Adverse Childhood Experiences and Their Impact on Children Part 2

08/03/2018
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NOTE: This is the second article in a three part series.

What if you could make a positive difference in a child’s life? Per the American Academy of Pediatrics, the Adverse Childhood Experiences (ACEs) study involved collaboration between the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente’s Health Clinic.

The study examined data for over 17,000 middle class Americans. It became clear that adults from all walks of life (from different socioeconomic status, race, etc.) were at much higher risk of long-term physical, mental, and behavioral health issues as a result of their exposure to adverse childhood experiences, such as divorce, violence, or substance abuse in the home. The risk for long-term health complications increases as the ACE score increases.

A high ACE score equals and high amount of toxic stress. We all experience some type of stress. Studies show that there are different types: positive, tolerable, and toxic. According to the type of stress you experience, and the way you deal with the event and move through the situation successfully or not is called resilience. The American Academy of Pediatric defines resilience as “the process by which the child moves through a traumatic event, utilizing various protective factors for support, and returning to “baseline” in terms of an emotional and physiologic response to the stressor.” Resilience is crucial to a child’s ability to navigate through stressful events successfully. Resilience includes the following 5 Protective Factors: parental resilience, social connections, concrete support in times of need, knowledge of parenting and child development, and social and emotional competence of children. Knowledge and usage of these factors build family strengths and encourage a positive family environment that promotes optimal child and youth development.

In our previous article we met Little Johnny, a foster child that has been taken away from his mom and placed in foster care. He has been moved to a foster home with strangers in a different County, transferred to a new school with no friends, and has seen a new doctor that is not familiar with his medical or social history. He was prescribed several new medications for what was diagnosed as constipation, ADHD, and insomnia.

In reality, Little Johnny’s “symptoms and behavior” all stem from the traumatic events he has experienced in life. He has watched his mom use drugs, he has gone to bed scared and hungry, he has attended school in dirty clothes, and then he saw his mom arrested and taken to jail. Little Johnny was taken from familiar surroundings and placed in foster care. The only way Johnny knows how to express his feelings is through acting out in school. He worries about his Mommy and this makes his tummy hurt so he can’t sleep. He feels sad and alone. Let’s see how knowledge of Adverse Childhood Experiences (ACEs), Trauma-informed care can change the outcome of this story.

Mentally rewind to our initial story about “Little Johnny”. He was living at home with his mom who has a history of substance abuse, which in turn led to neglect and physical abuse. Little Johnny’s mom was recently incarcerated for illicit drug use. Little Johnny was placed in foster care in another county with Foster Parents that have been in a recent ACEs workshop and recognize that Little Johnny has been through several traumatic experiences. They understand that Little Johnny doesn’t understand what is going on or how to effectively verbalize his feelings. He has started acting out in school, is not sleeping, and complains of constipation and stomachache. They know the importance of keeping his health care with his same Medical Home and know he needs to receive Trauma-informed care.

The foster parents know that Trauma-informed care will assess Little Johnny’s situation from an innovative perspective. Instead of being asked, “What is wrong with you?” He is asked, “What has happened to you?” The good news is Little Johnny was able to see his regular doctor who has had trauma informed training and is able to recognize that he needs to express himself and learn resilience techniques to cope with his feelings and emotions.

Resilience is the ability to return to being healthy and hopeful after bad things happen. Research shows that if a child is provided a safe environment and is taught how to be resilient, it helps reduce the effects of ACEs. The American Academy of Pediatrics gives several Resiliency techniques and Trauma informed anticipatory guidance recommendations. Here are a few that were used in Little Johnny’s situation: For his tummy ache and constipation, instead of a medication, he is placed on a high fiber diet, given distraction methods (coloring, reading a story), he was taught positive talk methods, and deep breathing techniques. The doctor discussed Little Johnny’s disruptive behavior and advised the Foster Mom to praise good or desired behavior, remain calm and gentle even when he is expressing aggressive behavior, be understanding but consistent and calm when disciplining.

When discussing Little Johnny’s insomnia, the doctor suggested a consistent bedtime ritual that is soothing such as reading a book, dimming the lights, taking a warm bath, and having a night light in the room. He also advised no screen time 1 hour before bed (TV, computer, video games). The Foster Mom reported that Little Johnny has a favorite stuffed dog named Bingo that he sleeps with. The doctor explained to the Foster mom this is his transitional object and says this is a healthy resiliency practice as well. Bingo makes him feel safe and secure. The doctor suggested that the Foster Mom should encourage the child to take care of his special friend; this gives Little Johnny a sense of being needed and serves as an excellent distraction object.

Several weeks following the visit to the Trauma Informed provider, the Foster Mom can see a remarkable difference in Little Johnny. She is using the Resiliency strategies on a daily basis. Now, he is sleeping all night, doing better in school and is not complaining of a stomachache. His teacher has also noticed a positive difference in his behavior. Wow, what an extraordinary transformation. Knowledge truly is power when put into action!

In our final article, we will discover additional resilience guidance, ACEs education, coping skills, and local resources. We will also include a link for you to determine your ACE score.