The ACE Study
In addition, the CDC also lists other resources that can be utilized to prevent and help educate about ACEs. One thing that was mentioned was, VetoViolence, which is a website that acts as a source for trainings, tools, and resources for violence prevention professionals (CDC 2016). Its interactive tools and trainings are designed to help practitioners stop violence before it begins, which may address gaps between practitioners knowledge regarding ACEs. In addition, case studies have also been done in Washington and Oklahoma where ACE data has been used in helping to prevent child abuse and neglect. Oklahoma has strategically applied for, received, and disseminated federal funding to address childhood adversity specifically (CDC 2016). These
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efforts address the impact of ACEs and the importance of prevention and treatment. Information about ACEs led to the initiative, Prevention of Child Abuse and Neglect 2014-2018, which establishes a vision to improve children’s environments and development in order to reduce child maltreatment (CDC 2016).Washington has used their ACE data to develop a common language to provide a platform for child maltreatment prevention efforts. Washington has disseminated their unified narrative about the impact of ACE and importance of early prevention to various groups so that they may lead, collaborate, and develop prevention action (CDC 2016). As a result, Washington’s ACE Private-Public Partnership Initiative, is currently evaluating the effectiveness of scientifically supported child maltreatment prevention interventions in five Washington communities. Although various programs targeted towards ACE prevention exist and are coming about, there still remain gaps that need to be addressed.
Early on during the initial ACE Study, the CDC came up with something called, The ACE Pyramid, which represents a conceptual framework for the study from conception to death. At the bottom of the pyramid is adverse childhood experiences, then above that is social, economic and cognitive impairment, then adoption of health-risk behaviors, then disease, disability and social problems and finally, early death. During the 1980s and early 1990s, information about risk factors for disease had been widely researched and merged into public education and prevention programs (Felitti, Anda, Norderberg, Williamson, Spitz 1998). It was known that risk factors for many chronic diseases tended to cluster, being that, persons who had one risk factor tended to have one or more other risk factors too. However, it became known that many risk factors such as, smoking, alcoholism or drug use, were not randomly distributed and seemed to come from a specific origin (Felitti et al., 1998). Because of this knowledge, the ACE Study was designed to assess these “scientific gaps” about the origins of risk factors. These gaps are depicted as the linkage between Adverse Childhood Experiences to risk factors that lead to the health and social consequences as the pyramid gets higher. Specifically, according to Felitti et al., the ACE study was designed to help answer the question: “If risk factors for disease, disability, and early mortality are not randomly distributed, what influences precede the adoption or development of them?” By working within this framework, the ACE Study began to uncover how adverse childhood experiences (ACE) are strongly related to development of risk factors for disease and health and social well-being throughout the lifespan. Although this discovery was made, there still remains gaps as to what it is specifically about ACEs seems
to cause this domino effect of health and social deterioration. Mersky, Topazes & Reynolds (2013), address the fact that since ACEs can cause such a broad array of health and social consequences, there remains gaps, maybe more in some areas than others, in terms of creating effective preventative measures. Although, all this data from the ACE study was collected and results were analyzed, there were so many areas to be addressed in the end. As a result of the study, there were a few programs and initiatives that took off, including Essentials for Childhood Framework and case studies in a few states. However, there still lie gaps in connecting how ACEs lead to health development risks as these children grow older. The most important issue that needs to be tackled is prevention of ACEs as well as community awareness and education regarding the concept and ways to stop it from happening. This study was initially done over 10 years ago, however, little progress has been made in terms of prevention measures, health education and outcomes (Stevens 2014). These gaps perhaps exist because gaps regarding the origins of these risks still exist, or because not enough knowledge and research has been done in terms of effective preventative measures. It could also be due to a lack of knowledge or intervention by primary care providers at an early age or due to their lack of knowledge about the prevalence of ACEs and their link to risky behaviors and poor long-term health outcomes. People with ACEs die nearly 20 years earlier on average than those without ACEs (Felitti 2014). It’s a prevalent issue that needs to be tackled early on through preventive measures, whether that be screenings by pediatricians at an early age, family support groups or other specific prevention groups. Aside from preventive measures, health education of ACES in general and about the various resources that are available to help cope with any negative issues that may be going on, need to be made more aware of. Perhaps further research, more case studies and best practice measures need to be taken in order to fully understand the impact of ACEs and where exactly the gaps lie.
efforts address the impact of ACEs and the importance of prevention and treatment. Information about ACEs led to the initiative, Prevention of Child Abuse and Neglect 2014-2018, which establishes a vision to improve children’s environments and development in order to reduce child maltreatment (CDC 2016).Washington has used their ACE data to develop a common language to provide a platform for child maltreatment prevention efforts. Washington has disseminated their unified narrative about the impact of ACE and importance of early prevention to various groups so that they may lead, collaborate, and develop prevention action (CDC 2016). As a result, Washington’s ACE Private-Public Partnership Initiative, is currently evaluating the effectiveness of scientifically supported child maltreatment prevention interventions in five Washington communities. Although various programs targeted towards ACE prevention exist and are coming about, there still remain gaps that need to be addressed.
Early on during the initial ACE Study, the CDC came up with something called, The ACE Pyramid, which represents a conceptual framework for the study from conception to death. At the bottom of the pyramid is adverse childhood experiences, then above that is social, economic and cognitive impairment, then adoption of health-risk behaviors, then disease, disability and social problems and finally, early death. During the 1980s and early 1990s, information about risk factors for disease had been widely researched and merged into public education and prevention programs (Felitti, Anda, Norderberg, Williamson, Spitz 1998). It was known that risk factors for many chronic diseases tended to cluster, being that, persons who had one risk factor tended to have one or more other risk factors too. However, it became known that many risk factors such as, smoking, alcoholism or drug use, were not randomly distributed and seemed to come from a specific origin (Felitti et al., 1998). Because of this knowledge, the ACE Study was designed to assess these “scientific gaps” about the origins of risk factors. These gaps are depicted as the linkage between Adverse Childhood Experiences to risk factors that lead to the health and social consequences as the pyramid gets higher. Specifically, according to Felitti et al., the ACE study was designed to help answer the question: “If risk factors for disease, disability, and early mortality are not randomly distributed, what influences precede the adoption or development of them?” By working within this framework, the ACE Study began to uncover how adverse childhood experiences (ACE) are strongly related to development of risk factors for disease and health and social well-being throughout the lifespan. Although this discovery was made, there still remains gaps as to what it is specifically about ACEs seems
to cause this domino effect of health and social deterioration. Mersky, Topazes & Reynolds (2013), address the fact that since ACEs can cause such a broad array of health and social consequences, there remains gaps, maybe more in some areas than others, in terms of creating effective preventative measures. Although, all this data from the ACE study was collected and results were analyzed, there were so many areas to be addressed in the end. As a result of the study, there were a few programs and initiatives that took off, including Essentials for Childhood Framework and case studies in a few states. However, there still lie gaps in connecting how ACEs lead to health development risks as these children grow older. The most important issue that needs to be tackled is prevention of ACEs as well as community awareness and education regarding the concept and ways to stop it from happening. This study was initially done over 10 years ago, however, little progress has been made in terms of prevention measures, health education and outcomes (Stevens 2014). These gaps perhaps exist because gaps regarding the origins of these risks still exist, or because not enough knowledge and research has been done in terms of effective preventative measures. It could also be due to a lack of knowledge or intervention by primary care providers at an early age or due to their lack of knowledge about the prevalence of ACEs and their link to risky behaviors and poor long-term health outcomes. People with ACEs die nearly 20 years earlier on average than those without ACEs (Felitti 2014). It’s a prevalent issue that needs to be tackled early on through preventive measures, whether that be screenings by pediatricians at an early age, family support groups or other specific prevention groups. Aside from preventive measures, health education of ACES in general and about the various resources that are available to help cope with any negative issues that may be going on, need to be made more aware of. Perhaps further research, more case studies and best practice measures need to be taken in order to fully understand the impact of ACEs and where exactly the gaps lie.