Adverse childhood experiences
Adverse Childhood Experiences (ACEs) are traumatic experiences that occur in the life of a child before the age of 18.
These experiences range from suffering child neglect or physical, sexual or emotional abuse, to being raised in a household where domestic violence, substance abuse or mental health problems are present. Other ACEs can include having parents who are separated or who have spent time in prison.
There is a wide range of other types of childhood adversities that can impact the wellbeing of a child, including bereavement, bullying, poverty and community adversities such as living in a deprived area or experiencing neighbourhood violence.
These events can have a significant impact on children, often lasting into adulthood. So if we want to improve young lives, we have to consider ACEs.
What does evidence tell us about impact of ACEs?
Evidence from surveys in the US, UKand elsewheredemonstrate that ACEs can be associated with a range of poor health and social outcomes in adulthood and that these risks increase as the number of ACEs increase.
ACEs can increase an individual’s risk of developing health-harming behaviours such as: high-risk drinking, smoking, under-age sexual activity and drug abuse, which can in turn lead to an increased risk of poor physical and mental health in later life. These health risks include cancer, obesity, heart disease, diabetes, depression and anxiety, as well as negative social outcomes such as low levels of education, incarceration, and domestic violence.
However, not everyone who suffers ACEs experience the same harmful outcomes. Children and adults who function well despite experiencing ACEs demonstrate resilience. Resilience is the ability to overcome serious hardships and is often described as being able to ‘bounce back’.
But resilience should not be viewed just as an issue of individual capability: scaffolding child development by supporting families, building healthy communities and addressing social inequalities play a vital part in helping individual children and communities to develop resilience.
How LEAP is helping to address ACEs
As part of the A Better Start Programme, LEAP is committed to improving the life chances of babies and very young children through early intervention focusing on key child development outcomes including social and emotional development and communication and language.
We believe that supporting development in these areas amongst
children, parents and communities can help reduce ACEs, minimise their
impact and increase resilience of those who have experienced them. Since
early 2018, LEAP has been working in partnership with Lambeth Council
to start a conversation around tackling ACEs and promoting resilience in
This process was started by a screening of the film Resilience, which explores the science behind ACEs and how interventions can support resilience and was followed by an expert Q&A discussion of the issues. The event was attended by over 200 Lambeth professionals from across the workforce, demonstrating significant local interest.
As a result of the event, LEAP, in partnership with Lambeth Council, convened a group with representation from key Lambeth services, including schools, police, the youth offending service, public health, community organisations, early help, GPs and many more. The aim of the group was to initiate a multi-agency discussion about ACEs and their relevance to services in Lambeth, and begin to consider different approaches to prevent and reduce the impact of ACEs.
To support this work LEAP commissioned a comprehensive overview of the evidence relating to ACEs and efforts to tackle them.
LEAP also co-hosted the Lambeth Children’s Safeguarding Board Conference, which was focused on ACEs, to gather the views of local practitioners. Following this, we undertook a pilot of Trauma-Informed Practice training as part of an early help initiative in the borough. As a result of the various ACE related activity taking place in the borough, Lambeth’s Serious Youth Violence Board is working towards becoming trauma-informed, and LEAP will be a key partner in taking this work forward.
As we work to raise awareness of the impact of ACEs on children and families in Lambeth, we are deeply grateful for the encouragement of frontline staff who see first-hand how traumatic life-events shape a child’s world.
‘Working in a primary school we engage with children who have faced traumatic experiences on a daily basis. This is a new viewpoint for considering the reasons for their behaviour and how we, as a school, respond to this’ – Primary School Teacher
‘We need to become more ACE informed so that we can build resilience and change the lives of families and the people that we work with and change their outcomes’ – Midwife
‘I think it is very important that health practitioners are aware of the importance of ACEs because we are in a good position to help support children, young people and their parents at these vulnerable times in their lives when they can have an impact’ – GP
‘I hope we see more of a multi-agency approach, and more empathy for families’ – Communication and Language Consultant
‘I think it is really important because many young people in Lambeth are exposed to really serious situations which are effecting them in terms of long-term trauma’ – Youth Worker
Angharad Lewis, Early Childhood Workforce Officer at LEAP.
- ACEs research study from US - https://www.ncbi.nlm.nih.gov/pubmed/9635069
- ACEs research study in the UK - https://academic.oup.com/jpubhealth/article/36/1/81/1571104
- ACEs research study in Wales - http://www2.nphs.wales.nhs.uk:8080/PRIDDocs.nsf/7c21215d6d0c613e80256f490030c05a/d488a3852491bc1d80257f370038919e/$FILE/ACE%20Report%20FINAL%20(E).pdf
- ACEs research study in Europe – https://www.ncbi.nlm.nih.gov/pubmed/25378755
- Systematic review of ACEs research - https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(17)30118-4/fulltext
- Transforming Psychological Trauma: A knowledge and skills framework for the Scottish Workforce - https://www.nes.scot.nhs.uk/media/3971582/nationaltraumatrainingframework.pdf
- Prioritising adversity and trauma-informed care for children and young people in England https://youngminds.org.uk/media/2142/ym-addressing-adversity-book-web.pdf
- LEAP’s ACEs Screening Event video - https://www.youtube.com/watch?v=Igj7l928dCk
About A Better Start
A Better Start is a ten-year (2015-2025), £215 million programme set-up by The National Lottery Community Fund, the largest funder of community activity in the UK. Five A Better Start partnerships based in Blackpool, Bradford, Lambeth, Nottingham and Southend are supporting families to give their babies and very young children the best possible start in life. Working with local parents, the A Better Start partnerships are developing and testing ways to improve their children’s diet and nutrition, social and emotional development, and speech, language and communication. The work of the programme is grounded in scientific evidence and research. A Better Start is place-based and enabling systems change. It aims to improve the way that organisations work together and with families to shift attitudes and spending towards preventing problems that can start in early life. It is one of five major programmes set up by The National Lottery Community Fund to test and learn from new approaches to designing services which aim to make people’s lives healthier and happier
The National Children’s Bureau is coordinating an ambitious programme of shared learning for A Better Start, disseminating the partnerships’ experiences in creating innovative services far and wide, so that others working in early childhood development or place-based systems change can benefit.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship
of childhood abuse and household dysfunction to many of the leading causes of death in adults.
The Adverse Childhood Experiences (ACE) Study. American journal of preventive medicine. 1998;
Bellis MA, Hughes K, Leckenby N, Hardcastle KA, Perkins C, Lowey H. Measuring mortality
and the burden of adult disease associated with adverse childhood experiences in England: a
national survey. Journal of public health. 2014.
Bellis AB, Hughes K, et al (2014) Adverse childhood experiences and associations with
health harming behaviours in young adults: surveys in eight eastern European countries. Bull World
Health Organisation 2014 92641-6558.
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