Your actions could make all the difference for a child with Adverse Childhood Experiences, says Lorraine Jenkin…
Most people feel anecdotally that people who have had a tough childhood tend to have a tough adulthood. Things that happen to us as children shape us – positively and negatively – and affect our future choices and behaviours.
However, we’ve only recently started appreciating how tight the correlation is between the number of Adverse Childhood Experiences (ACEs) and the health and wellbeing of adults.
Adverse Childhood Experiences are when a child has experienced physical, sexual or emotional abuse. They may have grown up in a household in which there is:
Each one of these things is counted as a single Adverse Childhood Experience. Some children will obviously have multiple Adverse Childhood Experiences.
Certain levels – and periods – of stress are normal and indeed good for us. They teach children to cope with uncomfortable situations and build long-term resilience. However, extreme or prolonged stress changes a child at a cellular level.
Constant heightened awareness raises cortisol and adrenaline. Body chemistry becomes different compared to a child who has the occasional isolated incident to contend with.
The original Adverse Childhood Experiences research (at Kaiser Permanente, 1995–97) recognised this. It found that adults who have four or more Adverse Childhood Experiences are much more likely to have poor adult health – debilitating conditions such as cancer, heart disease or diabetes.
Those with six or more Adverse Childhood Experiences have life expectancies 20 years less than their peers with none.
They are also less likely to be able to cope with everyday life without resorting to activities that inflicted the Adverse Childhood Experiences on them in the first instance: substance abuse, violence, criminality, domestic abuse, mental illness and abusive behaviours. Thus, they continue the cycle for their own families.
The correlation is so strong that the government is seeking to not only tackle the Adverse Childhood Experiences happening in the first place, but also educate professionals who work with children to spot those suffering and seek assistance for them.
This is both to buffer against the Adverse Childhood Experiences and build resilience within them.
This will be multifaceted: health visitors, early years practitioners and teachers, police, firefighters, doctors and nurses.
If you consider that the death of a woman through domestic abuse costs the government £1.8 million (Home Office statistics), then you can see the financial (let alone moral) worth of investing to prevent it.
As professionals who work with children, you will be aware of your requirements to report to social services instances of abuse, for example.
However, many children’s problems are long-running and you may not necessarily consider them a reportable offence. For example, we may not necessarily consider having a parent with a mental illness a dangerous situation for a child.
However, couple that with the other parent not coping and self-medicating with prescription pills. There may be endless abusive arguments between the parents that eventually ends in parental separation. Suddenly you have a child with four Adverse Childhood Experiences.
These problems are compounded for the child due to the chaos that often surrounds such behaviours. Families may spend their budget on alcohol rather than food. An over-medicated parent may slump on the sofa instead of reading stories at bedtime.
There may be neglect regarding the washing of children’s clothes and bodies. There’s often no energy left for introducing exciting vegetable dishes. A child can very quickly feel isolated or shunned by peers. Thus the problems multiply.
Constantly alert to danger, a child (and then adult) loses the ability to rationalise the severity of the threat. They may see everything as a problem that needs a serious reaction. This can make them unpopular and someone to avoid.
Fortunately, there are actions that can buffer a child against the impact of Adverse Childhood Experiences and build resilience within them.
Children who have many interests outside of the home (if it is the home that is affecting them) can lessen the consequences of their Adverse Childhood Experiences.
Not only does time spent away from the source of pain and fear lessens the occurrence, but the mind being occupied with pleasurable things can allow the brain respite from the adrenaline and cortisol, and so lessen the cellular changes.
If a child can have at least one available adult who is ‘on their side’, then they can weather the storm much better.
Therefore, even if there are problems within the home, if at least one parent is maintaining structures, continuity and support, you can reduce the impact of Adverse Childhood Experiences.
Some children, sadly, won’t have this. Their home is a place of fear or chaos. That means that their supportive adults in, for example, their nursery or school, become even more crucial.
Assign the identified children a stable key person, rather than likely shorter-term placements. Persist in encouraging and giving the skills for friendships. For those children, no one else may be doing this.
Children with high numbers of ACEs need to be independent much more than their peers will.
Singing or engaging in crafts lifts the soul. The ability to spend hours with mates kicking a football around will provide a place for that child to go, so start it young.
Educate parents about Adverse Childhood Experiences if you can. Hand out leaflets from health visitors and be more urgent with the stable relatives of the children who might be suffering.
If Granny understands that the role she needs to play is far greater than expected, then she can be the buffer between the child and the Adverse Childhood Experiences. She can make the difference to not only her grandchild, but future generations.
Alert health visitors if confidentiality allows it, or urge the stable adult to do so. For those children moving up to school, inform teachers of their ACEs scores to ensure no break in pressure to build resilience and get help.
Working with children is always an important job, but for those children who have four or more Adverse Childhood Experiences, your actions could be making the difference between a future of happiness and a future of chaos.
Lorraine Jenkin is an author who has been involved in childcare for several years.
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