I’m going to tell you two stories today. One is about the CDC’s Adverse Childhood Experiences Study – the ACE Study.

Adverse Childhood Experiences (ACEs) is the term given to describe all types of abuse, neglect and other traumatic experiences that occur to individuals under the age of 18. The landmark Kaiser ACE Study examined the relationships between these experiences during childhood and reduced health and well-being later in life.

Between 1995 and 1997, over 17,000 people receiving physical exams completed surveys containing information about their childhood experiences and current health status and behaviors. The information from these surveys was combined with results from their physical exams to form the study's findings.

The CDC’s ACE Study. This groundbreaking epidemiological study by Dr. Vincent Felitti and Dr. Robert Anda measured ten types of childhood trauma. The usual five -- physical, verbal and sexual abuse, and physical and emotional neglect. And five household dysfunctions -- Witnessing a mother being beaten or verbally abused. Living with a household member who's an alcoholic or addicted to some other drug.  A family member in jail or diagnosed with a mental illness. Losing a parent to abandonment or divorce.
 
Of course, there are other types of trauma -- witnessing violence outside the home, watching a sibling being hurt, experiencing severe childhood injury or disease, natural disaster and war -- that can have the same effects. But those were not included in this study.  
 
ACE Study researchers were stunned to find an unmistakable link between adverse experiences in childhood and adult onset of chronic disease.

And even more surprising to the researchers was how common
childhood trauma is, even among the white middle-class. The study’s participants were 17,000 mostly white, middle and upper-middle class college-educated people living in San Diego, CA. They were all employed and had great health care – they all belonged to Kaiser Permanente, a health maintenance organization, which partnered with the CDC on the study.
 
As Dr. Robert Anda, one of the co-founders of the ACE Study says, “It’s not just them. It’s us.”

The ACE Study revealed three important findings:
-- Childhood adversity is very common, even among the middle and upper-middle class – 66 percent experienced at least one type of childhood trauma.
-- If there's one type of childhood trauma, there’s an 87% chance that there are others. In other words, traumas such as child sex abuse rarely happen alone.

The more types of adverse childhood experiences, the higher the likelihood of long-term effects, such as depression, alcoholism, heart disease, cancer, auto-immune diseases, and gastrointestinal diseases.

Our childhood experiences have a tremendous, lifelong impact on our health and quality of our lives.
The ACE Study showed dramatic links between adverse childhood experiences and risky behavior, psychological issues, serious illnesses and the leading causes of death.

The risk of perpetrating domestic violence increases, for men AND for women. Being a victim looks similar. As does teenage pregnancy and unwanted pregnancies.

Unemployment and disability increase with the number of ACEs.

As does financial instability.

ACEs are responsible for a big chunk of workplace absenteeism, and costs in health care, emergency response, mental health and criminal justice. So, the fourth finding from the ACE Study is that childhood adversity contributes to most of our major chronic health, mental health, economic health and social health issues.

Twenty-one states have done their own ACE surveys, and are finding similar results. Many other ACE studies have been done in the last few years, including by the Crittenton Foundation, the National Survey of Children's Health, Washington State University’s survey of elementary schoolchildren, of people living in Philadelphia, and of populations in England and other countries.

The ACE Study one part of a perfect storm of interconnected research.

Also hundreds of biomedical research publications show that toxic stress during childhood can cause the body to stay in a red alert status, which puts a lot of wear and tear on the body. Too much adrenaline can weaken the heart and lead to Type 2 diabetes. Too much cortisol can lead to arthritis, gastrointestinal disease, depression and shrink lymph nodes. Too little cortisol, which regulates our immune response, can cause our immune system to attack parts of our body. This can lead to lupus, multiple sclerosis, rheumatoid arthritis and fibromyalgia.

The research from epigenetics — the study of how social (and other) environments turn our genes on and off — surprises many people who believe that the DNA we’re born with doesn’t change and programs all that we are during our entire lifetime.

Here’s the reality: Toxic stress can alter genes and cause long-term changes in all parts of our bodies and brains. And these changes can be transferred from generation to generation. Essentially, a process called methylation – the addition and subtraction of tiny groups of chemicals – can turn genes on and off.
http://en.wikipedia.org/wiki/Epigenetics

Epigenetic research into how childhood adversity changes genes is still in its early stages. However, one study that compared the brains of adults with childhood trauma who committed suicide with the brains of adults without childhood abuse who committed suicide found a distinguishing difference. In the brains of those who had experienced childhood trauma, the genes that regulated stress were 40 percent less functional.

I think that this body of research – the epidemiology of ACEs, the neurobiological effects of toxic stress on children’s brains, the biomedical effects of toxic stress, and the epigenetics of toxic stress -- marks a pivotal point in our understanding of human development. It is, can and will change everything.

It’s the plate tectonics of geology. It’s the Elvis Presley AND the Beatles of rock n roll. It’s the Internet. It’s the iPhone.

But with all this bad news about how trauma hurts us, there’s good news. Our brains are plastic. Our bodies are plastic. Resilience research has identified many ways that individuals, families, communities and systems can implement ways to prevent childhood adversity and stop further traumatizing already traumatized people.

The research is so compelling that many organizations and agencies in the U.S. are developing trauma-informed and resilience-building practices. In the federal government, the first agency to do so was the Substance Abuse and Mental Health Services Administration, and all federal agencies are now aware of ACEs and are figuring out how to incorporate them. But most of the action is taking place at the local level, where many people and systems are also integrating trauma-informed and resilience-building practices. Some examples:

Lincoln High School is an alternative school in Walla Walla, WA. It’s where they put the “throw-away” kids. Almost every city has one of these schools. The first year after principal Jim Sporleder implemented trauma-informed practices, suspensions dropped 85% and expulsions went down 40%.

By the 2012 school year, suspensions dropped another 50%, and there were no expulsions. And their academic scores and graduation rates went up. The kids know they’re safe and loved; they say the school is their family. They’ve done their own ACE survey, and found that their average ACE score is 5.

This story has touched a nerve. Since it was published in 2012, it’s gone viral twice, and has had more than 690,000 page views.

When a pregnant woman visits the Jefferson County Public Health clinic in Port Townsend, WA, she’s asked the typical questions about tobacco, alcohol and other drug use. She’s also screened for something that most public health departments, ob-gyns or primary care providers don’t even consider asking about: her childhood trauma.

That’s because the public health nurses at Family Health Services know that a childhood full of toxic stress causes a lifetime of health problems, and, if not addressed, is usually passed on from parent to child, just like a disease.

There are hospitals, hospital emergency departments, pediatricians and physicians who are beginning to screen for ACEs.

In San Francisco, pediatrician Nadine Burke Harris is screening children for ACEs.
In Portland, Oregon, pediatrician Teri Petersen is screening parents of four-month-old babies for ACEs.

In 15 Connecticut cities, revolutionary home-visiting service Child First uses a trauma-informed evidence-based approach to help kids who have behavior problems.
Their secret sauce?
Not only do they help the kids, they help the parents…with basic necessities, with their own trauma and with learning how to bond deeply with their children.

After Dave Lockridge, an evangelical pastor, heard Vincent Felitti speak, he said he realized in his efforts to help his most troubled parishioners, he’d been doing everything wrong. Lockridge closed his church, got a psychology degree, and designed a course with a workbook that combines epidemiology, neurobiology and Bible studies.

Suddenly, parts of the Bible take on a whole new meaning. Take Proverbs 14:12, Dave says -- it talks about the long-term consequences of the way we cope with childhood adversity -- “There is a way which seemeth right unto a man, but the end thereof are the ways of death.”

In other words, meth will take care of your depression now, but it’ll rot your teeth out and kill you in the long run. The Bible says it so much better!

Dave’s course is now being used in 20 states.

And, by the way, methamphetamine was manufactured by Burroughs WellCome pharmaceutical company as Methedrine. This is the Lilly Company’s version. It was prescribed by doctors as an anti-depressant. Knowing about the number of people who have ACE scores of three or higher, do you wonder why meth is so popular?

In the Canadian town of Prince Albert, Saskatchewan, the police department adopted the Community Mobilization program.

At its core is the Hub – staff from every policing and social-services agency in the community: substance abuse, city and state police, mental health, child services, probation, education.

Every week, they review cases involving children and families. Example: A 13-year-old girl reported missing was found intoxicated by patrol officers and returned to her home.

At the meeting, the school reported that she had been truant and had recently adopted a “poor attitude.”

Police officers and social workers talked to the teen and her mother.

They discovered that her stepfather had been abusing the girl.

He was arrested.

The girl started going to school. No more problems.

Community Mobilization has spread to more than a dozen other Canadian cities and is looking for partners in the United States.

A local artist became vice-mayor and rallied the people of her community to declare themselves to be the first trauma-informed city in the nation. Everyone in that community is asked to bring a piece, even just a small piece, to Peace4Tarpon. A school, a local housing authority and a hospital are among those that are implementing resilience-building practices.

Other cities on the same track are Walla Walla, WA, Philadelphia, PA, and Camden, N.J. In California, San Diego, San Francisco, Yolo and Sonoma counties have nascent efforts underway.

By the way, these communities aren’t just saying they’re trauma-informed.

Some of them have put standing committees in place to move things forward, one small step at a time.

I’m founder and editor of ACEsTooHigh. It's stories are aimed at the general public.

There are ACE task forces or trauma-informed groups in Philadelphia, Chicago, San Francisco, San Diego, and several other communities and states, including one here in Yolo County. Many participate on ACEsConnection, which recently received a major grant from the Robert Wood Johnson Foundation to grow the network.

ACEsConnection is the accompanying community of practice social network. Most of it's more than 2,300 members are implementing practices based on ACE- and trauma-informed concepts.