While the original ACE study focused on ten specific categories, there are many other ways children can experience adversity that might lead to a toxic stress response. The tools commonly used to screen for ACEs in young people include a set of questions to identify additional potential sources of toxic stress including:
For teens, there are two additional factors considered:
While no tool can address every potential stressor our children may face, starting here can help us gain insight into how much their lived experiences may be impacting their well-being.
The more adversity a child experiences without support, the more likely they’ll develop a toxic stress response.
For children and teens, toxic stress could lead to health and other issues, including asthma, allergies, rashes and eczema, aches and pains, depression, self-harm, learning or behavior problems, developmental delay, ADHD, not graduating high school, early use of alcohol or drugs, and early sexual activity.
As parents, this can sound overwhelming. We face incredible odds holding our families together every day, especially those of us coping with barriers like racism, discrimination, low incomes, and communities lacking resources.
The outcomes for children and teens with high ACEs are not predetermined pathways. Our brains and bodies are amazingly resilient and ready to change – especially when we’re young.
With our knowledge of ACEs, we can look at the behaviors and symptoms of our kids and teens through a new lens, knowing that their brains and bodies may be responding to their lived experiences.
It may also be helpful to talk with your child’s doctor, teacher, school counselor, or other trusted adults in your child’s life so they can become active members of your child’s support team. We may want to keep in mind that in many states and US territories, most people who work with kids are required by law to report to child protective services or law enforcement any known or suspected child abuse or neglect.
There’s a lot we can do to help provide antidotes to the adversity our children face. Nurturing, supportive relationships; safe and stable environments for living, learning and playing; engagement in community; and participation in social activities (like art, music, theater, or sports) are key elements to helping our kids thrive. Learn more about the building blocks of HOPE (Healthy Outcomes through Positive Experiences).
No child is too young to be affected by ACEs. Babies are more vulnerable than any other age group. Their brains are developing rapidly through every new experience and encounter. ACEs and toxic stress can cause developmental challenges, along with a host of other cascading effects, as babies and toddlers grow, especially if they’re not surrounded by safe, nurturing relationships and environments.
ACEs can be impactful even if they don’t appear to cause harm in the moment. When kids don’t have their needs met over a period of time, they may demonstrate a lack of focus and inability to concentrate that’s serious enough to result in an ADHD diagnosis. When kids witness interpersonal violence between adults, they may develop asthma. When a caregiver’s anger boils over frequently, with screaming and a loss of emotional control – even without any contact – the results may be as harmful biologically to children as physical abuse.
As parents with ACEs, we’re more likely to be coping with our own lasting physical and mental health consequences. We also may be more likely to lash out verbally, or to have more difficulty controlling our impulses, especially when we’re feeling overwhelmed. When we’re dealing with intense stress – the pandemic, economic stress, job stress, then challenges with kids on top of all that – we may find ourselves pushed near the edge of our coping abilities. Crisis resources are available any time to help us. Asking for help is a sign of strength and resilience.
It’s helpful to remember that behavior is communication. Rather than needing to “fix” our child’s behavior, we can look for ways to understand their behavior as our child’s attempt at communicating.
Parenting infants and young children can be especially stressful. Children ages zero to three have the highest rate of neglect and abuse of any age group, and babies in their first year of life are most at risk. If you feel overwhelmed, know that you’re not alone. It’s okay to ask for help. Get immediate support by contacting the Crisis Text Line for free counseling 24/7 by texting the word ACES to 741741. To learn more about parenting with ACEs and connect to a community for support, check out the Parenting with ACEs Community from PACES Connection.
Journaling is a time-honored practice of recording our thoughts, feelings, and ideas in a private space. Having a family practice can help us get in touch with our feelings individually and share them in community.
Encourage everyone in the family to keep their own journal. This doesn’t have to be just for writing — we can use drawing, collage, doodling, colors, and song lyrics to express ourselves.
This is journaling shared between us and our child or teen. One of us creates an entry in the journal – writing, drawing, or whatever they’d like, then passes the journal to the other. The other contributor adds responses, creates their own entry to the journal, and then passes it back. You could also decorate a “mailbox” and write letters back and forth to each other. This type of journaling process can make it easier to communicate about things that might be hard to talk about face to face.
Have your child or teen create a rainbow on the cover or first page of a notebook. Together, assign each color a mood. In the journal, draw a weekly calendar of seven squares. Each day, in addition to any journaling they may do, your child can color in one or two colors to show the major mood they experienced that day. At the end of the week or month, you can look back on the journal pages and see how things are going, and if there were any patterns or changes. This type of journaling can bring about breakthrough insights for kids, teens, and families.