The Health Federation of Greater Philadelphia
Programming from the Institute for Safe Families now resides at the Health Federation of Philadelphia.
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ACEs, ACEs Everywhere...But Are We on the Brink?

In just a few short weeks, many people around the world will close the door on 2012 and celebrate the arrival of a new year. This coming year 2013 will mark the 15th anniversary of the publication of the original Adverse Childhood Experience (ACE) Study findings in the American Journal of Preventive Medicine by Dr.’sVince Felitti, Roberta Anda, and six other researchers: a study that changed long-held and accepted wellness paradigms in the United States, and challenged the models upon which many of our public and human service systems were founded.

Since the publication of the ACE Study in 1998, which was conducted with the participation of thousands of adults in California from 1995 to 1997, the design and intent of the study has been replicated many times over in different regions and among various populations across North America. There are growing applications of the ACE Study findings in research, policy, and practice across a wide range of child and family-serving systems, including innovative initiatives that integrate the ACE Study framework throughout the United States and Canada.  These initiatives blend trauma theory, continuously emerging neuroscience, the principles of trauma-informed care provision, and science on toxic stress with the ACEs framework in order to shift our service delivery systems from reaction to prevention and to shift our culture from retraumatizing survivors to healing.

The abundance of training, education, advocacy, organizing, and professional development efforts to inform and develop a new framework for service delivery to children and families through the lens of trauma and early childhood adversity has been nothing less than amazing:

  • Thousands of miles to the west in Iowa and south in Arizona, government, hospital, and community-based child abuse prevention advocates are engaging in advocacy and using powerful education strategies including a standardized, statewide train-the-trainer program and a renowned social marketing campaign with a simple but powerful message of “ACEs can last a lifetime, but they don’t have to…” in order to affect major transformations within the state.
  • In Washington State, upstate New York, throughout California, in Oregon, and in the City of Philadelphia, further research is currently underway to investigate the impact of ACEs among adults in urban and rural settings, and to identify prevention strategies for reducing and mitigating the risks of intergenerational ACEs transmission between family members.

In addition, a new brand of health care journalism has emerged to document the expansion of ACEs and trauma-related work and initiatives unfolding throughout the country. Social media has played an invaluable role in connecting these efforts and the key stakeholders responsible for leading them. ACEs Connection, a social networking site founded by award-winning health reporter Jane Ellen Stevens with the goal of fostering communication and collaboration among ACE professionals, has experienced significant growth in membership and rich content over the past year since its inception. Through ACEs Connection and her complimentary blog, ACEs Too High, Ms. Stevens is leading an innovative charge to create sustainable dialogue and relationships through social networking that will ultimately help to advance the ACEs movement and framework into our health infrastructure and social safety net.

For the majority of 2012, I have been fortunate enough to have the opportunity and privilege of tracking these efforts and exploring the extent to which the ACE Study findings are being actively applied in health care, human service, educational, and other settings while completing a Stoneleigh Foundation Fellowship at the Institute for Safe Families (ISF) here in Philadelphia. Through the generous support of Stoneleigh and other local and national funders, including the Robert Wood Johnson Foundation and the Scattergood Foundation, along with a team of dedicated local partners that comprise our Philadelphia ACE Task Force, ISF has been able to diversify our portfolio of ACE and trauma-related initiatives under the umbrella of our Philadelphia ACE Project.

The story of ISF’s ACE project development echoes innovative efforts that are escalating nationwide. Consequently, there is an urgent need for a clearly defined action plan on the national level in order to coordinate the burgeoning number of ACE programs and fully operationalize and enshrine the ACEs framework. Tremendous progress has been made in educating professionals using cross-systems approaches. Now as some organizations move into an early implementation phase with screening adults for ACEs, there is hope that children, parents, caregivers, families, and communities will benefit from these ACE-informed services and interventions. These are early days: many questions remain about how and when policy decisions, funding mechanisms, and resource allocation will catch up with the courageous efforts among service provider agencies already engaged in this work relying on lessons learned from  the ACE Study and limited resources to inform their work to prevent and treat ACEs.

What are practitioners doing in community, family, pediatric, and other health care settings to prevent and/or treat ACEs? What are they learning from these efforts?  What kinds of policy shifts must occur in order to address the enormous implications and cost of ACEs for our society? How can we apply visionary policy recommendations, such as the 2012 Policy Statement on Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician from the American Academy of Pediatrics and put them into practice to affect the changes we need?

These and others are the questions that we intend to tackle at the National ACEs Summit in May of 2013, which will be held in Philadelphia at the Independence Visitors Center, hosted by ISF and the Robert Wood Johnson Foundation, and co-sponsored by the American Academy of Pediatrics, the Academy on Violence and Abuse, and Futures Without Violence. We look forward to sharing the fruits of this highly anticipated meeting of the minds around ACEs with the Scattergood readership as well as many other stakeholders and partners, and in the meantime, we wish everyone a Happy New Year in 2013!