ACEs are common and future health risk increases with repeated exposure.
One biological marvel of the human brain is that it is an adaptable organ,
able to alter its structure based on life experiences. Because childhood
is a time when rapid and significant development occurs – walking
and talking, for example – the brain is susceptible to events that
occur during this critical developmental period. While brain sensitivity
in childhood is crucial for growth and learning, that same sensitivity
can also make the brain more vulnerable to harm from traumatic life events
occurring at a young age.
Traumatic life events in childhood are commonly referred to as Adverse
Childhood Experiences, or ACEs, for short. Multiple clinical studies have
demonstrated that ACEs affect children and families across all community
types, ethnicities, and socioeconomic backgrounds. In simpler terms, the
incidence of ACEs can be categorized as common in the entire population.
What's more, extensive research also suggests that the incidence of
ACEs in childhood can put an individual at a significantly increased risk
of chronic neurological conditions later on in life as an adult. For example,
the adult risk of mental health disorders, problems with addiction and
substance abuse, chronic pain, disordered sleep, and dementia increases
relative to the number of ACEs experienced as a child.
Life, even in childhood, can sometimes be stressful – especially
during the pandemic. Much learning and brain development can come from
"struggling" to attain a new skill or learn a new concept. These
aren't the types of childhood stressors I am referring to in this
article, and I believe it is crucial to give context to the term "traumatic
life event" when categorizing it as an ACE. ACEs involve several
categories of adverse childhood experiences individuals may have been
exposed to before 18.
- physical, emotional, and sexual abuse;
- physical and emotional neglect;
- growing up in a household where a parent was mentally ill, substance-dependent,
or incarcerated; and
- growing up in a home where there was parental separation or divorce or
As one can see, ACEs aren't simply "run of the mill" stress.
And yet, as previously mentioned, their experience is pretty common in
the population and cumulative with dose-response. In an original ACE study,
after which much additional research has been based, two-thirds of the
people at the subject study site (a large health plan in Southern California
which was 70% Caucasian and 70% college educated) had experienced at least
one ACE, and 1 in 8 study participants had experienced 4 or more. What
this study found, and many after it has supported, is that the higher
the number of ACE exposures, the higher the risk of chronic neurological
and other physical conditions in adulthood.
What we know today is that ACEs are associated with an increased risk of
developing several chronic health issues based on the development of something
called a "toxic stress response." This toxic stress response
develops because of the experiences that occur during brain development.
When traumatic toxic stress occurs chronically, it can lead to long-term
harmful modifications to the function of the brain.
But there is good news. With any health condition, it's always preferable
to stop it before it starts rather than treat it once it develops. Because
the research on ACEs has evolved so significantly over the last few decades,
the ability for pediatric clinicians and mental health specialists to
recognize and implement interventions to prevent these events in children
is better than it has ever been, and it's continuing to improve. Furthermore,
and especially when parents and health workers partner immediately after
an ACE has occurred, there are various risk reduction strategies now available
that can mitigate the potential future damage from the triggering event.
Also, that incredible adaptability of the brain that I touched on at the
beginning of this piece? It doesn't disappear in adulthood. The brain
can still change for the better, even when we're older. Though it
may take a more concerted effort and is significantly aided by management
from a neurological or other health professionals, our ability to retrain
our brains to develop a more favorable life response is available to each
of us. Mindfulness meditation, exercise, and optimized sleep are examples
of interventions that can mitigate the effects of the toxic stress response
and the risk of chronic neurological complications and consequences of
ACEs. These strategies are key to optimizing Neurological health across