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Session 1

Introduction to Adverse Childhood Experiences (ACEs) and Toxic Stress

Adverse Childhood Experiences (ACEs)

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. ACEs can also negatively impact education and job opportunities. However, ACEs can be prevented

  • ACEs are quite common, even among a middle-class population
  • More than two-thirds of the population report experiencing one ACE, and nearly a quarter have experienced three or more.
  • There is a powerful, persistent correlation between the more ACEs experienced and the greater the chance of poor outcomes later in life
  • Dramatic increase risk of heart disease, diabetes, obesity, depression, substance abuse, smoking, poor academic achievement, time out of work, and early death.

How ACEs Relate to Toxic Stress

  • ACEs research shows the correlation between early adversity and poor outcomes later in life.
  • Toxic stress is the explanation of “How” ACEs ”get under the skin” and trigger biological reactions that lead to those outcomes.
  • Experiencing ACEs triggers all of these interacting stress response systems.
  • When a child experiences multiple ACEs over time— without supportive relationships with adults to buffer with protection—the experiences triggers excessive and long-lasting stress response

3 Types of Stress

Positive Stress

Positive stress response is a normal and essential part of healthy development, characterized by brief increases in heart rate and mild elevations in hormone levels.
Some situations that might trigger a positive stress response are the first day with a new caregiver or receiving an injected immunization.

Tolerable Stress

Tolerable stress response activates the body’s alert systems to a greater degree as a result of more severe, longer-lasting difficulties, such as the loss of a loved one, a natural disaster, or a frightening injury.

If the activation is time-limited and buffered by relationships with adults who help the child adapt, the brain and other organs recover from what might otherwise be damaging effects.

Toxic Stress

Toxic stress response can occur when a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support.

This kind of prolonged activation of the stress response systems can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment, well into the adult years.

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Summary of ACEs

We encourage family involvement, fun, physical fitness and literacy.

ACES affect people at all income and social levels

ACES can have serious and costly impact across the lifespan

Everyone is reparable and no one is irreparably damaged

We need to acknowledge traumas effects on our lives

We must reduce sources of stress to provide children and adults with responsive relationships

We must strengthen core life skills we ALL need to adapt and thrive


Center on the Developing Child, Harvard University, 2020

Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. Vincent J Felitti MD, FACPRobert F Anda MD, MS, 1998

Pediatrics and Child Health;The Social Determinants of Child Health, 2018

Neighborhood Wellness Foundation, grassroots observations and interactions, 2017-2021