How to Build Buffers Against ACEs and Their Consequences
Stressful events during childhood can have a negative impact across the lifespan. But building buffers can help all children thrive.
Children’s earliest experiences directly affect the architecture of their developing brains, which then provides either a sturdy or a fragile foundation for all the development and behavior that follows. Because of this, adverse experiences during childhood can negatively impact developing brain architecture and have lifelong impacts. In fact, according to a recent federal report, at least five of the top 10 leading causes of death are associated with adverse childhood experiences (ACEs).
“If you look at a community’s prosperity, all of these different health and behavioral concerns—addiction, depression, obesity, graduation rates—have been found to have a direct dose response relationship with adversity in childhood,” says NICHQ Project Director Loraine Swanson, MPH. “So, if we want healthy communities, we really need to look at preventing and mitigating adversity in childhood as one of the key components to get us there.”
The best way to address ACEs is to prevent them. But, even under optimal circumstances, adversity is sometimes unavoidable. Fortunately, according to the Centers for Disease Control and Prevention, families and communities can actually create buffers that protect children from many of the negative health and life outcomes that stem from adversity.
Promoting these protective factors, or buffers, is a vital way that public health professionals, health care providers, families, and policy makers can help more children have a healthy future.
Child Trends recently released several important resources that provide research-based guidance and new data to inform decisions about how best to meet the needs of all children and their families in the midst of COVID-19. Please see these vital resources below.
These buffers can and should stem from both families and communities, because adverse experiences are present across the spectrum of children’s early experience, says Swanson. “We need to account for the conventional ACEs, which focus more on household disfunction, and for those associated with adverse community environments, such as witnessing violence, living in an unsafe neighborhood, or experiencing racism. With this framework, we can think about how to help families and communities offer buffers that are protective against ACEs, so that children have every opportunity to build resiliency.”
Helping families create buffers
Research shows that responsive parent-child relationships during the early years of life not only foster healthy brain development, but also protect the brain against the harmful effects of toxic stress that can arise from ACEs. By engaging in responsive relationships with their children, then, parents can help mitigate the effects of ACEs that may be outside of their control, such as those stemming from adverse community experiences. Moreover, strong parent-child relationships also help children build lasting resiliency—the relationships themselves are buffers against the effects of external hardships children might experience.
You can find specific strategies to help strengthen parent-child relationships through the well-child visit here.
Health professionals can help families engage in responsive relationships by talking to families about the importance of serve-and-return interactions during early childhood. These back-and-forth interactions between children and their parents and other family members (e.g., when parents hug their baby when crying) are the building blocks for healthy brain development and provide buffering protection. Through serve-and-return interactions, parents teach their children how to navigate stressful experiences, regulate their emotions, and self-soothe.
Policies that increase funding for home visiting services during pregnancy and after birth are vital for helping parents establish these responsive relationships, says Swanson. Home visitors can provide needed support during early months when parents may feel overwhelmed caring for their new baby. “We have this culture where if you have to ask for help, you’re not seen as a strong family, and we have to change that,” says Swanson. “One of the CDC’s biggest recommendations for mitigating adversity is promoting safe, stable, nurturing environments and relationships; sending families home with a newborn without some added support doesn’t set any one up to succeed.”
Similarly, federal and state policies that require paid-parental leave after birth and organizational policies that allow for flexible schedules and sick time to care for children also give parents the time and freedom to develop strong, nurturing relationships with their children.
Supporting community-based buffers
By looking beyond the home to the community environment, we can give children even more opportunities to develop buffers against the effects of ACEs, says Swanson. This is especially important as children move from infancy to adolescence and then into adulthood.
In the early years of life, all children should have access to high quality child care where they can experience safe and nurturing relationships. As children grow older, schools are another opportunity for children to foster strong buffering relationships and, if they are struggling with the effects of trauma, connect with additional resources and support. Public policies that support trauma-informed schools can help ensure that teachers, administration and staff are trained to recognize children who are affected by trauma, offer appropriate responses, and refer them to supportive services and interventions when necessary.
As children mature, they can benefit from numerous community-level buffers, from participating on sports teams to engaging in the arts or faith-based activities to volunteering. “It’s all about creating healthy peer relationships and figuring out what is meaningful for each person,” says Swanson.
“The important thing to remember is that throughout a person’s life there are a number of opportunities for buffers that can continue to help offset the adversity they experienced in childhood.”
Interested in learning more about preventing and responding to early childhood trauma? Read this recent article about California’s work to launch universal early childhood trauma screenings.
Exploring a Nonbinary Approach to Health
NICHQ is not abandoning the traditional use of the terms “mother” and “maternal.” We are embracing the inclusive language of “birthing person/people” across our work. A move toward inclusive language does not force us to stop using language that so many people identify with; at its core, inclusion is about creating more space for one another. We are taking care to expand the use of these terms in our communications, on our website, in our resources, and eventually, in all our projects.
NICHQ Employee Spotlight: Olivia Giordano
Olivia Giordano, MPH, Project Manager shares how her work with NICHQ’s Supporting Healthy Start Performance Project (SHSPP) is supporting 101 Healthy Start community sites to harness lessons learned, implement innovative approaches to improvement, and ultimately start to close the disparity gap in maternal and child health.
It Starts with Us and It Starts Now: Healing for Moms and Babies Begins with Ourselves and Our Systems
NICHQ CEO Scott D. Berns, MD, MPH, FAAP shares a message on healing and the ongoing need for equity-designed systems in 2021 and beyond.
Safe Sleep and Breastfeeding Initiative Invites Advocates to Join Communities of Practice
A multi-year initiative to improve infant safe sleep and breastfeeding is launching sector-specific Communities of Practice in 2021 to address policies, improve skills, and learn from other advocates’ experiences.
Top Equity Resources for Pursuing Change in 2021
Throughout this year, it has become clearer to many that the hard truth of the racism that shaped our nation requires us all—now, today—to acknowledge and address its impact in our health care systems and in ourselves. That's why we're sharing a collection of NICHQ articles and webinars that your community found most valuable in their equity journeys.
The Top Ten Children's Health Stories of 2020
In the final weeks of 2020, we’re looking back at our most popular articles of the year. From supporting children's health during the COVID-19 pandemic to pursuing equitable health systems, here’s a rundown of the top ten NICHQ articles you found most engaging over the past year.