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Hi all,

I'm wondering if anyone has any advice on how to do the ACES and Resilience tests with children who have grown up in orphanages and therefore do not have information about their biological family. My NGO is teaching at a university where 90% of the kids have come from orphanages. Since the questions all ask about relationships to parents, should I advise them to answer as if they were answering about their caregivers at the orphanage? This leads some of them to have no ACES, even though they have student psychological development due to lack of attachment and family-based care. For the resilience quiz, many questions ask about whether their parents cared about them or other family members. If they have no frame of reference for this, should they answer zero? Or 2 for not sure for all of these?

I'm about to start a research project to learn about the lived experiences of children from orphanages in my country of Thailand and I would like to include these scores as part of my methodology but want to make sure everyone understands and is answering the questions from the same perspective.

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Dear Heather:

As an parent via international adoption as well as a trauma survivor, I suggest a few things:

  • Have you seen the original and expanded and adapted ACEs surveys in our Resources Ctr? They might be helpful.
  • Have you heard of Lifebooks by Beth O'Malley? It's written by a social worker, adoptee from foster care, and adoptive mom of a child who lived in an orphanage (one person who is all of those). While she doesn't write about ACEs, specifically, she helps adults whether it be parents, social workers, or other caregivers get skills and tools and talking to kids about hard circumstances such as abandonment, war, poverty, racism, trauma, and neglect, but in kid friendly ways.
  • Have you looked at the World Health Organization survey?
  • With older kids, teens, I think ACE studies and surveys as well as the research on what supports healing can be helpful and using surveys that go beyond the original 8-10 or even expanded 14 questions are helpful because the others don't always include abandonment by both parents, or entire birth family, and loss of birth language, culture, etc. as well as living in foster care and/or orphanage settings. Some also don't include the trauma of adoption due to war, poverty, the one-child policy, neglect, etc. While I personally consider abandonment and neglect as well as traumatic loss as part of any adoption experience - I'd consider customizing an ACEs survey that's more specific as the goal is to help show kids (and adults) that we're all impacted by the presence or absence of adversity as well as the presence or absence of advantages, buffers, etc.

    While we are impacted, and know that is true at the population level, it's also true that ACEs aren't destiny and we have a higher risk if we lots of ACEs of lots of things, but that doesn't guarantee that we'll have those things (or that those without ACEs will not). It's just general population level data and that can be shared even without going into individual ACEs or resilience quizzes - and be used to help kids and adults create language, words, and narrative which I think is the important part.

I'm sure you are aware of the great work of the Attachment Trauma Network, as well as people such as Dr. Bruce Perry who have worked with lots of adoptive families in and outside the U.S.  And we have lots to share in our Parenting with ACEs community although the focus there is on the experiences of parenting and parents - which of course impacts children but isn't entirely spot on.

Please share back any tools you develop or modify as I'm sure others will be interested (I know I am).


Thanks Cissy, you gave me some new resources to check out! I haven't seen the WHO survey or read any of Dr. Perry's research. I'll look into it now. The ACES test I gave to my college students the other day was the expanded 14 question one which does include growing up in foster/orphanage care, but doesn't add anything about abandonment, which I know a lot of these kids really struggle with. Many of them only had 1 ACE, which was growing up in an orphanage, but we know that that does cause many of the same developmental delays due to lack of attachment. So, I think your idea to adapt it is good. I'm going to see if a Thai researcher I know who is working on some new research with kids leaving care can help me adapt it. I think it would be an interesting topic to do more research on. The students really got a lot out of learning about how they affect our brains and the activities we did that teach healing from ACES.

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