Adverse Childhood Experiences (ACEs) are in reference to traumatic experiences that children under the age of 18 have experiences in an out of the home environment. When someone experiences these adverse events, it can affect the emotional, psychological, and physical aspects of someone's life. The persons' stability, emotional regulation, social interactions, and processing abilities may be affected by the experience - especially if it is reoccurring. It is imperative for those working with children under 18 to understand the effects of trauma on students as trauma doesn't leave the student when they walk through the classroom door. 

The ACEs assessment often used to determine data of an individual's trauma doesn't include all forms of trauma as well. These are categorized and generalized into an assessment that covers only a fraction of adverse experiences children may face before they reach 18. However, it is imperative that screening occurs to help understand and support students effectively. To find out more, please go to the next section, "How are ACEs assessed?" to learn about how ACEs are assessed and the limitations to this assessment. 

Check out these links for key takeaways for understanding trauma: 

• NEA - Trauma-Informed Schools ACEs

• Key Takeaways - file:///Users/nvollmer/Downloads/Understanding%20Trauma_%20Key%20Takeaways.pdf

More information on ACEs and its origins in the tabs and videos below. 

Adverse Childhood Experiences are assessed through a questionnaire in order to measure the amount and type of trauma someone under 18 years of age has experienced. This assessment was created in the mid-late 1990s by Kaiser Permanente with over 17,000 participants surveyed. However, this questionnaire is limited in its representation of childhood trauma whereas it only displays 10 prevalent types of trauma shown in the study. It does not take into account the severity and/or frequency of traumatic experiences. This questionnaire was created as a research tool to collect data about the exposure of ACEs. Additionally, the questionnaire includes questions that are not pertaining solely to the child's personal experienced abuse, but also if they witnessed any traumatic events of their parents in/out of the home. Trauma can be experienced when the person feels their safety and wellbeing is being threatened or placed in an environment where they are feeling helpless, as well as,  their fight/flight/freeze mode is activated. Also, traumatic experiences are unique and what works best for one student may not be the solution for another. A counselor can be the one to administer the assessment. 

Link to ACEs Assessment: ACE Quiz

These generalized experiences the ACE questionnaire provides range from a variety of abuse and neglect:

• Emotional abuse,

• Physical abuse, 

• Verbal abuse, 

• Sexual abuse,

• Physical neglect

• Emotional neglect

What is NOT included in the ACEs assessment?

• Natural Disasters 

• Immigration

• Racism 

• Forced displacement 

• Terrorism 

• War 

• Homelessness

• School violence

• Community violence 

• Legal status 

• Gender Issues 

• Traumatic loss, seperation, or bereavement 

• Cultural lens and cultural definition of punishments 

Greeson, J. K., Briggs, E. C., Layne, et al. (2013)

Oral, R., Ramirez, M., Coohey, C., Nakada, S., Walz, A., Kuntz, A., Benoit, J., & Peek-Asa, C. (2015)

Anda, R. F., Porter, L. E., & Brown, D. W. (2020). Inside the adverse childhood experience score: Strengths, Limitations, and misapplications. American Journal of Preventive Medicine, 59(2), 293–295. https://doi.org/10.1016/j.amepre.2020.01.009

CDC Module 

Whereas anyone can experience trauma in various situations, there are groups of people who are at a higher risk of experiencing adverse experiences before the age of 18. Additionally, just because these groups of people are at a higher risk of experiencing trauma, does not necessarily mean they will experience life long negative effects. If they receive support from community members, family members, peers, as well as have positive experiences, it is possible that the person can negate the adverse effects.   

These populations of people are:

• Several Racial/Ethnic groups 

• Women

• LGBTQ+

• Individuals with disabilities 

• Homeless individuals 

• Low Socioeconomic groups 

• Military families 

According to Child Trends, 45% of children in the United States have experienced at least one ACE before the age of 18. The most common adversities children face are considered economic hardship and parental seperation/divorce. Additionally, adverse childhood experiences are not equally experienced among racial and ethnic groups. The statistics from the Child Trends article relating to various racial and ethnic groups are as followed:

• About 61% of Black non-Hispanic children and 51% of Hispanic children experience at least 1 ACE by the age of 18. Most regions will show that Black non-Hispanic children are at the highest risk of exposure to adverse experiences. 

• About 40% of white non-hispanic children and 23% of Asian non-Hispanic children experience 1 adverse childhood experience. Asian non-Hispanic group will predominately show in all data captured that they will experience the least amount of adverse experiences. 

• The next most common adverse experience for Black non-Hispanic children is parental incarceration. 

• The next most common adverse experiences for Hispanic children is living with an adult with a substance problem and parent incarceration, similar to Black non-Hispanic children. 

• Unfortunately, data implies that Black non-Hispanic children are more likely than all other groups to experience a death of a parent and/or legal guardian before the age of 18. 

Link: https://www.childtrends.org/publications/prevalence-adverse-childhood-experiences-nationally-state-race-ethnicity

Persons with Disabilities:

• Persons with disabilities are also at a higher risk of experiencing ACE's in the community, home, and schools. 

• Research show this group is often overlooked and under-reported in ACE related incidents. 

• This does not mean all persons with disabilities will experiences these events, it means they are at a higher risk of potentially experiencing them. 

• Interesting findings in research include that persons with disabilities may experience increased physical discipline, increased family stress and social isolation depending on severity of disability, lower adaptive behavior, and negative impact on attachment in persons with disabilities. 

• Similarities regarding multiple studies addressed in article show the following:

  • Multiple ACE categories is common

  • Possibly more than one offender of neglect/abuse

  • Multiple contacts with various professionals and medical workers who fail to support or report neglect, abuse, or exploitation. As well was, misuse or inappropriate use of medication.

  • Lack of concern from professionals when reporting abuse due to empathy for caregivers

  • May be seen as non credibility when reporting abuse

  • Rejection of reports made

  • May be unable to defend themselves or report on own

  • May often be taught to be passive or compliant 

  • May be threatened of coerced by withholding care

  • May not be able to leave abusive situations due to limited and/or lack of accessible transportation and space in shelters

  • May have limited incomes financial and may believe they are unable to leave due to it

• Link: Adverse Childhood and Developmental Disabilities Powerpoint Adverse Childhood and Developmental Disabilities Powerpoint

• Link: Adverse childhood experiences and developmental disabilities: risks, resiliency, and policy

Culture is an important element to a person's identity. It encapsulates religion, ethnicity, race, values, traditions, beliefs, language, and many more.  As culture is an essential aspect of how one walks through life, it is important to recognize and understand its role in being trauma-informed. To be trauma-informed means to acknowledge the culture your students associate with, your explicit and implicit biases, privilege, and embrace diversity and inclusivity in the classroom. Students of color, like Latinx students, are disproportionality disciplined when compared to White students (Jennifer Castillo - Tolerance in Schools for Latino Students). Schools need to reflect on their discipline measures and see if they are consciously or unconsciously systematically affecting students of color in negatives ways like suspensions and expulsions. These types of negative punitive measures can perpetuate the school to prison pipeline route. However, the intersectionality of culture and trauma-informed practices are limited in practice. This limitation is due to schools, teachers, staff, and district employees needing to be involved and practicing similar procedures, rules, and expectations consistently which is often not the case for many schools and districts (Traumatic experiences widespread among U.S. Youth, New Data Show, 2021). 

Trauma-informed practices emphasize by SAMHSA include safety, trustworthiness, peer support, collaboration/mutuality, empowerment/voice/choice, and cultural/historical/gender issues. In order for trauma-informed practices to be properly instilled in a school community, there needs to be consistency and commitment by all members to encompass these values. Additionally, culturally understanding of students needs to be accounted for before implementing occurs. Once that data has been collected, the school community can use it to integrate important cultural characteristics into the curriculum and instruction of the materials being learned. Additionally, professional development can be orchestrated to reflect important integration of cultural values and activities that reflect their identity is cherished and welcomed. 

Also, by learning and understanding your students' cultures, teachers and staff can better provide resources and support that students would feel more comfortable with. Culture can influence how someone recognizes their symptoms of trauma, communicate those symptoms to trusted persons, types of coping mechanisms used, and whether or not they are willing to seek support (Ogundare, T., 2019). By understanding our students and their culture, teachers and staff can better support students with their trauma and provide appropriate interventions. A school cannot say they are trauma-informed if they do not include and celebrate the diversity and cultures in their school community. 

For example, mental health in the Latinx community has a stigma around it. Often, mental health is not talked about openly and supports for mental health are often funneled towards spirituality (Caplan, S. and Lombana, Y., 2021). Additionally, gender norms in Latinx culture play a part in someone responds to emotions and seeks help (Cerdeña, Rivera, et al, 2021). For example, men may find it harder to express emotions and have them validated. It may be hard for Latinx students to express their emotions and seek support for their mental health due to how mental health is perceived in their culture. Mental health issues often lead to ostracization, family shame, and possible loss of character in eyes of the family unit (Caplan, 2019). Suffering in silence is a common way Latinx persons try to mitigate their mental health issues (Caplan, 2019). This type of coping mechanism can lead to isolation and possible depression. As family is an important characteristic of Latinx culture, it is a driving factor in how and/or if Latinx individuals seek help for their mental health. Another defining factor of Latinx culture is religion. Frequently, mental health is seen as a spiritual ailment so religion is increasingly used to try and support those with mental health issues (Caplan and Lombana, 2021). Moreover, when teachers and staff are trying to practice Trauma-informed approaches, they have to learn more about their students' culture and that cultural view of mental health, as well as, cultural 'supports' for mental health. Finding ways to recognize and affirm the various cultures of students is the first step to integrating culture and trauma-informed practices in the classroom. 

Examples of cultural inclusion of trauma-informed practices:

• Cultural practices used at home in the classroom 

• Language supports for student/family when having meetings (if needed) 

• Cultural values incorporated into classroom rules/expectations

• Check family understanding of mental health, behavioral issues, and support systems

• Encourage diversity and respect for cultures through activities and readings

• Provide cultural perspectives in curriculum

• Check with family and students if there are specific decision-making and communication processes

• Show respect by working with student's beliefs, traditions, and customs as well as respecting working with family structure. 

• Consider supports that reflect familiar practices students may be more inclined to use

Risk Factors:

• Risk factors are conditions, characteristics, environments, events, or traits on the individual, family, community, or cultural level that would potentially increase the risk of someone experiencing adversity.

 Few examples of risk factors include: 

• Poverty

• Community violence

• Poor social connections 

Protective Factors: 

•  Are relating to characteristics, conditions, and/or events that promote healthy and positive development.

Few examples of protective factors include:

• • • Supportive family, community member, person in child's life

    • Positive self esteem and sense of worth

    • Sense of safety in living dwelling and community 

Using positive interactions (protective factors) to counteract the negative affects of ACEs are helpful in building resilience. Resilience can be built individually and through the community.  Teachers can build resilience in their classroom through various practices that encourage peer relationship building, being consistent with rules/expectations, emotional processing, and self care. Check out Preventing Adverse Childhood Experience by the CDC to learn more about preventing ACEs. 

Here are some therapy and program interventions to prevent ACEs:

• Prevention and Intervention programs 

• Parent-child interaction therapy (PCIT)

• Child parent psychotherapy (CPP)

• Cognitive behavioral therapy 

Resource(s): Oral, R., Ramirez, M., Coohey, C., Nakada, S., Walz, A., Kuntz, A., Benoit, J., & Peek-Asa, C. (2015).

Here are some ways to build resilience with students:

• Building relationships with peers and teacher

• Consistent routines and expectations 

• Create a safe space to allow for emotional processing and sharing 

• Teaching basic self-care methods that fit the age group 

• Creating obtainable goals 

• Encouraging and modeling positive perspective and hopeful outlook 

Resource(s): Alvord, M. K., Gurwitch, R., Martin, J., & Palomares, R. S. (2020).