Adverse Childhood Experiences

What they are, why they matter, and what a congregation can do

by Lauren Hales
Illustration by Terri Scott

Amy Scott, director of Bethany Christian Services of Greater Chattanooga, is working to change the way faith communities react to, and understand, health and behavioral problems. Amy is a certified ACE (Adverse Childhood Experiences) awareness trainer who delivers ACE trainings to decrease stigma and increase education on this often-overlooked topic. Congregations, which often have caring children’s ministries even in small churches, have significant opportunity to intercept the negative impact of ACEs and instead leave positive marks in the lives of children living with chronic stress.

ACEs are, as Amy explains, “stressful or traumatic events such as abuse, neglect or family disfunction that disrupt a safe and stable nurturing environment—which children need to thrive.” ACEs do not all look the same. “In terms of abuse, it could be physical, emotional or sexual. With issues of neglect, it could also be physical or emotional, and even with the category of household dysfunction it could be the presence of mental illness, an incarcerated relative, a mother who has been treated violently or divorce.”

Through that one relationship, that child has the capacity to be buffered from the negative health impact of ACEs.

The first quantitative study to name and research ACEs, the “CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study,” took place from 1995–1997 in Southern California. This work set the tone for understanding just how large an impact childhood trauma has on a person’s mental and social development. As Amy states, the current framework for ACEs includes thinking about these traumatic events as either abuse, neglect, or household dysfunction, and within those categories a person can identify with multiple challenges—such as emotional abuse in addition to a household member who has struggled with alcoholism. The Kaiser study found that as the number of identified ACEs increased (a person’s ACE score), so did their risk for negative health outcomes such as, depression, liver disease, suicide, poor academic achievement, and smoking, just to name a few. ACEs range in severity. For instance, the ACE of having parents who were once separated is not the same as an ACE of experiencing sexual assault. However, because of the frequency of these childhood traumatic events and their association with health outcomes over a lifetime, ACEs are becoming a major public health issue. For instance, according to the ACE Awareness Foundation, a 2014 ACE survey in the state of Tennessee showed that 52 percent of survey participants experienced at least one traumatic event during childhood, and those who had an ACE score of four or more were almost two times as likely to have developed cancer and almost four times as likely to have chronic bronchitis or emphysema during their lifetime. Due to this research, the importance of a stable and nurturing environment during the first 18 years of a child’s life is a proven social determinant of health.

Amy became involved in promoting the awareness of ACEs in her community because, “for the last 11 years I’ve been working with families who have brought children who’ve experienced traumatic events during their lives into their homes through adoption. Through that work I’ve become aware of a lot of research, and the term ACEs has been featured lately in a lot of popular articles related to trauma. Then the state of Tennessee became especially interested in reducing ACEs, and Governor Haslam put in place a project to increase awareness and make funding available to reduce ACEs. As part of that funding they hosted a two-day training for professionals, and I was selected to attend because of my work with Bethany Christian Services.” Amy expresses gratitude for being selected to become a trainer because, “Understanding ACEs is second nature, but then I’d meet people who think this is mind-blowing to finally know the impact these events have on lifelong health and what can be done to prevent them. When I saw how shocked people were, it compelled me to be more passionate about spreading the word on ACEs.”

Amy has taken her ACE training to various social service organizations around Chattanooga, and she has also presented with local congregations and faith communities—including the Hamilton County Baptist Association. “Because we (Bethany Christian Services) are a faith-based organization, we’ve been drawn into opportunities to present on ACEs, which has been great.” Most of those who have received the ACE awareness training from Amy (including congregations) are already in positions of ministering to children in their communities, and are simply looking for tools to help. Partnering with the faith community is a natural fit because the church is oftentimes the hub of family life and can provide numerous opportunities for support and personal development. Out of Amy’s experience with both ACEs and talking to faith communities come three principle suggestions congregations can take to heart to leverage the work they’re already doing in the lives of children and families.

1. Be curious. The primary benefit of using Adverse Childhood Experiences as a framework for understanding where behavioral and health issues can stem from is that, “It changes the mindset from ‘what is wrong with you?’ to, ‘what has happened to you to cause you to act this way?’ This shift in attitude gives a more compassionate mindset to the worker to be more curious to get to the bottom of what may be going on in a child or young adult’s life, instead of just being inconvenienced by behaviors.”

2. Be committed. The training Amy offers explains what ACEs are, but it also emphasizes the ways adults can come alongside children who are experiencing ACEs to become a “buffer” against that toxic stress. “One of the things that I want everyone to leave with is that ACEs are not a destiny. Research shows that one committed adult can be a buffer to a child and through that relationship there is capacity to repair some of the deficits that may have resulted from exposure to ACEs. I want to leave people with the hunger to be that adult to these kids.”

Churches are uniquely equipped to provide emotional and physical support to children who are experiencing ACEs (and to adults who are now suffering from the effects of childhood stresses) because, “A lot of kids these days do not have access to extended family, so it has to be that coach, or teacher, or childcare worker, or pastor, or church volunteer who has particularly taken interest in them. But through that one relationship, that child has the capacity to be buffered from the negative health impact of ACEs.”

3. Be companions. Congregations can play a significant role in increasing curiosity and compassion toward both children and adults who have been affected by ACEs. In Amy’s experience, “A lot of adults who are at risk for ACEs are very afraid of social service providers or community agencies because they do not want to lose their kids, so they are afraid to be vulnerable about what their needs might be. The church is overall a softer approach. Churches can come alongside these families where the family might be more open to receiving support and care.” What can churches do to be compassionate compassions to families working their way toward healing from the effects of ACEs?

• Host trainings, like the one that Amy offers, for their childcare staff and volunteers; contact a local health department or other social service organizations to request information about an ACE training at your congregation.

• Provide basic life skills classes. These may be for struggling parents who want to do better for their children, for teens navigating toward adulthood without support at home—such as managing money or filling out applications—or helping younger children develop literacy or study habits.

• Provide safe and consistent stress-relieving activities, such as children’s intramural sports or adult exercise classes.

• Set up mentoring programs for struggling families—parent-to-parent, family-to-family, or adult-to-child.

These are just a few examples.

The ACE awareness training provides education and tools for countering the effects of Adverse Childhood Experiences, but it also provides hope—the hope “that little influences can majorly change the trajectory for a child’s life.”

Churches can choose to take up this cause, to learn more about ACEs, and recognize that childhood toxic stress and trauma is not irreversible. Through intentional relationship building, education, and compassion, congregations have the power to create lasting positive change in a child’s life and future health.

Adverse Childhood Experiences

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Physical neglect
  • Emotional neglect
  • Intimate partner violence
  • Mother treated violently
  • Substance misuse within household
  • Household mental illness
  • Parental separation or divorce
  • Incarcerated household member

Chronic Stress

  • Disrupts neurodevelopment
  • Impairs cognitive functioning
  • Leads to unhealthy coping behaviors
  • Contributes to disease and disability
  • Increases risk of mental and substance abuse disorders
  • Increases risk of smoking during adulthood
  • Associates with risky sexual behaviors

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