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Adverse Childhood Experiences (ACEs) and Their Impact on Brain Development

- Friday, May 11, 2018

You might have heard talk lately about “ACEs” and wondered what it meant. ACEs is short for “Adverse Childhood Experiences.” Between 1995 and 1997, the Centers for Disease Control and Prevention along with Kaiser Permanente conducted a study about ACEs with more than 17,000 participants. In the study, they looked at ten identified “Adverse Childhood Experiences”

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Physical neglect
  • Emotional neglect
  • Intimate partner violence
  • Mother treated violently
  • Substance misuse within household
  • Household mental illness
  • Parental separation or divorce
  • Incarcerated household member

The study found that there was a strong correlation between the number of ACEs and high-risk behavior in adulthood, including smoking, alcohol and drug abuse, promiscuity and severe obesity. Especially significant was the link between the number of ACEs and physical health problems, such as heart disease, cancer, chronic lung disease, stroke, diabetes, and a shortened lifespan. Moreover, there was a significant correlation between a high number of ACEs and mental health problems, such as depression, anxiety, behavioral disorders and suicidality.

While not a new concept, there has been a lot of buzz about ACEs recently because of studies that have shown a strong link between the number of ACEs and brain development. MRI studies have shown that the higher an individual’s ACEs score, the less gray matter they have in key areas of the brain, including the prefrontal cortex (an area related to decision-making and self-regulatory skills) and the amygdala (the fear-processing center of the brain). Scientists have also found that when the developing brain is chronically stressed, as it is when one experiences a number of ACEs, the hippocampus (the area of the brain that processes emotion and memory, and manages stress) shrinks. So ACEs can impact brain development, which in turn impacts functions such as decision-making, self-regulation, fear-processing, memory and stress management. This understanding helps us to grasp the complexity of the effects of trauma.

It is important to note, however, that having a high number of ACEs does not mean a person will necessarily develop correlating physical and behavioral health problems. It simply means that they are at greater risk. Moreover, while ACEs can impact the development of the brain, the effect is not irreversible. Parts of the brain can grow and new pathways develop.

ACEs are counteracted by resiliency. Resilience means an individual’s ability to overcome adversity and continue their normal development. The single most important factor that influences a child’s resiliency is having the support of at least one stable and committed relationship with a parent, caregiver, or other adult. In addition, here are some suggestions from the American Psychological Association of things that caregivers can do to promote resiliency in children:

  • Teach your child how to make friends, and build a strong family network
  • If it is in alignment with your belief system, introduce your child to the concept of connecting with a higher power
  • Help your child by having them help others
  • Maintain a daily routine
  • Encourage play
  • Teach your child self-care, including eating properly, exercising and getting adequate rest
  • Teach your child to set reasonable goals
  • Nurture a positive self-view
  • Help your child to see that there is a future beyond the current situation and that the future can be good
  • Accept that change is part of living

Click here for the entire American Psychological Association tip sheet on promoting resiliency in children.

Just because a high ACEs score might lead to future behavioral, physical and mental health problems, this does not mean that the reverse is true. A person may experience phenomena such as substance use, heart disease and depression without having a high ACEs score. There are a host of factors, including genetic and biological, that influence a person’s development.

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