Adverse Childhood Experiences (ACEs)

Policies that strengthen household financial security (e.g., tax credits, childcare subsidies, other forms of temporary assistance, and livable wages) and family-friendly work policies can prevent ACEs by increasing economic stability and family income, reducing parental stresspdf icon, increasing maternal employment, and improving parents’ ability to meet children’s basic needs and obtain high-quality childcare.  Strengthening economic supportspdf icon for families is a strategy that addresses the needs of parents and children so that both can succeed and achieve lifelong health and well-being.

Public education campaignspdf icon are one way to shift social norms and reframe the way people think and talk about ACEs, and who is responsible for preventing them. They can help shift the narrative away from individual responsibility to one that engages the community and draws upon multiple solutions to promote safe, stable, nurturing relationships and environments for all children. Legislative approaches to reduce corporal punishment can help establish norms around safer, more effective discipline strategies to reduce the harms of harsh physical punishment, particularly if paired with public education campaigns. Bystander approaches and efforts to mobilize men and boys as allies in prevention can be used to change social normspdf icon among young people in ways that support healthy relationship behaviorspdf icon. Such approaches work by fostering healthy norms around gender, masculinity, and violence with the goal of spreading these social norms through peer networks. They also work by teaching young people skills to safely intervene when they see behavior that puts others at risk and reinforcing social norms that reduce their own risk for future perpetration.

A child’s relationship with others inside and outside the family plays a role in healthy brain development, as well as in the development of physical, emotional, social, behavioral, and intellectual capacities. Early childhood home visitation can prevent ACEs by providing information, caregiver support, and training about child health, development, and care to families in their homes to build a safe, stable, nurturing and supportive home environment.  Additionally, high-quality childcare and preschool enrichment programs help children build a strong foundation for future learning and opportunity by improving their physical, social, emotional and cognitive development, language and literacy skills, and school readiness.

Teaching children and youth skills to handle stresspdf icon, resolve conflicts, and manage their emotions and behaviors can prevent violence victimization and perpetrationpdf icon, as well as substance use, sexually transmitted infections, including HIV, and teen pregnancy. Social emotional learning programspdf icon are used to enhance interpersonal skills related to communication, problem-solving, alcohol and drug resistance, conflict management, empathy, coping, and emotional awareness and regulation. Safe dating and healthy relationship programspdf icon address similar skills within the context of dating with the goal of promoting caring, respectful, and non-violent relationships. Parenting skills and family relationship programspdf icon cover developmentally appropriate expectations for child behavior; teach behavior management, monitoring, and problem-solving skills; safe and effective discipline; healthy relationship behaviors; and work with parents to enhance parent-child communication and ways to support children and youth.

Relationships with caring adults who are positive role models can prevent ACEs and improve future outcomes for young people. Mentoring and after-school programs are ways to connect youth to caring adults and activities. Mentoring programs pair youth with an adult volunteer with the goal of fostering a relationship that will contribute to the young person’s growth opportunities, skill development, academic success, and future schooling and employment outcomes.  Mentoring programs may be delivered in a school or community setting and to youth of all ages, from early childhood through adolescence. After-school programs are a way to provide opportunities for youth to strengthen their behavioral, leadership, and academic skills and become involved in school and community activities.

Programs range from those offering tutoring and homework assistance to more formal skill-based programming and structured learning activities. These programs also address other key risk and protective factors for high-risk behavior by providing adult supervision during critical periods of the days, such as between 3:00 to 6:00 p.m., when youth crime and violence peaks. Mentoring and after-school programs can reduce the prevalence of crime, violence, and other adolescent risk behavior and pave the way for positive outcomes in adulthood.

Timely access to assessment, intervention, and effective care, support, and treatment for children and familiespdf icon in which ACEs have already occurred can help mitigate the health and behavioral consequences of ACEs, strengthen children’s resilience, and break the cycle of adversity.

Enhanced primary care may be used to identify and address ACE exposures with brief screening assessments and referral to intervention services and supports.  For children and adult survivorspdf icon of violencepdf icon, victim-centered services can be both lifesaving and helpful in reducing the harms of violence.  Treatmentpdf icon to lessen the harms of ACEs may be also used to address depression, fear and anxiety, post-traumatic stress disorderpdf icon (PTSD), problems adjusting to school, work, or daily life, and other symptoms of distress.  Treatment to prevent problem behavior and future involvement in violence includes therapeutic interventions and other supports to address the social, emotional, and behavioral risks associated with ACE exposures.