With South Carolina ranked No. 42 nationally on indicators of child well-being, Children’s Trust has launched a statewide initiative using the Adverse Childhood Experiences (ACE) Study to address the correlation between child maltreatment and poor adult health and social outcomes. Neil White recently talked to professionals attending an ACE training session hosted by Children’s Trust about the importance of this work.
A few years ago Kristine Hobbs first heard about the negative health issues in adults being linked to their adverse childhood experiences. She soon began to share this information in her job with the South Carolina Department of Health and Human Services.
As a mental health integration coordinator who works with pediatric practices to make mental health as routine as physical health, Hobbs immediately understood the ACE Study’s connection of childhood abuse and family dysfunction to a multitude of health and social problems later in life.
“This study shows us we can’t grow into physically healthy adults if we’re not focused on these early experiences,” Hobbs said. “That’s what got me hooked on the study. It was a way to link physical health to emotional health. My job is to get pediatricians to look at mental health issues of kids and families they serve.”
Hobbs has joined Children Trust’s initiative as a volunteer ACE master trainer to better inform individuals who have an interest in the study and want to take this information back to their workplaces and communities. The sessions aren’t just for professionals like social workers, medical workers, teachers, counselors and policy makers, however. They’re for any person who cares about the health and well-being of their community.
Master Trainers engage in a session on adverse childhood experiences at the Children’s Trust office.
By using data collection and dissemination, building a prevention framework, and promoting sound legislative policy, Children’s Trust looks to address how child maltreatment impacts a range of populations not limited to a specific geographic region, race or ethnicity, or socioeconomic status. Through the organization’s work, it knows that child maltreatment is common, related to a number of other issues that include substance use and poverty, and can be passed down from one generation to the next.
The work in South Carolina builds upon the original ACE Study, ongoing collaborative research between the Centers for Disease Control and Prevention in Atlanta and Kaiser Permanente in San Diego. The research starts with an ACE score calculator, a list of 10 questions that gives one point for each affirmative answer for exposure to childhood trauma. The points are added for a score of 0 to 10, with higher scores denoting greater risk of negative health and social outcomes as adults.
The BlueCross BlueShield of South Carolina Foundation, which also recognizes these profound connections between ACEs and negative health outcomes, awarded a $325,000 grant to Children’s Trust to support the ACE Initiative over the next three years. Dr. Melissa Strompolis, who directs research and evaluation at Children’s Trust, is guiding the initiative on ACEs in this state.
Melissa Strompolis leads a session on ACEs at the 2015 Prevention Conference.
“We know that child maltreatment not only has enormous economic costs, but is associated with large and powerful health and social costs,” Strompolis said. “Given that we know a lot about child maltreatment, the causes, associations, and effects, that also makes child maltreatment preventable.”
Hobbs likes how the information allows child-serving professionals to think strategically about building a healthier future for the next generation. Other trainers share her enthusiasm for what’s starting to take place in ACE sessions across South Carolina.
Pat Patrick, the director of S.C. Families First for the Department of Social Services, can see awareness growing as he relates how children exposed to trauma like physical and emotional abuse, substance abuse, and domestic violence can become adults with problems like depression, alcoholism, heart and liver disease, and STDs.
“I see the kind of a-ha moment, when the light bulb goes off, among staff on how this in many ways is what’s missing in our work with children and adults,” Patrick said. “It helps people to understand how the root cause of many (health and social) issues we deal with are related to those adverse childhood experiences.”
The trainers drive home four points: ACEs are common, ACEs are interrelated, an accumulation of ACEs has an enormous impact on public health, and ACEs are preventable. That final point is a key one for those involved in this work.
Jenah Cason, Federation of Families for the Children’s Mental Health of South Carolina
Jenah Cason, the youth outreach coordinator for Federation of Families of South Carolina, believes this focus on ACEs can provide a new framework for people to view their experiences.
“It allows them to have some hope in the ability that they can change some things to allow some healing,” Cason said. “These are things that we can do to help ourselves and help our community to prevent this from continuing to be an issue.”
Her organization works with families who have children with behavioral health needs, and in many cases, they include family members who have had their own ACEs.
“This can help them connect with what they need to think about and put things like the protective factors in place for their children,” Cason added.
Cason likes how the ACE score calculator exercise puts the work into perspective for trainers, who can see just how common ACEs are and the light they shed light on what’s needed for change. That also allows trainers to be more compassionate about the people they serve.
Candice Lively, Children’s Law Center
Candice Lively, a senior resource attorney with the Children’s Law Center at the University of South Carolina, wants to bring a greater perspective to law enforcement and child-welfare officials in her training sessions as they deal with children who have ACEs. She believes they can play a significant role in healing while building both resiliency and community trust.
“One of the things they need to understand is that by looking at these children and their situations how they can be more empathetic in responding to them,” Lively said. “It’s not one of these things where they should have a knee-jerk reaction in disciplining and controlling these children. It’s more of sitting down and talking about what has happened to them instead of what’s wrong with them.”
Strompolis realizes the Children’s Trust goals of increasing statewide awareness of ACEs, facilitating local and state prevention efforts, and having an impact on local and state policy can’t be achieved without the strong commitment of its 26 master trainers, a number that continues to grow, recruited from various agencies and organizations.
“Given everything that we know about child maltreatment, we know we can’t do it alone,” Strompolis said. “The issue is so complex and connects to so many other issues and organizations that we need a coordinated and collaborative response to improve multiple facets of child and family health and well-being.”
