What are ACEs?
“Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). For example: experiencing violence, abuse, or neglect witnessing violence in the home or community having a family member attempt or die by suicide. Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding, such as growing up in a household with: substance use problems, mental health problems, instability due to parental separation or household members being in jail or prison”(“Adverse childhood experiences (aces)“, 2023). It is not just limited to the ones above there are other situations but just to name a few and get an idea of what ACEs are.
Understanding (ACEs) and Intervention Strategies to Better Support Individuals and Families
Social Work practitioners can integrate their understanding of ACEs into their assessment and intervention strategies to better support individuals and families by ACE screening; it is essential to help assess if an ACE is present. “ACE screening has been successfully integrated into a wide range of clinical settings, including pediatric primary care, adult primary care, family medicine, and women’s health and prenatal care” (“Benefits of screening for aces,” 2021). These screenings have an impact on children, “Routine screenings for children can capitalize on critical opportunities for prevention, early detection, and intervention.” Adults should also be screened because “ACE screening can validate and empower patients and contribute to improved family health” (“Benefits of screening for aces,” 2021). It is also essential to do screenings on pregnant women because “ACE screening promotes a positive cycle of health by reducing the intergenerational transmission of ACEs and toxic stress” (“Benefits of screening for aces,” 2021). “Screening can mitigate toxic stress and improve health outcomes” (“Benefits of screening for aces,” 2021). Screening can allow social workers to use their understanding of ACEs and provide a significant intervention to allow better support for not only children but also adults and pregnant women. This also allows social workers to have more insight and better assess their clients, which in turn allows them to help with their intervention strategies more effectively.
Systemic Barriers and how Social Workers can Advocate for Change
Some systematic barriers that children and families could face resulting in inadequate support to mitigate the impacts of ACEs include “Children and youth who don’t feel close to their parents/caregivers and feel like they can’t talk to them about their feelings, families with caregivers who have a limited understanding of children’s needs or development, and families with caregivers who were abused or neglected as children” (“Adverse childhood experiences (aces),” 2023), to demonstrate a few examples. These could result in communication barriers to seeking help in preventing ACE impacts. Social Workers could help advocate change by bringing awareness to the issue and shedding light on the fact that ACEs are an issue. I think bringing awareness to schools would be so beneficial and crucial in advocating for change because many adolescents, I am sure, do not know what ACEs are; I did not, and I just graduated in 2023. I feel that allowing kids to understand what ACEs are and giving them a safe space to talk about it and their situation could be so beneficial. I also think bringing information home to the younger students could allow for change. One of the points I mentioned earlier, a systematic barrier that could result in inadequate support to mitigate the impacts of ACEs, is “Families with caregivers who have a limited understanding of children’s needs or development” (“Adverse childhood experiences (aces),” 2023), while this is definitely an issue by sending information home with the younger children it would help shed light on what their children’s needs are and understand their development. Not to mention, as children get older, they are less likely to show their parents what they bring home from school; it usually just sits in their backpacks and gets thrown away at the end of the year. However, usually, with children in younger grades like elementary school, parents usually go through their backpacks, so including information that could bring awareness to parents and caregivers would be more beneficial in the younger years of a child’s schooling. Maybe having a presentation in high schools or maybe even middle school could help bring awareness and change to the source, the children, and allow them to feel safe and talk about what they are experiencing, which would be a great way to also allow for change. Going back to what I mentioned earlier, with a systematic barrier that could result in inadequate support to mitigate the impacts of ACEs, “Children and youth who don’t feel close to their parents/caregivers and feel like they can’t talk to them about their feelings” (“Adverse childhood experiences (aces),” 2023). By allowing the children to understand ACEs, this helps for those who necessarily do not want to talk about their feeling with a parent or caregiver and may feel more comfortable with the school social worker or if the school does not have a social worker someone within the school could provide more information to a social worker who could help and better assist the student. This allows more information not only to the parent or caregivers but also to the younger teenagers, which could allow social workers to help advocate for change to allow both children and families to have adequate support for the impacts of ACEs.
How can Social Workers be Culturally Sensitive and Responsive in Understanding and Addressing ACEs?
Social Workers can be culturally sensitive and responsive in understanding and addressing ACEs by “Cross-Cultural Knowledge: Social workers shall possess and continue to develop specialized knowledge and understanding that is inclusive of, but not limited to, the history, traditions, values, family systems, and artistic expressions such as race and ethnicity; immigration and refugee status; tribal groups; religion and spirituality; sexual orientation; gender identity or expression; social class; and mental or physical abilities of various cultural groups”(Standards and Indicators for Cultural Competence in Social Work Practice, n.d.). This could also be achieved through “Cross-Cultural Skills: Social workers will use a broad range of skills (micro, mezzo, and macro) and techniques that demonstrate an understanding of and respect for the importance of culture in practice, policy, and research”(Standards and Indicators for Cultural Competence in Social Work Practice, n.d.). I feel that it is essential for social workers to be inclusive, stay up to date on cultural importance, and effectively understand and address ACEs to be culturally sensitive and responsive to the diverse backgrounds of the clients they serve. I think this could be achieved through training to get more targeted knowledge on the topic and an overview of what is to be expected when needing to be culturally sensitive and responsive. Something I think would also be very beneficial I saw in the blog “Cultural Modesty” written by Alex Beaudouin, where it was mentioned that “It would be very beneficial for social workers to attend community events that hold cultural significance to the communities they are working in”(Beaudouin, 2024). I feel this would be great in understanding culturally sensitive and responsive ways to address the diverse backgrounds of the clients they serve because they would be actively participating in community events directly linked to the cultural significance of some clients they may serve. Mixing training and participating in culturally significant community events allows for a direct way to learn about the culture and provide insight into whether their approach to understanding and addressing ACEs is culturally sensitive and responsive to the diverse backgrounds of their clients.
Overall Takeaway
I do not personally have any experience with ACEs, but as I said before, I just graduated high school and had no knowledge of what ACEs were. That is why I feel that bringing information to schools is so important. Then, it can not only bring information to the parents or caregivers at an early age but can also spread the word and provide knowledge to those who are older in school. I think ACEs definitely need to be talked about more, mainly because of the impacts they have. They are so common, “About 64% of U.S. adults reported they had experienced at least one type of ACE before age 18, and nearly 1 in 6 (17.3%) reported they had experienced four or more types of ACEs” (“Adverse childhood experiences (aces),” 2023). They lead to health problems, “by preventing ACEs, up to 1.9 million heart disease cases and 21 million depression cases potentially could have been avoided” (“Adverse childhood experiences (aces),” 2023). They are costly, “ACEs-related health consequences cost an estimated economic burden of $748 billion annually in Bermuda, Canada, and the United States” (“Adverse childhood experiences (aces),” 2023). This is significant in showing how common ACEs are and the impact they cause and further shows why they need to be discussed more and brought more awareness too. The content fits within the broader landscape of social work by showing that awareness needs to be brought to ACEs and sheds light on the impact that ACEs have. It was very educational and provided great information about some of the risks that can bring about ACEs, some protective factors to help prevent ACEs, some prevention strategies, and some facts about ACEs. This was a great source of information to learn and enhance my understanding of ACEs. The content influenced my understanding of social work by allowing me to understand how beneficial it is to have a social worker help with this critical issue. Before I took this class, I knew limited information about social workers and how they could effectively help people, but this further shows how social workers can help people in a situation that happens so frequently. It is not just one targeted group. It is children, families, and even communities. While I do not plan on being a social worker, I could use the knowledge I gained from this to effectively spread the word about it and help bring more awareness to it.
References:
All photos are taken from google, including the featured image.
Beaudouin, A. (2024, February 15). Cultural Modesty. Social Work 103. https://swk103.community.uaf.edu/2024/02/14/cultural-modesty/
Benefits of screening for aces. ACEs Aware. (2021, December 20). https://www.acesaware.org/learn-about-screening/benefits-of-ace-screening/
Centers for Disease Control and Prevention. (2023, June 29). Adverse childhood experiences (aces). Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/aces/index.html
Standards and Indicators for Cultural Competence in Social Work Practice. NASW, National Association of Social Workers. (n.d.-b). https://www.socialworkers.org/Practice/NASW-Practice-Standards-Guidelines/Standards-and-Indicators-for-Cultural-Competence-in-Social-Work-Practice