ACEs and Resilience: Trauma-Informed Care in Rural Communities
Adverse Childhood Experiences (ACE) Study
Beginning in 1995, Dr. Vincent Felitti from the health maintenance organization (HMO) Kaiser Permanente and Dr. Robert Anda from the Centers for Disease Control (CDC) began what would become a revolutionary study, the Adverse Childhood Experiences (ACE) study. Interviewing 17,000 Kaiser Permanente patients, the ACE study surveyed childhood trauma experiences across the areas of abuse (i.e., physical, sexual, emotional abuse), neglect (i.e., physical, emotional neglect) and household dysfunction (i.e., domestic violence, household substance abuse, household mental illness, parental separation or divorce, incarcerated household member),
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It had long been theorized that individuals in rural residence would have higher ACE scores due to the prevalence of poverty and low educational attainment in these areas. Recent research on urban and rural children demonstrated that rural children have higher ACE scores than urban children (HRSA, 2015). Studies of adults, however, have shown that, after adjustment for demographics, urban and rural adult populations have similar odds of experiencing multiple ACEs (McCall-Hosenfeld, Mukherjee, & Lehman, 2014; Talbot, Szlosek, & Ziller, 2016). Nevertheless, ACEs are a noteworthy problem among rural adults. Over half of rural adults report experiencing at least one ACE, with more than one in ten individuals reporting four or more ACEs. Unlike urban populations, however, rural populations experiencing ACE exposure require service providers hoping to prevent ACEs, and to mitigate the negative effects of ACEs, to take into consideration the local rural culture and rural health delivery …show more content…
Preventative factors include positive family relationships, which reduce the incidence of child abuse and neglect and promote resilience skills, such as self-regulation, social competence, autonomy, problem-solving and sense of purpose; parenting and home visiting programs (e.g., Triple P, Parents As Teachers); and consistent well-child checks and the establishment of medical home (American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Osteopathic Association, 2007; Bethell, Newacheck, Hawes, & Halfon, 2014; Borden, Schultz, Herman, & Brooks, 2010; National Center for Injury Prevention and Control, Division of Violence Prevention, 2014). Factors found to mitigate the effects of ACEs include the adoption of trauma-informed practice by service providers (Kaiser Permanente, National Council for Behavioral Health, 2015; SAMHSA,
The trauma-informed care lab was a very impactful experience for me as a student pharmacist and as a person. Prior to the lab, I have always believed that childhood experiences can influence a person’s outcome as an adult. While this belief humanizes those, who have made poor choices in life, it is difficult for me to vindicate every case I see. However, after seeing the statistical facts from the ACE study and especially the movie Healing Neen, I found it easier to show empathy and understanding to those who made those choices.
National Rural Health Alliance (2007). Yearbook and Annual Report 2006–2007 [Electronic version]. Retrieved April 09 from
On page of our textbook it outlines the parallel process, which is how the characteristics of one relationship influence another. For example, caregivers who have a positive relationship with their coworkers carry the positive methods of communication that they employ there to their relationship with parents. The ability to maintain, strengthen and establish relationships is not usually a part of child caregivers training. Instead, it’s a skill that must be learned and practiced. An individual that has healthy relationships, and solid communication skills, usually learns these skills through trial and error.
The concept behind home visitation as a coping strategy to curb child abuse is to alleviate it before it happens or to find signs of child abuse by having public health works conduct visits to every hou...
Implementing successful prevention strategies will require the need to provide assistance to the entire family and focus both on the child’s safety and well-being as well as the parents’ emotional and economic well-being.
For decades, individuals living in rural areas have been considered medically underserved. Access to healthcare is a problem that has been increasing for individuals in rural America due to aging populations, declining economies, rural hospital closures, rising healthcare costs, healthcare provider shortages and difficulties attracting and retaining healthcare personnel and physicians (Bauer, 2002). This population experience more health disparities than t...
Adverse childhood experiences known as the ACE Study, was developed to determine whether childhood events had long-term health consequences, which has important implications for Healthy People 2020 Policy planning, as well as for key social work roles in disease prevention. (Larkin, Felitti, Anda, 2014). Based on the Michael’s case he has experienced six ACEs, child abuse that was both emotional and physical, alcohol abuse, single parent home, working class, and lack of support/closeness with family. Some studies suggest that the experience of four or more ACEs is a threshold above which there is a particular higher risk of negative physical and mental health outcomes. (Sacks, Murphey, Moore, 2014) Early life stress, including neglect and abuse,
Adverse childhood experiences (ACEs) are the extremely traumatic events that take place in an individual’s childhood that negatively affect their future attempts to succeed in life. ACEs include enduring physical and verbal abuse, living in dysfunction and over exposure to violent and criminal behavior. It was determined that children who are in the child welfare system are more likely to suffer ACEs and develop physical and mental health issues as well as engage in risky behavior (Brown & Shillington, 2017); children who suffer ACEs also have lower self-efficacy than other children. In all of the research prior to this study, much of the focus was on the psychological and behavioral outcomes of ACEs and what children were more susceptible to them. The problem that the researchers in this study have identified is that in no prior research has anyone
In Chapter1 of How Children Succeed Paul Tough argues that trauma in childhood would cause a negative effect on children. However, this negative effect can be changed.
Child abuse is a problem that affects the well-being of children, and it is something that can be avoided with the proper detection and implementation of interventions (Sanders Jordan & Hatfield Steelman, 2015). Harris discussed bruises and disclosed that detected abuse is relevant to a nurse working with families because they can assess for signs such as suspicious bruising, areas in which this occur include the back, genitals, abdomen, cheeks, and neck (2015). The abuse they experience can result in them obtaining the most mental health problem, compared to other children who do not encounter abuse (Ben-David, 2016). Caneira, & Myrick discussed in their journal that child abuse is important to detect as soon as possible because it can go on to affect them later in life, this is the case with pregnant women who experience post traumatic stress disorder from childhood abuse and end up resulting in adverse perinatal outcomes due to bad self care behaviours (2015). Using screening techniques will reduce the amount of children who experience abuse and go unrecognized. Using these techniques, addition resources, and establishing a therapeutic relationship with the patients, will help in minimizing the amount of child abuse (Caneira, & Myrick, 2015). Child abuse is relevant to health care professionals working with families and should be routinely assessed to minimize the
There are several domains that must be considered when treating a survivor of child abuse: the need for safety and trust, sense of belonging, protection from perceived or actual threats, facing the defendant in court, prevention of revictimization, and empowerment (Sawyer & Judd, 2012). Davis, 2005, states that “children terrorized through sexual abuse, neglect, physical abuse, or wartime atrocities may suffer from lasting wounds, nightmares, depression, and troubled adolescence involving substance abuse, binge eating, or aggression.” Victims of child abuse need to regain their sense of control over their lives. Experiencing healthy relationships, being nurtured by adults and helping them to learn resilience are all interventions that have been well-documented (Sawyer & Judd, 2...
The Adverse Childhood Experiences Study was done by Dr. Vince Felitti and Dr. Bob Anda at the Centers for Disease and Prevention (CDC) and together, they asked 17,500 adults about their exposure to what they called “adverse childhood experiences,”
Funding is awarded to support ongoing research programs to identify, prevent and treat child abuse and neglect and to collect and distribute data. Projects that are currently funded are Child Welfare Information Gateway website, the National Resource Center for Child Protective Services, National Quality Improvement Center on Differential Response, annual publication of Child Maltreatment and the initiative on Supporting Evidence-Based Home Visitation to Prevent Child Maltreatment.
When the topic of abuse comes up, many different forms of abuse pop into individuals heads. Whether its Physical abuse, sexual abuse, verbal abuse or even drug abuse, the list just keeps going. Now take all those different forms abuse and imagine them happening in a family. A father physically abusing his children, a mother verbally berating her daughter about her body image, a child growing up in fear. According to the research by David Wolfe in the Journal of Consulting and clinical Psychology, that the number of children that have suffered a physical injury due to physical abuse is between 1.4 and 1.9 million annually. With such a high number of physical abuse happening to children, one can imagine how high the number of all the
Child abuse has become a chronic and common issue in the country today. In the United States of America, an estimated three million children are victims of abuse every year. Whether the abuse is physical, emotional, sexual, or neglect, the scars can be deep and can have a negative effect on a child’s education. According to academic research preformed at Brown University in April 1996, it was noted that abused children have a harder time maintaining good grades in school due to their stressful home lives, which leads to a lack of focus in the classroom. These issues are severely hurting the education of many children which damages their conscious development. Unstable households are the number one cause of children not performing at the level of proficiency in the classroom. (Family Mobility Helps) There are four different types of abuse, but the effects are similar, which is physical, or emotional harm placed upon the child. There are certain types of abuse that are often harder to identify. Neglect is the most common form of child abuse. Family members and caregivers are the abusers in most cases. Research has shown there are three major reasons why abuses children suffer academically. The reasons are withdrawal, poor communication/social skills, and behavioral problems. Child abuse does not only hurt a child’s education, but can lead to deaths. Therefore prevention is the key to the success of a child’s future. (Rynders)