ACEs

ACEs

ACE –

Does that mean anything to you? For some it might conjure up the lyrics of an old George Straight song that says, “You’ve got to have an ace in the hole.” For others it brings images of poker games and winning hands. For others, names of all-star professional baseball pitchers. For others, the experience of serving in tennis and never getting a volley back. Maybe for you, it’s the terminology for someone who is always seemingly ahead – “He’s holding all the aces.”

But how many of you saw ACE and thought about difficult childhood experiences? I’m guessing not very many of you. This past week I had the opportunity to sit in a training which discussed trauma informed care. As part of that discussion, the ACEs were mentioned.

So, what are the ACEs?

ACEs in this context stands for Adverse Childhood Experiences. These are experiences that occur before the age of 18 that have a dramatic impact on how we live, function, and make decisions as an adult. The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study began in the mid-1990s and continued through 2015 and has consistently shown the impact of childhood experiences on adult functioning. Let’s take a minute to look at what was studied and the major findings.

The ACE Study looked at the occurrence of 10 major childhood experiences, which are typically divided into 3 main categories.

Source: https://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean

 

What It Said 

According to the CDC, Adverse Childhood Experiences (ACEs) are common. So common that almost 2/3 of participants reported at least one ACE, and more than 20% reported three or more ACEs. – Pause for a minute – that is statistically the majority of people that you meet every day. That is 1 in 5 who have had multiple significant experiences – most of which we don’t like to talk about.

So what does that mean? Per the CDC, as the number of ACEs increases, so does likelihood of the risk for the following:

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

 

It covers it all – health problems, increased risky behaviors and a decreased life potential. It also leads to an increase likelihood of premature death.

Look at the list above again and let’s talk about students – especially high school students. Often, we as parents, youth workers, teachers, and Teen Life Facilitators spend a great deal of time talking about poor grades, teenage pregnancy, suicide attempts, self-injury behaviors, depression, anxiety, drug and alcohol use/abuse. But do we stop to take the time to think about what experiences might have contributed to these decisions? When we are feeling frustrated, do we see the behavior as defiance or a coping skill?

So now that we know what the ACEs are and what the research shows, what in the world do we do?

Build relationships.

According to Dr. Karyn Purvis, “The child with a history of loss, trauma, or abuse has no hope of healing without a nurturing relationship.” The presence of safe, stable, and nurturing relationships can greatly increase resiliency among children and youth who have experienced multiple ACEs.

Are you willing to look past the hard choices, to look past the mistakes, in order to see the experiences that have impacted the students in our lives? And when you do, are you willing to stick it out to connect and empower youth to overcome?

 

***For More Information about The CDC ACE Study can be found here and here. More information about the ACEs in general can be found here. More information about Dr. Karyn Purvis and her Trust Based Relational Intervention can be found here.

Beth Nichols is Teen Life’s Program Director. With her background in social work and experience as a mom of 4, her perspective is invaluable.
The Red Line

The Red Line

In 1934 as part of the New Deal, the government created the Home Owner’s Loan Corporation (HOLC) and the Federal Housing Administration with the goal of preventing foreclosures through mortgage refinancing.  The Home Owner’s Loan Corporation (HOLC), a government sponsored lender, proceeded to draw maps of American cities to determine which areas were worthy of mortgage lending and which areas were too high-risk. The HOLC color coded communities into green, blue, yellow, and red areas. Each area came with a definition.

Green – “hot spots,” new, well planned sections of the city

Blue – completely developed areas – these areas were still good but not new

Yellow – areas in a transition period, characterized by age, lack of care

Red – “high-risk” areas predominately with residents of Color – labeled as areas with detrimental influences and poor maintenance– were considered undesirable areas

 

The term “redlining” was coined to explain this practice of denying loans and services based on a neighborhood’s demographic makeup. In 1968, the Fair Housing Act made these maps and practices officially illegal, but the long-term ramifications continue on 50 years later.

We, as parents, teachers, youth workers, or mentors have often grown up with “red lines” in our lives, especially those of us raised with a faith-based background. Red lines are topics, or even people, we aren’t sure we want to be involved with.

For example, ask those around you how sex education was handled in their home growing up. Based on those who I have asked, the answer was one of three things:

1. We just knew not to do it

2. We didn’t talk about it

3. In 5th grade health class.

 

A red line. An area too risky to walk into.

When we, as adults, walk on eggshells regarding certain topics, teens know. When we talk around topics, they pick up on it. Teens know walking on eggshells is a tool adults use to avoid the long-term ramifications of knowing the truth – to avoid the potential fallout associated with the truth. Teens know you aren’t willing to ask the hard questions and believe you aren’t willing to hear the true answers.

 

Here are a few topics that are commonly redlined by adults…

  1. Sex – You talk about sex, right? Talking about how bodies are changing and developing. Talking about respect for their body and for other’s bodies. Asking about impulse, self-control, and definitions of couples/partners. Asking if they are sexually active. Talking about consent and sexual assault.
  2. Suicide – When you suspect a child is struggling, are you direct? Asking, “Are you planning to kill yourself?” or “Are you planning to attempt suicide?” opens the door to keep people “safe for now” according to Living Works. Then ask follow-up questions such as, “Do you have a plan?” “When do you plan to kill yourself?” “Do you have access to ____ (whatever means needed to attempt suicide)?” “Have you attempted suicide before?”
  3. Drugs/Alcohol – Ask the direct question, “Have you been drinking?” or “Are you using drugs?” You can also ask, “What is your drug of choice?” or “How often do you use?” They might lie at first, but the ability to ask these questions opens the door for later conversations because they know you see them and you care.
  4. Mental Health Issues – Are you willing to ask about feelings of depression or anxiety? Are you willing to talk about their friends who may be struggling with these things? Ask youth if there is someone they are worried about.

 

What are the redlines in your past? How do they impact your interactions now? Who do you need to stop walking on eggshells around? What hard questions do you need to ask? What you choose today impacts the future.

**If you want to see these redlining maps or a picture of these ramifications, you can find more here.

 

 

Beth Nichols is Teen Life’s Program Manager. With her background in social work and experience as a mom of 4, her perspective is invaluable.