Adverse Childhood Experiences (ACEs) and Toxic Stress (Nursing)

00:00 So, now I'd like to move into adverse childhood experiences. The reason why I would like to step aside and look at adverse childhood experiences is because these experiences actually have an impact on the psychological development of the child throughout their lifetime and as we go through ACEs or adverse childhood experiences, you're going to be noticing how these experiences not only affect the child psychologically, but they have a physical component that is going to start this child in a trajectory of ill health throughout their lifetime. So, ACEs are experiences that a person has in their childhood that permanently alter the future of that child and alter it in a negative way. The ACEs might be trauma; it might be physical, sexual, or emotional abuse; it could be loss of a parent either thru divorce or thru death or thru immigration. The child who is exposed to domestic violence also has a higher likelihood for ACEs. If a parent has mental illness, that child is growing up in a household where they are being exposed to some trauma. If a parent or adults in the house are using substances, drugs, or alcohol, that child again has that exposure which increases the likelihood of ACEs. And if a parent or a significant other of the child is put in prison, is incarcerated, again the likelihood of ACEs increases. ACEs really is a way of saying exposure to toxic stress. It provides this emotional as well as a physical impact in this exposure to trauma and it's trauma that is not looking at having any impact of support or health, so the child is actually helpless. And without having the power of being an adult, they are not only helpless but they are truly powerless. This can lead not only to the chronic emotional issues, but also chronic health issues. Children depend on the adults that they live with. They depend on them for food, for support, for housing, for love, and when they are growing up in environment that is a desert of these things, the child is not going to be growing up with a healthy outlook. The child is going to be learning how to cope in an incredibly toxic stressful environment. So, what we see is that there is an increase in depression in these children, that there is an increase in asthma and think about the fact that depression is not something they're going to pass thru in childhood. But without help, without treatment, depression, asthma, diabetes, the development of conduct disorder, the engagement in risky behavior, these are issues that end up even getting worse escalating into other health issues as the child gets older.

04:17 These children are learning how to cope in a situation that is intolerable and so their coping mechanisms are not coping mechanisms that are actually going to help them when they get to be adults. Their coping mechanisms that are just going to help them get through this day may be through this half hour as they hear screams and yells of someone being beaten in the room next door. Unfortunately, living under this level of toxic stress makes it impossible for these children to develop any healthy coping mechanisms. Healthy coping mechanisms would increase the person's ability to ask for help. Without that, it increases the possibility and likelihood that this child is going to grow up using drugs, abusing and using alcohol and other substances, getting involved in criminal behaviors, and even leading to incarceration. Also associated with this toxic stress environment is a shortened life expectancy because these children grow up and they have chronic medical illnesses.

05:44 Their maladaptive coping mechanisms like smoking and drinking like engaging in risky behaviors because it doesn't matter any way ends up cutting off years and sometimes even decades of their life.