In the mostly rural communities along Interstate 75 in east Tennessee, well-known to law enforcement as a North-South drug corridor, caseworkers are getting an increasing number of calls to check on the welfare of children who live with parents addicted to prescription painkillers or methamphetamine.

What lies on the other side of a knock on the door is often an abused or neglected child. Even in these circumstances, caseworkers find that a child who has had just one caring adult in his or her life remains resilient, said Julie Rotella, executive director of regional support for the Department of Children’s Services.

“For me, a lot of times it’s just looking kids in the eye to see whether they have had support wrapped around them,” Rotella said. “Some kids can’t even look you in the eye or barely meet your eyes. What that tells me is that child doesn’t have support in their life. They’re in survival mode. Other kids have some hope in their eyes, and you know they’ve had someone looking out for them.”

Research on the far-ranging impact of childhood trauma — what experts are now calling “Adverse Childhood Experiences” or ACEs and “toxic stress” — has prompted state leaders to take a harder look at prevention efforts.

In November, a newly launched Memphis-based charitable initiative, The ACE Awareness Foundation, will convene a Nashville summit of business leaders, charities, social welfare agencies, education officials and state government in an ambitious effort to create a statewide awareness program with the goal of making Tennessee a model in combating toxic stress in generations to come.

Map:Prevalence of 2 or More Adverse Childhood Events Experienced by Tennesseans

In 1995, the Centers for Disease Control and Prevention and Kaiser Permanente in San Diego launched a long-term study tracking the 17,000 people into adulthood who were being served by the California health insurance agency. The study measured each participants’ adverse childhood experiences and how those affected them through life.

As the annual results were released over recent years, researchers concluded that the greater number of adverse experiences in early childhood, the greater the risk for health problems including heart disease and diabetes, depression, suicide, poor anger management, substance abuse and incarceration.

Neuroscientists have documented the impact on a child’s developing brain. In the first few years of life, there are 700 new neural connections made in a child’s brain every second, according to Harvard University’s Center on the Developing Child.  In the rapidly developing brains of children from birth to age 3, exposure to even one adverse childhood experience — such as divorce, abuse, a parent with mental illness or one who has died — can cause the brain to rewire.

The whir of brain activity that makes children open to learning in their early years also makes them vulnerable to damage from the stress that accompanies adverse experiences, permanently altering the brain’s chemistry.

Those traumas also come at a financial cost, said Chris Peck, director of the Memphis-based ACE Awareness Foundation. Early intervention to protect against adverse experiences, often called  “toxic stress,” can lead to $143,400 in increased lifetime earnings and $28,200 in reduced health care costs, he said.

In Tennessee, one in five residents had been exposed to three or more adverse experiences in childhood, according to a telephone survey by the Department of Health modeled on a questionnaire developed by the CDC. In some counties, more than 40 percent of residents had been exposed to two or more adverse childhood experiences. A Tennessean with four or more adverse childhood experiences is twice as likely to be out of work and half as likely to have health care coverage as a person with zero.

The ACE Awareness Foundation is partnering with the Haslam administration and the Baltimore-based Annie E. Casey Foundation to launch a statewide education initiative to make the case to leaders in private industry, health care, government agencies and social welfare organization that investing in prevention efforts now will “save the state a lot of money, reduce the impact on the special education system, the criminal justice and health system so future generations of Tennesseans aren’t having to deal with the residue of adverse experiences.”

The ACES Foundation will host a summit in Nashville on Nov. 12 to begin to launch a statewide conversation. Director Chis Peck said his goal is for Tennessee to become a national model over the next three years in prevention and in creating ways of instilling resiliency in children. Research from Harvard University shows that even children exposed to multiple adverse experiences can develop resilience if there is just one engaged and caring adult in their lives.

Mobile users:  View a map of the prevalence of adverse childhood events experienced by Tennesseans

Prevalence of 2 or More Adverse Childhood Events Experienced by Tennesseans (Over age 18), 2012.


DISCLAIMER: County* level data are estimates, which may be statistically unstable, and should be interpreted with caution.              

SOURCE: Source: Behavioral Risk Factor Surveillance System Public Use Dataset (2012), Centers for Disease Control and Prevention            

(http://www.cdc.gov/brfss/annual_data/annual_2012.html. Accessed February 5, 2014)

Analysis performed by Division of Family Health and Wellness, Tennessee Department of Health            

Report Date: October 1, 2015            


*If county is not listed, no data available

Reach Anita Wadhwani at 615-259-8092 or on Twitter @AnitaWadhwani.

ADVERSE CHILDHOOD EXPERIENCES

Stressful or traumatic experiences that disrupt the safe, nurturing environment that children need to thrive are defined as Adverse Childhood Experiences. The Centers for Disease Control developed the following categories of ACEs:

Separation or divorce

Substance abuse

Emotional abuse

Violence between adults

Mental illness

Physical abuse

Sexual abuse

Incarceration

Source: Tennessee Department of Health