Adverse Childhood Experiences and COVID-19
The COVID 19 pandemic has brought the world to a standstill, with every industry rethinking their ways of production for a healthy sustainable future. The recovery community has been hit hard by COVID-19 with overdoses and substance use on the rise. Job loss, job insecurity, and economic devastation has led to a tremendous increase in relapses and overdoses. The pandemic could also lead to an increase in the amount of adverse childhood experiences (ACEs) in households around the nation. ACEs are traumatic events occurring before the age of eighteen and they include, but are not limited to, emotional, physical and sexual abuse; emotional and physical neglect; growing up in a household where domestic violence occurs; members of a household abuse alcohol and/or drugs; members of a household have a mental illness; and/or members of a household exhibit criminal behavior. Those who have a substance use disorder or addiction of any kind almost always have at least one of the ACEs mentioned. Not all addiction stems from trauma, but the research study created by Kaiser Permanente in the late 1900s, concluded that child abuse and neglect have a lasting effect on the health and well-being of those abused, ranging from heart diseases and obesity to addiction.
Developmental delay and academic risk are main factors to consider when talking about the effects of ACEs on children. Children who have any form of ACEs are 3.4 times more likely than those without any to fail academically, 4.9 times more likely to have attendance problems, and 6.9 times more likely to have behavior problems in school. Toxic stress can disrupt brain development and/or function, and growth which leads to general health problems and addiction in their adult life.
In the mid 1900s, increasing evidence in animal and human studies stated that experiencing especially high or sustained levels of psychosocial stress, primary attachment deprivation and/or maltreatment in childhood severely impacts adult behavior. A research study lead by Emily Zarse states that out of 8,629 respondents who reported experiencing one type of maltreatment also reported at least one type of adverse childhood experience. “Early ACEs can damage later parental attachment, nurturing and protective behaviors, that produce transgenerational cycles of trauma-spectrum neuro-psychiatric illness.” This leads to children growing up and having long lasting problems that lead to addiction.
For each increase of an ACEs score, the likelihood of being addicted to nicotine increases by 20-30%. If an ACE score is greater to or equal to 4, then the chance of developing an alcohol use disorder is 3.72 times more likely than a score less than 4. If parents are misusing alcohol in their homes without any regard to their kids, then the parental relationship with alcohol can accelerate their children’s ACEs score and the risk of addiction and future health problems for their children increase. A higher ACE score also predicts a higher chance of illicit drug use in the future.
ACEs are common across all populations, almost two thirds of study participants reported to have at least one ACE and more than 1 in 5 participants reported having three or more ACEs in a recent 2018 CDC study. There are several ways that the CDC proposes to prevent adverse childhood experiences before they happen. Strengthening economic supports to families is one prevention. Family friendly work policies like paid leave and flexible but consistent work schedules as well as, policies that strengthen financial security in a household such as tax credits, childcare subsidies, and livable wages are only a few ways to help parents that are facing financial hardship combat stress, depression, and conflict in their relationships with family.
Promoting social norms that protect against violence and adversity is another way to prevent ACEs from developing in children. Norms are defined by group level beliefs and expectations about how members of that group behave. Promoting community norms around a shared responsibility for the health and well-being of all children and having safe and effective discipline at home are just some social norms that can protect against adversity. Discipline without any violence (emotional and/or physical violence) is key to producing a household in which a child feels safe and protected. We need to teach kids at a young age what is okay and what is not okay in relationships with family and intimate partners. So many parents are uncomfortable with having those uncomfortable conversations with their kids, but those conversations need to happen to foster safe norms. Parents also need to be good role models in their own relationships. Lastly, public education campaigns and other legislative approaches can help shift the narrative away from individual responsibility to responsibility for the whole community to foster nurturing environments. They can reduce corporal punishment and can help establish norms around safer, more effective discipline strategies.
Children and youth with ACE exposures may show signs of behavioral and mental health problems and knowing the signs of depression, acting-out behaviors, difficulty sleeping and/or concentrating or showing other traumatic stress symptoms can be an avenue for early intervention and assessment. Timely access to assessment and intervention can prevent and help children who are showing signs of adverse childhood experiences, so they do not grow into adults who are unable to process those emotions. Without intervention and the extreme likelihood of unprocessed emotions, children can then go on to develop substance use disorders in adulthood. Therapeutic treatments like Parent-Child Interaction Therapy, Alternatives for Family – Cognitive Behavioral Therapy (CBT), Individual CBT, Trauma Focused CBT, and/or Dialectical Behavioral Therapy can help parents and children improve their relationship with each other as well as help prevent children with ACEs cope with traumatic stress in a way other than engaging in unsafe coping mechanisms like drugs and alcohol when they grow older.
With kids being home from school and everyone self-isolating at home during the pandemic, it is predicted that ACEs scores are going to increase. Firstly, living in a pandemic and normal life being disrupted is an adverse childhood experience in and of itself. Children must learn a new routine of homeschooling and working online, their parents watching over them all day, and not being able to socialize with friends are all adverse effects that can cause traumatic stress. Secondly, on top of having to homeschool, if parents drink or do drugs, are violent and/or have mental health problems then kids are not going to able to get away. Sometimes school is their only safe space and being home every day is going to accelerate any adverse childhood experiences. Therefore, the prevention methods mentioned above need to be implemented even more in crises like the COVID-19 pandemic and everyone needs to be educated on how this time period can affect our children.