Implicaciones y orientaciones pedagógicas

14.2.1 The Adverse Childhood Experiences (ACE) study is a

collaborative research project, involving 17421 adults, between the Center for Disease Control and Prevention and Kaiser Permanente Preventative Medicine, San Diego, California202_.

14.2.2 An Adverse Childhood Experience (ACE) is growing up with one

or more of the following in the household prior to age 18:

• Recurrent physical abuse • Recurrent emotional abuse • Contact sexual abuse

• An alcohol and/or drug abuser in the household • A household member in prison

• Domestic violence • One or no parents

• Emotional or physical neglect

• Someone who is chronically depressed, mentally ill, institutionalised, or suicidal

14.2.3 An ACE score calculator is available online203_.

14.2.4 Child abuse and trauma in the household leave a child incredibly vulnerable which has the potential, in the early years, to disrupt the normal development of the brain. ACEs appear to be associated with a predictable path towards disease and disability. Recognising this path and tackling it at the earliest possible opportunity is crucial to give children the

Figure 14: Adverse Childhood Experiences (ACEs) link with early death204

14.2.5 An emerging multidisciplinary science of development supports an ecobiodevelopmental framework for understanding the evolution of human health and disease across the lifespan of an individual. Epidemiological studies, developmental psychologists and longitudinal studies of early childhood interventions have demonstrated significant associations between the ecology of childhood and a wide range of developmental outcomes and life course trajectories206_.

14.2.6 What happens in early childhood can matter for a lifetime and sadly the children of Arizona lead the nation in experiencing one or more adverse childhood experiences in the ACE study conducted in the State:

• Living with someone who is mentally ill or who has suicidal ideation • Experiencing divorce or parental separation

• Living with someone who has an alcohol or drug problem • Being a victim or witness of neighbourhood violence • Experiencing socioeconomic hardship

• Witnessing domestic violence • Having a parent in prison

• Being treated or judged unfairly due to race or ethnicity • Experiencing the death of a parent

14.2.7 In Arizona, Phoenix Children’s Hospital have been spearheading a State-wide ACE Consortium aimed at drawing attention to the crucial importance of ACEs and putting in place community projects to try to encourage parents to build Positive Childhood Experiences (PCEs) – protective factors that will enable children to succeed. Based on the findings of Arizona’s ACE study the following have been recommended strategies to reduce ACEs in this area and to build stronger Arizona communities207_:

• Increasing public understanding of ACEs and their impact on health and well-being

• Enhancing the capacity of families and healthcare providers to prevent and respond to ACEs

• Improving the effectiveness of public-health campaigns by refining their messages regarding ACEs

• Promoting identification and early intervention of ACEs within child and family health systems.

14.2.8 Early childhood intervention is arguably one of the best ways to improve the chances of children growing up to succeed as best they can and to have the best possible chances in life.

14.2.9 Vermont has already grasped the importance of combatting ACEs to build a healthy and

successful society208_.

14.2.10An individual with an ACE score of four has a three times higher risk of depression, is five times more likely to become dependent on alcohol, is eight times more likely to experience sexual assault and is up to 10 times more likely to attempt suicide. An individual with an ACE score of six or higher is 46 times more likely to abuse intravenous drugs. An individual with an ACE score of seven or higher is 31 times more likely to attempt suicide204_.

14.2.11These are not just statistics that do not mean anything to an individual community or child within it – these are figures obtained from the longitudinal follow up of over 17000 adults and clearly show an association between adverse experiences in childhood and significant

14.2.12Early experiences influence the developing brain, chronic stress can be toxic to this development, significant early adversity can lead to lifelong problems, early intervention can prevent the consequences of early adversity and stable, caring relationships are essential for health childhood development209_.

14.2.13This is not just something that affects children living in Phoenix. It is not restricted to children living in Arizona. It is not only about children living in the United States of America. There is a lesson and a message for all of our societies obvious in this. Adverse Childhood Experiences have a terribly deleterious effect on children’s lives. Living in households where domestic abuse and violence are the norm has a significant and adverse effect on the development and mental health of children. Suffering from abuse, be it physical, emotional, sexual, exploitative, trafficking or neglect, can have a profound effect on the emotional well-being of children and their ability to grow up and realise their true potential as the future of our society.

14.2.14Recommendation TWELVE

The concept of the importance of detecting and, where possible, eliminating Adverse Childhood Experiences (ACEs) in the UK, and beyond, ought to be included in undergraduate and postgraduate educational programmes for professionals working with children and families.

14.2.15The “Darkness to Light’s Stewards of Children” programme and publication seek to empower adults to prevent child sexual abuse and they are useful resources for professionals working on preventative measures within the community210_.

14.2.16It takes a community to protect a child and it is clear that society has a role that is more important than ever before to protect those children within it who are at risk of, or who have suffered from, significant harm. The challenge for the people and organisations responsible for resourcing societies is what weight they will place on the importance of positive childhood experiences and what resources will be provided to allow children to maximise their potential.

14.2.17Recommendation THIRTEEN

Organisations working in the community on child abuse prevention programmes should incorporate material relating to Adverse Childhood Experiences (ACEs) and provide community education about the importance of minimising ACEs as well as recognising when they are present in the community and seeking appropriate community-based or professional assistance.

14.2.18The challenge for communities and the societies in which they function is whether or not they are prepared to accept the responsibility that society clearly has in protecting children, for if they do not, and protecting children is seen as someone else’s business, it cannot be expected that things will improve for the children who live within those communities in the future. Adverse Childhood Experiences certainly can last a lifetime.