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What do foster parents need to know about PACEs?

Updated: Dec 27, 2022

ACEs: What do I need to know as a foster parent? Obviously, I'm glad you asked me. Let's recap what the ACEs study is and the results of the study. Here is the introductory post I did, where you will find a link to the study and the results.

From the CDC, we find that...

The CDC-Kaiser Permanente adverse childhood experiences (ACE) study is one of the largest investigations of childhood abuse and neglect and household challenges and later-life health and well-being. The original ACE study was conducted at Kaiser Permanente from 1995 to 1997 with two waves of data collection. Over 17,000 Health Maintenance Organization members from Southern California receiving physical exams completed confidential surveys regarding their childhood experiences and current health status and behaviors. -CDC

As foster parents, we should crave information. We should create concern about the ACE questions. The entire study refers to the respondent’s first 18 years of life. Just the time they will be in foster care, potentially in our home after such an adverse experience.

I think it is good to look at definitions for the study of abuse and examples from the CDC website. They are as follows:

  • Abuse

    • Emotional abuse: A parent, stepparent, or adult living in your home swore at you, insulted you, put you down, or acted in a way that made you afraid that you might be physically hurt.

    • Physical abuse: A parent, stepparent, or adult living in your home pushed, grabbed, slapped, threw something at you, or hit you so hard that you had marks or were injured.

    • Sexual abuse: An adult, relative, family friend, or stranger who was at least 5 years older than you ever touched or fondled your body in a sexual way, made you touch his/her body in a sexual way, attempted to have any type of sexual intercourse with you.

  • Household Challenges

    • Mother treated violently: Your mother or stepmother was pushed, grabbed, slapped, had something thrown at her, kicked, bitten, hit with a fist, hit with something hard, repeatedly hit for over at least a few minutes, or ever threatened or hurt by a knife or gun by your father (or stepfather) or mother’s boyfriend.

    • Substance abuse in the household: A household member was a problem drinker or alcoholic or a household member used street drugs.

    • Mental illness in the household: A household member was depressed or mentally ill or a household member attempted suicide.

    • Parental separation or divorce: Your parents were ever separated or divorced.

    • Incarcerated household member: A household member went to prison.

  • Neglect1

    • Emotional neglect: Someone in your family never or rarely helped you feel important or special, you never or rarely felt loved, people in your family never or rarely looked out for each other and felt close to each other, or your family was never or rarely a source of strength and support.2

    • Physical neglect: There was never or rarely someone to take care of you, protect you, or take you to the doctor if you needed it2, you didn’t have enough to eat, your parents were too drunk or too high to take care of you, or you had to wear dirty clothes.

I'm sure you see a correlation. A correlation exists between the reasons a child is put in foster care and the ACE study, right?

ACEs: What do I need to know?

ACEs: What do I need to know?

ACEs: What do I need to know? Absolutely Everything?

Actually, we just need to be aware of the study and its impact. More importantly, please be aware of the children impacted by these real-life issues each day. You may not get a child who simply has a divorced parent.

Realize that because of her divorce, a mom may struggle. She may struggle financially or emotionally and then use drugs to cope. (That is three ACEs in one child's life.) The cycle of one adverse experience could lead to another.

I also see a parallel between incarceration and foster care. If incarceration of a parent leads to issues later in life, then foster care has to. Foster care by name is excluded from the original study.

Four ACEs are the equivalent of five ACEs when calculating the adversity that will follow. So if you score a five or six, it is the same as a four. Four seems to be a cut-off of sorts to adversity in adulthood through lifestyle or illness.

There is another study, a similar study, that states the following in an abstract. Here are the results and conclusion:

More than half of respondents reported at least one, and one-fourth reported ≥2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P < .001). Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, ≥50 sexual intercourse partners, and sexually transmitted disease; and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life. -CDC

Their Conclusions:

We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.

ACEs: What do I need to know? You need to know that ACEs are very real and affect children into adulthood. Not only will the experiences affect the child's adulthood, but the experiences will also impact the next generation.

Your role is paramount in seeing foster care as a traumatic experience and doing something about it.

Finally, I will be giving advice on what we can do to help these children overcome the ACEs. Creating resiliency in foster children will be your top priority as a professional foster parent. More ways to become professional are:

ACEs: What do I need to know?

Leave a note if you took the ACE survey, read one article of research on ACEs, or both.

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Impressing Minds is about creating value in the mind of a child through the foster parents. Imagine the mind of a child being made of play-doh, and you are about to make a permanent impression. What type of impression will you make? I will encourage you to make a soft, lasting, affirmative impression in their mind by giving tools to get started fostering, accomplishing a great foster care home, and serving the children in your care. I offer support to you and others fostering. An important element of Impressing Minds is the support that others have given to those in need.


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