Adverse Childhood Experiences

This guide provides healthcare students and professionals with a foundational background on adverse childhood experiences (ACEs) - traumatic early life experiences, which can have a profound impact on health in later life. ACEs can include being a victim of abuse, neglect or exposure to risk in the home or community. How healthcare students and professionals learn to recognize, react and respond to persons affected by trauma will lay the foundation for their relationships with patients. This book intentionally uses micro-to-macro lenses accompanied by a structural competency framework to elucidate health implications across the lifespan. It explores the nature of adversity and its effects on the physical, emotional, cognitive and social health of individuals, communities and society. The book, written by two experienced psychiatric nurses, will equip healthcare students and professionals with an understanding for critical change in practice and offer action steps designed to assist them with prevention and intervention approaches and steps to help build resilience. This book will be core reading for healthcare students within mental health, pediatric and primary care nursing courses. It will also be of interest to students and professionals in the social work, psychology and public health fields who are exploring resilience and trauma-informed practices

Roberta Waite is a Professor at Drexel University, College of Nursing and Health Professions and Assistant Dean of Academic and Community Integration and Evaluation at the Stephen and Sandra Sheller Eleventh Street Family Health Services of Drexel University. Ruth Ann Ryan is a Board Certified Clinical Nurse Specialist and a Psychoeducation Training Specialist with the Healing Hurt People Program in the Center for Non-Violence and Social Justice at Drexel University College of Medicine. She is co- founder of the Sanctuary Model and was the Clinical Director of the program for 20 years. .

PART I Knowledge development about ACEs - Introduction: Repression to Spoken Truth - Opening Up - Making the Connection: The ACE Study - Toxic Stress, Adversity, and Trauma PART II Understanding ACEs from a life course health development perspective - The Body Keeps Score: Epigenetics - Early Brain Development: Childhood Trauma and Adversity - Developmental Psychology: Implication of ACEs - Community and Social Structural Determinants: Implications of ACEs PART III Reducing ACEs 8 Socioecological Model: Individual and Family Influences 9 Socioecological Model: Context and Cultural Influences PART IV ACE INTERVENTION: A SOCIAL-ECOLOGICAL APPROACH 10 Early Identification and Trauma-Informed Approaches 11 Community and Societal Trauma-Informed Interventions PART V CONCLUSION 12 Moving Forward