Dr. Nadine Burke Harris, founder and CEO of the Center for Youth Wellness, provides an impassioned plea for pediatric medicine to confront the prevention and treatment of trauma, head-on.
Adverse Childhood Experiences (ACEs) are stressful or traumatic events experienced before age 18. They are grouped into three categories: abuse, neglect, and household dysfunction (Felitti & Anda, 1998; RWJF, 2013). The term, “ACEs,” was coined in 1998 following the publication of the Adverse Childhood Experiences Study (ACE Study).
The ACEs Study and subsequent studies on the topic have surfaced a public health crisis hidden in plain sight.
In the ACE Study, the prevalence of at least one ACE was 67% and four or more ACEs was 12% (Felliti & Anda, 1998). In children, the prevalence of at least one ACE has ranged from one-third to nearly one-half of the population in nationally representative samples (Bethell et al, 2014; Bright et al, 2015; Wing et al, 2015) and among populations at high-risk for maltreatment, the rate reaches as high as 91% (Flaherty et al, 2013). Since 1990, many additional studies have replicated and expanded these findings around the ongoing and significant prevalence of this issue.
See the prevalence of ACEs in your state, on this map provided by Data Resource Center for Child and Adolescent Health.
The study found that ACEs were not only common within the population, but were strongly related to the prevalence of numerous health problems (Felitti & Anda, 1998). The ACE study found that ACEs were not only common within the population, but were strongly related to the prevalence of numerous health problems (Felitti & Anda, 1998).
In children and adolescents, a greater number of ACEs have been associated with fair or poor general health (Bethell et al, 2014; Flaherty et al, 2013), illness requiring a doctor (Flaherty, 2013), fair or poor dental health (Bright et al, 2015), lifetime asthma (Bethell et al, 2014; Wing et al, 2015), ADHD (Bethell et al, 2014), autism (Bethell et al, 2014), and being overweight or obese (Bethell et al, 2014; Burke et al, 2011).
In addition, studies have found an association between ACEs in childhood and adolescence and delinquent behavior, bullying, physical fighting, dating violence, and weapon-carrying (Duke et al, 2010).
In adults, ACEs have been found to have a strong, dose-response association with cardiovascular disease, chronic lung disease, headaches, autoimmune disease, sleep disturbances, early death, obesity, smoking, general poor health, depression, posttraumatic stress disorder, anxiety, and substance abuse (Kalmakis & Chandler, 2015).
Source: Robert Wood Johnson Foundation, 2013