Adverse Childhood Experiences

A few years ago, I managed a statewide non-profit that worked with youth who were involved in various systems of care or part of certain social institutions (foster care, juvenile justice, mental health services, homeless shelters, etc.). A large part of the work we did focuses on building resilience (with peer support, group activities, cultural events, discussions, etc.) through adversity. Earlier in the week, I shared some of the various types of adversity that people face, in a general sense of the word. Adversity can be deeply profound in a way that has real lifelong implications for a person. Overcoming adversity is not an easy feat, and not everyone can develop the supports and stability they need to push through their hardship.

I want to explore judgment later, but I want to note that when we judge folks who look like they need a change from the outside (we often see them when looking at people who are obese), remember that often times people are struggling with their own versions of overcoming some type of adversity. This is not to give an excuse to certain behavior, but, often times, we will use unhealthy coping (food, drugs, relationships) mechanisms to deal with what we are going through.

The CDC researched how adversity affects young people for the duration of their entire life. Some factors are related to those discussed in the previous blog, and some are more specific. The Adverse Childhood Experiences Study looked at factors of adversity and explored findings of negative health effects based on surveys from respondents who were 18 years old and younger.

Risk Factors

  • Alcoholism and alcohol abuse
  • Chronic obstructive pulmonary disease
  • Depression
  • Fetal death
  • Health-related quality of life
  • Illicit drug use
  • Ischemic 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

According to the Adverse Childhood Experiences — ACE — study, the rougher your childhood, the higher your score is likely to be and the higher your risk for various health problems later.

[CDC, 2016]

Looking at the risk factors, any one of them could alter someone’s life in a profound way. The increase in situations of adversity increases the likelihood that a person will experience even more of these factors, which even include early death! So, what factors did the CDC look at to determine the definition of adversity?

  • Abuse
    • Emotional abuse: A parent, stepparent, or adult living in your home swore at you, insulted you, put you down, or acted in a way that made you afraid that you might be physically hurt.
    • Physical abuse: A parent, stepparent, or adult living in your home pushed, grabbed, slapped, threw something at you, or hit you so hard that you had marks or were injured.
    • Sexual abuse: An adult, relative, family friend, or stranger who was at least 5 years older than you ever touched or fondled your body in a sexual way, made you touch his/her body in a sexual way, attempted to have any type of sexual intercourse with you.
  • Household Challenges
    • Mother treated violently: Your mother or stepmother was pushed, grabbed, slapped, had something thrown at her, kicked, bitten, hit with a fist, hit with something hard, repeatedly hit for over at least a few minutes, or ever threatened or hurt by a knife or gun by your father (or stepfather) or mother’s boyfriend.
    • Household substance abuse: A household member was a problem drinker or alcoholic or a household member used street drugs.
    • Mental illness in household: A household member was depressed or mentally ill or a household member attempted suicide.
    • Parental separation or divorce: Your parents were ever separated or divorced.
    • Criminal household member: A household member went to prison.
  • Neglect
    • Emotional neglect: Someone in your family helped you feel important or special, you felt loved, people in your family looked out for each other and felt close to each other, and your family was a source of strength and support.2
    • Physical neglect: There was someone to take care of you, protect you, and take you to the doctor if you needed it2, you didn’t have enough to eat, your parents were too drunk or too high to take care of you, and you had to wear dirty clothes.

Three types of adversity that make for a tough childhood.

[CDC, 2016]

These factors are not exhaustive by any means, but they demonstrate a deeper version of what adversity can be defined as. Minority groups experience adversity as it relates to racism All of these points illustrate adversity as it relates to adult > child relationships, which is important to examine. As we grow older, the ways in which our negative experiences affect us get buried underneath the surface. When traumatic events happen in our lives in youth, our brain development is altered. We are shaped by our experiences, but we can also rise above those experiences. We develop strategies to deal with the world around us, sometimes with the behaviors that were created in response to these events.

I wanted to focus on adversity that happens in childhood because when I learned about this study when I was working with at-risk youth, I was amazed at my person scores on the ACES. The study only looks at 10 types of trauma, but coming up with a score of 7, stunned me. It’s important to note that the ACES does not take into consideration the positive factors of resilience you have in your life (family, friends, activities, social programs, school, etc.). Without going too into detail, life was a challenge growing up at times, but I also knew that there were many people who had it worse. I never experienced any physical or sexual abuse, but my parents struggled with their own mental health and substance abuse that consumed a large part of their energy. In looking at my parent’s life before they were 18, I am sure their ACES were likely 8 or 9, and at a much more severe intensity. My parents did a much better job than their parents did, but, as a family, we still had our very real struggles.

When you grow up in situations of adversity, you often do not see them as a problem until you are met with some life experience that shifts this perception for you. For me, it was the Upward Bound program. I am going to talk more about this program in a later feature, but the program started me off by overcoming the types of adversity we looked at earlier. The academic program that helps at-risk, low-income youth find their direction to college gave me positive experiences, positive role models, new found self-esteem, and a belief in my future. Looking beyond just the ACES, school didn’t feel like a safe place with a fair amount of bullying, dealing with health concerns (asthma, chronic sickness, depression & anxiety), and navigating all of the regular woes of teenage life.

I was talking to my brother not too long ago and we were reminiscing about our upbringing, and how differently we could have turned out. We’ve both been fairly successful despite having gone in different directions (military vs. education). The fact that we both were able to find success (looking at relationships, economics, ability to find happiness) is truly amazing.

I want to share this study because it gives an insight into some of the origins of our adversity (backed by some research), and, personally, it gives an example for me to share my own experiences and show that, despite adversity, we can overcome and find success and happiness. Your scores on this study does not define your ability to overcome obstacles but can give an awareness of our past as I believe our past can be an important key to unlocking some doors we’ve closed on ourselves. When you are facing adversity, try to fall back on what you DO have in your life, as protective factors are far more important than the risk factors.

  • Parental resilience
  • Social Connections
  • Knowledge of parenting & child development
  • Concrete support in times of need
  • Children’s social and emotional development

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