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

2. 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

3. 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

4. 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

5. 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.

6. 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

7. 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

8. Dr. Nadine Burke Harris

9. 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

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

12. 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.

13. 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

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

15. 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.

16. 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.

17. 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)

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