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Adverse childhood events (ACE) are a strong predictor for adult mental health and violence issues and even for unrelated things such as heart disease and diabetes. Understanding how to help a child through these stressful situations is important to help them grow into healthy adults.
An adverse childhood event sometimes called an adverse childhood experience, is any potentially traumatic event experienced before the age of 17 years. These events can have long-term impact on the child’s physical health, mental health, and ability to form healthy relationships (including with their own children). Examples of adverse childhood events include:
Not all traumatic experiences are considered ACEs. For example, natural disasters are typically not considered under the umbrella. ACEs cause “toxic stress,” which is damaging to the development of the body and brain. However, the COVID-19 pandemic has been associated with an increase in ACEs and an exacerbation of existing ones. For example, for some children in dysfunctional households, school is a refuge. School closures and lockdowns thus make the situation worse for these children.
According to the CDC, about 61% of adults experienced at least one type of ACE and 1 in 6 adults have experienced four or more different ACEs. They estimate that 21 million cases of depression could be avoided by preventing ACEs.
Girls and children from ethnic minorities are more likely to experience four or more types of ACEs. The link between discrimination and ACEs is questioned as discrimination is experienced throughout life, but many experts do consider sexism, racism and issues related to sexual orientation and gender identity to be potential ACEs.
Adverse childhood experiences have many long-term consequences. They increase physical and mental health risks. Also, children who witness or experience violence and/or abuse are more likely to become perpetrators of violence in adulthood.
Some of this is due to an increase in risk-taking behavior which might result in sexual promiscuity, binge drinking, and/or doing things which can result in physical injury (such as careless driving, showing off, etc).
They are also associated with poor outcomes in school, unstable work history as an adult, and difficulty forming healthy relationships. This can easily lead to generational poverty.
It is possible to prevent some ACEs. If you are having difficulty in your marriage, then seeking couples or family counseling can help you work out the best course of action. (Note, it is not always staying together for the kids when you are miserable, as that too can put stress on them). Seeking treatment for mental health and substance use disorders can help parents build a healthier family. Removing toxic or violent individuals from access to your children might be hard, especially if they are family members (or worse, their other parent), but in some cases should absolutely be considered.
Taking parenting classes and learning the skills needed to properly communicate with and nurture children can help both by reducing ACEs caused by parents and helping build positive childhood experiences that can mitigate their impact.
People can also push for public and private policies that help reduce or prevent adverse childhood events, including:
Unfortunately, these programs are not always well-funded and families are often left trying to deal with these issues on their own and finding ways to get their children through them. Poverty is a particular problem, as families in poverty can seldom afford to get their children therapy and other help. This often leaves these children having to deal with the impact as an adult.
Some ACEs may be particularly hard to prevent, such as the sudden suicide of a relative. Fortunately, there are also things that can help children deal with these events and become stronger adults.
In some cases, an adult may not know that something has happened. Teachers and parents need to be aware of the potential “symptoms” of an adverse event they might not know about. For example, parents might not know that a classmate has been suicidal, and teachers may not know about issues at homes.
Signs of trauma in children include:
Any of these can also be a sign that a child is being bullied by peers. Children who have experienced trauma can show the long-term effects, such as difficulty forming relationships, surprisingly early. They may also show particularly poor results at school, which can appear to be a learning disability.
It can be challenging to talk to a child about what might be happening in their life, whether you are a parent, teacher, or other concerned adults. However, it is important to establish whether a child is going through trauma quickly so that they can be given the support they need…whether it’s therapy or just a hug.
Parents and caregivers play a primary role in mitigating ACEs. In some cases this might not mean the original caregivers, such as if a child has to be removed from an abusive home. Thankfully, ACEs can be mitigated and many children will show a lot of resilience.
Here are some things which can mitigate the effect of ACEs:
Even one positive relationship can make a huge difference. Anyone who interacts with a child should strive to make the experience positive and open lines of communication with the child. Even young infants are aware of their social interactions with the adults and older children around them.
Children should be encouraged to form positive relations with others the same age, which can sometimes lead to lifelong friendships. They should also be encouraged to avoid toxic people and relationships and taught to set boundaries. Healthy relationships with siblings, especially close-age siblings, can also help.
Children should be encouraged to form positive relations with others the same age, which can sometimes lead to lifelong friendships. They should also be encouraged to avoid toxic people and relationships and taught to set boundaries. Healthy relationships with siblings, especially close-age siblings, can also help.
Going out and doing something fun together can help children build positive memories to mitigate the negative ones. While a trip to a zoo can’t erase trauma, it can help with resilience and take everyone’s minds off of their problems for a while.
Family counseling can also help improve parenting skills and support more positive relationships with parents and siblings. Child-parent psychotherapy is
A healthy diet to mitigate the physical effect of stress and discourage comfort eating of sugary or salty snacks. This can otherwise become a lifelong habit and contribute to poor health outcomes.
ve parenting skills and support more positive relationships with parents and siblings. Child-parent psychotherapy is
Some children will absolutely need therapy to help them through the problem and these interventions are best done right after an event that could trigger stress in a child. Parents should consider therapy after a death in a family, during and after separation or divorce, after the death of a friend, etc. Children can even be affected negatively by the unexpected death of a family pet, and there is no shame in seeking grief counseling for an animal. Therapy should be preventive, not left until it’s clear a child has experienced trauma. Encouraging therapy after a negative event also helps children develop a good attitude toward mental health and will make it easier for them to seek treatment as adults, and not to judge others for seeking treatment.
The most important thing is nurturing family relationships. Counseling as a family can help ensure that parents are not engaging in behavior that harms their children accidentally or because it is how they were raised (or a reaction to how they were raised). It can also help families work through conflict and problems peacefully and positively.
Many adults are struggling with the physical and mental impact of adverse events in childhood. Not only can these issues worsen physical and mental health, but adults with unresolved ACEs present a strong risk factor for children in the household.
Because of this, affected adults must seek help with their issues. If planning on having children, they should consider parenting classes to help them build and model healthier parenting techniques. Affected adults will often raise their children the same way they were raised, or they will recognize it as unhealthy and go to the other extreme. For example, somebody neglected as a child may become a “helicopter parent” who never allows their children to grow and develop independence.
“Trauma informed” therapy is one approach adults can use. This often involves yoga, mindfulness training, and/or art therapy. Art therapy and journaling can help adults bring out their trauma and face it. Adults who experienced multiple ACEs often experience issues with sexual behavior, such as sexual risk-taking, unhealthy promiscuity, or potentially harmful sexual activities such as voyeurism.
A key factor is not to be ashamed of what happened. Some adults may also avoid seeking treatment because they don’t want to acknowledge that their parents treated them poorly (or are afraid of what might happen if said parents find out, even in adulthood). Family therapy, including grandparents, can sometimes help with this, bringing all generations together to help everyone communicate and heal.
Dialectical behavioral therapy can help if people have lingering issues with emotional dysregulation, which can lead to self-harm, addiction, and eating disorders.
Many people experience ACEs and are just fine and are able to grow into healthy adults. This is fortunate given the high prevalence of ACEs. However, some have lingering psychological symptoms and these can pass on to the next generation.
Steps For Change offers high quality mental health treatment in the Minneapolis area. For families and survivors, we offer:
Child therapy for children between 4 and 17 years old, to help them understand their struggles and deal with stressors such as grief, divorce, addiction in the family, etc.
Family therapy helps support healthy relationships and bring the family together. Family therapy is key to mitigating the impact of ACEs. We can offer family therapy to couples with children as well as to single parents and potentially involve other relatives such as grandparents. Our specialist family therapists know exactly how to help your family.
Dialectical behavioral therapy, which can help break negative thinking patterns and is particularly useful for dealing with the emotional dysregulation that can result from trauma. DBT is also good for promoting positive relationship skills. We can include DBT in family therapy sessions.
Couples therapy helps couples build a stronger relationship, resolve conflicts and build trust. This can lower the risk of separation and resultant trauma on children (alternatively, we can help couples decide when staying together is not the healthiest course of action).
Eye movement desensitization and reprocessing therapy, which can help adults deal with unresolved trauma and negative memories.
Any combination of these can help your family heal or, alternatively, build resilience. For example, engaging in couples therapy to solidify your relationship before having children can help ensure that your children are born to a healthy relationship with people who know how to communicate with them and each other.
If you have a child who has experienced an ACE, or are dealing with your own trauma, contact Steps For Change to find out how we can help you and your family.
Brooklyn Center Outpatient Office
6040 Earle Brown Dr. Suite 420
Brooklyn Center, MN 55430
Edina Outpatient Office
7401 Metro Blvd. Suite 495
Edina, MN 55439
Steps For Change (SFC) is using the information provided by credible sources, including the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the American Red Cross, to guide our approach to the virus. Currently, SFC’s offices remain closed to clients/families, guests, and non-essential personnel. SFC is still accepting new referrals and teletherapy appointments are being offered through Zoom to new and pre-existing clients. Our goal is to continue to provide good customer service to all our visitors and ensure all staff are employing best practices.
For more information please refer to the Steps For Change Preparedness Plan: SFC Covid-19 Preparedness Plan Effective 6.15.2020
When entering into a Steps For Change location, please abide by the following Safety Precautions: COVID19 Safety Precaution Policies 6.15.20 (COVID19 Safety Precaution Policies – Spanish 6.15.20)
