Traumatic childhood events have a profound effect on our lives, long into adulthood.
They effect how we cope with stress, the quality of our relationships and, ultimately, how long we live.
This is the first in our series of Swimming Upstream reports, examining the inequalities experienced by children in care.
Research into traumatic events has developed the concept of Adverse Childhood Experiences (ACEs). There are ten ACEs, in three groups: Abuse, Neglect and Househole Dysfunction Homelife
– Physical abuse
– Emotional abuse
– Sexual abuse
– Physical Neglect
– Emotional Neglect
– Witnessing domestic violence in the home
– Parental substance misuse
– Losing a parent through divorce or separation
– Losing a parent through imprisonment
– Poor parental mental health
An experience, or multiple experiences of each type of traumatic experience during childhood counts as one “ACE”.
Additionally, for Looked After Children, there are specific traumas. Being taken into care; losing contact with birth family; settling into a strange new town.
ACEs affect a child’s development. They make it more difficult for them to form secure attachments. This repeated trauma results in children going into permanent survival-mode, fight or flight. They become hyper-vigilant and live in a constant high state of stress.
Disrupted development impacts on their ability to form trusting relationships. They find it harder to problem-solve and to regulate their emotions.
In survival mode, they are unable to think ahead and consider long-term consequences. They are more likely to make poor decisions and make unhealthy choices.
This leads to increased risk of disease, disability and social problems. Unemployment, criminal activity and early, unplanned pregnancies are common.
Too many unresolved ACEs result in premature death. The pyramid below shows the knock-on impact of ACEs throughout one’s life.
Adverse Childhood Experiences cause stress, triggering fight-or-flight response. This response shuts down the parts of the brain responsible for higher level thought, such as logic, reason, empathy and problem solving.
When a child is in a constant state of stress, these areas of the brain do not fully develop.
This disrupted development affects the child’s cognition and their ability to form empathic and trusting relationships with other people.
In turn, this can lead to poor decision making, adverse risk taking and unhealthy choices.
As a consequence, they develop health problems and can have a shorter life expectancy.
The statistics for children who have experienced four or more ACEs are pretty stark. Almost every child in care will have experienced at least four or more ACEs.
The effect of ACEs is cumulative. Higher ACEs scores lead to ever-increasing health, social, and behavioural problems.
The charts below show how the risks of unhealthy adulthood is linked to the number of Adverse Childhood Experiences someone experienced while growing up.
(Graphs calculated from original ACEs research paper – pdf)
The More You Need, The Less You Get
On top of ACEs, children in care are more likely to have been living in poverty. They will have missed a considerable amount of education. Even by the time they come into care, they are at a significant disadvantage.
Fortunately, the impact of ACEs is not cast in stone. It does not have to be inevitable that children with 4+ ACEs will go on to suffer these inequalities. We can reduce these risks by giving the child a stable, loving and safe environment in which to recover.
However, in reality, this isn’t always the case. In reality, the more ACEs a child has experienced, the less likely they are to get this vital opportunity to recover.
The “Inverse Care Law” suggests that people with the greatest need for care are least likely to receive it. This principle certainly seems to apply to children in care.
The more traumatised a child is, the more likely it is that challenging behaviour, self harm, and attachment issues will be features of how they cope.
This in turn makes it more likely that they will experience multiple placement breakdown, moves to new towns and in and out of different schools. Hence, they are less likely to ever experience the stability and emotional safety they need.
We need to urgently rethink our whole approach to supporting traumatised young people in the care system. Children on Care Orders are, almost by definition, the most disadvantaged 0.57% of the population.