This post, written by Kate Wiebe, originally was published on November 10, 2015, on the ICTG blog.

ACEs stands for the Adverse Childhood Experience Study. If you've been following this blog, you know we talk about them frequently. To learn more about them, you might try visiting the list resources below that explain why ACEs matter to communities and how medical professionals are beginning to address the massive problem. You also can find out more about the ACE study origins, as well as learn about an ever-expanding network of professionals who utilize this study in their own settings.

Perhaps most profound thing about the ACE study – besides the significant fact that it demonstrated trauma does not discriminate and exists in every community in the country – is the strong correlation it demonstrated between childhood experiences and adult onset illnesses.

​The ACE study found that survivors of childhood trauma are nearly 5000% (yes, you read all those zeros correctly) more likely to attempt suicide, have eating disorders, or become IV drug users. Dr. Vincent Felitti, the study's founder and co-conductor, along with the Centers for Disease Control and Prevention, details this remarkable and powerful connection. 

The magnitude of this correlation, and the complexity of dealing with the problem of severe stress in childhood after the fact is so huge, Dr. Felitti, says, realistically the only serious and effective approach is going to have to involve primary prevention. He admits, "No one knows how to do that, but it's the right question to focus on." 

At ICTG, we recognize how community groups, schools, after-school programs, and congregations are prime locations for not only putting that question at the forefront but also for providing primary prevention. 

Trauma Informed Community Practices for Prevention

• ​Create policies for safety (see this post for links to tools for measuring safety and creating policies) and keep them up-to-date
• Have a staff person dedicated to keeping well-educated on best responses to trauma and providing sound management of fellow staff members and volunteers
• Keep all staff and volunteers well informed about current mandatory reporting laws and expectations
• Maintain an up-to-date and vetted referral base for local counselors, social workers, and spiritual directors
• Provide ongoing studies, education classes, and prayer groups that make use of best trauma response practices and understandings
• Dedicate specific annual events or worship service(s) for providing safe practices of storytelling, prayer, confession, sacraments, or healing rituals for staff and members to acknowledge privately or corporately the existence of trauma among the community and seek restoration.  

Ideally, our community's organizations are safe havens from life's storms. They are the place where play, education, worship, and mission derive from true restoration of body, mind, and spirit in community. Every day, you, as a leader or volunteer, are invited into making it so.

​Share your stories in the comments below about how you see healing from ACEs happening in your congregation. 

Recommended Resources:
TED TALK by Nadine Burke Harris
ACE STUDY ORIGINS by the CDC
Center for Youth Wellness website
ACES TOO HIGH website
VIDEO by Vincent Felitti

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Rev. Dr. Kate Wiebe and Doug Ranck, along with the many other ICTG blog contributors, have already noted that adverse childhood experiences (ACEs) are widespread across all racial groups and socioeconomic strata. The ACE study's concluding results, executed by CDC- Kaiser Permanente in 1997, presents staggering research that pessimistically foreshadows the future for youth experiencing abuse, neglect, or other household challenges. The CDC describes ACEs more broadly as traumas relating to physical, emotional, or sexual abuse, emotional or physical neglect, and household challenges such as violence, substance abuse, mental illness, incarcerated family member, or divorce in the home.

ACEs follow a dose-response pattern, which means that the symptoms are directly correlated to the frequency of exposure to the stressor. Therefore if a child experiences multiple ACEs, they are at a higher risk for an exhaustive list of physical and emotional health issues such as substance or alcohol abuse, teenage pregnancy, suicide, and heart disease to name a few. With the prevalence of ACEs and their unavoidable consequences, it begs the response of grace and compassion rather than one of punishment from educators, Sunday school teachers, and youth ministers.

Dr. Nadine Burke Harris, doctor and research advocate for childhood adverse experiences, states that "toxic stress is the changes that happen in the body as a result of being exposed to high doses of adversity in childhood." Both children and adults are exposed to stress each day in which our fight or flight hormones are activated regularly. These hormones are innately good because they instigate our reactions to possible threats or dangerous situations. In the unfortunate circumstance in which a child experiences chronic stress on a daily basis, the fight or flight hormones become fixated in a continuous loop and fail to be appropriately metabolized. Dr. Harris suggests that the frequency of stress leads to a physical reshaping of the brain. When students encounter high amounts of stress, the neocortex of the brain, the part responsible for impulse control, is impacted. Children begin to lose control of their emotions and behaviors because what was once stabilizing their various feelings is now under acute toxic pressure. Children will react to both minor and major threats with vigilance, disrupting a child's daily rhythm.

The ACE study demands an educated response to how we interact and engage with the youth in our communities. As a future educator and past student participant in church youth group, I have been interested in researching how schools are responding to the trauma in children. Schools around the nation are adjusting their programs and systems to cater to their youth who are survivors of trauma.

Crocker College Preparatory School in New Orleans is one such school recognizing the effects of trauma. Crocker Prep understands the unique consequences of ACEs and intentionally seeks to help traumatized youth in classroom settings. The teachers are more informed about ACEs and seek to understand students who misbehave or have outbursts as "sad, not bad." School administrators and teachers at Crocker Prep have altered their disciplinary system in order to uproot the true problem rather than offering punitive measures to an event or instance they could not control. They found that detentions and suspensions for behavioral violations were not effective because the misbehavior was not the problem, but rather the trauma at its origin. The number of detentions and suspensions dramatically decreased over the school year in which the new rules took enactment and grades significantly increased among the students. Teachers and parents noticed students complaining less frequently about physical pains or trouble sleeping when their trauma was more directly attended to and teachers took note that students were more present in class and were not withdrawing from class activities. Like schools, congregations looking to become more trauma-sensitive must adopt the similar measures to meet the emotional needs of their youth.

Re-framing the way we view and understand troubled youth calls for a gracious and compassionate response. While working with troubled youth may be frustrating and discouraging, grace and compassion can help us reconstruct the ways we address, process, and talk about bad behavior. Compassion shifts questions like, “What is wrong with this kid?” to “What happened to this kid?” The different language transforms how we understand our youths' stories and marks the desire to express compassion before pressing judgment. “What happened to this kid” is a question that demonstrates that the trauma is responsible for the misbehavior and is not an identifier of character. Trauma has the physiological power to dictate emotion and physical action and it is our responsibility as educators, youth pastors, and Sunday school leaders to teach students, with grace and compassion, how to regain control over their behavior.

Sources:
1. cdc.gov
2. Katy Reckdahl, "A new movement to treat troubled children as ‘sad, not bad.'" The Hechinger Report
3. Dr. Nadine Burke Harris, "Stress Factor" Video, and "How Childhood Trauma Affects Health Across a Lifetime"  Ted Talk
4. Melissa Hellmann, "This Town Adopted Trauma-Informed Care—And Saw a Decrease in Crime and Suspension Rates," Yes! Magazine
5. Bruce Perry, "The Brain Science Behind Student Trauma," Education Weekly 

This post, written by Kate Wiebe, originally was published on July 23, 2017, on the ICTG blog. 

More community and faith-based leaders need to be engaging this question. For example, if you're a church or ministry leader reading this post, are you familiar with the ACE Study? Do you know how many of your members or visitors have experienced ACEs and what kind of ACEs they've experienced? How are those experienced impacting your mission? Put another way, to what extent does your mission interface with ACEs? How does your congregation or ministry group actively counter the effects of ACEs?

Have I lost you? If so, please allow me to explain. Your health, your organization's health, and the health of your greater community depend on your understanding ACEs and their far-reaching impacts. 

ACEs stands for Adverse Childhood Experiences. If you've been following this blog, you know we talk about them frequently. 

If you're new to the topic, learn more about them in the following ways:

• View a TED talk by a prominent pediatrician Nadine Burke Harris that explains why ACEs matter to communities and how medical professionals are beginning to address the massive problem
• Read Bessel van der Kolk's salient book, The Body Keeps the Score, which will provide you with detailed descriptions about how childhood experiences of trauma result in sick adults 
• Review findings from the original ACE study origins here
• Participate in an ever-expanding network of professionals who utilize this study in their own settings here

​
Perhaps most profound about the ACE study – besides the significant fact that it demonstrated trauma does not discriminate and exists in every community in the country – is the strong correlation it demonstrated between childhood experiences and adult onset illnesses.

​The ACE study found that survivors of childhood trauma are nearly 5000% (yes, you read all those zeros correctly) more likely to attempt suicide, have eating disorders, or become IV drug users. In the video below, Dr. Vincent Felitti, the study's founder and co-conductor, along with the Centers for Disease Control and Prevention, details this remarkable and powerful connection. 

"With an ACE score of six – experiencing any six of the ten categories that were studied – that person was 4,600% more likely to become an IV drug user than a person who experienced none of those six categories. Now you read in the newspaper the latest cancer cure of the week – prostate cancer or breast cancer increases 30% and everyone goes nuts – I'm talking 4,600% increase. The same ACE score of six produces a likelihood of attempting suicide between 3,100% and 5,000% greater than the likelihood of suicide attempts in someone with none of those life experiences. So the power of this relationship is enormous." ​- Dr. Vincent Felitti

The magnitude of this correlation, and the complexity of dealing with the problem of severe stress in childhood after the fact is so huge, Dr. Felitti, says, realistically the only serious and effective approach is going to have to involve primary prevention. He admits, "No one knows how to do that, but it's the right question to focus on." 

At ICTG, we recognize how many community-based and faith-based organizations are prime locations for not only putting that question at the forefront but also for providing primary prevention. At ICTG, given the evidence, we recommend organizational leaders consider to what extent their agencies, youth members, or volunteers have experienced ACEs. For faith-based leaders, we provide assessment tools to discern ACEs within your group and to gauge your organization's resiliency and response capacities in our General and Youth Ministry Resource Guides. ​Also, while becoming a trauma-informed congregation by creating a culture marked by specific traits, trauma-informed congregations can incorporate preventative measures into their common practices. 

Trauma Informed Practices for Prevention

• ​Create policies for safety (see our previous post for links to tools for measuring safety among your congregation and creating policies) and keep them up-to-date
• Have a staff person dedicated to keeping well-educated on best responses to trauma and providing sound management of fellow staff members and volunteer leaders
• Keep all staff and volunteer leader well informed about current mandatory reporting laws and expectations
• Maintain an up-to-date and vetted referral base for local counselors, social workers, and spiritual directors
• Provide ongoing studies, prayer groups, and education classes that make use of best trauma response practices and understandings
• If a faith-based organization, dedicate specific annual worship service(s) for providing safe practices of prayer, confession, sacraments, or healing rituals for staff and members to acknowledge privately or corporately the existence of trauma among the community and seek restoration.  

Ideally, schools, after-school groups, and congregations are safe havens – healing sanctuaries – from life's storms. They are the place where learning, play, worship, confession, prayer and mission derive from true restoration of body, mind, and spirit in community. Every day, you are invited into making it so.

​Share your stories in the comments below about how you see healing from ACEs happening in your community. 

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