Responding to adverse childhood experiences - An evidence review

Public Health Wales' Policy, Research and International Development directorate in conjunction with the Public Health Collaborating Unit at Bangor University, has produced a new report 'Responding to Adverse Childhood Experiences'.

The new report, developed by Dr. Lisa Di Lemma, examines evidence across a variety of programmes responding to adverse childhood experiences (ACEs). The report looked at programmes and interventions for 11 individual ACE types, and ACEs as a collective term, to identify common approaches across programmes.

Dr. Alisha Davies, Head of Research for the directorate explains:

"There is no single intervention or approach which addresses the complexity of ACEs. By bringing together an extensive and complex evidence base, we have drawn out seven key themes from the literature which are common and important when it comes to prevention and mitigation of the harms from adversity across the life course".

The 7 Key Themes:

• Promoting cognitive-behavioural and emotional development in childhood
• Promoting self-identity and confidence in both children and adults
• Building knowledge and awareness about the causes and consequences of ACEs amongst the public and professionals
• Developing new skills and strategies for those affected to cope with adversity
• Early identification of adversities by therapeutic and interfacing services to identify andsupport parents, children and those affected through the life course
• A collaborative approach across sectors and organisations

Dr. Davies also reflected that:

"This report is not an exhaustive systematic review of the interventions for specific ACE types, nor does it advocate any specific intervention, but it seeks to present a summary of the research evidence on common approaches.

"Most of these programmes were developed in the USA, so while they appear to deliver promising results, these results will need to be 'translated' into a UK context before they can be implemented".

Dr. Davies concludes, "The complexity of ACEs across the life course is a difficult and important challenge to address, and one which requires a response extending across sectors and generations. We hope this report will be a useful resource to support innovation and development towards an ACE free future."

ACEs are stressful events that occur during childhood. These can include being the victim of physical or sexual abuse, or growing up in a household where there is alcohol or substance misuse, domestic violence, mental ill-health and family incarceration. Around half of the Welsh population has suffered at least one ACE.

Individuals who have experienced four or more ACEs, are at higher risk of suffering the detrimental effects associated with ACEs. ACE studies in Wales have identified the scale of these risks for those with four or more ACEs compared to those with none to be:

• Four times more likely to be a high-risk drinker
• Six times more likely to have received treatment for mental illness
• Six times more likely to be a smoker
• Fifteen times more likely to have been involved with violence, and
• Twenty times more likely to have been incarcerated