Mark Your Calendar

The Chadwick Center proudly announces the 35th year anniversary of the founding of the Center and our 25th celebration of the Annual International Conference on Child and Family Maltreatment. Below you will find a short description of the conference, contact information, and a link to download the informational and registration brochure.

Title:  The 25th Annual San Diego International Conference On Child and Family Maltreatment

Dates:  Saturday, January 22 through Friday, 28, 2011

Venue:  Town and Country Resort & Convention Center, www.towncountry.com

The San Diego Conference focuses on multi-disciplinary best-practice efforts to prevent, evaluate, investigate, treat, and prosecute child and family maltreatment.

The objective of the San Diego Conference is to develop and enhance professional skills and knowledge in the prevention, recognition, assessment and treatment of all forms of maltreatment including those related to family violence as well as to enhance investigative and legal skills. Issues concerning support for families, prevention, leadership, policy making and translating the latest research into action are also addressed.

Read more about the conference and download the brochure: http://www.sandiegoconference.org.

If you have any questions about the conference and/or would like to know more about the conference in detail please contact sdconference@rchsd.org or phone (858) 966-4972.

Judy Nelson

Faculty, Conference Coordinator

Chadwick Center for Children & Families

Rady Children’s Hospital-San Diego

Childhood Trauma and Adult Illness

The Impact of Adverse Childhood Experiences on Your Adult Health

by

Ellen Taliaferro, MD, FACEP

Have you thought about your childhood lately? If you find yourself struggling with a medical, social, or behavioral disorder that seems to defy standard treatment, you might benefit from examining your childhood.

We now have good evidence to support the link between adverse childhood experiences and later negative health effects in adulthood. The connection between those childhood experiences and later negative health effects are underscored by the decades-long, ongoing adverse childhood experiences (ACE) study, a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente.

This collaborative study began in the mid-1980s. Dr. Vincent Felitti and his colleagues working in an obesity program in Kaiser Permanente’s Department of Preventive Medicine in San Diego noted that their patients who were most successful at losing weight were the ones most likely to drop out of the program. Examination of this unexpected observation revealed that the patients had been reaping sexual, physical, and emotional protective benefits from overeating and their subsequent obesity.

This realization lead to another realization: From the patient’s standpoint, obesity was not a problem but a solution. A solution to what? The ACE study soon began to supply answers by finding common adverse childhood experiences in the patients participating in the study.

To date, ten adverse experiences consisting of abuse, neglect, and household dysfunction have been identified, falling into these categories of experiences during the first 18 years of life:

• Abuse:

1. Emotional
2. Physical
3. Sexual (by contact)

• Neglect

1. Emotional
2. Physical

• Household dysfunction:

1. Watching mother being battered
2. Parental separation, divorce, or loss in childhood
3. Mental illness in household
4. Incarcerated household member
5. Presence of alcohol and/or substance abuse

As the ACE study progressed, the researchers noted that patients who had one adverse childhood experience in their lives were at risk for having additional adverse childhood experiences. For instance, growing up in a household where the mother was battered increased the patients’ risk of having one or more adverse childhood experiences in the form of:

• Emotional abuse
• Physical abuse
• Sexual abuse
• Emotional neglect
• Physical neglect
• Parental separation or divorce
• Substance abuse
• Mental illness

Thanks to this study, we now know that approximately two-thirds of our population has an ACE score of 1 or higher. The higher the score, the more likely a person will be to:

• Smoke or abuse alcohol or drugs
• Experience unintended pregnancy, teen pregnancy, miscarriage, and stillbirth
• Be promiscuous, have sex before the age of 14, and have sexually transmitted diseases
• Have poor work performance
• Attempt suicide
• Experience depression and have a poor health-related quality of life
• Have liver disease, ischemic heart disease, diabetes, obesity, and experience other leading causes of death in the United States.
• Experience a high level of perceived stress
• Have difficulty in controlling anger
• Have an increased risk of becoming a perpetrator of relationship abuse or domestic violence

The researchers conducting the ACE study note that their findings likely reflect the accumulative neurobiological effects of early trauma and stress in a person’s life. Such accumulation of stress and trauma can result in long-term changes in brain function and structures. In turn, these changes can impact adult emotional and physical responses to stress and contribute to substance abuse, sexuality and memory disturbances as well as aggression.

Adult response to childhood trauma in the form of disease and behavioral disorders can appear late in life, masking the relationship between the distant trauma and current life problems. To compound matters, such adult disease and behavioral disorders are often complex and resistant to standard biologic treatment.

The ACE Study researchers recommend an approach that addresses the early childhood trauma as well as the adult disease and distress. When treating patients with past adverse childhood events, these physicians augment standard pharmacological treatment with the use of medical interviews and autobiographical writing to explore how their patients perceive that the earlier childhood events have shaped their adult life and well-being.
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What Is Your ACE Score?

By
Ellen Taliaferro, MD

Can the woes and traumas of your yesterdays take a toll on your state of health today? Indeed they can and do. At least that’s what our grandmothers always seemed to know.

Now, thanks in large part to the Adverse Childhood Experiences (ACE) Study, medical research validates this concept. Dr. Vincent Felitti, Founder of the Department of Preventive Medicine in Kaiser Permanente in San Diego, and his colleagues at the Center for Disease Control and Prevention (CDC), have identified ten adverse childhood experiences that correlate with adult health status half a century later.

What are adverse childhood experiences? To date ten have been identified in children younger than 18 who grow up in a household with:

• Recurrent physical abuse
• Recurrent emotional abuse
• Sexual abuse
• An alcohol or drug abuser
• An incarcerated household member
• Someone who is chronically depressed, suicidal, institutionalized or mentally ill
• Mother being treated violently
• One or no parents
• Emotional or physical neglect

Any one of the above ten items receives a score of one, no matter how many times it occurred. For instance, if you were sexually abused once or many times as a child, your ACE score is one and only one. The higher your ACE score, the more likely you will be to experience a wide range of health and social problems in your adult life.

Last summer, Dr. Felitti spoke in San Mateo, CA, and presented an overview of the findings from the ACE Study. He noted that the official questionnaire for determining an ACE score was several pages long and needed to be professionally evaluated. However, recently the ACE Study Group developed a “self-test” version of the questionnaire.

Of note, Dr. Felitti and his team use writing as part of their practice by asking their patients to write out their autobiography in five-year segments.

This survey has only ten questions and can be explored and taken by clicking the link below.

Click here to download a copy of the ACE survey