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PACEs in Pediatrics

Trauma in adulthood can begin in the first 2 months of life [heraldnet.com]

 

By Paul Schoenfeld, HeraldNet, June 9, 2019.

Last week, I attended the 30th annual International Trauma Conference in Boston. Several thousand mental health clinicians from around the world attended. It was sponsored by Dr. Bessel Van der Kolk, one of the world’s foremost researchers and clinicians in developmental trauma. He wrote an excellent book, “The Body Keeps the Score,” which I highly recommend.

In the last 10 years, the field of neuroscience has blossomed. With new imaging techniques, we can better map the brain and see how it works in real time. We are beginning to understand some basic processes. Even so, we have a long way to go.

Sadly, we know that despite our best intentions, 12.6% of the population experienced four or more adverse childhood experiences. These can include witnessing domestic violence, abuse, neglect and divorce, or a family member with mental illness, substance abuse, suicidal thoughts or who was jailed. With four of these events, a child is far more likely to experience health and emotional distress as an adult. The consequences of early-childhood adverse experiences can have a devastating impact on an adult’s health.

Why? The brain, primitive at birth, is exquisitely sensitive in its early development. As the infant encounters the world, the brain develops and establishes pathways and connections that are informed by experience, not just by DNA. Brain structures that regulate our response to the world react differently when encountering sustained stressors. The developing brain prepares itself for a hostile world by overreacting to potential threats, and can be continually bathed in stress hormones. The brain wires itself for danger and unpredictability. It becomes dysregulated and disorganized, constantly on the lookout for danger.

As a psychologist, I often administer the Adverse Childhood Experiences questionnaire to my patients. Many of them have these challenging experiences as children, with some having six or more of these events. Indeed, some researchers have found that adversity experienced in the first two months of life can have profound effects on our neurobiology, and set a painful life path for children.

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