Best Practice

Adverse childhood experiences and the implications for schools

Half of children will live through an adverse childhood experience and around one in 10 will suffer four or more. How can schools support these young people? Lynn Miles, who suffered ACEs herself, explains more and offers her advice

It is becoming increasingly apparent that large numbers of children in this country are growing up in a high state of distress.

Around one-third of our children are living in poverty according to the Child Poverty Action Group, while the Mental Health Foundation reports that one in 10 of five to 16-year-olds has a diagnosable mental illness.

Studies conducted in England and Wales show that around half of adults suffered one adverse childhood experience (ACE) and around one in 10 endured four or more by the age of 18 (eight per cent in England, 14 per cent in Wales) (Bellis et al, 2014 & 2015).

Such ACEs include neglect, emotional, sexual and physical abuse – often perpetrated by the primary care-giver – and living in a house where there is mental illness, drug and alcohol addiction, domestic violence or parental incarceration. The long-term impact of this adversity – particularly in the very early years when children are at their most vulnerable developmentally – on educational outcomes, physical and mental health, life chances, quality and length of life is shocking. Schools, in particular, should be aware of the extent of the issue and what they can practically do in response.

Trauma is one of the possible outcomes of exposure to adversity. It occurs when a person perceives an event or set of circumstances as extremely frightening, harmful or threatening – either physically, emotionally or both. Some experiences can be so overwhelming for children and young people that it creates a sense of terror and helplessness in the short term, which can be triggered without warning later in life.

Likewise, when children experience adversity that is extreme, severe and long-lasting without adequate support from a care-giving adult, the stress response system (fight, flight or freeze) becomes over-active and recalibrated. This is known as “toxic stress” and it gradually wears the body and brain down over time.

It is a tremendously worrying situation, but fortunately there is increasing evidence and enough success stories out there to show us what needs to be done – and, as is so often the case, school is well placed to make a significant impact and change the trajectories of struggling children’s lives.

I am one of the 10 per cent of children who suffered four or more ACEs. At primary school I was violent and unpredictable and at secondary school withdrawn and disengaged. I was angry, hurt, could not see the point of education and I did not trust adults. Why would I – they lie, let you down and cause you pain. No-one had bothered to show me how to express my emotions or to ask for what I needed – so I threw things. I threw books, chairs, desks, even children, and, every time I did, I got the teachers’ attention.

Fortunately, thanks to a few perceptive teachers, flexibility in the school system and my welfare being more of a priority than exam results, I turned out okay. They understood what my throwing meant and took the time to build relationships with me, taught me new strategies to deal with my emotions, filled the skills gaps I had, then channelled my strength and anger into throwing javelins instead of furniture.

Somehow, these teachers just got me. I could never sit still and could not relax because I need to release my anxiety regularly. I was permanently hypervigilant, so every new room I walked into I scanned for safety and needed to choose where I sat – it was exhausting, for them and me, but they made the necessary accommodations. School was my safe place – it was the few hours of joy I experienced every day. I dreaded the holidays, evenings and weekends and tried to stay at school for as long as I could.

So now, 30 years after getting out of the frightening environment that I lived in for my first 18, I still deal with the damage done to my physical and mental health, my understanding of people and relationships, my education and my work – every day. If it had not been for those teachers, my life would have been very different and I would not have trained to be a teacher and chosen to work with children like me throughout my career.

All school staff need to understand what it is like to live in the body and life of a child experiencing adversity – but you can never truly understand it if you have not actually lived it. You cannot imagine what it is like never to feel safe and to be hypervigilant all the time. To this day the slightest noise wakes me up in the night, a door slamming activates my stress response system, people arguing and changes to my routine cause me to freeze, and unexpected questions from managers at work impact on my ability to think clearly. Those of us who have experienced adversity do what we must to get ourselves through the day.

However, schools can assist in making life better for these children and can even begin to help them heal. If our education system is supposed to prepare our children for life and give them the tools they need to succeed, we cannot ignore their suffering and must create environments that allow them to learn, flourish and fulfil their potential.

A handful of strategies implemented over a term by a few staff will not work here – there is no low-cost, quick-fix solution. This damage has been done to these children over many years and the current school system is exacerbating their difficulties. Whole school changes to policy and practice – consistently implemented – are the way to address these challenges and research tells us it is the best approach for all children, not just those who are having difficult childhoods.

There is no one-size-fits-all model either – this is complex. Buying in an intervention and training all the staff to use it will not always work – schools, particularly senior leaders, need to truly understand what they are dealing with and proactively take steps to address it, so we help children to thrive rather than just survive.

Yes, it is quicker to buy in, but all schools and contexts are different and while it can be difficult tackling these concepts, making them tangible and implementing them on the ground, it is what needs to be done. Explicit whole-school training, support, strategies and resources are therefore the best approach – this needs to be for all staff, often personalised and on-going. A few sessions can raise awareness but can merely cause frustration for teachers who are on the front-line and work in a system where the policies do not support what needs to be done.

Zero tolerance, punitive behaviour policies are ineffective and there is plenty of research to support this. They especially do not work for children who have had difficult childhoods, as incentive or threat-based strategies are not powerful enough to stop deep-rooted behaviour that has served as protection in the past. Restorative practices are needed to improve and repair relationships between people and communities. Mercifully schools are beginning to replace “discipline” policies with “relationship” polices.

Children experiencing adversity are likely to be a year behind their peers academically by the time they finish year 6. It seems some secondary schools have started to prepare children who are lagging behind from year 7 for GCSEs, but narrowing the curriculum and focusing on the basics for these children is the wrong approach. They need music, art, drama, dance, sport and technology – subjects that are practical with therapeutic qualities that help children regulate, allow them to feel a sense of success, let them express themselves and their creativity, and help to repair some of the damage done to the brain through early adversity.

These children also need the most qualified and experienced staff. Not unqualified teachers, teaching assistants or supply staff – permanent, knowledgeable professionals who understand what has happened to them and the impact it has had on their bodies and minds. Staff who will be there consistently and compassionately, no matter what these children throw at them.

Ultimately, schools need to become ACE-aware, Attachment-aware and trauma-informed to create safe environments for our children, build supportive and trusting relationships with them, teach them the skills to regulate their disregulated bodies so they can begin to manage their emotions and behaviour, and get to a place where they are ready to learn.

Recommended tools that can have a significant impact include:

  • Continuously maintain an awareness of the impact of ACEs, toxic stress and trauma and strive to ensure that all pupils feel safe, supported and connected.
  • Maintain a safe, predictable, calm environment that prioritises relationships and consistency.
  • Show unconditional positive regard to all pupils (and school staff) at all times.
  • Remember that behaviour is a symptom of the problem, not the problem. Be curious about behaviour – ask “what happened to you?” rather than “what is wrong with you?”
  • Eliminate stress triggers from the environment – loud voices, abrupt sounds, etc.
  • Take an interest in the pupils – they need to know you care.
  • Teach pupils to self-regulate and calm their stress response system.
  • Listen to the pupils more and talk at them less.
  • Focus on the positive – communicate pupils’ successes to them and their families regularly.
  • Support the pupils’ care-givers and connect with the whole family – it improves the pupils’ outcomes.
  • Follow your instincts – welcome them back after a break.
  • Take care of yourself – the children need you to be at your best.
  • Do not take things personally – it is not about you.

Implementing these changes and success with these pupils will be slow and challenging, but the evidence is clear – if we continue as we are many vulnerable children are likely to struggle for the rest of their lives.

  • Lynn Miles is a lecturer in education at Teesside University, which offers related ACE short courses, whole school CPD and, from September 2019, an MA Education (Trauma Informed Practice).

References

  • National Household Survey of adverse childhood experiences and their relationship with resilience to health-harming behaviours in England, Bellis et al, BMC Medicine, 2014.
  • Adverse Childhood Experiences and their impact on health-harming behaviours in the Welsh adult population, Bellis et al, Public Health Wales, 2015.