Childhood adversity is one of the greatest health risks to both children and adults (American Academy for Pediatrics, 2016) and poverty is one of the largest determinants of adverse health experiences.

What is childhood adversity?

Children between the ages of 0 and 6 years (including pre-birth) are extremely vulnerable to the negative effects of chronic stress in their environment.  The more stress they experience, the more their developing minds and bodies are affected and compromised.  When children live with chronic, chaotic and toxic stress, their brains operate main in survival mode which inhibits the development of executive functioning.  The normal brain development that needs to occur during that critical window period of growth literally cannot take place and the function and structure of brain is altered leading to long-lasting negative effects.

The kinds of adverse experiences that are considered adverse for child development include (but are not limited to):

  • Emotional, physical and sexual abuse
  • Emotional and physical neglect
  • Growing up with domestic violence, substance abuse or mental illness in the home
  • Parental separation or divorce
  • Crime and the incarceration of a family member

The more of these adverse experiences a child is exposed to, the greater the negative health consequences throughout the life-span.

These adverse childhood experiences (called ACEs) are linked to the development of the following:

  • The way emotions are regulated
  • Bodily issues
  • Pain
  • Obesity
  • Sleep disturbances
  • Substance abuse
  • Teenage pregnancy
  • Risky behaviours
  • Heart disease
  • Lung and kidney disease
  • Depression and suicide
  • Smoking
  • Instable relationships
  • Risk of re-victimisation
  • Poor workplace performance

People who have experienced 4 or more ACEs are 50% more at risk for depression and 20% more likely to attempt suicide.

Learners with 3 or more ACES are 2 and a half times more likely to fail a grade.

Workers with 4 or more ACES are 18% more likely to experience performance problems in the workplace.

People with 6 or more ACES have a decreased life expectancy of up to 20 years!

ACES are extremely common and tend to cluster together.  For example, where you find alcohol abuse in a household, you are also more likely to find child neglect, domestic violence and parental separation.

How do ACES harm children?

When children are repeatedly exposed to adverse experiences and toxic stress and their fight-or-flight response is overly activated, this survival mechanism changes from a life-saving system to a health-damaging system.  The overload of adrenaline and cortisol inhibit the normal brain development and children and the structure and function of the brain is altered.  These children find it difficult to concentrate and learn in school and also struggle with building trust in relationships.

What can we do?

It is important to recognise the problem.  In South Africa the majority of people live in poverty which is a single greatest contributor to other adverse conditions for children.  In other words, most children in South Africa are exposed to ACES.  We know this for a fact.

When we can recognise that impact of toxic stress on the development of the child, we can begin to place challenging behaviour in context and can begin to develop more appropriate ways of responding.  Children who are exposed to toxic stress are often unable to differentiate between real and perceived threats, and therefore often respond with aggression.  There is a tendency from parents, teachers and other professionals to focus on the behaviour as deviant, dysfunctional or oppositional – when in fact it is symptom of a much deeper problem.  Addressing the pain-based behaviour of children require looking beyond surface behaviour.