Adverse Childhood Experiences – The Silent Crisis

There is a large, ongoing crisis that gets surprisingly scant attention in the media or from politicians. It is pervasive throughout the nation, affecting every demographic. It exacts a huge toll in terms of human misery, ruined lives and financial cost to society. It is the ACE crisis.

The acronym ACE stands for adverse childhood experiences. An ACE score is a tally of different types of abuse (physical, sexual and verbal), neglect, and other hallmarks of a rough childhood. In addition to personal factors, the ACE score takes into account household environmental factors such as the presence of domestic violence, substance abuse, and mental illness. 

According to the Adverse Childhood Experiences study conducted by the Centers for Disease Control (CDC) and Kaiser Permanente in 1998, the rougher your childhood, the higher your ACE score is likely to be and the higher your risk for later problems – in school, with relationships, on the job and with your health. The results obtained by the CDC and Kaiser Permanente have been confirmed many times over. Thirty-six states and the District of Columbia have conducted their own studies and obtained similar results. More than 70 studies have been published since the original ACE survey with similar results.

It turns out that a high ACE score (4 or more) is a very good predictor of future chronic health problems, as well as social and emotional issues in adulthood. In the original study, 12.5% of the 17,000 respondents had an ACE score of 4 or higher. And this is an issue that transcends ethnicity or income levels. In fact, the participants in the CDC study were mostly white, middle and upper-middle class, college-educated, with good jobs and good health care benefits.

This is important beyond the suffering that a large number of  individuals with high ACE scores needlessly endure throughout their lives.It also puts tremendous stress on our societal institutions – e.g.,

• Healthcare – These individuals are far more likely to have chronic physical and mental issues requiring ongoing care and prescriptions.
• Education – The negative effects of ACEs can lead to deficits in attention, learning, language and communication skills and memory recall. Children from dysfunctional homes are more likely to struggle in school, have impaired social and emotional learning skills, and drop out.
• Law enforcement – A higher ACE score often portends substance abuse, perpetuated domestic violence and attempted suicide
• Economy – A higher ACE score correlates with higher worker absenteeism, financial problems, and lower performance on the job..All these, in aggregate, contribute to lower productivity.

The CDC has estimated the cost of the additional resources required to deal with the fallout of childhood maltreatment at $124 billion annually.

The hopeful element in this otherwise tragic situation is that children, with the right support from caring adults, focused on helping them develop social and emotional learning skills, can overcome even the worst dysfunctional home environment.  With this type of approach, we can help children rebuild their confidence and resilience, and combat the lifelong toxic effects of the ACE crisis, one child a time.