Adverse childhood experiances

ACE study results

ACES are COMMON occurrences a person with ONE ace is likely to experience other traumatic events too there is a STRONG relationship between the number of ACES and the development of significant health and behavioral issues with a cumulative effect SINCE the initial study, there have been over 100 other studies performed, which confirm this strong, graded relationship DOSE DEPENDENT RELATIONSHIP more aces=more adverse health issues

what can nurses and community members do continued....

ACES can be prevented and treated ensure cultural humility assessment of the infant and caregiver relationships home visiting teach and support children and families to confront stressful situations in a calm manner children are never too young to learn self care teach children to talk through their feelings Instruct children and families to take deep breaths (mindfulness activities)

what are ACES?

Adverse childhood experiences are significant NEGATIVE experiences occurring during infancy or childhood -these can influence a child's development in many ways, with resultant impacts on the child's emotional, cognitive, social and neurobiological wellbeing these affect emotional and physical health LATER in life

toxic stress

BUT when stress is prolonged or repeated, there is not enough POSITIVE resources to counteract their efforts and stress can become dangerous

primary prevention of ACES

activities directed at the general population and attempt to stop the trauma before it occurs -focuses on enhancing protective factors, such as positive parenting, education, and family economic supports

Child abuse contains

acts of commission and acts of omission

HOW does helping someone through ACES affect someone on a cellular level?

acts of kindness cause the release of oxytocin, which sends positive self-affirming signals to the brain oxytocin, along with dopamine and serotonin, increases the production of neuro-chemicals, which counteracts and neutralizes the effects of adrenaline and cortisol

traumatic experiences may overwhelm a persons

coping resources/mechanisms

ACES can cause

differences/variations in the brain structure, which can impact communication, emotional responses, stress management and difficulty in school

what can nurses and community members do?

routinely seek a hx of ACES from patients through a questionare provide education to families and communities use existing systems to help with current problems as well as system's for primary prevention

in traumatic experiences, a person may find coping mechanisms work in the ___________ but can cause serious harm in the __________

short run, long run

effects on the brain due to ACES

the physiologic mechanism by which ACES lead to negative health outcomes is due to the REPEATED activation of the stress-response system, and this is when stress hormones are CONSTANTLY elevated

What nurses can do?

the precense of just ONE positive adult influence in a child's life can help mitigate against the detrimental effects of ACE's Therapeutic communication is SO important

epigenetics

the study of how behaviors and environment can cause changes that affect the way your genes work (occurs in aces) This is REVERSIBLE because it does NOT change DNA but can change how the body READS a DNA sequence

childhood experiences are powerful determinants of

who we become as adults

effects on the developing brain continued...

"bear in the woods" -the presence of danger or even severe unpredictability causes the brain to send a message to the glands to release adrenaline and cortisol -These are GOOD levels of stress and the SHORT periods of pressure that push us to complete a task when we need to achieve it. The stress then passess and body recovers quickly BUT when stress is prolonged or repeated, there is not enough POSITIVE resources to counteract their efforts and stress can become dangerous. This is toxic stress

acts of omission

neglect, failure to provide or failure to supervise

secondary prevention of ACES

focused on preventing further harm and trauma after someone has experiences and ACE -teaching, coping skills, building resilience and finding community

what is an ACE score

a tally of different types of abuse, neglect and other adverse child experiences on experiences as a child ACE screening tools are used A higher score indicates a higher risk for health problems LATER In life score is 0-10, and each trauma counts as 1, no matter how many times it has occured

categories of ACE's

abuse, neglect, household dysfunction

what is an ACE score continued...

ace scores do NOT tally the positive experiences in early life that can help build resilience and protect a child from the effects of trauma resilience is brought forward by support and resources examples: having a loving grandparent, a teacher who understands and believes in the child or a trusted friend that can confide in

the HIGHER the ace score the greater the likelihood of

-severe and persistant emotional problems -health risk behaviors -serious social problems -adult disease and disability -high health and mental health care costs -shorter life expectancy

Influence of ACES on well-being

These influence health and wellbeing

HOW and WHEN to conduct an ACE screening

give to a parent OR child over the age of 10-12 use the upfront universal screening in PC settings screening can be done face to face OR independently screenings should BENEFIT patient- need to have support in place BEFORE screening is performed screening does NOT mitigate harmful impact of traumatic experiences

ACE study

largest investigation of childhood abuse and neglect, done at kaiser permanente study was designed to assess the association between childhood adversity and the development of physical, mental and behavioral problems in later in life

What makes a child resilient?

perceived social support/social reactions having supportive adult relationships finding supportive relationships outside the family positive self image of children helps to build their strength to handle future challenges

acts of commission

physical, sexual, psychological abuse

ACES are _________ and/or __________

preventable and modifiable

Trauma

refers to intense and overwhelming experiences that involve serious loss, threat or harm to a persons physical and or emotional well-being This may occur at any time in a persons life. it may involve a single traumatic event or may be repeated over MANY years

How to help kids build resilience

teaching them to solve problems independently without this skill, kids experience anxiety and shut down in the face of adversity

Resilience

the ability to adapt in the face of adversity, trauma, tragedy or stress "bouncing back"

how does trauma affect a person?

the experience of being in a relationship with another person and with the world around us has profound impacts on who we are and what we will become -human experiences CAN be stored in our bodies, not just our minds Our ENVIORNMENT can shape us into who we are today (epigenetic's)

effects of ACES on the developing brain

the human brain can alter its structure to adapt to certain life experiences, particularly, those that occur during childhood cells in our brain are ALL connected in a complicated network, and overtime, new connections are formed and old connections are lost and existing connections are strengthened OR weakened Throughout childhood, these connections are continually created and modified (we want POSITIVE connections, NOT negative)

Effects of toxic stress on the body systems of a child: endocrine system

toxic stress can inhibit the functioning of hormones that regulate growth and development. it can lead to obesity and impede or accelerate the onset of puberty

Effects of toxic stress on the body systems of a child: Nervous system

toxic stress disrupts the developing brain, including changes to the hippocampus, prefrontal cortex and amygdala. This raises the risk of cognitive impairment, learning disabilities, hyperactivity, poor self-regulation, inhibited memory and attention span and anxiety

Effects of toxic stress on the body systems of a child: CV system

toxic stress increases a childs risk for developing high blood pressure later in life because it elevates levels of inflammation that can damage the arteries. This can lead to heart disease, stroke and other serious heart issues

the intergenerational transmission of trauma

toxic stress of ACES might not be experienced by an individual but could also be transmitted from one generation to the next at a GENETIC level Some researchers have studied historic periods of trauma, like the civil war or holocaust, and have seen how it can impair at some level of functioning for future generations who are not living in the same adverse circumstances

Effects of toxic stress on the body systems of a child: immune system

toxic stress raises the risk of infections and autoimmune diseases due to chronic inflammation and other factors. This can impair the normal development of the body's immune system (more susceptible to certain cancers)