July 2017,  OneVoice CSDA Newsletter

What’s Your ACE Score?

By David Kilgore, Director, Riverside County DCSS

More importantly, what is the ACE score of the participant you are serving today?

An ACE (Adverse Childhood Experience) score is a tally of different types of abuse, neglect, and other hallmarks of a rough childhood. According to the Adverse Childhood Experiences study, the rougher your childhood, the higher your score is likely to be and the higher your risk for later health problems.

There are three types of ACEs:  Abuse, Neglect, and Household Dysfunction.  Within each of those three broad categories are a variety of potential adverse experiences a child may experience.

Studies on ACEs indicate that ACEs are common. Information coming out of the CDC-Kaiser ACE Study reports “Almost two-thirds of study participants reported at least one ACE and more than one in five reported three or more ACEs.” The more ACEs you have, the more likely you are to have negative health and well-being outcomes later in life.

In short, ACEs will occur with almost everyone.  The question is, how resilient is the child in overcoming instances of adverse experiences.  A child with poor support and resources and few options is likely to have:

  • Physical effects such as obesity, high blood pressure, diseases, etc.,
  • Psychological effects like post-traumatic stress disorder, conduct disorder, and learning and attention challenges,
  • Behavioral challenges like delinquency, teen pregnancy, and challenges finding and maintaining relationships,
  • Economic barriers with increased costs associated to health, productivity, criminal, and special education.Here are some statistics about our county:

Riverside County, like many other cities and counties, is attempting to tackle this concept of “Building a Resilient Community.” We’ve acknowledged that, for the adult population, our ability to reshape their future declines drastically the older a person gets. We continue to provide services, but the demand is always greater than the capacity and the root cause is not being addressed.

  • 20% of all households in Riverside County have experienced 4+ ACEs.
  • 31% of 7th, 9th, and 11th grade students have Depression-Related feelings.
  • 19% of 9th and 11th grade students have considered suicide in the past 12 months.
  • 25% of youth (12-17) need help for emotional or mental health problems.

We’ve taken the time to gather statistics from each county department, school district, First 5 Program, etc. and layered that data geographically on top of each other to see just where our largest pockets of ACEs reside in a heat index.  When you layer reported Abuse and Neglect, Household Dysfunction, Behavioral Health reports, probation, child support case counts, and poverty on top of each other, a map, such as the one below, emerges.

Amazingly, in a rough count, there are more than 100 plus services identified that provide direct services to individuals ages 0-19 in Riverside County. Those services, to date, are not coordinated.  Riverside is resolving to change this coordination challenge despite the challenges.  The resources are there, they just need to be connected.

I’m guessing your community, like Riverside, is facing a similar map of challenges.

Child Support

We all know that in child support, our goal is the health and well-being of the children in our caseload. Through collecting child support, we hope to provide additional support and resources to combat instances of ACEs events and give them the best chance we can for a bright and hopeful future.

The problem is, very often, we are attempting to collect child support from individuals who may have a high ACEs score themselves.  We do not know the participant’s story.  And often, when they do try to tell us their story, we patiently wait them out so that we can get down to the business of child support.  We do not acknowledge their ACEs experiences and recognize the impact that years and years of traumatic experiences have lead the individual to this very moment in our office.

Child abuse and neglect results in improper brain development, impaired cognitive (learning) and socio-emotional skills, lower language development, smoking, alcoholism, drug abuse, and more. This is the individual that you are interviewing.  Our expectation is that the individual before us stands up and takes responsibility for themselves and their child even though they may have never seen what that is supposed to look like.

Considerations

The business of child support is important. We play an important part in the battle against poverty and resilience in the children of our community.  However, we must be cautious of a single-minded approach to our business.  If handled improperly, we could be contributing to additional ACEs events because of the way we work with the parents.

There are several key considerations to keep in mind:

  1. Increase general awareness of ACEs/Trauma and Resilience.       Train everyone on the topic and their impacts on the individuals we serve.
  2. Try to build a Systems Approach for Collective Impact.       Child support cannot conquer this alone. What other resources can you bring to bear on the family’s life to improve their resilience?
  3. Early Intervention and Prevention is key! Know what protective factors can be put into place and use screenings for detection. Make referrals often and routinely. The one time someone takes you up on a referral might be the turning point in that person’s life.
  4. Identify Evidence-Based/Research Informed Practices to implement.       Continuous improvement and consistent review of practices is required for long term, sustained, impact against this massive societal challenge.

For more information on ACEs, consider following the link below which includes a whole host of additional resources and links to explore.

Centers for Disease Control and Prevention: ACEs information:

https://www.cdc.gov/violenceprevention/acestudy/index.html