It is common knowledge that childhood impacts adulthood. There is strong evidence showing that activities such as engaging in play or reading to your child will have long-term positive effects on brain development and social functioning.

However, the studies into the darker aspects of childhood have been slower to emerge. This might be because of the content matter, or it might be because of the “bootstrap” ethos that permeates our culture. As a society we are quick to associate successes with positive upbringing, yet slower to correlate failures with negative upbringing.

While research continues to advance, the data overwhelmingly shows childhood trauma negatively impacts development and has long-term effects on the victim.

Further, childhood maltreatment is very prevalent. Last year alone one in seven children in the United States experienced abuse or neglect.1

The ACEs Test

There is nothing groundbreaking about the notion that childhood trauma is a contributing factor in someone’s life, but as research continues to confirm and quantify its effects on mental and physical health in adulthood, we as attorneys have opportunities to utilize this information to advance our clients’ interests.

In Wisconsin, the Department of Health Services has recognized that “[t]he positive and negative experiences we have during childhood have a lasting effect on our health and well-being.”2

The Healthy Wisconsin campaign has devoted time and energy promoting the predictive abilities of the Adverse Childhood Experiences (ACEs) test.3 The ACEs test addresses 10 broad categories of experiences:

  • recurrent physical abuse;

  • recurrent emotional abuse;

  • recurrent verbal abuse;

  • contact sexual abuse;

  • an alcohol and/or drug abuser in the household;

  • an incarcerated household member;

  • someone in the household who is chronically depressed, mentally ill, institutionalized or suicidal;

  • mother is treated violently;

  • one or no parents; and

  • emotional or physical neglect.

The test simply asks whether a person has been subjected any of the above experiences. The “yes” answers are tallied to create a score. The higher the score, the greater the correlation with adverse mental and physical health conditions in adulthood.

For example, participants who scored four or higher on the ACEs test were six times more likely to have been diagnosed with depression, four times more likely to have respiratory problems, and had a life expectancy of up to 20 years less than participants who scored lower.4

A Tool for Better Advocacy

Although it is clear that adverse childhood experiences correlate strongly to health and behavior later in life, nothing is written in stone. Negative childhood experiences are not necessarily determinant of a challenging adulthood. A high score on an ACEs test is simply a way to understand how to best help our clients, and how to best tell their story.

Knowing and applying the research behind childhood maltreatment and its impacts can result in better advocacy for our clients; and better advocacy is a goal we all share.

Endnotes

1Preventing Child Abuse and Neglect Factsheet, Centers for Disease Control and Prevention (Feb. 26, 2019).

2ACEs Stands for Adverse Childhood Experiences,” Wisconsin Department of Health Services, Healthy Wisconsin.

3 The ACEs study was a joint effort funded by the Center for Disease Control and Kaiser Permanente’s Health Appraisal Clinic in San Diego. It is by far the largest study addressing childhood abuse and its impacts on health. SeeViolence Prevention: Adverse Childhood Experiences,” Centers for Disease Control and Prevention.

4 Chang, X., “Associations Between Adverse Childhood Experiences and Health Outcomes in Adults Aged 18-59,” Public Library of Science 14(2) (Feb. 7, 2019).