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Gracelyn Ross

Professor Gordon

URWT 1104-003

21 November 2019

The Impact of Adverse Childhood Experiences on the Brain's Development

“The world breaks everyone, and afterward, many are strong at the broken places”

Ernest Hemingway

I first heard this quote in a powerful film called ​Broken Places ​directed and written by

Academy Award nominee, Roger Weisburg​. Broken Places i​ s a documentary on early childhood

adversity. This documentary poses the complex question of why some children can overcome

adversity and thrive, while others are left severely damaged. To answer this question, Weisburg

documented several families battling various forms of adversity over a 40-year time span,

recording from a time lapse perspective of how the families evolved. Through the moving 76

minute film, the audience gets the chance to peer into the lives of three families and their

personal battles with adversity followed by each of their feats of individual resilience. This

documentary has the ability to touch the hearts of viewers, as it did mine, and is an empowering

must see! I owe this documentary and its cast my utmost gratitude for raising my curiosity on

this topic and inspiring me to pursue my Extended Inquiry Project focusing on childhood trauma.

In my inquiry project, I will be addressing the impacts Adverse Childhood Experiences (ACE)

have on early childhood development.

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For some of you who are new to this topic, you may be wondering what in fact are

ACEs? In 1998, the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente

caused a shift in the medical community's approach to disease by looking at the root of mental

and social health problems through addressing the concept of ACEs (Adverse 1-5). Adverse

Childhood Experiences are evaluated by using an ACEs test. As represented in the figure below,

this is a test formulated from ten questions intended to explore different childhood traumas based

on three main categories: Abuse, Neglect, and Household Dysfunction (Herzog).

The higher the score in said category or all categories, the more adverse childhood experiences a

person has been exposed to and, therefore, the higher likelihood of health and social problems.
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An overwhelming number of children experience childhood traumas. According to The

National Council for Behavioral Health (2019), nearly half of adolescents (ages 0-17) in the

United States are exposed to adversity in their home lives. These adversities are linked to risky

health behaviors, chronic health conditions, low life potential, and even early death (About

Adverse). The original 1998 ACE study of 17,000 middle class citizens, documented a direct

correlation between peoples’ ACE scores to significant negative physical and mental health

outcomes that impacted more than 60% of those adults (Adverse 1-5). The picture below,

provided by the National Public Radio, illustrates some of the potential negative impacts ACEs

cause.
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I wanted to discover for myself how ACEs impacted the UNCC community around me. I

created a survey using the ten ACEs evaluating questions and asked classmates to complete the

anonymous survey. I did not receive as many responses back as I would have liked, nevertheless,

I appreciated the results I did receive. I learned that the top three ACEs that the people I

surveyed had experienced (1 being the most common) were:1) One or more household members

struggled with alcoholism or drug use 2) One or more household members struggled with a

mental illness and/or attempted to end their own lives 3) Parents have been separated or

divorced. I was not surprised that these were the top three results, but it is still very disheartening

to recognize how commonly these issues occur.​ ​These results as well as the 1998 ACE study

results, continue to be reaffirmed with more recent studies to conclude: As the number of ACEs

increase per child so does their susceptibility for these negative outcomes.

The presence of ACEs does not guarantee that all children will experience these negative

consequences, but it does significantly increase their chances. The ​Broken Places ​film​ ​touches

heavily on this concept with the main point addressing the question of why some children are

more or less likely to be emotionally taxed by adversity than others. In the film, the Chief of the

Division of Developmental Medicine at UCSF, Dr. Thomas Boyce, dissected this question and

gave a meaningful and easy understanding of this concept on the differences between children

who seem to be completely unfazed by childhood stressors and those who tend to be more

sensitive to their surroundings. Over his years of experience, he began to liken these two types of

children and identify them as either a ‘dandelion’ or an ‘orchid’. Boyce explains how the

majority of kids tend to be “dandelion children” and are resistant in terms of coping with stress.
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However, the minority of kids are “orchid children,” and are biologically more reactive to their

circumstances. Like the flower, Boyce says, “The orchid child is the child who shows great

sensitivity and susceptibility to both good and bad environments in which he or she finds herself

or himself” (Broken Places). I found this concept to be significant because it breaks down an

abstract and complex thought into something more simplistic. This analogy can be applied to

everyday ideals and reminds us to approach others with compassion because everyone is

conquering their own giant.

Pictured: Dr. Thomas Boyce and his book ​The Orchid and the Dandelion
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Science and medical professionals are beginning to understand the biology behind

multigenerational trauma and how the impact of even one childhood experience can pass on

through generations. The epigenetics field has started to look into how trauma can “activate”

certain genes leading to negative physical and mental consequences. (Coffey).

To understand the root of childhood stressors, it is important that we first understand the

role of stress. Stress itself is a subjective experience to each individual. If one is in a healthy and

supportive environment, this stress may not be toxic. On the other hand, toxic stress can be

experienced when a child is exposed to prolonged and frequent adversity. This prolonged

activation can disrupt all parts of the brain and body leading to the negative outcomes addressed

earlier (Adverse 1-5). Nevertheless, stress is an individual experience for everyone, and for one

child, what may seem to be a traumatic experience may be merely a hiccup in another child's life,

thus bringing us back to our previous “Dandelion and Orchid” analogy.

Another key point to recognize when addressing childhood stressors is the biology behind

trauma. As a child grows and acquires new experiences, there are three main influential systems

that are present: social/behavioral, neuroendocrine, and genetic. One's ability to overcome the

different adverse situations life has to offer depends heavily on the interactions between these

three systems. In recent studies, scientists have observed several key factors that contribute to

childhood traumas including facts such as: the brain is not fully structurally complete at birth,

structural development of the brain can be affected by one's environment, and effective

stimulation requires interactions with other people (Adverse 1-5). All of these facts help to shed

a light on triggers of negative outcomes due to early childhood adversity.

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When looking at ACEs from a neurological standpoint, there are many pieces to this

complex puzzle. After a child undergoes a traumatic experience, psychological and psychosocial

mechanisms are known to then be activated in the brain and, in some situations, cause mental

disorders. Due to “cognitive compromising” in the brain towards threatening stimuli, these

alterations impact functional day-to-day behaviors that reside in the stress and emotion

processing parts of the brain. These respective brain regions include the hippocampus, ACC, and

amygdala, and all become especially vulnerable to ACEs. Several studies have shown that

exposure to selective ACEs affect the sensory systems differently, dependent on the percent of

trauma involved during said experiences (Herzog).

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Psychologists and other physicians are beginning to see the benefit in identifying

children's ACEs in order to combat social problems due to childhood stressors before they

become detrimental. Physicians are looking into preventative measures to reduce the likelihood

of these stressors negatively impacting children's futures. Dr. Rahil Briggs, National Director of

Healthy Steps, (a program providing behavioral health and parenting interventions for parents

and children), identifies innovative solutions for preventative mental health care. Some of these

solutions include maternal depression screenings, parental ACE screenings, the Ages and Stages

Questionnaires (Broken Places). Another point for optimism is that there are now several

effective clinical treatments for kids suffering from adverse childhood experiences including

Trauma Focused Cognitive-Behavioral Therapy and Parent-Child Interactive Therapy. These

programs focus on strengthening parent to child relationships as well as promoting resilience in

the home life (Adverse 1-5).

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Based on the information provided, there are many variations of impacts ACEs have on

children including mental, physical, and emotional imbalances. That said, pinpointing a definite

negative outcome that affects every child in the same way is not simple. Individual experiences

cause individual negative impacts. However, there is a light at the end of the tunnel of ACEs. As

research on childhood traumas becomes more prevalent, more evidence based treatments similar

to the Trauma Focused Cognitive-Behavioral Therapy and Parent-Child Interactive Therapy are

being created. The question remaining is what kinds of early childhood interventions are most

effective at strengthening resilience, and how can we make these interventions widely available

to the children most at risk? In the words of director Roger Weisburg, “I believe that the answers

to these questions hold the keys to solving the greatest public health crisis we face today.”The

greater the awareness on adverse childhood experiences is shared, the sooner we can find more

definite solutions to eliminate some of the negative outcomes these pesky ACEs cause.
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Work Cited

“About Adverse Childhood Experiences |Violence Prevention|Injury Center|CDC.”

Centers for Disease Control and Prevention​, Centers for Disease Control and Prevention,
9 Apr
2019,​https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/aboutace.h
tml​.

“Adverse Childhood Experiences and the Lifelong Consequences of Trauma.” ​American

Academy of Pediatrics ,​ 2014, pp. 1–5. ​American Academy of Pediatrics​,
doi:10.1007/springerreference_184213,
https://www.aap.org/en-us/documents/ttb_aces_consequences.pd​f

Broken Places,​ Roco Films, 2018, ​https://brokenplacesf​ilm.com/​.

Coffey, Sara.“Addressing the Impacts of Adverse Childhood Experiences.” ​BH365,​

29Aug.2019,​https://www.thenationalcouncil.org/BH365/2019/08/29/addressing-the-impa
cts-of-adverse-childhood-experie​nces/​.

Herzog, Julia I, and Christian Schmahl. “Adverse Childhood Experiences and the Consequences
on Neurobiological, Psychosocial, and Somatic Conditions Across the Lifespan.”
Frontiers in Psychiatry​, Frontiers Media S.A., 4 Sept. 2018,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131660/​.
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Illustration Sources

“Home.” ​Ages and Stages,​ agesandstages.com/.

“Myfamily.ucsf.edu.” ​MyFamily at UCSF - News​, myfamily.ucsf.edu/news/381.

“Positive Psychiatry and Mental Health.” ​Coursera​,

www.coursera.org/learn/positive-psychiatry​.

“Spring 2019.” ​NEW COLLEGE BERKELEY,​ www.newcollegeberkeley.org/spring-2019.

Starecheski, Laura. “Take The ACE Quiz - And Learn What It Does And Doesn't Mean.”
NPR,​ NPR, 2 Mar. 2015,
www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-le
arn-what-it-does-and-doesnt-mean.

“UK's First Child Trauma School Planned in Norwich by Experts.” ​b**p​, 2 Oct. 2018,
www.nebeep.com/uks-first-child-trauma-school-planned/.