How Many ACEs Are You Holding

I was working with an advocate on adding a teacher resource to accompany this video when you email came through. I appreciate you contacting me again. I also appreciate the other adversity children will face due to poverty, neighborhood violence and bullying to name a few. That is the broader piece of ACEs and one that each producer of a video has to narrow. Since this video will be used in classrooms I was constricted to a time or length. We pushed it going to 59 min. because many classes are only 45-55 mins. Therefore, we had to prioritize.

I can guarantee our written resource will encourage teachers to discuss things like poverty, ability to protect in violent neighborhoods and of course the need for education. I'm talking about core subject education. Our youth must understand the fastest way to break out of these other adverities is education and do not begin having children until you can provide, protect, love and nuture. If even one of those components is missing there will be problems when the child becomes the adult.

This community of advocates would be better served if they would make time to meet with a FACS (Family Consumer Science) teacher in their local high school. We need to remember therapist generally get one hour a week with a patient but the teacher have students in their classes 5 days a week 9 months of the year. They are also required to stand in the hall between classes, take their turn watching the activities in the lunchroom, coach after school sports and other teams, are advisors for after school clubs and often attend the extra-curricular competitions. They are with our students when they are with their peers and have a much better handle on how these kids tick. I just believe this has been the missing piece and we can all begin promoting the need to make parenting education a national priority. I can't be the only voice on this.

Rene, I appreciate the clarification and have nothing but admiration for the work that COPE24 is doing. Your advocacy for parenting education in high schools is an important part of the broader effort to reduce adversity among children.  I also understand that your teaching materials include a broader view of ACEs.

My concern is that this excellent video will be used by others in the ACEs community to teach about childhood adversity without the broader context that COPE24 provides. I have similar concerns, for example, about the widely used graphic -- The Truth About ACEs -- that the Robert Wood Johnson Foundation continues to post on its website. Like your video, it suggests that childhood adversity is limited to the 10 items in the original ACE survey. I worry that too much of ACE training takes this narrow view because not everyone has the broad contextual view that you and I share.

Again thanks for your response and for you for all that you do to advance the teaching of parenting skills.

Craig....Thank you for your thoughts.  In my opinion you summed it up best in your first sentence "...provides a powerful look at family dysfunction as a source of childhood adversity and makes a strong case for parenting education to help break intergenerational cycle of transmission of ACEs."

That was the purpose of this work. I have never even implied that there is no need to improve community resourses or a multi faceted aproach. We must deal with the problems that already exist. However, the mission of COPE24 is to see the need to make parenting and child development education a national priority. This education should be reaching all high school students in every high school. You may not be aware but we have a department of teachers known as Family Consumer Science (FACS or FCS). They offer these classes in most of our HS as electives. Currently, they report that about 10% of the student population will select these course. The problem is more than 80% of us become parents. That is the gap COPE24 is trying to close.

This documentary was produced with a primary target audience in mind...reaching our youth. The FACS teachers have many textbooks and other supplemental material at their disposal. Now we have added another tool. Much of the material they use also target those other social issues you write about. Their education to our teens is not as narrow as implied.

My goal is that this ACEs community would be aware of this resource that can be used in many ways. Promoting parenting education before our teens become parents is the most proactive and great path towards prevention. This community is a nationwide network where we promote many approaches and solutions. COPE24 just believes that until we make this type of education a priority we will continue to have the problems we have always had.

“How Many ACEs Are You Holding?” provides a powerful look at family dysfunction as a source of childhood adversity and makes a strong case for parenting education to help break the intergenerational cycle of transmission of ACEs. Unfortunately, it completely neglects the social contexts of families that help produce household dysfunction and that themselves can create toxic stress among children. Thus, it is a highly problematic resource for training and teaching about childhood adversity.

By ignoring social context, the effect of the video is to miseducate audiences about childhood adversity which extends deep into community and neighborhood contexts – well beyond the 10 items in the ACE index. To begin with, each of the ten ACEs is distributed unevenly in the population – by income, race and residential location, for example. A broader framework of social determinants of health (https://www.cdc.gov/socialdeterminants/about.html) highlights the importance of this social context for understanding health inequities. In addition, many of these social determinants can themselves induce toxic stress in children. Indeed, neuroscience research makes clear, for example, that long periods of family poverty during early childhood significantly increase the likelihood of toxic stress.

The video also miseducates by suggesting that parenting education – as important as it is – is the sole route to breaking the cycle. As noted earlier, households operate in contexts -- neighborhood danger, limited job opportunities and income, housing instability, changing job schedules for care-givers, systemic racism, lack of paid leave for illness, unavailable health care  – that make positive parenting difficult. Positive parenting (and successful parenting education) can thus be increased by changing the social contexts of families through increased resources – for example, low cost and high-quality child-care, higher minimum wage, affordable housing, accessible mental health services and addiction treatment programs, and much more. This means that changed social policies are a key part of a multi-faceted approach to breaking the cycle.

Importantly, the video notes the central importance of protective factors – nurturing social relationships that can protect against the emotional and physical effects of toxic household environments. What it neglects to say, however, is that the availability of protective resources is highly unequal in our society. By improving community resources that support resilience, we increase the likelihood that children can resist the health and behavioral effects of toxic social conditions and household dysfunction. These resources complement positive parenting or may substitute for them. Once again, policy advocacy is necessary to expand those resources.

Primary prevention of ACEs – defined narrowly as in the video or more broadly as suggested by the social determinants of health – requires multi-faceted approaches. Certainly, parenting education is one of them. But targeted policy changes and building of community resources for resilience are vital components of a strategy as well.