Training Module 1 of 10: ACEs, Stress, and Trauma Understanding the root causes

Consider this… “Remember, everyone in the classroom has a story that leads to misbehavior or defiance. Nine times out of ten, the story behind the misbehavior won’t make you angry. It will break your heart.” -Annette Breaux

What are ACES? They are defined as some of the most intensive and frequently occurring sources of stress that children might suffer in life Abuse (physical, sexual, emotional) Neglect (physical and emotional) Household Dysfunction Domestic violence, addiction, mental illness, divorce or separation, incarceration

The ACE Study Groundbreaking public health study Kaiser-Permanente’s Department of Preventive Medicine & CDC 17,000 patients 10 question survey asking about adverse childhood experiences

The Results…. Only a third of the patients had an ACE score of zero. Increased likelihood of multiple ACES wheat at least one was present. One in six had a score of 4 or more. One in nine had a score of 5 or more. A score of 6 or more shortened their lifespan by 20 years. There is a profound proportionate relationship between ACE scores and health outcomes.

With at least one or more ACES… More likely to smoke More likely to suffer from alcoholism More likely to suffer from Depression Higher risk for sexual behavior as teens Less likely to gain and maintain employment The study compared their current health status to their ACE score

ACES Research concluded that those who experienced 3 or more ACES in their early lives were much more likely to have: Social, emotional and cognitive impairment Adoption of at-risk health behaviors Disease, disability and social problems Early death Watch video on Dr. Nadine Burke https://www.google.com/search?q=ted+talks+nadine+burke&oq=ted+talks+nadine+burke&aqs=chrome..69i57j0l2.17628j0j7&sourceid=chrome&ie=UTF-8

Dr. Nadine Burke Harris

Evidence from the ACE study suggests: “Adverse childhood experiences are the most BASIC cause of health risk behaviors, morbidity, disability, mortality and high healthcare costs.” --Vince Felitti

Stress = Demands > Resources What is Stress? Stress = Demands > Resources

Three Levels of Stress Response POSITIVE – brief increases in heart rate, mild elevations in stress hormones TOLERABLE – serious temporary stress responses, buffered by supportive relationships TOXIC – prolonged activation of stress response systems in the absence of healthy protective relationships.

Toxic Stress “The excessive or prolonged activation of the physiologic stress response systems in the absence of the buffering protection afforded by stable, responsive relationships.” --American Academy of Pediatrics

Toxic Stress = ACES Show vide clip on The Still Face Experiment – Dr. Ed Tronick

What Makes an Experience Traumatic? Overwhelming, very painful, very scary Fight or Flight incapacitated Threat to physical or psychological safety Loss of control Inability to regulate emotions The ability to cope is completely overridden Trauma is the response to the event, not the event itself It is the FEELING that the event creates for you. A child needs a caring confident stable adult to help them navigate a traumatic event, absent of that, the child develops maladaptive coping skills in that place.

Areas of the Brain Impacted by ACES Prefrontal Cortex – center of executive functioning, regulates thoughts actions, emotions Hippocampus – center of short term memory, connects emotion to fear Amygdala – triggers emotional responses.

Persistent State of Alarm… Repeated and overwhelming stress “sensitizes” the amygdala and it becomes hyper-alert to danger. Troubled children reset their normal level of arousal. Even when no external threats exist, they are in a persistent state of alarm... (Bruce Perry)

Training Module 1 of 10: ACEs, Stress, and Trauma Questions, Resources, Thoughts, Concerns, Putting it into Practice