After ystrdy’s viral thread on ACES, here’s a follow-up...ACES aren’t “caused” by events. ACES *are* the events.ACES are evnts that increase t risk you will struggle later in life,becuz yr body’s abilty to cope w/ stress got damaged.Not guaranteed struggle.Incrsd RISK of struggle
2. Ths is what Felitti&Anda were trying to get at whn they devised an “ACES score”. Ths is what they meant by “dose response”. How much risk had a child encountered? How many tough,scary events?They were trying to find some way to measure RISK. Like: exposure to stressful stuff
3. There wasn’t anything sacrosanct about t 10 items on their eventual checklist. These were simply the “10 major types” of scary things that patients had mentioned in initial ACES studies & in t trauma literature. You can read about this history here: acestoohigh.com/2012/10/03/the…
4. In t 20 yrs since t 1st ACES publicatn, other types of scary events hv been highlighted: poverty, violence in yr neighbourhd, bullying, bereavement, etc. These are ACES too. Felitti&Anda just had to start somewhere. Their task was hard enough already. Colleagues doubted them.
5. So t ACES checklst isn’t meant to measure ALL adversty. Whr it is being used by health systms (like California), it is considred “good enough” to help doctors evaluate, at a basic level, how much RISK a child hs bn exposed to. The “full” levels of childhd fear cd be even worse
6. So ths tells us “ACES” is a lens, an idea,a mechanism. It’s an explanatn as to why childhd distress/fear shd hv any impact at all on t possibility of struggles later life. It lets us pay attentn to protective factors whn a child has to face fear. That’s: reliable RELATIONSHIPS
7. And play. Play is a protective factor too, whn a child has to face fearful events. Remembr: ACES *are* t events. Play lets them process events, gives relief,lets thm unconsciously discover self-regulatn techniques that help. A worry: Our kids 2day get less play than in t past
8. So with all that in mind, here are other events that count as ACES, which are caused by societal circumstances or systems. Many of these events were/are implemented in the belief they would be good for children. The distress caused was ignored/discounted.
9. POVERTY. This 2014 briefing from the USA identified “economic hardship” as “by far the most common adverse childhood experience reported nationally”. childtrends.org/wp-content/upl…
10. SCARY NEIGHBOURHOODS. Ths 2019 research paper on “expandng t original definition of ACES” highlights t impact of “early experiences of victimisation &helplessness in t face of perceived intentional emotional &physical threats or actual harm by others”. link.springer.com/article/10.100…
11. ISOLATION BOOTHS IN SCHOOLS. Of course schools who employ isolatn booths are creatng an ACE. Booths are designed to create isolation -accompanied by fear,shame, anger&helplessnss. That all risks damaging a child’s biological stress systm @pauldixtweets theguardian.com/education/2020…
12. AUSTRALIAN FIRES. Of course these fires are ACES. The distress&fear childrn feel will be placng thm at RISK of struggles for decades to come. Especlly as parents are understandbly likely to be too stressed to buffer. Communities togethr r best buffer. bbc.com/news/world-aus…
13. RESIDENTIAL SCHOOLS. Of course 19th centry schools that removed childrn frm “native” or “aboriginal” populations (ie, their home) is an ACE. They were designed to create disconnection. They happened all over. Canada is only one example. @ACEsCanada2020 cbc.ca/news/canada/a-…
14. SCHOOL CAMP. Of course camp is an ACE. Homesicknss = attachmnt fear. If that fear is overwhelmng, w/ no help or resolution, it risks biological damage. No, that doesn’t mean camp is a bad idea. No, it doesn’t mean all kids are affected. It means whn fear occurs,we shd listen
15. SCHOOL CAMP. While I’m on ths theme, if you are thinkng: “What?? I went to camp.Never hurt me. It was great!” -then you are lucky, not entitled. I spoke ths wk to a woman who has struggled her whole life since staff flat refused to let her call mum. (TY to that woman)
16. NURSERY. Of course nursery is an ACE. (I know that’s hard to hear.) If t culture of an EY settng isn’t highly attuned to emotional needs of yng childrn (whose biological stress-handlng systm is still incomplete), it puts them at risk of stress overload &thus biological damage
17. You get the idea... If you are thinking, “God, is everythng an ACE now??” Well, yes, sort of. Tons of things can cause children distress - tho some events pose greater risks than others. The point is: We adults shd be trying to help children. Not ignoring/denying thr feelings
18.Does all ths mean we shd protect children frm risk&feelngs of fear? NO. Life is full of fear,up until death.Humans need a biology that cn cope w/ fearful moments (& also notice others’ distress). Childrn develop tht biology becuz someone walked beside thm.They didnt feel alone
19. At its core, ACES is an idea, an explanatn that reveals somethng abt our world, abt ourselves. Its not “a thing”. Its an insight,like “t world is not flat” or “gravity makes things fall”. So: “too much lonely chldhood fear [toxic stress] changes us biologclly &risks illness.”
20. Does that mean that this idea of ACES is fully understood? Nope. There are things to learn, things to discuss, things to unpick. All explanations (theories) need that. Felitti & Anda were brave enough & curious enough to get us started on ths new idea. They fought disbelief.
21. Can we all please keep in mind that Felitti&Anda’s insights came out of realisations abt t pain of child sex abuse? Colleagues denied those discoveries: “We all know that patient statements are fabrications to explain failed lives.” #MeToo Movemnt... acestoohigh.com/2012/10/03/the…
22. Does it mean that an ACES explanatn can’t be misappropriated by politicians&policy makers to assign blame to “feckless individuals&families”,as some critics are rightly worried about? Nope. Ths is entirely possible. But t problem is blaming & shaming - not t ACES lens itself.
23. Does ths mean that organisations&individuals will get everythng right as they try to understnd&talk abt ACES? Nope. That’s t risk of public translation of science. Language will be clumsy. Some applicatns will be misguided. So: we HELP each to understnd, not crucify mistakes.
24. Does ths mean t ACES explanatn of 1998 or of 2020 is complete? Nope. Thr are things yet to discover. Thr are gaps in our knowledge. That doesn’t make anybody “wrong”, either those pursuing an ACES line of enquiry or t “critics” who are worried. It means we need more curiosity
25. Attachmnt researchers started 75 yrs ago trying to get t public&professions to understand t long term consequences of childrns emotional experiences of relationships. They were askng t same questions ACES asks. See, eg, this piece, w/ CSA at its core. journals.sagepub.com/doi/abs/10.117…
26. I think it significant to ask: Why weren’t they successful in creatng an Attachment Movement in 20th century? How did we waste the potential to help generations of children? What is it abt the ACES language/lens that has yielded an internatnl ACES Movement in t 21st century?
27. But that question is a question for another day. This thread is already way way too long. 😊 (I celebrate anyone who has stuck with it on a sunny Sunday afternoon.) Here is the reason I wrote it:
28. Children need adults who are emotionally ABLE to be curious abt their feelings. Children need adults who understand they hv a RESPONSIBILITY to be curious abt thr feelings, not just “manage” children’s behaviour. This is a big cultural shift. This is hard for grown-ups.
29. Whn childrn hv their feelings HEARD, whn thr emotions are acknowledged & not denied, they feel SAFE. It is as “simple” as that. Learning to listen to our childrn (thr griefs,terrors,confusions) changes them biologiclly. It builds strong internal teddies (aka: resilience)
30. Once upon a time, nobody understood how gravity worked or that t earth wasn’t actually flat. Things got better whn they did. T ACES Movement has a chance of helpng t public understand how child developmnt works, how humanity works, how we can solve intractable social problems
31. I don’t know if t ACES Movement will succeed. I don’t know if it has come too late anyway. Perhaps climate change - & the terrible human conflict that awaits us, that we seem to have trouble accepting is just around t corner - is going to wipe us out sooner than we imagine.
32. What I know is that the ACES-Trauma Movemnt offers more potential for our society (not just our professions) to meet childrn’s (& fellow adults’) needs than anything I’ve known in my lifetime. No better opportunity is coming. Ths is t best shot we’ve got,as far as I can see.
33. So I celebrate evry single person who has allowed ACES to help thm get more curious abt human pain, evry leader who has figured out a way for thr organisatn to be more self-reflective, evry communty who is trying to build connection.We will get nowhere worth being w/out these
34. And right now, I really do celebrate anyone who found it in themselves to read what has become perhaps the longest thread in the history of Twitter. 😊 Thank you your indefatigability... I’m putting on the kettle now, because I so need a cup of tea. (End) ☕️☕️
35. ps: Actually, does anyone know what the longest thread in the history of @Twitter actually is? I love it when my brain dreams up questions I never thought to ask before! 😊
