Understanding ACEs

Adverse childhood experiences (ACEs) are potentially traumatic events in childhood (0-17 years).
ACEs include aspects of a child's environment that can undermine their sense of safety, stability, and bonding (such as living in a household with substance misuse or mental health problems).
ACEs can negatively impact physical, mental, emotional, and behavioral development. ACEs can also have lasting effects on health, well-being, and prosperity well into adulthood.
The consequences of ACEs are intergenerational (can be passed down from one generation to the next) if children don't have protective buffers like PCE (Positive Childhood Experiences) or a caring adult in their lives.

Prevalence of ACEs

Adverse childhood experiences are common across all parts of society. [1]
2/3 of Ohioans have been exposed to an ACE, 1/3 of Ohioans are exposed to two or more ACEs.
Multiple studies show that people who identified as members of these groups as adults reposted experiencing significantly more ACEs. Among these groups are:
● People with less than a high school education● People who are unemployed or unable to work● Black, Hispanic/Latino, or multiracial people● People making less than $15,000 per year● Lesbian, gay, bisexual, or transgender people.

Types of ACEs

There are 10 original types of ACEs:
Abuse1. Physical Abuse2. Emotional Abuse3. Sexual Abuse
Neglect4. Physical Neglect5. Emotional Neglect
Household Challenges6. Mental illness7. Incarceration8. Witnessing Domestic Violence (Mother treated violently)9. Divorce or separation10. Substance misuse
Additional Factors- Bullying- Community violence- Refugee or wartime experiences- Experiencing or witnessing acts of terrorism- Natural Disasters - A car accident etc.

ACEs Pyramid Explained

The experiences a child has during the first several years of life shape what they do and who they become. ACEs (adverse childhood experiences) have the potential to impact physical health, long-term mental health, and behaviors, including:
● Smoking, ● Alcoholism, ● Drug use, ● Depression,● Missed work, ● Suicide attempts,● Heart disease, ● Diabetes, ● Severe obesity, ● Cancer,  ● Stroke.

The effects of ACEs can add up over time and affect a person throughout their life.
Children who repeatedly and chronically experience adversity can suffer from TOXIC STRESS
Toxic stress happens when the brain endures repeated stress or danger, then activates a STRESS-RESPONSE SYSTEM, releasing FIGHT-OR-FLIGHT HORMONES like cortisol.
This INTERNAL ALARM SYSTEM increases heart rate and blood pressure and damages the digestive and immune systems.

Sustained activation of the body’s stress response, toxic stress, impacts many of the brain’s vital systems:
THE STRESS PATHWAY – Dysregulated HPA Axis, decreased hippocampal volume: leads to anxiety, depression, and impaired learning and memory.
EMOTIONAL PROCESSING AND REGULATION – Decreased gray matter in the prefrontal cortex (PFC) and increased amygdala volume leads to hypervigilance and reduced attentional control.
EVALUATION OF REWARD – Decreased reward response in the ventral striatum leads to anhedonia, the difficulty in experiencing joy.
BRAIN CONNECTIVITY – Disrupted amygdala to ventromedial PFC pathway, decreased activity in the default mode network, and increased activity in salience networks leads to difficulty understanding the relevance of situations and how to respond.3