Adverse childhood experiences, or ACEs, are traumatic experiences that occur during childhood and relate to categories of adversities that fall into areas of abuse, neglect and/or household dysfunction. According to the Centers for Disease Control and Prevention (CDC), ACEs can also include experiences that can undermine their sense of safety, stability and bonding, such as growing up in a household with substance use problems, mental health problems and instability due to parental separation or household members incarcerated.
And, research suggests more and more that ACEs can have significant and lifelong impacts. The CDC reports that around 61% of surveyed adults across 25 states reported that they had experienced at least one ACE, with one in six people reporting that they had experienced at least four kinds of ACEs.
“We know that trauma such as abuse and neglect is better conceptualized as an impact on development, versus what people traditionally think about in terms of flashbacks and memories and things. That can be important, but it’s really the impact on development that’s most important when you’re looking at trauma in children,” said Dr. Stefani Smith, chief clinical officer at the Hanna Boys School.
Smith said that ACEs can have different effects based on the age of the child. “For example, if you have a young child — 5, 6, 7 or even younger — their big ‘task’ is to be able to learn to regulate their emotions,” Smith said. “Trauma at those age groups will impact that ability both on a neurological level but also in terms of using primary care relationships, they won’t really learn how to regulate their emotions.”
As kids get older, different areas may be impacted. Children who experience ACEs in middle school may have difficulty developing healthy friendships, Smith said.
“If I now have an adult or a teenager, if they had a lot of early childhood trauma, they still sometimes act emotionally as if they were 4 or 5. It doesn’t matter what age they are now, but it’s looking at when the trauma initially (occurred),” Smith said.
Locally, promoting awareness of ACEs, as well as bringing resources and training on trauma-informed care and practices to the forefront of discussions about mental health has become a priority.
The Hanna Institute, a branch of the Hanna Boys Center, was established in 2016 and is devoted to providing trauma-informed care training and research surrounding ACEs.
Erin Hawkins, co-director of the Hanna Institute, said that the institute provides public programming and events to the community as well as training and consultant services to local organizations.
“(The events) look like speaker series’ where we bring in folks who specialize in hip hop as a form of therapy and resistance, it looks like bringing in leaders from our Indigenous community to speak about how what we consider all this new science around trauma really isn’t new science, it’s old science that’s finally getting its due,” Hawkins said.
In early 2021, the Hanna Institute also received $275,000 in grant funding to provide ACEs training activities and seminars on trauma-informed practices to Medi-Cal providers and any agencies that work along the spectrum of building good health and community.
One of the trainings that the Hanna Institute has brought to various agencies revolves around Rainbow Dance, an evidence-based early education program “that’s a dance and arts-based performance practice with little littles, using all of the science that talks about how do you build empathy, how do you build regulation, how do you build confidence in children,” Hawkins said. The program can be embedded into classrooms, daycares and other childhood environments.
Smith said that things like free play and imaginative play are important for cognitive development, but kids who are experiencing ACEs may be on high alert while at daycare or in school, which will inhibit their ability to engage in free play.
“There’s a plus and minus here — if the trauma is happening at home, it may be keeping you from actually engaging in what you should be doing out of the home, which then exacerbates development issues. On the plus side, there’s an opportunity there, because there are other places where you can develop these developmental tasks and those other places can help bridge those missing stairs (in childhood development),” Smith said.
If a child feels safe in an environment like a school or child care center, they’re more likely to engage in a way that they may not be at home, which could balance out any gaps in development that may be occurring.
The Hanna Institute has worked with the Sonoma County Office of Education on grant-supported trainings with schools for therapists and clinicians who went to schools in the county and worked with students who were impacted by wildfires.
“We’ve been hired by Santa Rosa City Schools, by Healdsburg, to build the knowledge, to build the capacity of everyone from school bus drivers to teachers aids to clinicians and counselors to teachers, to embed this work within their school culture,” Hawkins said.
“We know our students are feeling profound anxiety and depression,” Hawkins said, referencing Sonoma County’s Youth Truth Survey. The survey found that, of over 18,000 middle and high school students surveyed, 50% of middle school students and 70% of high school students reported that their greatest barrier to learning was feeling depressed, stressed or anxious.