In the late 1990s, Vincent Felitti and Robert Anda conducted a landmark study that examined the effects of adverse childhood experiences (ACEs) — including abuse, neglect, domestic violence and family dysfunction — on 17,000 mainly white, predominately well-educated, middle class people in San Diego. They found a powerful connection between the level of adversity faced and the incidence of many health and social problems. They also discovered that ACEs were more common than they had expected. (About 40 percent of respondents reported two or more ACEs, and 25 percent reported three or more.) Since then, similar surveys have been conducted in several states, with consistent findings.
This distinction is critical, because it opens the way to new opportunities to prevent a cascade of health problems. It is exceedingly difficult to alter the environments that produce major stress for families, particularly poverty. However, children can be shielded from the most damaging effects of stress if their parents are taught how to respond appropriately. “One thing that is highly protective is the quality of the relationship between the parent and the child,” explains Darcy Lowell, an associate clinical professor at Yale University School of Medicine and the founder of Child First, a program based in Shelton, Conn., that has marshaled strong evidence demonstrating the ability to intervene early, at relatively low cost, to reduce the harm caused by childhood stress in extremely high-need families. “Early relationships, where adults are responsive and attentive, are able to buffer the damaging effects on the brain and body,” she says.
Child First, initially developed at Bridgeport Hospital in Connecticut, now works in partnership with community-based agencies in 15 locations across the state, where staff members deliver its program of home-based parent guidance and child-parent psychotherapy. In awell-controlled study, children served by Child First were compared with those receiving usual social services and were found to be significantly less likely to have language problems and aggressive and defiant behaviors. Their mothers had markedly less depression and mental health problems, and the families were less likely to be involved with child protective services even three years later.