ACEs (Adverse Childhood Experiences)

What is meant by the term ACEs?

  • Adverse Childhood Experiences (ACEs) refer to events that cause children to experience chronic stress, either by directly harming the child (e.g. physical abuse) or the environment in which he/she lives (e.g. domestic violence). (Bellis et al, 2015).
  • Trauma – An overwhelming experience that is not effectively contained for the child and they are therefore unable to return to a relaxed state. This has both psychological and neurological consequences and can lead to feelings of panic and loss of control. (Bombèr, 2007).

Sentinel markers of adverse childhood experiences from the Adverse Childhood Experiences Study Source: Felitti V et al2

Public Health Wales, ‘The Welsh Adverse Childhood Experiences (ACE) Study’ (2016)

Public Health Wales, ‘The Welsh Adverse Childhood Experiences (ACE) Study’ (2016)

Adverse Childhood Experiences

Adverse Childhood Experiences

Adverse Childhood Experiences - Aces

Adverse Childhood Experiences – Aces

The Adverse Childhood Experiences (ACEs) study is one of the biggest Public Health studies of all time (17,000 people) in mid-1990s in USA. There are ten types of childhood trauma in the original study. 5 are personal- emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse. 5 are related to family members- a family member depressed/mental illness, loss of a parent or parent separation, a family member being addicted to drugs or alcohol, witnessing domestic violence and a family member in jail.

ACEs are a Risk factor- it is not inevitable just makes poor outcomes more likely

It is important to point out that ACEs increase the RISK of these outcomes and do not determine these outcomes. ACEs have a profound impact although some people are less affected by the experience of ACEs. The importance is that we need to know that the experience of ACEs can have a long-term impact on young children’s lives. We need to be aware of this and consider how we can provide appropriate and helpful support to reduce this impact through our range of services.

The more ACEs a person is exposed to, the higher the risk of these outcomes. ACEs are really common. British studies more recently found that nearly 50% of the population have experienced 1 ACE, and between 9- 14% have experienced 4 or more.

People with 6 or more ACEs are on average more likely to:

  • Die 20 years earlier than those with no ACEs
  • Die 35x more likely of suicide
  • Are 46 x more likely to be intravenous drug user (men)

The study found that adverse childhood experiences are a leading determinant of the most common forms of physical illness (cancer, diabetes, heart) mental illness (depression and anxiety) and early death in the western world.

This highlights the importance of early intervention by teams working with families and young people to interrupt or prevent this trajectory.

How can Protective Factors help reduce the impact of ACEs?

Research has shown us the impact of putting protective factors at the heart of our work with families. Interventions, referred to as Protective Factors, can interrupt the possible trajectory from childhood adversity to challenging behaviour, learning difficulties, long term mental, physical and societal ill-health.

Don’t ask, ‘What’s the matter with you?

Do ask, ‘What has happened to you?’

One Emotionally Available Adult can be enough and for many children that adult will be someone at school or community organisation.

This is a message with hope.

Research shows that this suffering is preventable.

A ‘key person’ has the power of working with the child and parent/carer. It doesn’t matter how old you are, you can meet your EAA as an adult. ‘Wasted’. Ian Wright is able to describe and talk about how he is feeling….the power of noticing how you are feeling and acknowledging it.

Having some resilience resources more than halved the risk of current mental illness in those with 4 or more ACEs (Hughes et al, 2018)

Early Learning Contacts

Nicola Theobald, Early Years Improvement Officer
Kate Hubble, Senior Foundation Years Consultant
Nicky Bale, Foundation Years Bristol Standard Consultant
Beth Osborne, Foundation Years Consultant Birth to Three
Kate Irvine, Interim Foundation Years Consultant
Ali Carrington, Interim Foundation Years Consultant