We educators even with the best intentions, separate, isolate kids and make them feel that they are different and inadequate. If we think screening needs to be done, it's because this is our usual practice.  Unfortunately, our usual practices are inadequate when it comes to helping kids with ACES better function at school.

ACES research strongly indicates strong positive relationships and fostering a feeling of belonging is essential to healing.  Yes, inform kids that they are not alone in their difficulties.  By all means have these conversations.  But beware of using the data gathered as yet another "screening" tool to provide an ad hoc service - and fail to make systemic changes within the classroom, the school and the policies around challenging behaviors.  Habits, beliefs, and practices of teachers & principals are difficult to break.  Let's not treat ACES as yet another way to sort and label.  That's why I discourage my workshop participants and school clients from using a screening tool - we have to retrain and rethink, not identify who has ACES.  Screening students it's not relevant to us educators since our task is make positive changes that affect every student.  And by the way - ACES can change - maybe you have none now, but when one is living in it, the experiences could change overnight.  A score last month means nothing - anyone at any time could go from zero ACES to have multiple ones due to changes in ones life circumstances.  So it's not even practical for educators to screen.  Leave the screening tool for what it was intended - medical and mental health use.  We educators need to instead change OUR game and change our practices.

I hope this helps you Margo!  Good luck.

http://whitewaveseducation.com

Hi, I am a retired school social worker and currently an instructor for a University Social Work department. I teach Trauma Informed Systems - Resiliency and Sustainability; Social Work In Schools Design and Practice. Both of these courses emphasize how systems can become trauma informed/trauma sensitive. I wholeheartedly agree with your response. We need to ethically use any screening tool for its intended purpose.

I don't believe anyone in this forum is saying not to acknowledge and respond to ACES.  Understand that screenings are not an intervention, just a tool for whoever is gathering data.  Screenings alone don't provide anything in way of an intervention.  Addressing the needs of children with ACES comes from actual programs, counseling, relationship building, improving teaching and disciplinary practices - all of which should be in place first because without these, there is no intervention.  As one other post alluded to, screenings in and of themselves without these programs does to help children build resilience and skills to deal with trauma.  In fact, those trained in trauma-informed practices, do not list "screening" for trauma because they may in fact trigger post traumatic episodes in the individual suffering adverse childhood experiences.  There's good reason to understand that while teachers and principals in our schools begin to become trained in trauma-informed practices, they should not assume that the model they use with reading, math and other learning difficulties can or should be applied to trauma.  I don't understand the comment "without strong data to support the status quo".  The objective is to get educators trained to understand appropriate responses and interventions because the "status quo" does not support or is insufficient to addressing their needs.  No one is "not moving out of fear" - the goal is to do what correctly meets the needs of trauma victims and caution against the actions that don't.

Thank you Corrine Anderson Ketchmark.  This is why it is important to have these communities where conversation and clarity can come through and help prevent misunderstandings and misinformation.  And we must be patient with those who are beginning the journey to understanding this work.  It is different and will take lots of explanation and thinking.  Thanks for your comment.

Susan - I agree with most of what you are saying. I will respectfully disagree with your statement that "screenings" done well, without judgment, with empathy, acknowledging that an individual is normal, worthy, and not alone  "are not an intervention". I'm saying that they can be with some modicum of skill. I probably wouldn't lean this far out on that ledge without knowing that Dr. Felitti seemed to believe so as well. 

Correction - From my earlier response - this -  "As one other post alluded to, screenings in and of themselves without these programs does to help children build resilience and skills to deal with trauma."    should read  "As one other post alluded to, screenings in and of themselves without these programs does nothing to help children build resilience and skills to deal with trauma."

The research Dr. Felitti has done is worthwhile and as you say Greg, done without judgment and with empathy.  But his research is not in question here. His research is not the same as what teachers and school personnel think of as "screenings".  When teachers talk about screenings, they mean basically "tests" used to gather things like ability and cognitive levels of incoming kindergarteners to determine if children have deficiencies.  I think Dr. Felitti would strongly agree that we do not want to have "screenings" of this type (called a deficit model) with children with trauma.  Having been an educator for many years, I know all too well that if educators without trauma training start "screening" for ACES, we are on a slippery slope because they are used to looking for "deficits" in a child's skills.  For me - I think you and I actually agree.  The screening isn't the problem. It's the question of those school personnel doing the screenings "are done well, without judgment, with empathy, acknowledging that an individual is normal, worthy, and not alone"  Unfortunately I have seen in my experience the lack of training, in less critical areas than trauma, have a detrimental effect on the effectiveness of an intervention.  This has happened where the district has not funded training to go with a screening product and so educators have to do the best they can with limited understanding. So before schools start screening any children, all should understand Dr. Felitti's work and be trained to understand that ACES data does not fit the standard practices model with "screenings".

And by the way - I thank you for your willingness to partake in this discussion.  Nothing wrong with disagreement - as long as we are still willing to be part of the discussion.  I also applaud what you do - tough work.  Thanks for contributing.

The results of an ACEs screening, by itself, tells you very little: two persons both can have a score of, say 4, but the impact on the individuals can vary widely. Which four and what was most significant? A person might have a score of 1, but that one factor might have been so traumatic as to affect them in a way comparable to someone with a score of say, 6.

If administered properly, an ACEs screening can provide the person completing the survey with valuable information, and the service provider with useful insights. What I think some of us are saying is that, if administered en masse, there is also potential for great harm, as sloppy or lazy staff start categorizing people as :sixes" or "seven plus." Your ACE score is not your destiny.

The ACE questions are very intrusive especially with children.  It is less intrusive to ask the resiliency questions. If a child has  some amount of ACE indicators but also has a high resiliency score they may be able to deal with the harms that are happening to them.   Just by observing students who are isolating  may help identify students at risk for traumatic situations in their lives.  Any community should be able to supply adult mentors to at risk students without having to use professionals.  If those mentors spend a little time each week valuing the student jut by showing up they can improve the  student's resiliency.

I agree, assessing resiliency is a strengths base approach that is embedded in relationships which supports the one caring adult concept of attachment, regulation and competency....

Susan J Ciminelli posted:

To Angela's question, in my trainings, I teach teachers how to incorporate coping strategies and imbed them in their daily instruction and routines.  By doing this, teachers learn that those same strategies - breathing, mindful activities, etc. are just a beneficial for them.  In fact, once they start doing these with their students, the teachers find themselves in a better place - because they are getting a double benefit.  The teacher benefits from doing the coping skills daily, and benefits from her students' improvement in emotional well-being.  My training goes deeper than the coping skills - so when they apply the other strategies I share, they improve students social interactions, relationships with the teacher and see academic success.  Which leads to a huge improvement in both students and teacher's anxiety.  It all goes together.

Susan, can I ask what your role in trainings is? I would love to be able to talk with you about how you train these teachers!

To Emma and anyone else - I have two websites - http://whitewaveseducation.com and http://traumasensitiveclassrooms.com

You can also find me on LinkedIn if you are curious about my experience and background.  I've listed some of my recent presentations at national conferences in the U.S. and Canada.

Prior to retiring as an elementary principal, I wanted specialized training in brain-research and addressing challenging student behaviors.  I went right to the sources.  I received first-hand training with Dr. Eric Jensen for the past four years.  And last year received first-hand training from Dr. Ross Greene, author of "Lost at School"  on his method called Collaborative and Proactive Solutions.  If you are interested in these, you can find out more at http://jensenlearning.com  and Dr. Ross Greene's work on his website,  http://livesinthebalance.org

Margo Buchanan posted:

Hello everyone! I am a social worker, coordinating a program in a local school system to help increase trauma-informed practices. A part of my job is to give trainings to staff on topics like ACES. A question that continues to come up is, "Why aren't we screening all students for ACES using the ACE calculator from the study?" My answers have varied, depending on who I am speaking to, however mainly I stick with the moral dilemma, which is: What are we going to do with the information once we know? We don't have supports in place at this time to meet the need in the school system I am working in. Another point is that the ACE calculator is a research tool, not meant to be used as a universal assessment. It also does not cover all ACEs, such as generation poverty, intuitional racism, death of a parent or sibling, etc. 

What I am curious about from you all is- Are there any resources out there that can help me to understand more about why we wouldn't necessarily use the ACE calculator in all human service or educational organizations and what other ways people are tackling this issue.

Thank you so much!

Margo

 

Hi Margo,

I'm new to this community so I hope I am replying appropriately.  It is my belief that the ACE calculator should not be administered if the administering person or agency is not equipped to treat the trauma.  Mental health providers who specialize in trauma would ultimately be the best equipped. Any other service provider or educational facility is not equipped to "deal with" the results and would be using them for purposes for which the information may not be appropriate.  I would assume that all schools have the ability to refer a student or student's family to or recommend mental health services, whether that be through the use of insurance benefits or cash pay.  When I worked in various high school settings often the students would tell teachers or school counselors about family situations that would alert those staff members to a need, even without the use of the ACE specifically.

If you think about the impact of asking a child if they were abused or their parent is mentally ill or chemically dependent.  Those can be very difficult questions for a child regardless of their A.C.E. score.  First realize the ACE questions were designed for adults to report on their childhood experiences.

Depending on the age of the child they may not know how to understand the question.  If the questions are directed towards resiliency deficits then it is easier for a child to understand, It has less stigma and it gives the means to identify children who would benefit from adult supportive relationships even if they do not have current ACEs experience.

William reminded me that schools are restricted by law on surveying children and the ACE questions being for adults.  The laws regarding surveying children and limits and liability are here:   https://www.law.cornell.edu/uscode/text/20/1232h

Susan J Ciminelli posted:

Should read  "Just as beneficial for them (the teachers) as for their students."

Susan, Thank you so much for this information. Do you have a link to this article? I cannot seem to find. Thanks!

I assume you mean the Cornell Law page - I did post earlier, but will do so again, no problem.  The laws regarding surveying children and limits and liability are here:   https://www.law.cornell.edu/uscode/text/20/1232h

I agree with William. From our organization's standpoint for the last 30 years, we have educated the professionals to be on the ready when they see kids and teens who are experiencing ACEs or when a child comes forward.  Demanding a child come forward through something like a screening can be extremely abrasive.  "Outing" a family, when you live by the "Don't feel, Don't trust, Don't talk" rules, is expecting a lot out of a kid.  The stress of being in such an awkward position could be suffocating for a child. 

And further - I think we need to be careful how we frame ACEs when we are talking to kids.  I am reading a lot of references recently that blur the distinction between trauma as it relates to an actual traumatic event vs the unresolvable stress.  Sometimes they are one and the same.  But if you portray trauma as only a traumatic event, a pool of children who are experiencing ACEs will never reveal themselves convinced that their situation "isn't really 'that bad.' "  I think it is very important to emphasize the unresolvable stress as the culprit of the ACE, and that the level of danger or violence is not the differentiator.  It is a very lonely place to be when you are overlooked by the very people who are advocating to provide services.

MaryBeth,

What do you mean by "unresolvable stress"?  My belief is that nothing is unresolvable if the client is willing to do the work, look at the painful or traumatic adverse childhood experiences (or any experiences), and they have the right (for them) clinician/therapist with the right tools.

Hi Anita,

I think you may have miss previous posts here and didn't realize we are talking about children in a school setting.  Your comment seems to be based on an adult client who has choices and who's traumatic experiences are in the past.  Mary Beth was speaking of children with trauma, who often live with the source of the trauma which is likely to be ongoing.  "Willing to do the work" doesn't apply to children because they have little to no control.  To quote Nadine Burke Harris, M.D., when you meet a bear in the woods, and you run away, your stress goes up, then returns to normal once the threat is gone.  But when you're a child and you come home to the bear that lives in your house, your amygdala is constantly on hyper-alert and the stress doesn't dissipate.  The problem becomes PTSD and often children not only lack the executive function to "do the work", they may be suffering from ongoing trauma.  The other condition you mention is "they have the right clinician/therapist with the right tools".  Again this discussion here has been concerning children in a school setting.  Clinicians/therapists aren't available in a school setting and thus MaryBeth was advising against educators from "screening" students and creating a situation where trauma is triggered and left unresolved.  I'm sure you'll agree that only trained therapists skilled in addressing trauma should be using the ACES questions with children and that schools should leave this to the professionals who can help the child.

As an observer of the ACE Study's usefulness and application, I think that this issue, posed by Margo Buchanan, is very relevant: "Are there any resources out there that can help me to understand more about why we wouldn't necessarily use the ACE calculator in all human service or educational organizations and what other ways people are tackling this issue[?]"

Here is my 'answer' from way out in left field: Everything is "energy." How do we use it, and witness the way it is used by others? The ACE evaluation is a tool by itself. When someone (of any age) answers it, the result is a snapshot of their status in the moment. It seems that giving the assessment to a child and using the result to build data, write a label, create a 'treatment' plan, or "do something with" is wrong. Adults should be able to access the evaluation, answer it for themselves and pursue some avenue of 'healing' that is a good fit for them.

Everyone is born as "gold." Everyone turns to "lead" in some way--just as any car starts depreciation the moment it is driven off the lot by a new owner.

Again, it is a matter of "energy."

If we start at this lowest common denominator and assume that everyone has some sort of ACE, some sort of inherent betrayal just because they became a human being in this wide, strange, beautiful, ugly, shades-of-light-and-dark-in-contrast world, then everyone should be taught to tap into their own ability to find compassion first for self, then for others.

Moving now from my post of observation, my personal belief is that traumatic events become the energy of "hurt." Hurt gets held in the body's overall memory ability as a quanta of energy. There are ways to locate and discharge this kind of energy, to neutralize it, and make it a fact that does not continue to radiate. I do not know how this happens, but I suspect that bringing a memory to consciousness and dealing with it gets it to a place where it can be neutralized.

This process is very personal! It is still quite mysterious. I've been working to figure it out since I first learned about the ACE Study in 2010, and I will stay with this mission for the rest of my life. Maybe even beyond my life if that is what it takes.

The human spirit is miraculous. The ACE Study is a gift to humanity. I wish "good energy" to all those who observe it, discern it, "use" it, and who--because of it--practice both the Golden Rule (treat others the way you want to be treated) and the Platinum Rule* (treat others the way you see that they want to be treated).

*Tony Alessandra, Ph.D.

I’ve been following this post and all responses with a pit in my stomach for the most part.  Several responses seem to point to “leave it to the professionals”. Unfortunately, if we do that the majority of people will never get help- that is why public awareness is vital.  There are a few posts that suggested we should just educate teachers to look for certain behaviors and letting that be our basis as to which students need help.  I agree, we do need to educate teachers but the problem with this strategy is that there are a lot of really resilient students that have learned survival tactics that prevent them from displaying the behaviors we are telling these teachers to look for and because it makes us rely on the teacher’s human judgment.

I have an ACE score of 9. My safe haven was school- it was also my coping strategy/survival tactic to keep myself busy and active, to overachieve and chase perfectionism.  I graduated highest honors, was the captain of the step team, the school news anchor, on prom court, etc I didn’t display any obvious signs of trauma or toxic stress, so it never crossed anyone’s mind that I needed help. I have met a great deal of people that have similar stories. As a result, we are well functioning average Americans with great jobs and healthcare (sound familiar? It should because that is the 17K+ people in the original ACE study) who fly under the radar until it is too late- our bodies (and our relationships) are breaking down from years of a dysregulated stress response system. We are having babies of our own, never knowing that we have developed self-sabotaging habits and behaviors that are going to cause ACEs in our new families. To make matters worse, based on this thread, it sounds like there are plenty of people that could have helped, but didn't because they didn't want to intrude or make us feel bad. That is heart breaking to me. There are hundreds of thousands of teenagers who are longing for this kind of information but don't know it exists until someone is brave enough to tell them. I really believe if someone had handed me an ACE questionnaire as a teenager I would have felt the same validation and freedom I felt when I finally stumbled on it while still desperately seeking answers at 25.  I still don't see an issue with giving them the option to anonymously take it for informative purposes, especially if you are also letting them know who to reach out to for help, giving them resources, and informing them that they are not alone. That would have been a gold mine for me. My heart breaks for these students, like me, who are flying under the radar because adults made the decision that either 1)they don’t display the behaviors so they don’t need help or 2) informing them was going to harm them more than their reckless or dysfunctional home life already has. I’m of the opinion we should do everything in our power to compassionately inform everyone, even the 0s- because they undoubtedly have friends with ACEs. One of the things I appreciate about the questionnaire is that it gives specific examples instead of broadly stating "Have you experienced abuse, neglect or dysfunction?" If you ask that question people mostly are going to say no because they don't consider their parent humiliating or criticizing them often or a parent with mental illness as one of those three categories.  That's why the questionnaire is so eye-opening in my opinion.  I also want to highlight the original question that Mary just reiterated- are there any resources that can help us understand why we wouldn’t use it? Not opinions, but scientifically proven data that suggests we shouldn’t? I'm fairly certain Nadine Burke Harris mentioned in her book that they encourage teenagers to self screen instead of having a parent complete the questionnaire on their behalf. I'm curious as to what age they start the self screening process. Has anyone seen that questionnaire? I assume it somewhat differs, but I am not sure how. 

Courtney,

Thanks for your post. While I know this is sensitive, I do think an expert trap has emerged a bit as well - indicating that only experts trained can do this sort of work. I believe there could be a danger in just "collecting" the information, and leaving it there without some explanation and follow up. I also believe that folks in general - and those who have experienced ACEs in particular, have a fierce resolve and have been coping with things that most adults - maybe even professionally licensed adults - have never had to deal with. Knowing their ACEs, alongside a caring adult who will be there to listen and support, will not derail them and may provide relief.

There have been some binary post - an either or position - that feels a little dangerous regardless of the subject (we all surely agree that, or we shouldn't do this), as if there is such a thing as undisputed fact - much less significant evidence. The version that Nadine Burke Harris uses - maybe the CYW - has a teen version. it is essentially the same 10 ACE questions combined with some other questions (maybe 6-8) around poverty and race, etc. that go beyond the scope of the initial 10 - and incorporates other things we have learned about what can be traumatic (witnessing community violence). I believe that she provides the screening tool to parents and teens - has them score it - and then only collects the overall number. She says she does not need to know the exact trauma that they have been dealing with to provide a framework about what it means to have experienced and now deal with the trauma.

Best,

Greg

Here is a link to an article cautioning the widespread use of ACEs screenings - giving some reasons and also indicating the kinds of resources you might want to have in place before doing so. It is one article - and I think you could find numerous others on both sides - but it provides some reasoning behind being cautious:

http://www.unh.edu/ccrc/pdf/CV350-InPress.pdf

Thanks Greg for joining the conversation and for the link to the article.  

Hi Courtney, I'm sorry to hear of your difficulties and thank you for sharing your own story with all of us.  Certainly your experience and perspective is an important reminder to all of us the importance of everyone being informed about ACES and understanding how prevalent it is and its life long impact.  I hope your circumstances are mitigated by having people in your life who love, support and care for you.

Thanks, Susan. It's a story of overcoming for which I am proud of and hope to help others have their own. Also, thanks for the article, Greg! 

William Bear posted:

If you think about the impact of asking a child if they were abused or their parent is mentally ill or chemically dependent.  Those can be very difficult questions for a child regardless of their A.C.E. score.  First realize the ACE questions were designed for adults to report on their childhood experiences.

Depending on the age of the child they may not know how to understand the question.  If the questions are directed towards resiliency deficits then it is easier for a child to understand, It has less stigma and it gives the means to identify children who would benefit from adult supportive relationships even if they do not have current ACEs experience.

 

Great points, William! As a teacher, I first thought students (high school) should be aware of their ACEs score.  Continuing on my learning journey about trauma, I have changed my mind.  I do NOT believe the score is as important as the students knowing their brain may have developed a little differently than some of their peer's brains (not in a negative way, just different) if they experienced or are experiencing trauma-related challenges.

Teaching at a 90-day residential drug and alcohol treatment facility for students ages 13-17 for the last 3 years has allowed me to explore even more.  I never give the ACE questionnaire to my students, but I do describe how trauma was indicated in the study originally used.  My main fear is that my students will turn on a family member or anyone else they may blame for the trauma and of course, this would cause even more trauma.  My students have already been through so much, I can't imagine causing more harm!

Currently, I share the study with my students and give VERY general definitions of how the study defined trauma.  I've had a few older/mature students research the study and find the questionnaire.  When this has happened, I discuss it with the student(s) one-on-one or small group (whoever was curious enough to look up the information and learn more).

I see both sides of this so I thought I would (very briefly) explain using some of my experiences.  My goal is to be a supportive adult to each and every one of my students and help them any way I can.