This informal CPD article ‘Understanding Adverse Childhood Experiences (ACEs) and Their Impact on Behaviour and Development’, was provided by Rachel Webb of Phoenix-Kaw Care Consultancy, a health and social care training and consultancy organisation dedicated to improving standards of care across the sector.
Adverse Childhood Experiences (ACEs) refer to potentially traumatic events that occur during childhood, such as abuse, neglect, or exposure to domestic violence. Research shows these experiences can have long-term effects on a child’s physical, emotional, and psychological development (1). Understanding ACEs helps professionals identify early risk factors and apply trauma-informed approaches that promote recovery and resilience.
The Main ACE Categories
ACEs are grouped into three main categories: abuse, neglect, and household dysfunction, such as parental mental health difficulties, substance misuse, or separation (2). These stressors can impact brain development, attachment, and emotional regulation, influencing how children respond to stress and relationships throughout life (3). Repeated exposure to trauma without appropriate support can increase the risk of anxiety, depression, or chronic health conditions in adulthood (4).
Protective Factors
Protective factors such as a stable, trusting relationship with at least one supportive adult, early intervention, and access to appropriate services can significantly improve outcomes (5). Professionals across education, health, and social care play a vital role in creating environments that promote safety, trust, and empowerment. Trauma-informed practice focuses on empathy, consistency, and collaboration, reducing the likelihood of re-traumatisation and promoting healing (6).
Recognising ACE Behaviour
Children affected by ACEs may show behaviours such as aggression, withdrawal, or hypervigilance often as coping mechanisms rather than deliberate defiance (7). Recognising these behaviours as communication of unmet needs allows staff to respond with compassion and understanding. Providing structure, reassurance, and positive reinforcement can help build stability and encourage emotional regulation.
Importance of Multi-Agency Collaboration
Addressing ACEs effectively requires strong multi-agency collaboration. When education, health, and social care professionals share information and coordinate support, children receive holistic and consistent care (8). Ongoing training, reflective supervision, and team discussions are key to embedding trauma-informed principles into everyday practice (9).
Final thoughts
Ultimately, understanding ACEs is about more than recognising trauma it is about fostering resilience, trust, and empowerment. By building safe relationships and promoting self-awareness and regulation, professionals can help children and young people overcome adversity and thrive (10).
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References
(1) Felitti VJ et al. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventive Medicine.
(2) Public Health England (2021). Adverse Childhood Experiences (ACEs): Understanding and Response. London: PHE.
(3) NHS Health Scotland (2019). Adverse Childhood Experiences (ACEs) and their impact. Edinburgh: NHS Scotland.
(4) Bellis MA et al. (2019). Adverse childhood experiences and mental well-being: from childhood to older age. BMJ Open.
(5) Early Intervention Foundation (2020). The role of protective factors in supporting child resilience. London: EIF.
(6) NICE (2022). Trauma-informed care: promoting psychological safety. NICE Guidance NG225.
(7) NSPCC (2020). How childhood trauma affects behaviour. London: NSPCC.
(8) Department for Education (2023). Working Together to Safeguard Children. London: DfE.
(9) SCIE (2021). Embedding Trauma-Informed Practice: Key principles and approaches. London: Social Care Institute for Excellence.
(10) YoungMinds (2022). Building resilience in children affected by trauma. London: YoungMinds.
