1. Adverse Childhood Experiences
How ACEs affects people throughout their lives
-Introduce Butte County Coalition with new name

2. “Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today.”
-Dr. Robert Block, the former President of the American Academy of Pediatrics

3. What are ACEs?
Traumatic experiences during childhood that have an affect on future health
There are 10 types of recognized ACEs in three categories:
Abuse
Neglect
Household Dysfunction
What is Trauma: An event, series of events or circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and has lasting adverse effects on individual’s functioning and mental, physical, social, emotional, or spiritual well-being
ACE’s can be experienced by everyone

4. The Initial Study
Roughly 2 of 3 people had experienced at least one ACE
1 out of every 8 had experienced 4 or more ACEs
Surveyed 17,000 adults
74.8% were Caucasian
75.2% had obtained college-level education
Completed in 1998 by physicians at Kaiser Permanente Medical Center in San Diego, California
The higher that ACE score, the higher the risks of poor health and negative health views
The ACE survey tells us:
Who
How many
And with what consequences
Toxic stress effects on the brain
Toxic stress on the body
Toxic stress passed from generation to generation
Resilience research

5. What were the top three most commonly reported ACEs?
According to 2014 data collected by the U.S. Department of Health and Human Services, roughly 702,000 children were victims of maltreatment of one type or another.
75% of cases were of neglect
17% of cases were of physical abuse
6.8% of cases were classified as other abuse

6. The Statistics…
¼ of children will experience some form of child maltreatment in their lifetime
(U.S. Department of Health and Human Services et al, 2012
Lifetime economic burden of new cases of fatal and non-fatal child maltreatment―$124 billion
(Fang, Brown, Florence, & Mercy, 2012)
According to 2014 data collected by the U.S. Department of Health and Human Services, roughly 702,000 children were victims of maltreatment of one type or another.
75% of cases were of neglect
17% of cases were of physical abuse
6.8% of cases were classified as other abuse
¼ of children will experience some form of child maltreatment in their lifetime
(U.S. Department of Health and Human Services et al, 2012
Lifetime economic burden of new cases of fatal and non-fatal child maltreatment―$124 billion
(Fang, Brown, Florence, & Mercy, 2012)

7. ACEs doesn’t discriminate
They impact everyone regardless of their race and ethnicity
There is correlation of higher ACE scores and a person’s poverty, education, and employment
A person with 4 or more ACES is:
21% more likely to be below 250 percent of the Federal Poverty Level (FPL)
27% more likely to have less than a college degree
39% more likely to be unemployed

8. More Statistics A person with 4 or more ACES is:
21% more likely to be below 250 percent of the Federal Poverty Level (FPL)
27% more likely to have less than a college degree
39% more likely to be unemployed

9. Health Impacts of Adults with 4 or more ACEs
Physical Health
Asthma
COPD
Kidney Disease
Mental Health
5 times more likely to suffer from depression
4 times more likely to be eventually diagnosed with Alzheimer’s or dementia
Self-Rated Health
1 or more poor physical and/or mental health days within a month
Poor health prevented them from their usual activities
Health Behavior
About 3 times more likely to:
Be a current smoker
Engage in binge drinking
Engage in risky sexual behavior

11. ACEs Pyramid How do ACE’s cause negative health outcomes?
Prolonged stress can:
disrupt the normal brain development during critical periods in childhood as well as the development of other organ systems.
cause an increased risk for development of stress-related diseases and cognitive impairment.
account for the correlation between increased frequency of ACEs and increased risk for disease or dysfunction during adulthood.
to a pregnant woman can cause stress to the perinatal environment causing changes in the brain development of the fetus.

12. ACEs effect on Parenting Abilities
Adults who experienced ACEs as children are:
More likely to subject their children to ACEs
Increased risk for difficulty dealing with stressors
More likely to project stress to children
People with ACEs are...
Less likely to have health insurance or a regular doctor
Almost 13 times more likely to be removed from their home as a child
Women with at least 3 violent ACEs are more likely to be a victim of intimate partner violence
Men with at least 3 violent ACEs are more likely to perpetrate intimate partner violence

13. Understanding Trauma: Learning Brain vs Survival Brain
ACEs You Tube Video UK
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14. ACEs and School Performance
There is a dose-response relationship between adverse childhood experiences and student learning.
Students dealing with trauma…
Are 2 ½ times more likely to fail a grade;
Score lower on standardized achievement test scores;
Have more receptive or expressive language difficulties;
Are suspended or expelled more often; and,
Are designated to special education more frequently.

15. How Trauma Affects Learning
Trauma can undermine the ability of children to form relationships, regulate their emotions, and learn the cognitive skills necessary to succeed academically.
Youth may be unable to process verbal/nonverbal and written information. Youth tend to have a limited ability to respond and understand instructions or explanations or to retrieve information on demand.
Youth may struggle to identify emotions, feelings and language to relate to people.
When things are “out of order,” their ability to organize, remember and store information may be inhibited.

16. How Trauma Affect Learning Continued…
When youth does NOT feel safe, they cannot fully develop a sense of self which can lead to an inability to:
define boundaries
make independent choices
articulating preferences
Executive Functions – setting goals, develop plans, anticipating consequences, carrying out goals, reflecting on the process. These skills are often lacking in youth that experienced trauma

17. The Six Principals (1-3)
Always Empower, Never Disempower: Avoid battling for control, instead be consistent, respectful and have unconditional positive regard for the youth.
Provide Unconditional Positive Regard: treat youth with sustained kindness and empathize with challenges
Maintain High Expectations: don’t be afraid to set limits. If you lower expectations, you could inadvertently send negative messages such as “you are different.”
Be constant, consistent and predictable.
Limits should be immediate, related, age-appropriate, proportional, and delivered in a calm and respectful voice.
If a child says “I hate you, you’re dumb.” A teacher can respond with “I’m sorry you feel that way. I care about you and hope you will get your work done.”

18. Six Principals (4-5)
Check Assumptions, Observe and Question: as staff, we can’t assume how a youth will respond to trauma or what their triggers will be. Make an observation instead, based on your observations, ask questions and then actively listen to the youth’s response.
Be a Relationship Coach: staff relationships establishes influence the tone and demeanor of the setting. Accept emotions (positive or negative) as a fact of life and use those moments to teach lessons and build closer relationships. Set limits, problem solve, chose solutions, if needed set consequences (zones of behavior) Green, Yellow, Red
“Sally, I notice that every time I raise my voice to get everyone’s attention, you throw your book down. Are you worried about what I might do?”

19. Six Principals (6)
Provide Guided Opportunities for Helpful Participation: have youth participate in activities which gives them:
Opportunities to be heard
Make choices
Have responsibilities
Engage in problem solving
Provide opportunities to make meaningful contributions to the welfare of others, which improves the feeling of self-worth. Giving back strengthens resiliency.

20. Through protective factors there is hope
Youth resilience
Social connections
Concrete supports in times of need
Knowledge of parenting & child development
Social & emotional competence of children
Youth Thrive:
Parental Resilience: the ability to handle everyday stress and bounce back from challenges including crisis
Social Connections: trusted and caring family and friends who provide support to parents in facing everyday challenges of raising a family
Concrete Supports in Times of Need: basic needs such as housing, food, clothing transportation and healthcare
Knowledge of Parenting & Child Development: accurate information about raining children, appropriate expectations, and behavior management
Social & Emotional Competence of Children: a child's ability to interact positively with others, control their behavior and communicate their feelings effectively

21. Progressive Muscle Relaxation (PMR)
Developed by Jacobson (1938)
A way to relax our bodies and our emotions
Let’s try it out…
Sit with spine as straight as possible
Do not cross legs or arms
Close your eyes
Isolate one muscle group, crating tension for 8-10 seconds
Relax the muscle and let tension go, notice how the tension flows away as the muscles relax

22. 3 R’s
Relationships- Connection that conveys caring, cooperations, and hope
Respect- that is unconditional for each youth, their boundaries and challenges, provide appriopriate expectations, consequences, activities and materials
Reasonable – accommodate for youth’s tempermental idiosyncrasies
Compassion – a feeling of deep empathy and respect for another who is stricken by misfortune and the strong desire to actively do something about it.
* Compassion is key for fostering resiliency.

23. This is How 936 Marbles can Change Someone’s Life – Josh Shipp

24. Strengthening Families
Learn more about ACEs:
Local Resources:
Butte 211
Other Resources:
ACEs Connection
ACEs Too High
Strengthening Families
Resilience
Child Trauma
All resources above are hyperlinked to website

25. Any Questions?

26. References:
Chamberlain, L., Ph.D. MPH, Hard Times and Healing Toolkit, A Resilience Framework for Domestic Violence (DV) and Adverse Childhood Experiences (ACEs)
Stevens, J. ACEs & the Unified Science of Human Development. ACEs Connection Foundation, 2016
Wolpow, R., Ph.D., Johnson, M., M.A., Hertel, R., B.S., Kincaid, S., Ph.D., Compassionate Schools: The Heart of Learning and Teaching, 2011