Adverse Childhood Experiences (ACEs) Public Education Campaign

Childhood adversity impacts everyone by reducing the human potential of future community members and imposing high costs via crisis interventions. Child abuse is preventable when families are supported, children are empowered, and institutions follow best practices. Recovery from childhood adversity happens every day and is possible. 

If our community is serious about preventing youth substance abuse and addressing youth mental illness, we have to get serious about preventing and addressing childhood adversity. ACEs involve child abuse, neglect, and family dysfunction, and are well-established risk factors for bad outcomes like alcoholism and suicide attempts. Most households at all income levels are impacted by the effects of childhood adversity: 46% of children and 61% of adults have at least 1 ACE.  Females and racial & ethnic minorities are more likely to experience 4 or more ACEs. 

The CCPTA has called for an effective ACEs public education campaign in Arlington as follows:

1. Prevent ACEs

   • 50% of ACEs occur from age 0-3, so a campaign of prevention needs to focus on educating parents of young children. The campaign should:

     1. • Reach parents where they already are, rather than require overwhelmed parents to attend a class. Prenatal clinics, diaper banks, and weekend mornings in the parks are good places to start. 

        • Condense messaging into 1 minute, 5 minute, or 10 minute segments and offer a choice to the audience.

        • Target parents of all income levels - families with financial resources also neglect and abuse children.

        • Coordinate with culturally-diverse community leaders to amplify the message within specific communities.

        • Address intergenerational trauma when a parent's own PTSD, ACEs, and cultural norms from their upbringing can lead to continued neglect and abuse of the next generation.

        • Address neglectful parenting styles (~10%) and authoritarian parenting styles (~25%) early. Neglectful parenting is the most damaging style to children, followed by authoritarian parenting. Promote the authoritative parenting style that preserves a child's trust and connection with parents instead. 

   • Conduct an inventory of current County and APS practices to align them with best practices to prevent "institutional abuse," and lead other organizations that supervise children to do the same. 

     1. • Institutional abuse -- harm children experience when they are under the legal supervised care of organizations such as schools, camps, daycares, sports leagues, and religious institutions -- is pervasive. For example, nationally, an estimated 10% of students reported experiencing sexual abuse at school. Abuse by adults represented a significant portion of those incidents. 

        • Abusers not only groom their victims, but they also groom their environment to gain access to victims and develop alibis. Organizations need to recognize and respond to environmental grooming attempts by their staff (even if they passed the background checks) by upholding policies and procedures that maintain appropriate boundaries between staff and children.

        • Train community groups on what the best practices are and how to implement them, scaling them up or down at all levels of organizational capacity.

2. Intervene to Stop Harm

   • The campaign should directly equip middle and high schoolers to understand their own ACEs and ACE-Associated Health Conditions. 9% of U.S. adults have a personality disorder, and some parents with personality disorders are incapable or indifferent to their own child's needs. Not every kid has a well-meaning parent who can try harder. Therefore, the campaign should:

     1. • Teach all students (a Tier 1 universal support) the facts about ACEs and ACE-Associated Health Conditions so that they can notice patterns -- if any -- between their own behaviors, symptoms, and past trauma(s).

        • Teach all students to recognize grooming behaviors and toxic relationships, so that they can be on the lookout for those situations when they encounter them. Expand the efforts of Arlington's Healthy Relationships Task Force to include all forms of relational harm, including among relatives, and including mental and emotional abuse.

        • Screen children for ACEs who are experiencing the most highly correlated ACE-Associated Health Conditions (absenteeism, ADHD, learning and behavior problems, alcohol and drug use prior to 14 years old), even if the student doesn't already qualify for Tier 2 or Tier 3 supports under an educational deficit model. If resources allow, continue screening children with other ACE-Associated Health Conditions (allergies, anxiety, asthma, depression, headaches, repeating a grade, obesity, teenage pregnancy).

        • Consider how to convey information to students raised within an individualistic culture (you are unencumbered by others, you should take the initiative towards opportunities as an agent) versus a collectivistic culture (you should restrain your own needs and adjust and conform to the environment, you seek to belong by acting in accordance with the social group). Arlington is culturally diverse, so messages must be effective among both groups. 

        • Recognize that children with ACEs are motivated by safety, not necessarily self-care. People with higher ACE scores have lower patient activation and less motivation for health promotion activities. Instead, they are hypervigilant about preventing things from getting worse, so targeted messages need to account for these differences. 

        • Inform students of the four parenting styles and encourage them to reflect on which one they are experiencing and what the impact of that style has been on their life.  

   • Teens need physical space that can be a refuge when they do not have comfortable places at home. The County should develop physical "third places" that students can access for free, are easily accessible by transportation, and are safe during extended weekday and weekend hours. Consider re-purposing and dedicating current space at libraries, schools, and community centers, or leasing new space, especially along the orange line corridor where there are no community centers currently. 

3. Mitigate Past Harm

   • The County and APS should follow best practices in handling reports of child abuse by:

     1. • Making reporting prominent and easily accessible -- such as a button on the main webpage -- to signal that reporting is welcome by institutions. 

        • Adopting policies and procedures to address the receipt, evaluation, tracking, and disposition of abuse reports in a centralized manner, so that patterns can be identified. Allow for anonymous reports, but acknowledge the receipt and provide updates for non-anonymous reports. 

        • Adopt formal procedures and criteria for assessing abuse reports, by staff who are not personally involved and who do not supervise persons referenced in the report.

        • Acknowledge staff fear of reputational damage to the institution possibly trumping the protection of children and ensure that staff who bring incidents to light are supported. 

        • Involve occasional external review of how abuse reports are handled to determine whether they are downplayed or whether investigations are adequate. 

        • Evaluate whether mandatory reporting can be streamlined or facilitated to be easier. 

   • Develop and promote a toolkit that children can use on their own. Don't wait to discuss ACEs with a child who is known to have them or who is exhibiting ACE-Associated Health Conditions because the County or APS doesn't yet have enough resources in place for professional interventions. Those kids are already engaged in self-help and coping mechanisms -- they just may not be ones that are visible or helpful. Instead, equip and empower children with strategies that can work while they wait for psychologists, counselors, or social workers to become available. Similar to the "Car-Free Diet" pop-up that engages community members with games and education where people already have gathered, the County should deploy an ACEs pop-up that equips youth and families. Toolkit ideas could include:

     1. • Belly breathing, which can be done at any time for free.

        • Age-appropriate self-help books can be featured for teens at libraries.

        • Journaling in a variety of mediums, which can be done solo. 

        • Development of a moderated, online space for Arlington children affected by ACEs, similar to TrevorSpace for LGBTQ+ children. 

4. Measure the impact 

   • The campaign should determine which indicators to track and set specific goals from the outset, such as:

     1. • increasing the number of child protective services reports

        • increasing the number of investigations completed for alleged child abuse or neglect

        • decreasing chronic absenteeism from school

        • increasing the number of reports received of peer-on-peer abuse (it's counterintuitive to see increases as a positive outcome, but this is based on the expectation that incidents are currently underreported because the perception is that it's pointless to report them, so the goal is to change that perception)

        • decreasing the number or severity of behavioral interventions at schools

        • increasing self-referrals to positive parenting programs and teen mental first aid classes

        • reducing youth drug overdoses and alcohol-related accidents