ACEs

ACEs

ACE –

Does that mean anything to you? For some it might conjure up the lyrics of an old George Straight song that says, “You’ve got to have an ace in the hole.” For others it brings images of poker games and winning hands. For others, names of all-star professional baseball pitchers. For others, the experience of serving in tennis and never getting a volley back. Maybe for you, it’s the terminology for someone who is always seemingly ahead – “He’s holding all the aces.”

But how many of you saw ACE and thought about difficult childhood experiences? I’m guessing not very many of you. This past week I had the opportunity to sit in a training which discussed trauma informed care. As part of that discussion, the ACEs were mentioned.

So, what are the ACEs?

ACEs in this context stands for Adverse Childhood Experiences. These are experiences that occur before the age of 18 that have a dramatic impact on how we live, function, and make decisions as an adult. The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study began in the mid-1990s and continued through 2015 and has consistently shown the impact of childhood experiences on adult functioning. Let’s take a minute to look at what was studied and the major findings.

The ACE Study looked at the occurrence of 10 major childhood experiences, which are typically divided into 3 main categories.

Source: https://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean

 

What It Said 

According to the CDC, Adverse Childhood Experiences (ACEs) are common. So common that almost 2/3 of participants reported at least one ACE, and more than 20% reported three or more ACEs. – Pause for a minute – that is statistically the majority of people that you meet every day. That is 1 in 5 who have had multiple significant experiences – most of which we don’t like to talk about.

So what does that mean? Per the CDC, as the number of ACEs increases, so does likelihood of the risk for the following:

  • Alcoholism and alcohol abuse
  • Chronic obstructive pulmonary disease
  • Depression
  • Health-related quality of life
  • Illicit drug use
  • Heart disease
  • Liver disease
  • Poor work performance
  • Financial stress
  • Risk for intimate partner violence
  • Multiple sexual partners
  • Sexually transmitted diseases
  • Smoking
  • Suicide attempts
  • Unintended pregnancies
  • Early initiation of smoking
  • Early initiation of sexual activity
  • Adolescent pregnancy
  • Risk for sexual violence
  • Poor academic achievement

 

It covers it all – health problems, increased risky behaviors and a decreased life potential. It also leads to an increase likelihood of premature death.

Look at the list above again and let’s talk about students – especially high school students. Often, we as parents, youth workers, teachers, and Teen Life Facilitators spend a great deal of time talking about poor grades, teenage pregnancy, suicide attempts, self-injury behaviors, depression, anxiety, drug and alcohol use/abuse. But do we stop to take the time to think about what experiences might have contributed to these decisions? When we are feeling frustrated, do we see the behavior as defiance or a coping skill?

So now that we know what the ACEs are and what the research shows, what in the world do we do?

Build relationships.

According to Dr. Karyn Purvis, “The child with a history of loss, trauma, or abuse has no hope of healing without a nurturing relationship.” The presence of safe, stable, and nurturing relationships can greatly increase resiliency among children and youth who have experienced multiple ACEs.

Are you willing to look past the hard choices, to look past the mistakes, in order to see the experiences that have impacted the students in our lives? And when you do, are you willing to stick it out to connect and empower youth to overcome?

 

***For More Information about The CDC ACE Study can be found here and here. More information about the ACEs in general can be found here. More information about Dr. Karyn Purvis and her Trust Based Relational Intervention can be found here.

Beth Nichols is Teen Life’s Program Director. With her background in social work and experience as a mom of 4, her perspective is invaluable.
Defiance or Survival?

Defiance or Survival?

You are running errands at Target. You see a mom with her pre-teen. The girl mentions that she is hungry, and her mom explains that they are almost done at the store and will get some lunch once they get home. As you stand in the check-out line, you see her eyeing the candy. She asks for some. Again. Mom says, “No.” As you watch, you see the child has opted to steal the candy from the store as opposed to waiting until they get home.

Pause for a minute. How would you handle that situation? What if you were the parent? If you are like most parents I know, you proceed to lecture your child on stealing and add a few lines about how you told her she could eat at home. You drag her back into the store, purchase the candy, make said child apologize, and then take her home to do chores and earn the money back you just spent. Or you repossess her allowance money. You confiscate the candy and promise more consequences.

Now, think of the most challenging youth you know. It may be a student from your classroom at school. Maybe a teen from your church. It may be a youth who is involved with the legal system. It may be your friend’s child. It may be your own child. How do you really view their challenging behaviors? As defiance? As a lost cause?

Each day as parents, school staff, and youth workers, we confront behavior. Sometimes it’s minor disrespect. Sometimes it’s fighting in a hallway where someone is physically hurt.

Consider this:

Is a child or youth’s inappropriate behavior intentional defiance or is it a survival skill?

Even asking that question probably raises a few eyebrows. Most of us have the same gut response. I told (fill in a name) not to do that. They did it anyway. They have no respect for me and need to have (fill in a consequence). But is that really the full story? For our children, we know their story and their history. For other youth – students we see twice a week at a sports activity or church, students in our support groups – we usually only know part of their story. It is much harder to see their needs.

In the words of Dr. David Cross, “Having compassion and understanding helps us to see the need. Seeing the need is changing your frame of reference so you realize that these aberrant behaviors are survival strategies rather than willful disobedience. If you look at your child’s behavior through the lens of his history, his actions make perfect sense. We don’t know all of the potential hurt so we can’t always understand what it takes to survive. How we view behavior changes everything.”

Is the behavior functional? No, most likely not. However, it isn’t fruitful to remove a child’s survival strategy, no matter how negative, without giving them a new strategy. Demanding a child stop stealing food without providing for the very real fear that they will not have food is not going to be successful. Demanding that a child use their words and not fists when they have had to fight to protect themselves or a family member will not change the behavior, without first providing another strategy.

A few questions to consider:

Who is the child or youth in your world that makes you feel like you are spinning your wheels?

How can you change how YOU see their behavior? Can you see their needs not just their actions?

What tools can you provide to the youth in your life in order to increase their success?

 

**The survival vs. willful disobedience concept was introduce to our team while attending a training on Trust Based Relational Intervention (TBRI.) More information on TBRI can be found here.

 

Beth Nichols is Teen Life’s Program Manager. With her background in social work and experience as a mom of 4, her perspective is invaluable.