Responding to Adverse Childhood Experiences: An Evidence Review of Interventions to Prevent and Address Adversity Across the Life Course

YouthREX Research Summaries ask Just Six Questions of research publications on key youth issues. These summaries get at what the youth sector needs to know in two pages or less!

1. What was this research about?
Adverse childhood experiences (ACEs) are potentially traumatic events that occur during childhood and can have serious, negative impacts on an individual’s present and future wellbeing. ACEs are common and can be transmitted across generations due to a complex interplay of individual and environmental factors. For example, parents/caregivers who use substances to cope with trauma may expose their children to ACEs, which can have negative impacts on emotional and behavioural development Resources that help build resiliency in childhood, such as trusted adult relationships and community involvement, can mitigate the negative impacts of ACEs.

This report reviews evidence-based interventions that can support children, youth, and adults who have experienced and/or continue to experience ACEs. The authors provide an overview of ACEs, explore common approaches for addressing ACEs, and present seven recommendations for supporting individuals, including youth, using an ACE-informed approach.

2. Where did the research take place?
The research reviewed in this report primarily took place in Wales, the United States, and the United Kingdom, and focused on home, school, primary care, community, and welfare settings.

3. Who is this research about?
This report is about children, youth, and adults who have been and/or continue to be exposed to ACEs.

“Findings suggest that in order to break the potentially complex cycle of intergenerational transmission of ACEs, efforts should be made to ensure a long-term combined and coordinated approach across the life course” (p. 29).

4. How was this research done?
The authors conducted an evidence review to identify common approaches to prevent ACEs and address their negative impacts across the life course. They reviewed peer-reviewed literature and publicly available reports published from 2008 to 2018. The search produced 110 relevant interventions. The authors note that the review is not exhaustive, and that, given its broad scope, it may not be relevant across cultures, specific populations or sectors.

5. What are the key findings?
The authors identified four common approaches across the interventions: supporting parenting; building relationships and resilience; identifying adversity early; and responding to trauma and specific ACEs.

Drawing on these four approaches, they identified seven recommendations for supporting the development of a multi-sector, ACE-informed approach across the life course:

i) Promote social development, cohesion, and positive relationships by supporting positive parent/caregiver-child relationships and building social skills, such as emotional regulation, empathy, and communication.

ii) Promote cognitive-behavioural and emotional development in childhood through parenting/caregiving interventions for those at greatest risk of adversity, and youth programs that focus on emotional regulation, decision-making, and problem-solving skills.

iii) Build self-identity and confidence in children, youth, and adults through school, community, and psychotherapy programs that focus on self-efficacy, self-esteem, and confidence, and that address any feelings of shame or embarrassment. Effective strategies include mentoring and positive role modelling.

iv) Build knowledge and raise awareness about the causes and impacts of ACEs among parents/caregivers, youth-serving professionals, and those who have experienced adversity. Emphasize the importance of protective factors and share information about effective services and policies.

v) Foster skills and strategies for coping with adversity, such as coping skills, relaxation techniques, and other strategies that allow those affected to regulate negative moods, thoughts, and behaviours.

vi) Focus on early identification of adversities, including conditions that can contribute to adversity (e.g., childhood abuse and neglect), as well as internalized or externalized behaviours. Evaluate assessment tools and approaches across sectors.

vii) Advocate for collaboration across sectors and recognize that preventing and responding to ACEs requires a multi-sectoral, evidence-based approach.

6. Why does it matter for youth work?
Organizations can draw on the seven recommendations identified in this report to support protective factors and build resilience among youth who have faced or continue to face adversity. For instance, programs may want to focus on skill development, engage parents/caregivers, raise awareness about ACEs, and prioritize early identification and early prevention, where possible. Youth workers can also support those affected by ACEs by advocating for increased collaboration across organizations and sectors.

Categorised in: Research Summary