ACE scores higher in families in trouble

If families don't receive any help to prevent trauma, can child trauma increase from one generation to the next? That's a question that begs to be answered if you look at the ACE scores of families participating in three programs for parents and caregivers run by Parent Trust for Washington Children.

But first -- what's an ACE score and why should anyone care? Well, your ACE score may explain the state of your health, or why you eat, smoke, work, drink, or do drugs too much or engage in risky behavior too often. The ACE Study (Adverse Childhood Experience) is an ongoing project of the Centers for Disease Control and Kaiser Permanente, in which researchers have followed the health of 17,000 people since the late 1990s. The study found a direct link between child trauma and the adult onset of chronic disease, including lung and heart disease, diabetes and depression. (For example, morbid obesity in women has been linked to emotional abuse in childhood.)

People with an ACE score of 4 or higher -- measured by the different types of trauma, not incidents of trauma -- have a greater risk of these diseases. You can do a rough calculation of your score by filling out this questionnaire. The startling findings have inspired many organizations, five states, the U.S. military and several countries to do their own ACE surveys.

Parent Trust for Washington Children is one of those organizations. Parent Trust has been serving families in Washington State since 1978 by "teaching families skills to promote early learning, improve family bonding, develop new family and life management skills for both parents and children, and prevent child abuse and neglect", according to its website. After receiving training in the ACE Study, the organization staff surveyed more than 600 parents and caregivers who participated in their programs between 2007 and 2010, and compared them to the CDC/Kaiser group. (By the way, when the CDC/Kaiser group showed startling links between child trauma and adult chronic disease, the researchers were stunned because the people participating are mostly middle- and upper-middle class, have jobs, good health insurance, have mostly attended college, and are mostly white. This could be a partial explanation of why alcoholism, depression and obesity are so prevalent in the U.S.)

Most of the parents that participate in these three Parent Trust programs -- Circle of Parents, Families in Recovery and Intensive Parent Training and Support -- have requested help or have been referred by other social service or health organizations; 20 percent have been ordered by a court to get help, or by the state Department of Social and Health Services. In other words, they're under enough stress that symptoms are breaking through the family bubble and coming to the attention of social service agencies, schools, neighbors or generally disrupting the family; they're likely to have money troubles in addition to dealing with addiction and violence.

The graph at the top of this post compares the ACE scores between the Parent Trust Circle of Parents program participants and the CDC/Kaiser Permanente group. It's clear that the percent of Parent Trust parents with ACE scores 4 and greater is much higher. This means their children are growing up in households where there's more abuse, neglect, alcoholism, family violence, mental illness, divorce and/or abandonment, and the likelihood of a family member being imprisoned.

The graph below is a breakdown and comparison between the Parent Trust groups and the CDC/Kaiser group of nine types of ACEs (in this study, physical and emotional neglect are combined).

Back to the question at the top of this post: what's the likelihood that children of parents who have high ACE scores end up with the same or higher ACE scores? And, in these recent very difficult economic times, are the increased stresses on families resulting in children with higher ACE scores?

And...taking this a step further....if you intervene with families and help them reduce the trauma that their children experience, can you lower ACE scores -- thus, potentially having more children grow up to be healthier adults -- from generation to generation?

Tagged: Health beat

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