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Adverse Childhood Experiences

 The biology of ACEs

The first large scale population study to link childhood adversity to poor adult health outcomes was completed by a partnership between the CDC and Kaiser Permanente in the mid-1990s. This study identified 10 specific childhood experiences (listed below) linked to a long list of chronic health conditions including heart disease, cancer, diabetes, and even depression. 

From a sample size of approximately 17,000 insured adults living in Southern California, the study revealed that Adverse Childhood Experiences (ACEs) are increadibly common, with 64% of the population having experienced at least 1 ACE. The study also discovered that the more ACEs a person had, the higher their risk for developing severe health complications as adults.  

10 ACEs

3 types of abuse: Physical, emotional, sexual

2 types of neglect: Physical, emotional

5 types of household dysfunction: 

Parental divorce or separation

Witnessing household violence

Incarcerated household member

Household member struggling with substance abuse

Household member struggling with mental illness

Helpful infographics



Toxic Stress

How does childhood adversity lead to poor adult health outcomes? This happens through the exposure to toxic levels of stress. Excessive or prolonged activation of the stress response system-- fight, flight, or freeze-- of a developing child can lead to structural changes in the brain as well as changes to other systems in the body. Exposure to toxic stress can lead to the development of behavioral coping skills meant for survival in unstable environments. Often, these coping skills, such as hyper-vigilance, are witnessed by adults as behavioral problems which are deemed disruptive in environments such as school. 

Helpful videos: 

Harvard Center on the Developing Child: Toxic Stress Overview

TED Talk by Dr. Nadine Burke-Harris

Resilience is Hope

Resilience is the ability to adjust or 'bounce back' after something bad has happened. It is the buffer to life's adversity and it can be developed and strengthened throughout life. 

 Snohomish Health District published a report on the local impact of ACEs in 2011 (PDF).

 Making Changes Today Can Improve A Child's Tomorrow (PDF)

Developing Resilience

Resilience  is the ability to adjust or “bounce back” after something bad has happened.

There are three core elements proven to increase resilience and protect children from the long-term effects of childhood adversity:


  • Nurturing relationships
  • Opportunities to develop one’s abilities
  • Connections to a supportive group

The Everett Public Library has compiled a children’s book list of 31 titles that demonstrate resilience. Organized by age group—Babies, Toddlers and Preschoolers—the list provides a brief description to help you and your child find the right fit.

(click to enlarge and print)

Reading to your child can support a nurturing relationship that can last a lifetime, and the books provide the opportunity to teach children how to talk about and manage their emotions to develop resiliency.

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