What are ACES?

The Adverse Childhood Experience Study (ACES) is the largest and first research study that established a direct association between childhood trauma and adult ill health. The study found that the greater the number adverse childhood experiences the greater the possibility of disabilities and dysfunction in adult life.

ACES began in a Kaiser Permanente’s Health Appraisal Clinic in 1995 and has a fascinating history. ACES is an ongoing study that is now a collaboration between Kaiser Permanente and the Centers for Disease Control and Prevention.

For more information about the study visit: https://www.cdc.gov/violenceprevention/acestudy/

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ACES in the Foster Care System

The original ACES study focused on adults. Researchers have been interested in learning more about childhood adverse experiences among children who have been reported to the child welfare system. This comparison provides perspective on the future challenges foster children may face, as well as preventive services and treatment services.

In order to apply ACES to foster children, researchers at the Administration for Children and Families used NSCAW II, a national longitudinal study of the well-being of 5,873 children who had contact with the CWS within a 14-month period starting in February 2008. The researchers found that more than half of all children reported to CPS had experienced four or more adverse childhood experiences BEFORE they even came into contact with CPS. “The levels of adverse events foster children are experiencing are extremely high. As a point of comparison, almost two thirds of the adult population of the ACES reported one or no adverse childhood experiences. Even the youngest children in the NSCAW population have already accrued more adverse childhood experiences than many of the adults interviewed for the ACES.”

(U.S. Department of HHS Administration for Children and Families, National Survey of Child and Adolescent Well-being, No. 20: Adverse Childhood Experiences in NSCAW)

ACEs and adversity is only one part of the equation. Children have their own characteristics and experiences that help them develop resilience despite exposure to ACEs. Children are not born magically resilient nor susceptible to ACEs. Resilience can come from a person’s own biological and developmental characteristics as well as nurturing relationships, family, community, and systems that mitigate the negative impacts of ACEs. Researchers studying resilience continue to explore the processes involved in developing and supporting resilience. However, all agree that close relationships with competent caregivers or other caring adults are vital in building and promoting resilience in children.


Well-Being and the Youngest of Children in Foster Care

Early experiences and relationships significantly impact a child’s development. From birth to five years old, children develop the foundation for their future linguistic, cognitive, emotional, social, regulatory, and moral capabilities. The science of early child development clearly shows the important of parenting and regular consistent caregiving to a child’s healthy growth and development . The health and well-being of children’s parents or primary caregivers are also crucial to a child’s early development. The growth and development of very young children are profoundly affected by abuse, neglect, and removal. As the largest group to enter the child welfare system, very young children who become the subject of dependency court proceedings face multiple disadvantages, traumas, and losses during a critical time of early brain development.

Even considering other factors such as economics, policy, administrative structure, and method of service delivery, age largely determines what happens to children in foster care. A baby’s social-emotional development, specifically attachment to a primary caregiver, is affected by removal from his parent and multiple placements while in care. Research shows that young children, even newborns and infants, experience long-lasting sadness, grief, loss, and rejection. Separations occurring between six months and approximately three years of age are even more likely to cause later emotional disturbances.

Judges, exercising their leadership role off the bench can communicate the importance of the needs of very young children and establish a shared vision for improving their wellbeing and permanency outcomes. Judges can lead efforts to design court-run interventions and support multidisciplinary trainings. In fact, many Judges across the country have taken the lead in elevating the needs of babies toddlers, and preschoolers in their jurisdictions through court-run projects and interventions such as the Zero to Three Court Teams for Change Initiative.

How childhood trauma affects health across a lifetime

Nadine Burke Harris