1. The Adverse Childhood Experiences (ACE’s) Study and the implications of outcomes
Josephine McKay, MSW

2. Found in the middle of the Brain
Limbic system
Found in the middle of the Brain
Known as “emotional bran”
Responsible for emotion, behavior, motivation, learning, & memory
Consists of: Hypothalamus, Thalamus, Amygdala, and Hippocampus

3. Limbic system Sexual Behavior Hunger/Thirst Sleep Body Temperature
Hypothalamus
Amygdala
Hippocampus
thalamus
Sexual Behavior
Hunger/Thirst
Sleep
Body Temperature
Hormone Secretion
Identify emotion from facial expression
Creating & storing new memories
Storage of long-term memory (emotions, location, people, objects)
Receives auditory, somatosensory, & visual signals
Controls sleep/wake states of consciousness

4. Cerebral cortex Outer portion of forebrain
Divided into 2 spheres: left and right
Divided into 4 lobes: frontal, temporal, occipital, parietal

5. Regions of the brain
Parietal:
Processes somatic
information, hearing
Frontal:
muscle movement,
thinking, emotional
control, personality
Occipital:
Receives visual
information
Temporal:
Receives auditory
information

6. Frontal lobe Left Positive Emotions: Happiness Joy Confidence Love
Right
Negative Emotions:
Sadness
Anxiety
Depression
Anger

7. right left Hemisphere Hemisphere
Left side of body
Faces
Emotional Expression
Non Language Sounds
Nonverbal Memory
Emotion of Speech
Sense Distance
Right side of body
Words & Letters
Sounds of Language
Verbal Memory
Speech, reading, writing, math
Function
Vision
Hearing
Memory
Language
Spatial Ability

8. Childhood Responses to Trauma
Cortex:
Cognitive Memory
Limbic:
Emotional Memory
Cerebellum:
Motor Memory
Cognitive- names, faces, facts
Limbic- fear, pleasure, sadness
Cerebellum- action like riding a bike, playing
Brainstem- anxiety or arousal states- fight or flight responses
Re-exposure to trauma (sights, sounds, smells) can elicit response from stored memories
As the events recur in the child’s mind, not only will the thoughts of the event be recalled but the emotions and feelings (fear, pain, anxiety) will be re-experienced too
Brainstem:
State Memory
Bruce Perry, Child Trauma Center

9. Childhood Responses to Trauma
Continuum
Rest
Vigilance
Crying
Tantrums
Aggression
Continuum
Avoidance
Detached
Fetal
Fainting
Internal State
Calm
Arousal
Alarm
Fear
Terror
Hyperarousal continuum- Fight or Flight Response
Dissociative Continuum- Freeze or Surrender Response
Fear changes thinking, feeling, and behaving
Internal state changes by increase in heart rate, blood pressure, respiration, glucose levels
Bruce Perry, Child Trauma Academy

10. Trauma- How do we get from here?

11. Trauma- to here?

12. Adverse childhood experiences (ace’s):
Vincent Felitti, MD- Specialist in prevention medicine Kaiser/UC San Diego
Question: “What if having a bad childhood could affect health in other ways?”
Robert Anda, MD- Epidemiologist with CDC&P
17,000 patients- White, middle-aged, upper-middle class
-First longitudinal study into childhood trauma and impact to brain development in relationship to emotional and physical health,
- Began when Dr. Felitti tried a new liquid diet for obese patients. One patient shared history of SA, asked another then found that half of the 300 patients had hx.

13. ACE’s Outcomes: Identified Adverse Experiences
10 Identified types of adverse childhood experiences:
-Sexual Abuse Loss of parent due to divorce
-Physical Abuse Loss of parent due to incarceration
-Emotional Abuse Mental Illness in parent
-Neglect Drug Abuse by parent
-Loss of parent due to death Alcohol Abuse by parent

14. ACE’s Outcomes What do the Numbers Mean?
Higher score on the tool = greater chance the child will have medical, mental, and societal challenges as an adult
Score of >4 = 4 to 12 times more likely to experience alcoholism, drug abuse, and suicide attempt compared to those with 0 score
Score of <4 = twice as likely to have heart disease
Women with score of >5 = 4 times likely to suffer depression
Score of 2-4 greater rates of smoking, poor self-rated health, and severe obesity
Significant impact of the study on prevention funding in mental health, substance abuse treatment for women pre-natally, early childhood education, afterschool programs-> all with aim at reducing family isolation and creating community interdependence.

15. How Does This Impact Me?
“Safety and security don’t just happen, they are the result of collective consensus and public investment.
We owe our children, the most vulnerable citizens in our society, a life free of violence and fear.”
~Nelson Mandela

16. Thoughts?
What took so long for the ACE’s findings to become public knowledge?
What can society do with this information?
What can you do as an individual with this information?
Is there hope for change?

17. Brain can rejuvenate
One solid caregiver can show affection and the brain can heal
Exercise can help restore metabolism to “normal” and reduce implications of diabetes, hypertension, cardiovascular disease
Sleep can reduce chronic stress; at least 7 hours per day, which reduces early mortality
Mindfulness practices can re-regulate the sympathetic nervous system, i.e. reset the “abused” flight or fight response