The damage done by childhood abuse — and new insights into recovery

A landmark study of the lasting and destructive effects of childhood trauma provides guidance with the potential to significantly improve the well-being of untold millions of people who have been, or will be, abused, neglected or similarly harmed. And the financial savings could be dramatic.

“The implications are revolutionary,” says David S. Lauterbach, a trauma expert who is president and CEO of the Kent Center, in Warwick. “When you think about the long-term permutations, it boggles the mind. So many of the issues that we’re facing as a world have to do with the damage that we’ve done to human beings and to developing brains.”

The study, by the federal Centers for Disease Control and Prevention in collaboration with Kaiser Permanente, the giant California-based health-care consortium, explored the backgrounds and present status of more than 17,000 mostly middle-class San Diego-area adults who are Kaiser members.

Describing it as “one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being,” the CDC has issued a call to action.

“It is critical to understand how some of the worst health and social problems in our nation can arise as a consequence of adverse childhood experiences,” the agency writes on its web site. “Realizing these connections is likely to improve efforts towards prevention and recovery.”

The heart of the study is a set of 10 types of childhood trauma that, if left unaddressed, increase the risk of mental illness, alcoholism, drug abuse and other behavioral disorders. The risks also rise for social problems such as homelessness, prostitution and unemployment — and even physical illnesses including cancer and diseases of the heart, lungs and liver.

These 10 so-called Adverse Childhood Experiences, or ACEs, are:

— Physical abuse

— Sexual abuse

— Emotional abuse

— Physical neglect

— Emotional neglect

— Mother treated violently

— Substance abuse in the home

— Mental illness in the home

— Parental divorce or separation

— Incarcerated household member

Each experience counts for an ACE score of one. Multiple experiences by the same child raise the ACE score incrementally — and as the score rises, the chance of mental, physical and social disorders later in life increases exponentially, the researchers found. The ACE researchers studied mostly well-educated middle-class people, but they and others believe that poverty compounds the effects of childhood trauma.

Citing the CDC/Kaiser study and other research, the American Academy of Pediatrics describes the physiology of childhood trauma, which affects the still-maturing brain and other body systems:

“While some stress in life is normal — and even necessary for development — the type of stress that results when a child experiences ACEs may become toxic when there is ‘strong, frequent, or prolonged activation of the body’s stress response systems in the absence of the buffering protection of a supportive, adult relationship.’

“The biological response to this toxic stress can be incredibly destructive and last a lifetime …. A child who has experienced ACEs is more likely to have learning and behavioral issues and is at higher risk for early initiation of sexual activity and adolescent pregnancy. These effects can be magnified through generations if the traumatic experiences are not addressed. The financial cost to individuals and society is enormous.”

How enormous?

The federal Substance Abuse and Mental Health Services Administration estimates the collective costs of “unaddressed” childhood trauma at $103.7 billion annually — roughly the equivalent of $425 a year for every U.S. resident 18 or older.

Lauterbach is campaigning to have the state Department of Health make reducing childhood trauma a public-health priority.

“If we started having some thoughtful public education on this, we would touch the pediatricians, we would touch the primary-care providers, we would touch the school teachers, we would touch the administrators,” Lauterbach says.

“Think of the problems we would impact if we had a consistent birth-through-21 health curriculum that made all our practitioners aware of this so we could identify the factors and begin to remediate them early on.”

Read about the ACE study at: www.cdc.gov/violenceprevention/acestudy/index.html

The American Academy of Pediatrics’ report “Adverse Childhood Experiences and the Lifelong Consequences of Trauma”: www.aap.org/en-us/Documents/ttb_aces_consequences.pdf

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