Tip Sheets

Resources for covering how adverse childhood experiences affect people's lives


Janice Lynch Schuster

By Janice Lynch Schuster

Since the late 1990s, researchers have known about the negative effects of adverse childhood experiences (ACEs) on adult health, particularly their dose-related effect on risks for several major conditions, including cancer, heart disease, lung disease and suicidality. A key CDC/Kaiser Permanente ACE study categorized (conducted in 1995-1997) ACEs into three groups – physical and emotional abuse, household challenges and neglect – alongside ten significant health or social problems. More recently, the Behavioral Risk Factor Surveillance System (BRFSS) provides 2014 data from 14 states.

More recently, a presentation at the Aspen Institute Summit on Inequality and Opportunity included a brief look at the biological underpinnings of ACEs — what physically occurs to the developing brain under the pressures of poverty. (Listen to it here). AHCJ’s 2017 annual conference in Orlando also hosted several panels on youth, stress and development. Here are some resources from the programs this year that could help guide coverage:

Experts on ACEs

Since the initial Centers for Disease Control and Prevention (CDC) study with Kaiser, other researchers have continued to examine the effects of ACEs at different points in childhood as well as the factors that contribute to resilience. Others have developed new programs and outreach efforts.

Sarah Enos Watamura, Ph.D., University of Denver, Stress Early Development & Research Center (SEED): Watamura,  SEED’s co-director, told the Aspen event that ACEs “have been found to have a graded dose-response relationship with more than forty health outcomes to date.”  With at least two-thirds of adults have experienced at least one ACE during childhood, the effects of repeated or constant exposure can be dire. Watamura noted ACEs impact on:

  1. health, such as obesity, diabetes, depression, suicide attempts, STDs, heart disease, cancer, stroke, COPD, and broken bones;

  2. behavior: smoking, alcoholism, illegal drug use; and,

  3. life potential: graduation rates, academic achievement and lost time from work.

Watamura and her colleagues are investigating the biomechanics of ACEs, trying to understand precisely how such adverse events become embedded in the nervous and immune systems. One proposed study, for example, seeks to find “the relationships among childhood poverty, chronic stress, and the neural correlates of emotional reactivity and regulation six years later.” Contact: seedresearchcenter@du.edu

The Health Journalism 2017 panel, “The science of toxic stress: early childhood experiences and brain development,” also featured several experts: Melissa Bright, Ph.D., assistant research scientist, Institute for Child Health Policy, University of Florida;

Dr. Mark Cavitt, medical director of pediatric psychiatry services, Johns Hopkins All Children's Hospital; and Dr. Daniel Taylor, associate professor, Drexel University College of Medicine and director of community pediatrics and child advocacy, St. Christopher's Hospital for Children.

Dr. Nadine Burke-Harris, founder of the San Francisco-based Center for Youth Wellness, a health organization  that works in partnership with the California Pacific Medical Center’s Bayview Child Health Center: Burke-Harris has called ACEs simply  “… things that get under our skin and change our physiology.” Burke-Harris, in a 2014 TEDMED talk, said her program takes a multidisciplinary approach to provide the care coordination aimed at helping to prevent future problems from occurring and screens young patients for ACEs. Contact: Emily Tolos, etolos@centerforyouthwellness.org, phone 415-684-9520, info@centerforyouthwellness.org

ACE resources

  • The Resilience Project of the American Academy of Pediatrics (AAP): AAP has declared that ACEs are a major public health crisis and, to this end, is developing strategies to screen, prevent, and treat for related problems. It offers an array of online programs for pediatricians, policymakers, and families and caregivers. The Resilience Project features online training programs about ACEs, ways to improve clinical practice, and a series of online mindfulness training programs for clinicians and their staff.  In addition, AAP links to several brochures it has developed for families and caregivers. Contact: AAP press offices (Illinois or Washington, D.C.), commun@aap.org.

  • The United Hospital Fund: New York-based UHF is funding efforts to address poverty-related adversity that occurs during the first five years of a child’s life through projects aimed at having a positive effect on lifelong physical, cognitive and social-emotional development of their patients. The new program, Partnerships for Early Childhood Development, links 11 hospitals and 18 community organizations with teams focusing on food insecurity, parental depression, unsafe housing, domestic violence, substance abuse, and unemployment. Its participating practices serve more than 26,000 children each year and New York City, according to the group.  Contact: www.uhfnyc.org, Catherine Arnst, director of communications, carnst@uhfnyc.org,  212-494-0700.

  • ACES Connection: Funded by Robert Wood Johnson and the California Endowment, this social network is centered around those who work with adverse childhood experiences and could help journalists seeking to reach those practicing in the field and find out local issues.  It includes Roadmap to Resilience, which links to several cities at various stages of implementing programs addressing ACEs in their communities by offering trauma-informed responses to patients. The project is also linked to a related site, ACEsTooHigh.com, aimed at the public. Contact: Jane Stevens, jstevens@acesconnection.com. 

Publications

  • Essentials for Childhood: Steps for Creating Safe, Stable and Nurturing Relationships and Environments.  CDC, National Center for Injury Control and Prevention, 2014. This report highlights possible strategies that communities … could use “to promote the types of relationships and environments that help children grow up to be healthy and productive citizens so that they, in turn, can build stronger and safer families and communities for their children.”

  • Preventing Child Abuse and Neglect: A Technical Package for Policy, Norm, and Programmatic Activities. CDC & National Center for Injury Control and Prevention, 2016.  A thorough discussion of policy changes essential to changing social norms and practices that would, in turn, change parental and community behavior. The findings look at options such as “…strengthening economic supports to families; changing social norms to support parents and positive parenting; providing quality care and education early in life; enhancing parenting skills to promote healthy child development; and intervening to lessen harms and prevent future risk. The strategies represented in this package include those with a focus on preventing child abuse and neglect from happening in the first place as well as approaches to lessen the immediate and long-term harms of child abuse and neglect.”