This article has been taken from the spring 2015 edition of “Apple” magazine, published by Alberta Health Services.

When ACEs are too high

Toxic stress can make it harder for children to reach their potential

Experiences shape our brains. A landmark American study in the 1990s found that the more adverse childhood experiences (ACEs) a person has, the higher the risk later in life of health and social problems. Dr. Rob Anda, a co-investigator of the study now with ACE Interface, calls ACEs “a pathway to disease.”

A recent study by the Alberta Centre for Child, Family and Community Research grouped ACEs into three categories: abuse, neglect and family dysfunction before the age of 18.

The effect of childhood adversity depends on the support and care children have from adults. When an adult helps a child in a sensitive way, adversity may have no effect at all. For example, a preschooler may get upset when his parents argue, but their occasional disagreements probably won’t have any permanent effect on his brain, especially if he sees them make up. On the other hand, if his parents are constantly and bitterly fighting about money and ignoring him, this is an example of an ACE and can lead to brain-altering toxic stress.

Growing up, we all need to experience positive and tolerable stress. These types of stress help us learn how to cope with life’s ups and downs. But when stress becomes toxic because of abuse, neglect and family dysfunction, it becomes harmful to young brains. And when toxic stress changes brain architecture, children and young adults have a harder time reaching their potential and can face a number of problems as adults.

Understanding your adverse childhood experiences may help you understand your past—and your health

People with three ACEs or more are more likely to use drugs at an early age, have a teenage pregnancy, develop a drug or alcohol addiction, or marry someone with an alcohol addiction. They are also more likely to have a lifetime history of depression or attempt suicide. Liver disease, heart disease, stroke, diabetes, chronic lung disease, chronic pain and irritable bowel syndrome are also linked to ACEs.

While it is clearly better to prevent and avoid ACEs, Anda says when people know their ACE score—become trauma-informed—it can give them a chance to write “a different narrative” about their lives and to “create a different path for the future . . . with hope, meaning and purpose.”

“It’s not what’s wrong with you,” he says. “It’s what happened to you.”

Sheila McDonald agrees. An epidemiologist with the Department of Pediatrics at the University of Calgary and lead researcher with the Alberta Centre for Child, Family and Community Research ACEs study, she says: “Adversity is part of life and the human condition. You can’t change your past but you can understand it better.”

Understanding ACEs may help you understand your past—and your health.

— Terry Bullick


ACEs explained

Adverse childhood experiences include, but are not limited to when:

  • An adult in a child’s home makes verbal insults or threats
  • An adult physically abuses (injures or bruises) a child in his home
  • An adult or someone five or more years older makes inappropriate sexual advances to or contact with a child
  • A child sees her mother or stepmother being treated violently (pushed, grabbed, slapped, had something thrown at her, kicked, bitten, hit)
  • Someone in a child’s home abuses alcohol or drugs, is depressed or mentally ill, or has a disability that limits or interferes with daily activities
  • A child is often bullied
  • A child often feels unloved, afraid and isolated
  • A child’s parents separate or divorce.

ACEs affect children in different ways and many children with multiple ACEs grow into adults with no ongoing health problems. ACEs are common, says psychologist Keith Dobson of the Alberta Aces Program. About 70 per cent of Albertans have had at least one ACE.

This fall, the Alberta ACEs Program will test an ACEs treatment approach with 8,000 patients and their family doctors.

To learn more about ACEs visit:

If you have questions about your health, call Health Link Alberta at 1-866-406-LINK (5465) or the AHS Addiction and Mental Health Line at 1-866-332-2322.

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