• You can learn more about ACES and figure out your ACES and your Resilience scores here.
• Here is a website developed by the U.S. Department of Health and Human Services that provides coping strategies someone may use when they are experiencing stress.
• To understand more about psychological and verbal abuse, watch this three-and-a-half-minute TEDx Talks video.
• The Pennsylvania Carey Law School presents a 19-minute video about the intersectional challenges that immigrant women face while trying to become independent, and the ways that domestic violence impacts their progress.
• The PBS 26-minute video Battling Elder Abuse will help you learn more about how to recognize and combat elder abuse.

1. What do you think is the most important lesson for parents and other caregivers to know about ACEs and protective childhood experiences? How do you think that knowledge of these two concepts could positively impact the behavior of individuals, the work of community organizations, or the development of public policy?
2. How do healthy interpersonal relationships impact our lives? What role do your loved ones play in creating a sense of stability and safety in your life?
3. Why do some families have more access to the resources they need to be safe? What kinds of changes do you think should be made to increase access to safety and stability for all families?
4. How can we better address sexual violence and rape culture as a society?
5. Can you think of any social supports (government assistance, community resources, relationships) that did or would have positively impacted the life of your family as you grew up? Are there any current social supports that you’re not currently receiving that could make a difference in your life? Why?
6. Out of all of the factors that can help promote and create safety and stability within families, which of the factors do you think is most important? Why?

• Adverse childhood experiences (ACEs): traumas that occur in an individual’s life before they turn 18, which include neglect, abuse, and household difficulties.
• Child abuse: the intentional emotional, negligent, physical, or sexual mistreatment of a child by an adult.
• Elder abuse: when older people are deprived of care or intentionally harmed by their caretakers.
• Emotional abuse: nonphysical maltreatment through verbal language.
• Epigenetics: the study of how your behaviors and environment can cause changes that affect the way your genes work.
• Intergenerational trauma: a phenomenon in which the descendants of a person who has experienced a terrifying event show adverse emotional and behavioral reactions to the event that are similar to those of the person who experienced the event.
• Intimate partner violence (IPV): any incident or pattern of behaviors (physical, psychological, sexual, or verbal) used by one partner to maintain power and control over the relationship.
• Neglect: failure to meet a child’s basic needs.
• Physical abuse: any act, completed or attempted, that physically hurts or injures someone.
• Protective and compensatory childhood experiences (PACEs): experiences that help children develop and promote resilience, even if they also have some adverse or traumatic childhood experiences.
• Rape culture: a society or environment where there is a culture of disbelief and lack of support for sexual violence survivors through normalizing and trivializing sexual violence despite its prevalent occurrence.
• Restorative justice: an intentional way of handling an offense involving three stakeholders within an organization or community: the person(s) who has offended, the person(s) who were harmed, and communities of care and reconciliation.
• Restorative practices: a social science that studies how to build, strengthen, and repair relationships among individuals, as well as connections within communities.
• Sexual abuse: maltreatment, violation, and exploitation where a perpetrator forces, coerces, or threatens someone into sexual contact for sexual gratification and/or financial benefit.
• Sexual violence: making degrading comments, touching in unpleasant means of harm, or addressing a partner in a degrading way during sexual intercourse, which includes marital rape.

It’s important to understand the long-term effects of trauma as well as the ways that communities can address safety and trauma. If you’d like to learn about these topics, participate in this activity.

Watch this video featuring the former Surgeon General of California and pediatrician Dr. Nadine Burke Harris, who explains how ACEs can impact health in the long term but also ways that communities can address these issues before they get to that level (figure 9.9).

https://youtu.be/95ovIJ3dsNk

Discussion Questions

1. How do ACEs impact children’s health outcomes?
2. What is the benefit of screening children for ACEs?
3. What can local and state public health agencies do to reduce the health impact that ACEs have on children?