ToolKit & Resources – Adverse Childhood Experiences – Full description
What are ACEs?
You may or may not have heard of ACEs before, although it is very likely you will of heard of some of the concepts involved in ACES. ACEs is an acronym that stands for Adverse Childhood Experiences which are things that can happen in young person’s life that result in a negative outcome later on in life. They are common, with almost 50% of people living in England having 1 ACE and 8% having 4 or more.
There are three important things for teachers to understand when it comes to ACEs
To understand what kinds of things are likely to create an adverse experience
To have some insight into what Toxic Stress is and does to the body
What can teachers to do to mitigate the impact of ACEs and reduce negative outcomes
What kind of things might be adverse experiences?
Adverse Childhood Experiences (ACEs) are stressful events occurring in childhood and typically involve abuse (physical, sexual or emotional), neglect, family member with physical or mental ill-health, death of a caregiver, alcohol abuse, drug abuse, divorced or separated parents or bullying. However, it is important to note that this is not a definitive list of all of the experiences that may be traumatic for a child, but rather an overview of the types of experiences that might result in toxic stress. Research suggests that the more ACEs a child has experienced, the more likely they are to engage in health-harming behaviours as they grow up such as smoking, engaging in sexual behaviour early, illicit drug use, alcohol abuse and violence. Those who had experienced 4 or more ACEs were 7 times more likely to have been involved in a recent violent offenceand 11 times more likely to have used Heroin or Crack Cocaine. These children were also 3.9 times more likely to have a chronic illness (Bellis et al., 2014).
Another term you might hear being used here is traumatic events
Psychological trauma is any experience or series of experiences that someone finds distressing to the point where their ability to cope with the stress is overwhelmed. These can include physical or sexual abuse, neglect or bereavement, living in poverty or bullying. Experiencing trauma can result in toxic stress. Toxic stress can physically alter the brain’s development, which can lead to social and emotional difficulties later on. Many children will face upsetting eventsbut most will bounce back and ‘return to normal’ relatively soon. However, depending on their experiences and other interacting factors such as temperament and resilience, some children can have ongoing difficulties as a result of their trauma, such as Post-Traumatic Stress Disorder (PTSD).
What is Toxic Stress and what role does it play?
Much like missing a lesson of Maths or English, if a child has not had their developmental needs adequately met there can be gaps in their social and emotional development which can lead to difficulties regarding . Therefore, when presented with a stressful situation, they are unable to manage their emotions, often resulting in what we observe as meltdowns or confrontational attempts to ‘end’ a stressful experience (e.g., shouting, getting angry etc.).
These gaps can also occur if the child have been exposed to adverse experiences. When an infant is very young (<3 years of age), they experience the world through their senses, and they learn through sensory input. Young children who have experienced neglect have had poor sensory input from their caregivers and as a result, their nervous system does not develop typically. If a child has experienced a gap in their development at this stage, they may show sensory-seeking or avoiding behaviours.
Toxic stress in its technical definition is the ‘prolonged activation of stress response in the absence of protective relationships’. A simpler way of thinking about this is that ACEs or traumatic experiences switch on the bodies stress response which we experience as anxiety. This results in a powerful stress hormone known as cortisol being released into the blood stream from the kidneys which turns on a stress response for the rest of the body e.g. heart rate increasing, blood pressure rising, sweating etc.
After each stressful or traumatic event, normally, a person’s stress levels should rise and the drop back to their usual resting point or baseline. A young person steeped in toxic stress however typically has a higher resting point for cortisol activation and will take longer to return to baseline once a stressful event has passed.
When this becomes repeated it can often have negative effects on the body. Toxic stress can derail healthy brain development, interfering with a young person’s ability to adapt, manage and regulate emotions. This may result in young people trying to find other ways of managing toxic stress by taking up health harming behaviours (such as smoking, drinking or drugs).
As time goes on these negative effects on coping with stress can impact a young person across their lives, and have a strong association with poor health in adults. This can sadly lead to an early death.
This is all very negative but there are reasons to be positive too. Poor outcomes for ACEs are not set in stone and can be avoided with the right knowledge and support.
As with all matters of wellbeing taking time to focus on areas such asemotional intelligence and social confidence helps to build an outlook that feeds into the interactions a teacher has with the young people they support. Whilst we are preparing ourselves to help others we must also look after ourselves, we’ve got some advice and guidance on this in the teacher wellbeing section.
What can teachers do to mitigate the impact of ACEs and reduce negative outcomes?
It is not always feasible, nor always suitable for teachers to be solely responsible for all of the issues that arise with ACEs. Sometimes the support that a child needs goes beyond what a teacher can do and moves into process of helping them get professional support assessing for risk.
Teachers, through the nature of their work, are well positioned to provide support to young people that have been exposed to high levels of toxic stress. A relatively simple but important way in which teachers can begin to support a young person’s well-being is to first learn and understand more about mental health and wellbeing. This may seem obvious, and it is, but taking time to focus on this area helps to build an outlook that feeds into the interactions a teacher has with the young people they support. In regards to toxic stress, we call this being “trauma informed” which means we begin to see things, such as a young person’s problematic behaviour not as a question of “what is wrong with you?” but more as a question of “what might have happened to you?”
Research has shown that a relationship with one trusted adult during childhood can mitigate the impacts of ACEs on mental and physical wellbeing. When we think about what we now know about toxic stress this makes sense. Having someone that a young person can trust creates an environment in which a young person can readapt to a sense of safety. In this environment a child’s stress response is normalised. This relates to the topic of , and the importance of a secure-base for the child. In a way teachers can lend their stress management tools to a young person and build their capacity for resilienceand self-esteem. Teachers can play an important role in this sense as they might be the only trusted adult a young person has in their lives at that point.
Of course, teachers were once children themselves, many may carry the unresolved burdens of ACEs themselves, and therefore it is paramount that teacher’s wellbeing is nurtured and supported as well. It is often through the reflection and understanding of our own mental health and wellbeing that we can be become truly effective in providing support to others .
If a teacher is feeling confident and comfortable with some of the foundations we have discussed here then they can move on to looking into ways in which we might incorporate this knowledge into practical ways to work with young people and help them learn more about their brains, bodies and capacities to cope.