In 1998, a researcher was trying to find out why a predominantly white, middle-class, sample of adults was dropping out of a weight loss program. By serendipity, a causal link was found between negative childhood experiences and long-term health consequences. Research since then has offered clear evidence for the cumulative negative influence of early-life Adverse Childhood Experiences (ACEs) on a person’s health.
The concept of ACEs, and what happens to the children who experience them, has engaged scientists, educators, and everyone who cares about giving children their best chances to succeed.
NEAR science is a term that combines four concepts about how a person’s history might impact later life — the acronym represents Neuroscience, Epigenetics, Adverse Childhood Experiences, and Resilience.
The Neuroscience component involves defining the science of toxic stress — a stress response that simply won’t let up (increased adrenaline output, heart rate, and production of a variety of stress hormones). Toxic stress has been shown to reduce neural connections in areas of learning and reasoning in the developing brains of children subject to chronic adversity.
We explore Epigenetics and ACEs on these pages. ACEs includes a list of causes of elevated stress, such as parental abuse and neglect, or exposure to domestic violence. That list has grown to include adversities inherent in growing up impoverished, or in the wake of neighborhood violence, or under the shroud of institutional racism.
The outcomes of exposure to ACEs remain the same: poor physical and mental health, lower educational achievement, and lower economic success, among other potentially life.long consequences. While all children are vulnerable to ACEs, no children are doomed because of what they experience, through no fault of their own.
Resilience — the capacity to recover from difficulty — is a biological mechanism that may be variable and hard to pinpoint, but is derived from factors such as the presence of caring adults, living in a supportive community, and even subjectively having a sense of purpose in the world. Says Becky Dale, of Minnesota Communities Caring for Children: “If we want to shift the grooves in our heads, we need to repeat the pathway we want to create. Knowing it takes a lot of energy to form a new pathway, and that through repetition new pathways get easier, can be helpful. It helps me weather discouragement, and empathy for myself when the old habits repeat even though ‘I know better.’ The same principals of practice and repetition apply to communities. We can learn together about how individual and historic trauma function.”
Dr. Canan Karatekin:
Adverse Childhood Experiences
Dr. Canan Karatekin is an associate professor at the University of Minnesota’s Institute of Child Development, and the lead researcher of its Child Wellbeing Research Group. She says the work of everyone is needed — from therapists working with individuals and families, to institutions like schools and clinics, to systems like education and justice, to government that works for fair policies. She adds that the best solution might be to “change society so Adverse Childhood Experiences don’t happen in the first place.”
As research reveals, ACEs leads to issues with mental and physical health, anxiety, depression, attitudes toward health care, and academic achievement. It leads to common health and behavioral issues in adulthood, such as a greater risk of smoking, alcohol and drug abuse, obesity, diabetes, sexually transmitted disease, and even cancer.
Essential to Dr. Karatekin’s work is bridging the gap between academic research and actual “practices on the ground.” In other words, are interventions and treatments applied to address the effects of ACEs doing any good?
Questions posed by her research group include:
• What community-based interventions are available for individuals with ACEs? How effective are they?
• How are the courts serving children and their families who are involved with the child welfare system?
• What services are provided in the community to families involved in the child welfare system?
• How best could we screen for ACEs to improve detection and early intervention?
Dr. Karatekin’s team finds answers to some of these questions by mining data from family court and medical records to determine what is being done to combat ACEs. For example, she says, a judge might order parental therapy, but whether it is completed is rarely tracked. Studies that count how many interventions were completed might lead to systemic changes.
Her group recently completed a study examining whether a checklist for ACEs can help identify college students at risk. The team also examines the relationship between a student’s current levels of stress and their history of ACEs.
Along with other faculty, staff, and students, Dr. Karatekin has put research results to work by developing a student organization called HOPE (Healing, Overcoming, Persisting, and Encouraging). The group intends to increase awareness about ACEs, particularly for those who work with students but might not have a background in mental health. The goal is for people like academic advisors to be better prepared for early intervention.
Dr. Ellen Demerath:
Dr. Ellen Demerath is a professor in the University of Minnesota’s Division of Epidemiology and Community Health. As she explains, inside every cell in our bodies are chromosomes — the carriers of our genes. For much of the cell cycle, our DNA is “tightly packaged” and wound around proteins. But in a certain phase, the chromosomes unwind to allow the cell to make the proteins it needs to carry out specific functions.
Early and chronic exposure to stress will impact behavior and health later in life. How this happens biologically is not as clear.
It has generally been thought that people are born with a set of genes that do not change over time. New research indicates, however, that events after birth can influence our genes, particularly the way they “speak.”
How do our bodies control this DNA expression? According to Demerath, within the last 20 years an entire branch of study, called epigenetics, has grown around a new theory of gene regulation. This new field of study examines how the expression of the gene changes — which in turn affects the body — without requiring an alteration of genetic code.
When she teaches genetics classes, Demerath says, “We spend a lot of time understanding the relationship between environment and the genome.”
She explains, for example, that the process of “methylation” impacts gene expression. This is why cigarette smoke and air pollution change the way a gene is expressed, compared to a person’s cellular make-up prior to the exposure. New research is finding that trauma and stress might have this same impact.
In other words, what we experience in life changes our epigenetic profile. Our life experiences, for good and ill, influence which genes “speak,” and which are silenced.
This biological phenomenon is well-documented by research, says Demerath. Many of the epigenetic changes are longstanding, she adds.
How this translates to the experience of childhood trauma is a new science. All studies involving epigenetics are expensive, she says, and still tend to have small sample sizes. Time and money have not allowed for the replication of studies needed to confirm results.
How epigenetic changes might be passed down through generations — something known as transgenerational transmission of trauma — is even more poorly understood biochemically, Demerath says.
Although it happens in research with animals, Demerath says, it will require four generations to determine whether a pregnant woman’s descendants have been impacted genetically by a woman’s environmental trauma.
In the meantime, Demerath says epigenetic changes can be reversed. In some of her experiments, a person’s methylation level was seen to change from day to day. The good news, she says, is that means that physical and mental resilience can play a role in overcoming the genetic impact of trauma.