Issue Brief: Adverse Childhood Experiences and Trauma Informed Care

November 01, 2018

Issue Brief: Adverse Childhood Experiences and Trauma Informed Care

What are ACEs?

If you’ve been listening to the discussion between leaders in healthcare or education recently, chances are you’ve come upon two acronyms, ACEs and TIC. ACEs stands for Adverse Childhood Experiences and refers to traumatic experiences that children experience which may affect them into adulthood. TIC refers to Trauma Informed Care, a developing method of adapting healthcare and education strategies for children who have experienced trauma in order to mitigate the impact that ACEs may have on their development both during childhood and later in life.

A wide array of experiences could be considered ACEs, and no list is going to encapsulate every possible experience, but common ACEs include: poverty, parental separation or divorce, living with someone suffering with alcohol or drug addiction, being a victim or witness to neighborhood or domestic violence, living with someone experiencing severe mental illness or suicidal thoughts, having a parent or close family member serve time in jail, being a victim of racist or discriminatory actions, or having a parent or caregiver die.

In 2016, Oklahoma had the highest incidence rate of ACEs among the states with 32.9% of children reporting two or more ACEs. In 2018, that rate had reduced to 26.6%, giving Oklahoma the tenth-highest rate of ACEs.

How do ACEs Affect Health and Educational Outcomes?

Pyramid graphic that depicts whole life perspective for children who have experienced adverse childhood experiences.ACEs can have long-lasting impacts on mental and physical health and development, with severe repercussions. According to research conducted by the U.S. Centers for Disease Control, individuals who have experienced six or more ACEs have a life expectancy that is twenty years shorter than individuals who did not experiences ACEs (60 years v. 80 years).

Experts recognize that ACEs represent a large public health concern. Children who have experienced ACEs are more likely than children who have not to develop unhealthy coping mechanisms such as drug abuse, excessive drinking, and tobacco use. Childhood trauma can increase demands on the public services, and is estimated to have a negative economic impact of $124 billion nationally due to productivity loss, increased healthcare costs, and other associated damages. ACEs are believed to be an important factor influencing Oklahoma’s high rates of opioid abuse and incarceration.

ACEs also affect classroom outcomes. Childhood trauma negatively impacts a child’s social-emotional development which can contribute to behavioral issues at school. Children who have experienced one or more traumatic events during their youth are more likely to perform below their grade level, fail a class, or drop out of school.

ACEs’ impacts on individuals’ health and educational outcomes have the additional negative impact of perpetuating generational cycles of childhood trauma. Both immediate impacts of ACEs—increased rates of substance abuse—and secondary impacts of ACEs—increased rates of poverty and/or incarceration—can contribute to generational cycles of trauma.

What has Oklahoma Done to Address ACEs?

During the 2018 Legislative Session, Senate Bill 1517 was signed into law, creating the Task Force on Trauma Informed Care. The task force will investigate and recommend a coordinated strategy for the state to prevent traumatic experiences in childhood, as well as interventions and treatments for children and families at risk of experiencing trauma. This task force will aid the state in harmonizing the efforts that state agencies are already making to address ACEs and implement TIC in their work, such as the Interagency Child Abuse Prevention Task Force. The Senate Committee on Health and Human Services is also conducting an Interim Study on Adverse Childhood Experiences and their impact on the state’s health and education outcomes. The work of the task force and the Senate committee should result in better estimates about the cost of ACEs on public services in Oklahoma.

At the local level, some Oklahoma school districts have begun integrating findings about Trauma Informed Care into their classroom behavior management plans and teacher trainings in order to address and mitigate the long-term impacts of childhood trauma.


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