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August 8, 2016 – How Maternal ACEs Affect Children

Teresa HuizarGood morning and happy Monday.  I hope this finds everyone well.  For most everyone who works in our field, the term ACEs, or adverse childhood experiences, is a familiar one.  The term comes from the study conducted by the Centers for Disease Control in partnership with Kaiser Permanente, and is one of the largest investigations of childhood abuse and neglect and later-life health and well-being ever conducted.  In the years since the study was first conducted, many researchers have confirmed that early life trauma results in negative physical and mental health outcomes as children reach adulthood.  But few, if any, have looked at the intergenerational effects of maternal ACEs on children, until now.

Child Maltreatment, the Journal of the American Professional Society on the Abuse of Children, recently published an article, “Intergenerational Effects of Childhood Trauma:  Evaluating Pathways Among Maternal ACEs, Perinatal Depressive Symptoms, and Infant Outcomes,” exploring this topic. [1]  This study looks at the ways in which “maternal experiences of childhood maltreatment and household dysfunction relate to maternal perinatal depressive symptoms, reproductive birth outcomes, and early infant functioning.”  Id., p. 1.
 
The researchers point out that “[m]aternal ACEs have been associated with a range of adverse reproductive birth outcomes,” including low birth weight and premature birth, both of which can lead to issues during infancy and “across the life span.”  Id.  Therefore, the researchers felt “it critical to identify specific pathways through which maternal ACEs relates to infant birth outcomes to determine factors that characterize women at the greatest risk for poor reproductive health.”  Id

Within the definition of maternal ACEs, researchers were careful to distinguish between childhood maltreatment and household dysfunction.  Household dysfunction “refers to exposure to a range of traumatic or stressful experiences within the family context including household substance abuse, parental separation or divorce, having a family member with mental health difficulties or in prison, or domestic violence.”  Id., p. 1.  The researchers hypothesized that in every category, including maternal age at first pregnancy, pre-and post-natal depressive symptoms, infant birth weight, gestational period and infant socioemotional outcomes, ACEs rather than household dysfunction would predict more negative outcomes. 

What they found, however, differed from what they hypothesized.  For example, they found that “household dysfunction, but not childhood maltreatment, was significantly negatively correlated with maternal age at first pregnancy.”  Id., p. 5.  On the other hand, the researchers found that “maternal experiences of maltreatment during childhood (1) predicted higher levels of prenatal and postnatal depressive symptoms and (2) were associated with a smaller reduction in depressive symptoms across the perinatal period.”  Id., p. 7.  Moreover, “[c]hildhood maltreatment was directly related to infant socioemotional functioning, such that mothers who endorsed more experiences of abuse and neglect in childhood had children with higher levels of socioemotional symptoms at 6 months.”  Id., p. 8. 

None of these findings should come as any great surprise, but they should serve to inform both our understanding of intergenerational effects and our treatment options when it comes to children and families.  For example, providers should “consider maternal ACEs in relation to prevention of perinatal depression or effectiveness of treatment.”  Id., p. 9.  Likewise, the distinction between household dysfunction and childhood maltreatment could also be an important factor for identifying different areas of risk and different preventive strategies.

But what it means for us as CACs and MDTs is perhaps best summarized by the rationale for NCA’s Mental Health Standard, which recognizes the importance of a caregiver’s health to the health and recovery of the child victim: “Evidence shows that family members are often the key to the child’s recovery and ongoing protection, and that mental health is often an important factor in a caregiver’s capacity to support the child.”  Standards for Accredited Members, p. 36.

I strongly urge you to download this article and read it in full, and to share it widely with your colleagues and team members, particularly those in the mental health field.  To the extent we can identify and assist parents who themselves struggle with ACEs, we can better assist their children, and break the cycle of intergenerational childhood trauma.

As always, I thank you for all your hard work and dedication and for all that you do on behalf of children and families.

Warm regards,  
Teresa 
 
[1] Full text of this publication may be found in the National Children's Advocacy Center's Child Abuse Library Online (CALiO ™) or by contacting the NCAC Research Digital Information Librarian. CALiO ™ is a service of the National Children's Advocacy Center (NCAC).  Please note that, because this is an article in press, to access the article in CALiO ™, you must go directly to the journal and then put in the title to have the article come up in full text.

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