April is Stress Awareness Month and Child Abuse Awareness Month. In recognition of both of themes of awareness, I want to raise cognizance of toxic stress and adverse childhood experiences (ACES). Both life long physical and mental health problems arise when children experience extreme stress (toxic stress) caused by ACEs. Daily many children in our community experience toxic stress related to adverse childhood experiences (ACE).
Between 1995-1997, the Division of Violence Prevention at the Centers for Disease Control and Prevention (CDCP), in partnership with Kaiser Permanente, conducted a landmark ACE study with more than 17,000 participants. The ACE Study was published in 1998 and is considered the most important public health research of our time. The study found: ACEs are common, 44% respondents reported histories of child abuse and another 12.5 % cited incidents of violence against their mothers; ACEs cluster, almost 40% of the Kaiser sample reported two or more ACEs and 12.5% experienced four or more; ACEs have a dose-response relationship with many health problems. (Anda, Felitti et al.,) ACEs considered in this study were divided into two general categories: 1) child abuse (i.e. physical, sexual, emotional) and neglect; 2) family dysfunction (violence at home, living with a parent with mental illness, drug or alcohol dependence, incarcerated parent, or divorce/ separation).
Exposure to ACEs, without buffering support can overwhelm a child’s normal stress response resulting in Toxic Stress. The National Scientific Council on the Developing Child has described three types of stress responses in young children—positive, tolerable, and toxic. Toxic stress occurs when there is a reoccurring, strong or prolonged activation of the body’s stress response with little or no buffering of a supportive, safe, nurturing and protective adult relationship. As the number of adverse childhood experiences and toxic stress increases, so does the risk of severe physical and mental illness.
Toxic stress can lead to drastic changes in a child’s brain structure as well as function. The early childhood brain is very sensitive to chemical influences such as persistently high levels of stress hormones. There is a strong association between early childhood toxic stress and impaired brain development in areas such as language, social–emotional, cognitive skills and executive functions. Scientific research has also shown that living in environmental conditions with toxic stress can affect whether and how a gene is expressed (epigenetic chemical modification). Hormones and chemicals produced by the body in a toxic stress environment can modify how genes are turned on or off which can cause permanent health problems. Children suffering with toxic stress are more likely to have health problems such as asthma or ADHD. Left untreated, the effects of toxic stress can set a child on a negative trajectory significantly increasing their risk of drug and alcohol abuse; suicide attempts; eating disorders, depression and anxiety etc. ACES and toxic stress can also increase their risk of having serious life long physical health issues such as heart disease, cancer, diabetes, stroke and high blood pressure etc. as well as a plethora of mental health issues.
According to Research Brief Child Trends published in 2014, OK is tied with Montana and West Virginia with the greatest number of children with more than 4 ACEs. And OK is the only state that rates in the upper quartile in all ACEs studied in the Kaiser Permanente CDC Study. In a 2011-12 ACES state prevalence survey Oklahoma ranked (with 50th being the worse): Divorce-50th; parent abused alcohol or drug - 49th; witnessed domestic violence - 50th; incarcerated parent - 48th; children that have already experienced 3 or more ACES - 49th. Environmental stressors such as poverty and food insecurity increase a child’s risk of toxic stress. According to the most recent Kids Count Data on Payne County: Children in Poverty (2016) - 19% ranked 61st/ 77 counties; Confirmed Child Abuse and Neglect (2016) - 383 children ranked 65th /77 and Child Food Insecurity (2015) 23.3% ranked 45th/77; WIC (Women Infant and Children) assistance program (2017) 16,194 ranked 69/77th.
Due to the prevalence of ACEs and the traumatizing consequences for children, we can no longer consider it uncommon and a problem for our direct service programs to solve. Creating a trauma sensitive community requires a better understanding of ACEs and resiliency. Supportive adults can have a dramatic positive impact on child victims of adversity. Safety and trust can be restored and the effects of toxic stress can be significantly mitigated. To learn more about the impact of ACEs and how to build resiliency to promote well being in our community, please join us at the Science of Hope Event at the Stillwater Library May 1st at 6:00 PM. There will be a showing of the Documentary Resilience produced by James Redford with a panel discussion hosted by the Payne County Resilience Coalition (PCRC). To learn more about the Science of Hope event and the PCRC please contact Co-Coordinators, Sheri Carter, United Way Director or Carolynn MacAllister at email@example.com