I was assigned some courses on ACEs and there was a great TED talk on the subject. Here are links to what I was to use in preparation for answering the questions below. I highly recommend the training, it was great!
The questions were simple, and were meant to be a basic reflection of learning posted in a group discussion.
Discuss your thoughts about what you have learned about ACE's. Did you know anything about them before this week's assignments?
I did know about ACEs before completing this week's assignment(s), and I have always felt very fortunate to have had a childhood that resulted in the score I have for ACEs. I first learned about ACEs in 2016 when my sister in law was completing her third master's degree - yep third. She is a Vice Principal now, but was initially a special education teacher, then a grade school principal in a school district filled with kids from socioeconomically challenged homes. The average ACE scores for the kids in her elementary school was seven. Seven!!
She was discussing it with me in 2016, and I had not heard of ACEs before, that I recall. What she shared with me, and learning about ACEs, inspired me to learn as much as I could about SDOH. I eventually went on to write my master's thesis with a focus on teaching nursing students about SDOH, and for my capstone I developed a curriculum for nursing students to learn about SDOH and I addressed ACEs and the correlation between SDOH and ACE scores throughout the curriculum.
If so, did you learn anything new?
I actually did learn something new this go-around. I did not realize that the ACEs are strongly considered preventable - I mean - I guess maybe cynically speaking, I did not feel empowered to succeed in preventing most ACEs. According to Centers for Disease Control and Prevention [CDC] (2023), "...we must understand and address the factors that put people at risk for or protect them from violence. Creating and sustaining safe, stable, nurturing relationships and environments for all children and families can prevent ACEs and help all children reach their full potential" (para. 13).
Who knew? "...can prevent ACEs..." I certainly didn't know.
How will what you learned affect how your provide care for your pediatric patients?
I suppose this new awareness entreats me to gather as much information as I can about school, community, government, and private resources that I can share with pediatric patients and their parents/caregivers, when I recognize signs of ACEs in my patients.
According to the Cleveland Clinic (2023), signs of an adverse childhood event can include:
- Fear of other people
- Difficulty sleeping or frequent nightmares
- Bedwetting
- Changes to their mood
- Difficulty showing affection towards friends or family
- Avoiding situations or events that relate to a traumatic experience
- Difficulty learning in school
But what are the warning signs before an ACE occurs?
There aren't really warning signs, as much as there are common risk factors. The Cleveland Clinic (2023, para. 9) indicates the common risk factors for ACEs include:
- children assigned female at birth
- minority racial or ethnic groups
- children with socioeconomic challenges
- children of caregivers who experience stress
- children who have family members/friends with substance use disorder or other mental health condition
And although "ACEs are common across all populations," (CDC, 2021, para. 13), I will be more likely to help prevent ACEs for my patients if I:
- maintain awareness of the most common risk factors
- identify the risk factors during my assessment of the patient
- intervene to extirpate the risks I can identify
What I learned from this assignment, will strongly impact my practice moving forward, and ultimately benefit the patients that are in my care.
References
Centers for Disease Control and Prevention (CDC). (2023, June 29). Fast facts: Preventing adverse childhood experiences. Violence Prevention. https://www.cdc.gov/violenceprevention/aces/fastfact.html
Centers for Disease Control and Prevention. (2021, April 6). About the CDC-Kaiser ace study. Violence Prevention. https://www.cdc.gov/violenceprevention/aces/about.html
Cleveland Clinic. (2023, April 4). Adverse childhood experiences (aces) & childhood trauma. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/24875-adverse-childhood-experiences-ace
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