a Descriptive research STUDY OF ADVERSE CHILDHOOD EXPERIENCES
Matthew Thifault
Appalachian State University
Introduction
Understanding Adverse Childhood Experiences (ACEs) and their relation to a student’s future outcome demonstrates the importance of combatting the effects early in a child’s life. More specifically, research shows that caring stable adult in a child’s life has the potential to offset the negative effects of childhood trauma. (Masten, 2001). If these experiences are not combatted early in a child’s life the future effects could be catastrophic. For example, one study done on a sample of 191 middle aged adults suggests that suggests that childhood truama negatively impact an adults social-emotional interactions in everyday life. Some of those negative effects are strain in social relationships, early onset of functional limitations, disease, and premature death. This study demonstrates how childhood trauma impacts health and social-emotional relationships throughout the majority of a person’s life (Infurna, Rivers, Reich, & Zautra, 2015). That is why understanding ACEs is vital to developing research based interventions that combat these affects early in a child’s life.
Given that childhood trauma affects a child’s life holistically and endures throughout their lives, this paper examines the issue relative to health-related outcomes, graduation and suspension rates, case studies, and teacher-student relationships that offset the negative outcomes. The first area outlines the methods I used to compile the references I found for the paper. The second area illustrates some of the potential lifelong effects of childhood trauma, specifically health-related outcomes and post graduate outcomes. The third area reviews case studies as well as research based interventions like restorative justice to analyze how these interventions offset the negative outcomes of childhood trauma before. The fourth and final area offers a summary of the research on childhood trauma along with practical and research implications.
Methods
I used the following three methods to obtain references for this review. First, I searched the Appalachian State Library resource to locate resource papers. For this database, I used the following keywords: Adverse Childhood Experiences, childhood trauma, restorative justice, education, teacher-student relationships, case studies, and outcomes of Adverse Childhood Experiences. Second, I used Google scholar to find more research papers. I narrowed my search by using the following keywords: Adverse Childhood Experiences, case studies, outcomes of Adverse Childhood Experiences, restorative justice, education, teacher-student relationships, and case studies. Third, I used the reference section from one of my key descriptive research study references. I used this reference section to find the research that the descriptive study used. Finally, the vast majority of references are from the past ten years.
Outcome of ACEs
The following section has two parts focused on the potential lifelong effects of ACEs. The first part focuses on the mental, social-emotional, and physical health-related outcomes of childhood trauma. The second part examines the role childhood trauma plays in graduation rates and incarceration rates.
When it comes to health-related outcomes the original ACE study showed that adults with four or more ACEs were at a greater risk of having various chronic diseases than adults with 0 ACEs. The symptoms of ACEs impact behavioral and emotional development as well as academic performance (Burke, Hellman, Scott, Weems, & Carrion 2011). This article is an investigation of adverse childhood experiences (ACEs) of youth in a low-income, urban community. It is a correlation study about how a child’s ACE score effects learning behavior problems, and obesity. The majority of the children who participated in the study experienced 1 or more ACEs and there was a positive correlation between the ACE score the risk of learning/behavior problems and obesity. The implications of this study are there must be increased screening for ACEs in children and that research based interventions must be developed to combat these effects.
A book chapter by Feliitti & Anda uses the Adverse Childhood Experience (ACE) Study to analyze 17,000 individuals who have experienced trauma during their childhood. It examines the correlation between childhood trauma and the causes of cardiovascular disease, chronic lung disease, chronic liver disease, depression and other forms of mental illness, obesity, smoking, and alcohol and drug abuse. The ACE Study categorized ten forms of trauma from into three different categories. These categories were abuse, household dysfunction, and neglect. Under these categories are emotional abuse, physical abuse, contact sexual abuse, mother treated violently, household member was an alcoholic, imprisoned, chronically depressed, suicidal, mentally ill, or in psychiatric hospital, not raised by both biological parents, physical neglect, or emotional neglect. Out of 17,000 individuals from the middle class one in six had an ACE score of four or more (Felitti & Anda, 2010).
Childhood trauma is linked to unhealthy habits that also lead to these health risks, such as smoking, alcohol dependency, and overeating (Infurna, Rivers, Reich, & Zautra, 2015). This was confirmed after analyzing research published in the Journal of American College Health I found that there is a positive correlation between ACEs score and levels of depressive symptoms, ADHD symptoms, cigarette use, alcohol use, marijuana use, and BMI, as well as lower levels of fruit and vegetable intake, and sleep. This article is a study focused on multiple health behavior outcomes associated with ACEs prior to age 18 years. The study uses a sample of 2,969 college students from seven universities in Georgia. Interventions suggested by this study are that programs can target more than one health behavior based from ACE screenings (Windle, al. 2018). This study shows that the effects of childhood truama prior to the age of 18 years continue to influence the health behavior and choices made throughout college years.
Post graduate outcomes don’t look too great for a person with four or ACEs. They are seven times more likely to end up in prison, two times more likely to have cancer or have a stroke and 12 times more likely to attempt suicide.
Case Studies and Research Based Interventions
The following section has two parts. The first part examines case studies of childhood trauma and what it looks like in the classroom. The second part analyzes research based interventions that have been shown to offset the negative outcomes of ACEs.
According to a survey by the National Survey of Children’s Health almost 50% of all children in America experienced one or more ACEs. This translates to over 30 million children nationwide (Stevens, 2017). “Adverse childhood experiences (ACEs) including abuse, neglect, and histories of domestic and community violence are significant public health concerns in the United States. More than 3.7 million cases are referred to Child Protective Services (CPSs) every year” (Burke, Hellman, Scott, Weems, & Carrion, 2011; p. 408). From this massive number of children who endure ACEs there are many professionals who are trying to find a solution to this problem.
One research based intervention I found that has been reproduced was a universal school-based violence prevention program on violent delinquency focused on children with maltreatment histories. The intervention was a violence prevention program in grade 9 and two years later it was analyzed for its effectiveness to see if it decreased acts of violence for maltreated youth. The study surveyed 1,722 students from 20 schools and found data that showed the intervention benefitted all students because it created a safer environment. Violent delinquency due to childhood trauma was decreased after attending a school with a higher perceived sense of safety. In schools without this intervention, students with more maltreatment in their past were more likely to engage in acts of violence (Crooks, Scott, Ellis, & Wolfe, 2011). This study shows a successful intervention that combatted the symptoms of childhood trauma.
An intervention that worked very well in combatting childhood trauma Lincoln Alternative High School in Walla Walla, Washington was restorative justice. This is how a student at Lincoln Alternative High School defines restorative justice: “Instead of learning from our behavior, schools just force us out without real conversations and interventions. Suspensions don’t work, summonses don’t work, arrests don’t work. Keep us in the classroom, keep us accountable, and build relationships. That works.” — Savannah, age 15 (Pritzker & Redford, 2016). The goal of restorative justice is to address and discuss the needs of the school community, build healthy relationships between educators and students, resolve conflict, hold individual and groups accountable, repair harm and restore positive relationships, and reduce, prevent, and improve harmful behavior.
Before restorative justice practices had been implemented at Lincoln Alternative High School they had 798 out of school suspensions, 50 expulsions, and 600 written referrals. Lincoln serves as an alternative to the larger, traditional high school in Walla Walla, Washington. Many students coming to Lincoln have had a history of truancy, behavior problems, and substance abuse (Pritzker & Redford, 2016). The first step was an ACE screening to see what the students were dealing with. Here are some examples of the questions the survey asked and the results they got: “Has there ever been an adult in your household that has hit you so hard that you had marks or were injured?” One-quarter of the students said yes. “How many sexual partners have you had? 10 percent said four to six. “Have you ever been forced to do something sexual that you didn’t want to do?” Almost 20 percent said yes. Other results indicated that 25% of the students are homeless, 84% have lost a loved one, 66% feel abandoned by their parents, 65% have an immediate family member in jail, 80% have suffered serious depression, 50% live with someone who abuses alcohol or other drugs (Pritzker & Redford, 2016).
To begin their journey, Lincoln Alternative High School set out to become a trauma-informed school. According to the research about childhood trauma, all of the risk factors for adverse experiences can be offset by one thing: the presence of a stable, caring adult in a child’s life.
Since implementing its trauma-sensitive approach, Lincoln Alternative high school has seen 60% fewer office referrals, 75% fewer fights, 90% fewer suspensions, a 55% increase in math assessment scores, a five-fold increase in graduation rates, and a three-fold increase in seniors bound for college (Pritzker & Redford, 2016).
DISCUSSION
References
Burke, N., Hellman, J., Scott, B., Weems, C., & Carrion, V. (2011). The impact of adverse childhood experiences on an urban pediatric population. Child Abuse & Neglect, 35, 408–413.
Crooks, C., Scott, K., Ellis, W., & Wolfe, D. (2011). Impact of a universal school-based violence prevention program on violent delinquency: Distinctive benefits for youth with maltreatment histories. Child Abuse & Neglect, 35, 393-400.
Felitti, V., & Anda, R. (2010). The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders, and sexual behavior: Implications for healthcare. Lanius, R. & Vermetten E. (Eds.), The Hidden Epidemic: the Impact of Early Life Trauma on Health and Disease (pp. 77-87). New York, NY: Cambridge University Press.
Infurna, F., Rivers, C., Reich, J., & Zautra, A. (2015). Childhood Trauma and Personal Mastery: Their Influence on Emotional Reactivity to Everyday Events in a Community Sample of Middle-Aged Adults. PLoS ONE, 10, 12-18.
Masten, A. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56, 227-238.
Pritzker, K. (Producer) & Redford, J. (Director). (2016). Paper Tigers [Motion picture]. USA: KPJR Films.
Stevens, J. (2013, May 13). Nearly 35 million U.S. children have experienced one or more types of childhood trauma. Retrieved from https://acestoohigh.com/2013/05/13/nearly-35-million-u-s-children-have-experienced-one-or-more-types-of-childhood-trauma/
Stevens, J. (2015, May 31). Lincoln High School in Walla Walla, WA, tries new approach to school discipline – suspensions drop 85%. Retrieved from https://acestoohigh.com/2012/04/23/lincoln-high-school-in-walla-walla-wa-tries-new-approach-to-school-discipline-expulsions-drop-85
Windle, M., Haardörfer, R., Getachew, B., Shah, J., Payne, J., Pillai, D., & Berg, C. J. (2018). A multivariate analysis of adverse childhood experiences and health behaviors and outcomes among college students. Journal of American College Health, 66, 246-251.