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Adverse Childhood Experiences (ACEs) and Future Neurological Health


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.

These include:

  • 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 domestic violence.

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 the lifetime.