Toxic Stress and ACEs

Stress is a strange thing. It’s both a feeling (a sense of being under intense pressure or emotional strain) and a mechanism by which the body’s systems respond to those feelings. We hear opposing statements about stress. Either stress is good for us because it motivates us to succeed, or all the stress in our lives in going to kill us… Which one is true? When it comes to stress, it’s a matter of degree. Yes, a little stress is part of human survival. It focuses us, energizes us, and helps us get things done. On the most primitive levels, feelings of danger trigger our body’s autonomic responses, flooding us with the hormones that once allowed us to flee from predators or enemies, or stand and fight them. Although that dramatic response is seldom needed these days, except in extreme cases of danger or sudden emergency, the stress response mechanism is still in place and vital in the rare instances when we need it. But this powerful system that’s built into every human body can be very dangerous—especially to children—when it’s triggered too frequently.

The body has several reactions to extreme danger or fear:
1.) It can embolden us to stand our ground and fight for our survival (FIGHT)
2.) It can trigger the strength and stamina we need to run away (FLIGHT)
3.) It can cause a state of near inertia in some people, thus the phrase “paralyzed with fear” (FREEZE)

It’s often hard to predict which response we’ll have in any given situation. In many cases, it seems that our body innately chooses for us but, in every case, the presence of danger sets off a series of chemical reactions in the body led by the brain and the endocrine (or glands and hormones) system.

The Immediate Effects of Adrenaline and Cortisol

The presence of danger or even severe unpredictability causes the brain to send a message to the glands to release adrenaline and cortisol. Between them, these two hormones do quite a lot to the body in a very short time:
1.) They increase the heart rate which raises blood pressure
2.) They expand the air passages to the lungs, bringing more oxygen to the body
3.) They rush sugar to the bloodstream
4.) They dilate the pupils of the eyes
5.) They prioritize the sharing of oxygen with muscles to give us power we may not know we had. Think about those news stories where people suddenly display incredible strength to save others, by lifting up a wrecked car to save a child, for example. Thank you, adrenaline!

However, adrenaline and cortisol are emergency measures — the last resort response for extreme situations. You might feel exhausted or quite nauseous after an extreme adrenaline dump, for example. That’s because your body is recovering from the intense activation and takes some time to manage and re-balance all the hormones in the blood. The body is always looking for homeostasis, or balance, where all systems are operating normally. Spikes of adrenaline and cortisol severely disrupt homeostasis and that’s a problem.

It’s true that there are good levels of stress. These are short periods of pressure that push us to complete tasks or focus on something we need to achieve. The stress passes and the body recovers quickly. However, when the stress is prolonged or repeated and there aren’t enough positive resources to counteract their effects, stress becomes dangerous and we call that toxic stress.

ACEs and Hormones

So why all this information on hormones and toxic stress? And how does it all tie back to understanding Adverse Childhood Experiences? Dr. Nadine Burke Harris, a pioneer in ACEs research, explains that adrenaline and cortisol are great if you encounter a bear in the woods. “The problem,” she says, “is what happens when the bear comes home single night?”

Continuous and repeated activation of the fight or flight response can “burn out” the system which is not intended to be in constant use. Adults suffer physical health issues if adrenaline and cortisol are released too frequently into their bodies. High blood pressure, chronic inflammation, high glucose levels, and low bone density are just a few of the numerous side effects which can result in:
• Anxiety
• Depression
• Digestive problems
• Headaches
• Heart disease
• Sleep problems
• Weight gain
• Memory and concentration impairment

The Effects on Children

For children, the situation is even worse. When little human brains and bodies are growing, there is a lot to do. The brain is developing at its fastest rate. Brain growth surges for the first 3 years of life, expands rapidly for the next ten years, then plateaus in the early 20s. But during the formative years, the body is using resources like the energy from food to accomplish countless tasks – building muscle, growing bone, honing the senses, and developing coordination and communication skills. With only a finite number of resources available, the brain allocates them to the most immediate and vital needs. In the case of constant fear and danger, the adrenaline process is triggered again and again at the expense of developing other parts of the brain and body.

Since survival must come first, that’s where all the energy goes, neglecting cognitive development and impeding those sectors of the brain vital for reasoning, self-regulation, and ultimately behavior and learning ability for the rest of a child’s life. In many cases, the lost ground is difficult, if not impossible, to make up.

A Life of Fear

So, imagine a child living in a home with domestic violence. He lives with daily uncertainty and apprehension. He is on constant alert, waiting for the next tragic event. He is always in fear of witnessing or being the victim of abuse. When it occurs, he suffers extreme terror and a sense of helplessness. He lives his life in a constant state of toxic stress. The healthy development we owe all children has, in a sense, been stolen from him.

Effects of Toxic Stress on the Body Systems of a Child

Nervous System:
Toxic stress disrupts the developing brain, including changes to the hippocampus, prefrontal cortex, and amygdala. This raises the risk of cognitive impairment, learning disabilities, hyperactivity, poor self-regulation, inhibited memory and attention span, and anxiety.

Cardiovascular System:
Toxic stress increases a child’s risk of developing high blood pressure later in life because it elevates levels of inflammation that can damage the arteries. This can lead to heart disease, stroke, and other serious heart issues.

Immune System:
Toxic stress raises the risk of infections and autoimmune diseases due to chronic inflammation and other factors. This can impair the normal development of the body’s immune system.

Endocrine System:
Toxic stress can inhibit the functioning of hormones that regulate growth and development. It can also lead to obesity and impede or accelerate the onset of puberty.

This is what toxic stress looks like: It’s the relentless fear, anxiety, uncertainty, and terror that can cripple a child’s developing brain and body.

ACEs are not just experiences, they are events that cause chemical disruption in the body and result in lifelong mental and physical health issues. When a child is traumatized, abused, or neglected, we are changing who they are at a cellular level and causing damage from which it is very difficult to recover.

But hormones are powerful agents for good, too. A few months ago, this blog series focused on resilience and how to be a buffer for a child. Science shows that the presence of just one positive adult influence in a child’s life can help mitigate against the detrimental effects of ACEs. How does that work on a cellular level?

The Science of Kindness
As well as hormones that protect us, we have hormones that keep us close as a society. Human beings are communal creatures and we’ve developed to co-operate and help one another. Our bodies are even programmed to want to do this because it facilitates our survival imperative: we are stronger together than we are alone.

Acts of kindness often bring us a good, warm feeling. That’s not just an emotion, it’s a chemical reaction in the body. Kindness or altruism releases a chemical in our blood called oxytocin which sends positive, self-affirming signals to our brain. It’s often called the happiness drug. Oxytocin, along with dopamine and serotonin, make up what’s called the Happiness Trifecta. They increase the production of neurochemicals that lift your mood.

Kindness, care, support, warmth, compassion, and love all release these amazing chemicals which have positive health effects like lowered blood pressure, which reduces strain on the veins and arteries and can help stave off heart disease. These positive chemicals are fast-acting, too. In fact, chemicals resulting from a kind or loving interaction can positively influence the brain in as little as 3 seconds!

Remember a time when you felt anxious or depressed. Think how good a simple hug from a loved one felt at that time. That’s oxytocin! There’s a reason it’s called the “cuddle hormone”. Think about how uplifting an unexpected compliment can feel. That’s dopamine! The Happiness Trifecta help both the giver and the receiver to raise their levels of good, happy hormones. And its these hormones that counteract and neutralize the effects of adrenaline and cortisol.

Every time you have an interaction with a child that’s focused on giving something positive to them–even if it’s a high-five, a thumbs up or a big smile–that’s medicine that works as an antidote to ACEs. It hardly seems possible that it’s also doing great things for your own body, too.

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ACEs and Pregnancy

For many women, seeing a positive result on a pregnancy test is a moment of pure joy, the culmination of months (or even years) of hope, and the start of a fulfilling journey to motherhood. But pregnancy isn’t easy, physically or emotionally. It places extraordinary demands on a woman’s body and may cause stress in relationships, introduce financial hardship, and affect self-esteem. It is undoubtedly the most dramatic and permanent life change most women will ever face.

As wonderful as the prospect of bringing a new life into the world may be, it comes with its own unique set of challenges when viewed through a trauma-informed lens. The two lives of a mother and her growing infant are inextricably intertwined, and stress and trauma can have a startling impact on both. While a mother brings her own childhood experiences to her pregnancy, she may also be encountering new ones, and since the baby is exposed to all the hormones and emotions of the mother during its crucial in-utero development, pregnancy is a critical time to discuss Adverse Childhood Experiences (ACEs).

To discuss ACEs and pregnancy fully, we need to understand it from two points of view.
1.) How ACEs have affected the mother’s life, how they may still be affecting her mentally and physically, and how they might interfere with her ability to nurture and care for her child.
2.) How a mother’s ACEs affect her developing baby and what effects the infant might experience in the womb and during its first few years of life.

A Time of Change and Challenge

Some of the issues a prospective new mom might be going through include:
• identity shifts
• fear of inadequacy as a parent
• loss of independence
• delay or loss of personal goals and dreams
• relationship conflicts
• financial uncertainties
• ambivalence about bonding with her baby
• body image difficulties
• hormonal dysregulation
These issues are especially magnified if the pregnancy is unplanned or unwanted.

In addition to all these new feelings and insecurities, finding out that she is pregnant often focuses a mother-to-be's attention on the concept of parenting. This can bring past traumas to the surface, especially if she was a victim of childhood abuse or neglect. Symptoms of depression, anxiety, or post-traumatic stress may return, or surface for the first time, during pregnancy. It's a tumultuous time and one when the consequences of ACE can be clearly seen but also an opportunity to intervene and hopefully prevent the cycle of ACEs from continuing into the next generation.

For example, a recent study using data from the 2010 Nevada Behavioral Risk Factor Surveillance System showed that a history of childhood stressors, such as physical, sexual, and emotional abuse, influenced alcohol use among pregnant women. The research found a dose–response relationship between ACEs and alcohol use during pregnancy. This study contributes to a growing body of research that shows that the factors affecting alcohol use during pregnancy begin long before fact, they likely begin in the pregnant mother’s own childhood.

Health Risks Associated with High ACE Scores

When adults become parents, the effects that ACEs have had on their own bodies, minds, and behaviors can influence how they experience their pregnancy as well as the physical health of their growing baby.

  • When a pregnant woman is exposed to chronic stress, large amounts of neurohormones are released into her blood stream and can change the developing fetus' own stress response system.
  • Maternal stress hormones can cross the placenta as early as 17 weeks into pregnancy.
  • Women with high ACE scores are more likely to develop gestational diabetes and high blood pressure.
  • They are more likely to deliver prematurely or have a baby that is underweight or requires NICU care.
  • Even when they deliver full-term, their babies are at greater risk for developmental delays.

The good news is that during pregnancy mothers are particularly receptive to ideas on how to positively impact their baby’s life and more open to positive reinforcement about improving their own lives. Pregnancy represents the perfect point to intervene on behalf of both mother and child. Often, just finding out that she is pregnant brings a new sense of hope and determination to a woman. Pregnancy offers the opportunity for her to discuss her own childhood issues, make improvements in her life, and perhaps really confront past traumas for the first time. Pregnant women should be encouraged to openly and honestly ask for support from family and friends. In most cases, once loved ones are aware of past trauma, they respond with concern and compassion, which can be a relief for the mother-to-be and a source of comfort. For some, this may well be the right time to consider counselling or seek professional support, if needed.

Identifying At-Risk Moms

Identifying moms-to-be with high ACE scores is crucial. A simple ACE questionnaire conducted during routine pre-natal care visits can indicate the need for early intervention. This tool can help begin discussion around the concept of ACEs -- that a mom's (and other caregivers') behaviors when the baby is in utero and during its first few years of life can position their baby either for success and wellbeing or for possible lifelong poor health outcomes.

According to a study published earlier this year in the Journal of Women’s Health, when moms-to-be were surveyed at two Kaiser Permanente clinics in Antioch and Richmond, CA, from March through June 2016, clinicians discovered that the women were receptive to filling out an Adverse Childhood Experiences (ACE) survey. The researchers found that the vast majority of the pregnant women — 91 percent of the 375 surveyed— were “very or somewhat comfortable” filling out the ACE survey. Even more, 93 percent, said that they were comfortable talking about the results with their doctors. Simply using the ACE questionnaire as a tool provides an opening for discussion and thus plays a small part in providing a safeguard for the unborn baby and hopefully preventing multigenerational trauma transmission. For the most at-risk women, an intensive course of action might be necessary.

How Can We Protect a Baby in utero When ACE Scores are High?

Providing an at-risk pregnant woman with intensive support and practical resources will benefit her, her baby, and those around her.
The ideal approach would include all or most of the following:

  • Conduct joint counseling sessions with a professional therapist, the mother, the father, and other children in the home. This can be extremely helpful and informative for all involved.
  • Fully integrate behavioral health services with the mother’s medical team to optimize outcomes.
  • Train all medical staff (including pediatricians, midwives, OB-GYN practitioners, and ultrasound technicians) to be trauma-informed.
  • Connect the mother with a nutritionist and other ancillary support services for after she delivers.
  • Encourage the mother to connect with the baby in utero to promote bonding and stimulate mothering instincts.

Center for Child Counseling works extensively to implement some of these best practices. Therapists in our Infant Mental Health Program (funded by the Children's Services Council) provide services throughout Palm Beach County for pregnant women, new mothers, and young children. We also partner with Healthy Mothers, Healthy Babies in their efforts to provide support to all new moms and their babies born in the County.

Research increasingly shows that the connection between a pregnant mother and her unborn baby is even more powerful than previously imagined. While love may be instantaneous and natural for most moms-to-be, it may not be as intuitive for women who have a history of abuse, neglect, or trauma. These mothers can work on building that bond by practicing some loving exercises with their unborn baby.

For example, here are some ideas to help a pregnant woman connect with her growing baby girl:

  • Tell the baby often that she is loved.
  • Share how happy you are that she is a girl.
  • Reassure the baby that you are eagerly waiting to meet her.
  • You are ready to care for her, meet her needs, and protect her.
  • Her birth is welcome. She is good news.
  • Read stories to her, sing to her, and laugh as often as possible.
  • Choose and use silly, loving nicknames for her.
  • Babies seem to respond strongly to music and rocking/swaying. Dance with her.
  • Your voice forms a bond with your baby. Talk to her.

The Role of "Buffers" for Moms and Babies

Since we know that “buffers” are the single greatest weapon in the fight against ACEs, pregnancy is the perfect time to be the buffer for an expectant mom.

Listening, showing genuine concern, and offering love and support is the single greatest gift you can give a mom with a high ACE score.

You might share strengths you see in her. Constantly reassure her that she is a kind, capable, strong woman and that she is going to be a wonderful, giving mom. She does not have to repeat mistakes from her past and can give her baby the gift of a happy childhood, even if she never experienced that herself. Support should come, crucially, from spouses or partners (if they are present), but friends, family members, and neighbors can help, too. Community support is key. Women who connect with no- or low-cost community support programs fare better than those who remain isolated. Mothers-to-be support groups, centering circles, and even children’s reading groups at local libraries are places where pregnant women and new moms can meet and share with one another.

Pregnancy is a time for teamwork at every level. When mothers who have experienced childhood trauma feel supported by the people around them, their risk of pregnancy complications and repeating negative patterns are substantially reduced.

ACEs don’t define who we are or who we will become. Every pregnancy is a brand-new start, a fresh chance to bring a happy, healthy new life into the world. With support, people who have endured ACEs can achieve emotional and physical well-being and be given a better chance to avoid repeating trauma-causing cycles. It is compelling to realize the real difference each of us can make in someone else’s life – simply by choosing to be a kinder, more compassionate, and more giving person.

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ACEs and Minorities

ACEs and Minorities

ACEs can affect anybody, anywhere. Children experiencing adverse situations, and adults who experienced adversity when they were children, come from all walks of life. ACEs are not confined to any particular race, religion, socio-economic background, or nationality. Any child can experience the sustained toxic stress associated with untreated trauma and suffer negative mental and physical health effects.

The original study on Adverse Childhood Experiences conducted by the Centers for Disease Control and insurance giant Kaiser Permanente in the mid-1990s unearthed this fact early in their research. Their study was conducted among 17,000 middle-class Americans living in Southern California. Even though these original participants were not necessarily representative of the average American, approximately half of them had still experienced at least one ACE.

Subsequent US-based ACE studies, including the largest study conducted to date between 2011 and 2014, have consistently shown the same general prevalence of ACEs among American children. This far larger sample group, and the data accumulated from many studies, highlighted some startling differences in who is most likely to suffer from ACEs. Children from minority backgrounds—whether based on race, socio-economic standing, or sexual orientation—were at distinctly higher risk of ACEs and their devastating life-long effects than middle-class white children.

At-Risk Minority Groups

Children of different races and ethnicities across the country do not experience the same exposure to ACEs. In the United States, 61% of black children and 51% of Hispanic children have experienced at least one ACE, compared to 40% of white children. In every part of the country, the lowest rate of ACEs was among Asian children. In most areas, the population most at risk was black children.

Geographic regions also showed different results. Compared to the national average of 1 in 10 children experiencing and ACE score of 3 or more, in 5 states—Arizona, Arkansas, Montana, New Mexico, and Ohio—1 in 7 children had experienced the same.

In Florida, 49% of children between birth and 17 reported no ACEs. 26% reported 1 ACE, 14% reported 2 ACEs and 10% reported 3 or more ACEs. This is generally in line with national averages.

The high occurrence of ACEs among minorities can likely be attributed to the uneven provision of services and opportunities in minority neighborhoods. This inequity is caused by social determinants of health. The World Health Organization describes the social determinants of health as “the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources.” These result in the unfair but avoidable differences in health status seen between different neighborhoods, zip codes, and even states. The social determinants of health are responsible for most health and other social disparities.

ACEs Clusters

ACEs are the result of not only situations children face within their own homes or families but the general circumstances in which they live. Because the impact of ACEs is cumulative, we see high rates in areas where several detrimental situations are occurring simultaneously. For example, a neighborhood where there is a high rate of unemployment, few educational opportunities, a strong gang presence, and high rates of domestic violence is likely to produce children who are suffering from clusters of ACEs. Because of this, ACE studies now look at the cumulative effects of ACEs rather than the individual effects of any one specific ACE.

ACEs caused by the community environments where a child is raised go hand-in-hand with the ACEs occurring in individual homes and within families.

So, ACEs aren’t a racial issue; they’re a societal one. People with low incomes and limited education are also more likely to experience ACEs, as are people who identify as gay, lesbian, bisexual, transgender, or are questioning their gender or sexuality (the LGBTQ community). According to numerous research papers, including one published by the US National Library of medicine/National Institutes of Health, this group has a dramatically higher chance of experiencing childhood trauma, probably the result of lack of understanding among family members, the taboo of discussing these issues in some communities, and the stigma often imposed by society at large.

Helping children in these particular minority groups involves cultural sensitivity and the kind of community education that takes a long time to penetrate established ways of thinking. For many children confronting overwhelming adversity and inequity, buffering relationships are needed. It is essential to address the rejection and hardships they are statistically likely to experience in their lives - with a mental health professional or caring mentor or teacher who understands the impact of these experiences. Success among marginalized groups involves developing strong internal fortitude in children and encouraging them to eventually find accepting, supportive friends, if these relationships are not available at home or school.

It’s clear that minorities, children living in economically challenged neighborhoods, and members of traditionally marginalized groups are in particular need of support in the fight against ACEs.


Now that we know that certain groups are more likely to experience ACEs, what can we do? As individuals and communities, we can channel our efforts. A high ACE score does not predestine a child for poor life outcomes, but it does identify that child as vulnerable. Since the fight against ACEs has two primary weapons, namely 1.) building resilience and 2) promoting healthy relationships (the internal and external supports, if you like), we can provide two practical forms of assistance to targeted groups.

Building Internal Coping Skills

To build resilience in children, they need to be taught how to self-regulate and cope. Anybody can help a child to develop these vital skills. Simple techniques like providing encouragement, supporting special interests, and even just taking notice of a child is, in some small way, building self-esteem and promoting independence and strength. Children will copy the actions of adults, especially those they admire. Showing children how to calmly and fairly negotiate, compromise, demonstrate empathy, and look at all sides of an issue can help them establish a new way of thinking. Remember that children mimic both positive and negative behaviors, so it’s important to carefully consider the messages you’re sending with your behaviors and choices.

Providing External Support Systems

Of course, the most at-risk children may need professional assistance to build effective coping skills and resilience. Offering age-appropriate early intervention and mental health care in childcare centers and elementary schools (especially in at-risk neighborhoods) is the obvious place to start. Center for Child Counseling, with support from local funders including Quantum Foundation, has developed a comprehensive model for childcare centers and schools, including trauma-informed education for all caregivers, classroom-based mindfulness activities, and direct services for children identified as needing assistance. The model focuses on transforming the school environment, which in the long-term, impacts all students.

Another approach is to provide supplemental support systems in at-risk neighborhoods. Many highly-respected nonprofits do just this by creating places where children can meet, play, and be in contact with positive, caring role models and mentors. Local organizations like Urban Youth Impact, the YMCA, Compass, and Big Brothers Big Sisters are all examples of nonprofits in Palm Beach County  focused on creating positive relationships that may be absent from the home.

And, as always, every one of us can play a role in the fight against ACEs by advocating for children, encouraging every child we encounter in our lives, and being on the alert for children who may need the support and help of a caring, ACEs-aware adult.

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ACEs: How to Be a Buffer for a Child

Research shows that just one positive adult can dramatically improve the outlook for a child suffering from Adverse Childhood Experiences (ACEs). Learn how your simple actions can provide a buffer against toxic stress and change the course of a child's life.

Remember when you were a child. Think back. Remind yourself how vulnerable you were. The world was big; you were little. Was there ever a time when someone protected you? For many of us, it was an older sibling, maybe a big brother, who stepped in, literally, and came between us and a bully or danger. Do you remember how safe that made you feel? How exhilarating it was, in your moment of need, to know that you could rely on help to arrive. When you hurt yourself or had your feelings hurt, you probably ran to a parent who gave you a caring hug and soothed you. Without consciously knowing it, those of us with these sorts of memories were running to a buffer, looking for the concern and protection every single child needs and deserves…but which not every child gets.

For millions of children worldwide, Adverse Childhood Experiences (ACEs) make growing up a challenge at best and a chaotic nightmare at worst. The brain of a child growing up in a home with attentive parents will create a world view where adults as safe, predictable, and a source of love and sustenance. But the brain of a child living in a home plagued by domestic violence or neglect will create a world view where adults are unreliable and a source of fear and pain. Children carry these ideas with them and they color all future relationships. Depending on their experiences and outlook, children can grow to become nurturing, invested adults or mistrustful, suspicious and withholding.

During this blog series, we’ve learned about ACEs, their tragic lifelong consequences for individuals and communities, and how we must urgently address this greatest of all public health crises. Rather than being overwhelmed by the statistics though, let’s focus on hope because healing is possible.

As a society, we now know more about ACEs than ever before. That knowledge empowers us. On a system level in Palm Beach County, we’ve mobilized the community to fight ACEs, but the truly encouraging news is that you don’t need to be an expert to help turn a child’s life around. Of course, severely traumatized children might need the professional help and compassion provided by skilled therapists like those at the Center for Child Counseling, but for many of the others the answer is relatively straight-forward. The answer is you.

As someone who loves and cares for a child, or who interacts with children often, it is vital to be ACEs educated and trauma informed. Simply by reading this educational blog series, you’ve demonstrated an interest in the subject. You’re already equipped to play your small but vital part in the fight.

Adjust Your Approach
Being trauma-informed really means adjusting our thinking and the way we respond and react to a child’s behavior. Instead of asking: “What’s wrong with you?” the focus should be: “What happened to you?” This changes our attitude to consider what the child has experienced rather than the resulting behaviors which may be frustrating. Follow-up questions will help get to the cause of the problem, questions like: “When did this happen?”, “How long has it been going on?” and “Who has been there to help you since this happened?” This way of approaching children helps to avoid re-traumatizing already traumatized people. It creates a safe, non-judgmental place where children feel secure enough to share their experiences and ask for help without fear of punishment or retribution.

Be a Buffer
Supportive, loving caregivers can buffer the effects of toxic environmental stress. There are many ways you can support a child with ACEs. Studies show that a positive, nurturing relationship with even one engaged adult can help a child cope with adversity. Consider how you interact with children—your own and other people’s—and focus on being loving, kind, and genuinely interested in them.

Easy Ways to be a Buffer
In the bestselling novel “The Help” by Kathryn Stockett, a devoted nanny repeatedly tells the young child in her care: “You are kind. You are smart. You are important.” Let that be your mantra when helping a child who has experienced ACEs. Whether you’re a teacher, neighbor, coach, community volunteer, or friend of the family, being a buffer means employing several different approaches aimed at:
• Reducing stress
• Building positive relationship
• Strengthening life skills

Here are some practical, real-world ways you can combat the toxic stress caused by ACEs.

When we celebrate a child’s achievements and challenges, both big and small, and affirm who they are as individuals, we support the development of their self-identity and remind them of their competence, importance, and lovability. When we acknowledge their birthdays, graduations, or everyday accomplishments like completing their homework, making a new friend, or doing chores, we help children build positive self-esteem. It may be something as simple as a clap, a smile, or a ‘thumbs up’. These simple gestures are expressions of support that can build self-confidence and help a child to thrive.

Comfort = Safety:
Children who have experienced trauma or toxic stress need comfort. Often, they need help to manage their emotions and to calm themselves down. Practicing relaxation, patience, and emotional regulation may help them connect with their feelings. Creating a safe environment is one of the most valuable components in re-establishing a sense of security and stability for a child. Whether the issue seems big or small, offer reassurance and always reinforce your commitment to be there for them. Sometimes it can be difficult to stay calm and supportive when a child exhibits the behaviors associated with toxic stress, but a measured response tells them that you are solid and reliable.

Help Children Collaborate:
Science shows that children who have been exposed to toxic stress may struggle to appreciate others’ perspectives. They may lack a sense of belonging. They may not have the skills or the know-how to reach out. And they may need help controlling their emotions, working through their problems, and gaining independence. Every day there are opportunities to collaborate or work with children towards common goals. With simple examples, you can teach problem solving and basic negotiating techniques to deal with conflict. When children learn to collaborate fairly, they feel like part of a team rather than isolated.

Grow Optimism:
We’ve already learned that a young child’s growing brain has plasticity – it’s still forming neural pathways and those pathways can be altered for the better. Brain science shows that we can actually train our brains to be more optimistic and hopeful about the future by practicing positive self-talk. You can reinforce this kind of positive brain growth in the children you know.

Don’t Just Hear…Listen:
It may sound easy, but listening is a skill we all need to practice. For all children, especially those who have experienced traumatic stress and violence, a patient and receptive adult who listens can help them feel safe and valued. Active listening means paying careful attention to what is being said, rather than simply hearing it. Listening is the foundation of learning and understanding what a child is trying to communicate. It shows care and concern. Listening to a child and teaching them how to listen helps them communicate and see situations from other people’s perspective – a key to empathy. Whether children are sharing happiness, sadness, anger, or fear, having someone truly listen to them matters.

Hold on to Healthy Relationships:
Often, when parents separate or divorce, it becomes a challenge to help kids maintain healthy contact with grandparents, supportive adults, and extended family members. One key to reducing stress is making the effort to maintain contact with these positive influences. It’s never a bad idea to let your children interact with people who truly love them…sometimes it means setting aside personal feelings in the best interest of the child.

To inspire someone means to lift them up with your words. Children need constant encouragement to recognize and reach their full potential. They need help identifying dreams and working towards them. Children who have witnessed violence and experienced traumatic stress can become negative, often have a low sense of self-worth, expect to be unsuccessful, and fail to foresee a positive future. But caring adults can help children reverse these negative responses. You can help inspire a child by identifying their strengths and natural talents and by connecting them to programs that help develop self-confidence.

Those who spend more time with children, like teachers, caregivers and, of course, parents have a greater opportunity to provide the tools that can really have a positive impact. Increasingly, schools, sports clubs and community events aimed at children are including elements of mindfulness training, self-care, and self-regulation activities in their work. But every one of us, even those of us who only have time to give a child a quick high-five, can consider it a privilege that we are contributing to that child’s resilience, health, and wellbeing.

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