What are examples of ACEs? (Adverse Childhood Experiences)

ACEs are associated with a range of poor health and social outcomes in adulthood — according to the original US study and subsequent studies, including in England and Wales.

ACEs can increase an individual’s risk of developing a range of harmful behaviours: 

• high-risk drinking
• smoking
• under-age sexual activity
• drug abuse

These behaviours in turn increase the risk of poor physical and mental health in later life, including: 

• cancer
• obesity
• heart disease
• diabetes
• depression and anxiety
• and negative social outcomes like low levels of education, incarceration, and domestic violence.

Not everyone experiences the same harmful outcomes from ACEs. 

Children and adults who function well despite experiencing ACEs demonstrate resilience. Resilience is the ability to overcome serious hardships. It is often described as being able to bounce back.

But we shouldn't think of resilience as individual capability. Supporting families, building healthy communities and addressing social inequalities are vital in helping individual children and communities to develop resilience.

As part of the A Better Start Programme, LEAP is improving the life chances of children through early years intervention. We are focusing on key outcomes, including social and emotional development and communication and language.

We believe that supporting development in these areas can help reduce ACEs, minimise their impact and increase the resilience of those who have experienced them. 

Since early 2018, LEAP has been working in partnership with Lambeth Council to start a conversation around tackling ACEs and promoting resilience in the borough. We started this process with a film screening of Resilience, exploring the science behind ACEs and how interventions can support resilience. After the screening, a panel of experts discussed the issues. Over 200 Lambeth professionals attended, demonstrating significant local interest.

As a result of the event, LEAP and Lambeth Council convened a group representing key Lambeth services — including schools, police, the youth offending service, public health, community organisations, early help, GPs and many more. The group discussed ACEs and their relevance to services in Lambeth, considering different approaches to prevent and reduce the impact of ACEs. LEAP supported this work by commissioning a comprehensive overview of the evidence relating to ACEs and efforts to tackle them.

LEAP also co-hosted the Lambeth Children’s Safeguarding Board Conference, recording local practitioners views about ACEs. Following this, we undertook a pilot of Trauma-Informed Practice training, which was part of an early-help initiative in the borough. 

As a result of the ACEs-related activity taking place in the borough, Lambeth’s Serious Youth Violence Board is working towards becoming trauma-informed, and LEAP will be a key partner in taking this work forward.

As we work to raise awareness of the impact of ACEs on children and families in Lambeth, we are deeply grateful for the encouragement of frontline staff who see first-hand how traumatic life-events shape a child’s world.

Lambeth Council has plans to embed trauma-informed practice across the early years sector and beyond: 

• Developing broader governance.
• Developing a strategy with local partners.
• Reviewing all policy and procedures through a trauma-informed lens. 
• Embedding training in trauma-informed practice throughout the partnership.
• Embedding trauma-informed supervision as a standard way of working for all practitioners.

LEAP will demonstrate the difference being made for practitioners and ultimately, children and families.

Adapted from a live illustration of conversations at Lambeth Safeguarding Children’s Board Conference, 2018

‘Working in a primary school we engage with children who have faced traumatic experiences on a daily basis. This is a new viewpoint for considering the reasons for their behaviour and how we, as a school, respond to this’ – Primary School Teacher

‘We need to become more ACE informed so that we can build resilience and change the lives of families and the people that we work with and change their outcomes’ – Midwife

‘I think it is very important that health practitioners are aware of the importance of ACEs because we are in a good position to help support children, young people and their parents at these vulnerable times in their lives when they can have an impact’ – GP

‘I hope we see more of a multi-agency approach, and more empathy for families’ – Communication and Language Consultant

‘I think it is really important because many young people in Lambeth are exposed to really serious situations which are effecting them in terms of long-term trauma’ – Youth Worker

Evidence shows that ACEs can increase an individual’s risk of developing health-harming behaviours.

ACEs are experienced by many people, reflecting key stressful events from before birth through adolescence. As explored in this report, adversity in childhood and adolescence can become traumatic and injurious to physical and mental health and wellbeing throughout the life course. 

The lens of ACEs prompts questions over the way we design and deliver services. As detailed in this report, adopting trauma-informed approaches and models of care can help support children, parents and adult survivors of ACEs.

Download the summary report.

For the full report and/or appendix, please contact Angharad Lewis: alewis@ncb.org.uk / 0207 582 4182.