Social Work and Adverse Childhood Experiences Research: Implications for Practice and Health Policy

Abstract

Medical research on "adverse childhood experiences" (ACEs) reveals a compelling relationship between the extent of childhood adversity, adult health risk behaviors, and principal causes of death in the United States. This article provides a selective review of the ACE Study and related social science research to describe how effective social work practice that prevents ACEs and mobilizes resilience and recovery from childhood adversity could support the achievement of national health policy goals. This article applies a biopsychosocial perspective, with an emphasis on mind-body coping processes to demonstrate that social work responses to adverse childhood experiences may contribute to improvement in overall health. Consistent with this framework, the article sets forth prevention and intervention response strategies with individuals, families, communities, and the larger society. Economic research on human capital development is reviewed that suggests significant cost savings may result from effective implementation of these strategies.

You Learn What You Live: Prevalence of Childhood Adversity in the Lives of Juveniles Arrested for Sexual Offenses

“…The research is clear and compelling that childhood adversity, especially when it is chronic, contributes to a complex web of neuro-biological, social, psychological, cognitive, and relational impacts across the lifespan, and increases risk for criminal behavior (Larkin et al, 2014;Young, 2014). Trauma-informed workers in the juvenile justice system should recognize the prevalence and impact of childhood adversity, expect the majority of clients to have experienced early trauma, and be well-versed in knowledge related to complex trauma responses and how they contribute to delinquent behaviors.…”

“…Childhood trauma, which is more prevalent in disadvantaged communities and oppressed populations (Eckenrode et al, 2014), increases risk for poly-victimization and subsequent psychopathology (Cloitre et al, 2009;Finkelhor, Turner, Hamby, & Ormrod, 2011). Unfortunately, American social policies designed to address child maltreatment have focused more heavily on offender punishment and child placement rather than primary prevention strategies (Larkin et al, 2014). In order to interrupt the intergenerational transmission of crime and victimization in our communities, it is critical that the child protection and juvenile justice systems invest in comprehensive prevention programs for high-risk families and intervene early with trauma-informed services for child victims (Anda, et al, 2010;Baglivio, et al, 2014;Miller & Najavits, 2012).…”

“…ACEs were surprisingly common in the original CDC sample, but are even more pervasive in poor, minority, marginalized, and oppressed populations commonly served by social workers (Eckenrode, Smith, McCarthy, & Dineen, 2014;Larkin, Felitti, & Anda, 2014). Pathogenic parenting and deprivational environments hinder family functioning and reinforce maladaptive coping styles, and household dysfunction is often exacerbated by the stress of impoverished socioeconomic conditions (Patterson, DeBaryshe, & Ramsey, 1990).…”

“…Finally, due to its long-reaching effects, childhood adversity is now commonly viewed as a public health crisis (Anda, Butchart, Felitti, & Brown, 2010;Felitti, 2002;Larkin et al, 2014). It is essential that public policies be reflective of our knowledge about the lasting impacts of toxic stress in childhood and their role in the development of criminal behaviors.…”

Trauma and Life Events in Adults with Intellectual Disability

“…Trauma from abuse and neglect was found to have detrimentally affected the development and then transition to independence of youth with intellectual disabilities [45] and increased the risk of sexual and violent offending [14•]. Childhood adversity has been linked to depression, substance misuse and obesity in adulthood in the general population [46]. Childhood abuse was found associated with obesity-related inflammation in middle-aged women in the general population [47], and with obesity high in intellectual disability populations [48], the link with past trauma may warrant consideration.…”