Section 2: Researching the Lifespan
2.5 Putting it together: A Research Example–ACEs
Diana Lang; Human Development Teaching and Learning Group; and Jennifer Ounjian
What Research Led to the Development of ACES?
Adverse Childhood Experiences (ACEs) research primarily revolves around identifying and understanding the impacts of various forms of childhood trauma on long-term health and well-being. These methods and designs help researchers develop a comprehensive understanding of ACEs, their prevalence, and their profound effects on health and well-being across the lifespan.
On this supplemental page, we will explore the different types of research that went into developing the concept of ACEs, how it is measured, and its impact.
We will cover ACEs in depth when we look at Psychosocial Development in Early Childhood.
What are ACEs?
The term Adverse Childhood Experiences (ACEs) is defined as a traumatic experience that happens to someone before the age of 18 years that the person “recalls” as an adult (Centers for Disease Control and Prevention, 2019).
ACEs can include sexual, psychological, or physical abuse. ACEs have been linked to premature death and various health conditions and risks (Center on the Developing Child at Harvard University, n.d.).
To determine your own ACEs score, visit this website to take the Adverse Childhood Experiences Quiz.
Key Features of ACEs Research Design
All of the research done on ACEs and the instruments developed to measure ACEs have some key features that have enhanced and reinforced the theory.
- Multidisciplinary Approach: The body of research combines insights from psychology, public health, medicine, sociology, and other fields.
- Focus on Both Prevalence and Impact: Studies assess how common ACEs are in various populations and lead to our understanding of their short-term and long-term effects.
- Consideration of Resilience Factors: Researchers identified factors that might mitigate (reduce) the negative impacts of ACEs and promote resilience.
ACEs Research Overview
Here are examples of some of the different research methods used to study ACEs. Each type of research brings its own strengths to further our understanding of ACEs in unique ways. Not any single study could provide all of the evidence needed to support the theory.
Epidemiological Surveys
- Population-Based Surveys: Large-scale surveys, such as the original ACE Study conducted by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente, collect data from large, diverse populations to identify the prevalence of ACEs. (Felitti et al., 1998)
- Cross-Sectional Studies: These studies collect data at a single point in time to identify the prevalence and correlations between ACEs and various health outcomes.
Longitudinal Studies
- Prospective Cohort Studies: These studies follow individuals over time, starting from childhood, to observe the long-term effects of ACEs on health and behavior (Danese et al., 2009).
- Retrospective Cohort Studies: These studies look back at existing data or use historical records to study the impacts of ACEs on adults’ current health (Anda et al., 2008).
Correlational Studies
- Researchers compare individuals with certain health outcomes (cases) to those without (controls) to assess the association between ACEs and specific conditions or behaviors (Whitfield et al., 2003).
Qualitative Research
- Interviews and Focus Groups: Collecting detailed personal accounts from individuals who have experienced ACEs to understand the nuanced impacts of trauma (Kalmakis & Chandler, 2014).
- Content Analysis: Analyzing qualitative data from interviews or written narratives to identify common themes and patterns related to ACEs.
- Synthesis of Existing Research: Aggregating and analyzing data from multiple studies to draw broader conclusions about the impacts of ACEs and the effectiveness of interventions.
Experimental Studies:
- Randomized Controlled Trials (RCTs): Testing the effectiveness of interventions designed to mitigate the effects of ACEs or prevent them (Murphy et al., 2014).
- Quasi-Experimental Designs: Evaluating interventions in real-world settings where random assignment may not be feasible.
Findings
Several studies have shown that ACEs are associated with health-related risk factors such as substance abuse, risky sexual behavior, obesity, cardiovascular disease, cancer, and diabetes (Ximenes et al., 2019.) Having multiple ACEs is an important risk factor for several unfavorable health outcomes, including early death. The research suggests that the impact of these adverse experiences in childhood on adult health status is strong and cumulative (Ximenes, et al., 2019).
Best-practice recommendations for preventing ACEs entail reducing child abuse and neglect by:
- Strengthening economic support for families,
- Supporting parents via education about positive parenting techniques,
- Providing high-quality care and education immediately following a child’s birth,
- Improving parenting skills to enhance healthy child development and well-being and;
- Providing early interventions to reduce adverse effects and prevent future risks (Centers for Disease Control and Prevention, 2020).
Attributions
Individual and Family Development, Health, and Well-being by Diana Lang, Nick Cone; Laura Overstreet, Stephanie Loalada; Suzanne Valentine-French, Martha Lally; Julie Lazzara, and Jamie Skow is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License,
References
Anda, R. F., Brown, D. W., Dube, S. R., Bremner, J. D., Felitti, V. J., & Giles, W. H. (2008). Adverse childhood experiences and chronic obstructive pulmonary disease in adults. American Journal of Preventive Medicine, 34(5), 396-403.
Center on the Developing Child at Harvard University. (n.d.). What are ACEs? And how do they relate to toxic stress? https://developingchild.harvard.edu/resources/aces-and-toxic-stress-frequently-asked-questions/
Centers for Disease Control and Prevention. (2019). About adverse childhood experiences. https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/aboutace.html
Centers for Disease Control and Prevention. (2020). Prevention Strategies. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau. https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/prevention.html ↵
Danese, A., Moffitt, T. E., Harrington, H., Milne, B. J., Polanczyk, G., Pariante, C. M., … & Caspi, A. (2009). Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers. Archives of Pediatrics & Adolescent Medicine, 163(12), 1135-1143.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., … & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245-258.
Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., … & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health, 2(8), e356-e366.
Kalmakis, K. A., & Chandler, G. E. (2014). Health consequences of adverse childhood experiences: A systematic review. Journal of the American Association of Nurse Practitioners, 27(8), 457-465.
Murphy, A., Steele, H., Dube, S. R., Bate, J., Bonuck, K., Meissner, P., … & Steele, M. (2014). Adverse childhood experiences (ACEs) questionnaire and adult attachment interview (AAI): implications for parent-child relationships. Child Abuse & Neglect, 38(2), 224-233.
Whitfield, C. L., Anda, R. F., Dube, S. R., & Felitti, V. J. (2003). Violent childhood experiences and the risk of intimate partner violence in adults: assessment in a large health maintenance organization. Journal of Interpersonal Violence, 18(2), 166-185.
Ximenes, R. de B. B., Ximenes, J. C. M., Nascimento, S. L., Roddy, S. M., & Leite, Á. J. M. (2019). Relationship between maternal adverse childhood experiences and infant development: A systematic review (protocol): A systematic review (protocol). Medicine, 98(10), e14644. https://doi.org/10.1097/MD.0000000000014644
