On the Job 

The negative experiences of children affect who they become, their physical and mental wellness, and their ability to succeed in life, according to a pediatrician and expert on child abuse featured at the Ohio Attorney General’s “Ideas for Our Future” conference.

Robert Shapiro, M.D, of Cincinnati Children’s Mayerson Center for Safe and Healthy Children told the almost 700 attendees gathered at the March 27 event in Mason, Ohio, that stressful experiences can change a child on a biological level, and those changes can last a lifetime.

Having a better understanding of the challenges faced by these children will go a long way toward providing solutions, said Ohio Attorney General Mike DeWine.

“Half of the children in foster care today are there because one or more of their parents are drug addicts,” DeWine said. “These children also suffer from being taken out of the home, which is sometimes very necessary, but no less traumatic. These are the innocent victims of this epidemic.

“Our summits and initiatives are having a positive impact across Ohio,” he said. “Together we’re making progress. But there’s still a great deal of work we have to do.”

Children who suffer as a result of their parents’ opioid addiction and chaotic living conditions adapt to survive. 

“If you have to deal with stress, if you are a victim of abuse and neglect, if your parents aren’t there for you because they are dependent on opioids, you have to be a different person to survive,” Dr. Shapiro said.

He cited the “Adverse Childhood Experiences” (ACEs) study, conducted from 1995 to 1997 by Dr. Vincent Felitti of Kaiser Permanente and Robert Anda from the Centers for Disease Control and Prevention, which connected a variety of adult diseases to the abuse, neglect, and household challenges that individuals experienced as children.

For the study, Felitti and Anda sent questionnaires home with 17,000 patient volunteers. The study found that 10 questions could be used to predict patients’ health.

Shapiro was not surprised at the outcome of the ACEs study, which showed that if a person grew up in a home with abuse and neglect, he or she might experience mood disorders or anxiety disorders, substance abuse issues, and poor impulse-control as an adult.

He was especially interested in the statistics, which show a link between early childhood trauma and a shorter lifespan.

“Those who have zero ACEs have a 60 percent chance of living to age 65 or more, and those with ACE scores of four or more have a less than 3 percent chance of living to the age of 65,” he said.

Recent studies indicate survival adaptations extend to chromosomes. Telomeres, the DNA–protein structures found at both ends of each chromosome, protect them from damage. Telomere length, which can be affected by lifestyle factors, can change the pace of aging and onset of age-associated diseases.

ACE scores of four and up can indicate a higher risk for heart disease, stroke, chronic lung disease, and diabetes. The score, however, is not destiny, Sharpiro said. Good relationships can offset the negative effects of a high score and toxic stress.

With help, children can build resilience and overcome their trauma.

“Positive relationships can shield children from ACES,” Shapiro said. “Teachers, coaches, and other adults in the community play a critical supportive role at building resilience.

“We can address ACES by helping parents cope with subjunctive childhood behaviors. We can provide mental-illness and substance-abuse treatments. We can provide support programs for parents and help with teen pregnancy prevention. We can encourage home visiting programs. We can address intimate partner violence. We can provide social support for parents. We can offer high- quality low-income daycare and sufficient income support to families with low income.”

Adverse Childhood Experiences (ACEs) quiz

To find your Adverse Childhood Experiences (ACE) score take this quiz.
Prior to your 18th birthday:

1. Did a parent or other adult in the household often swear at you, insult you, put you down, or humiliate you or act in a way that made you afraid that you might be physically hurt?If yes, add 1 __
2. Did a parent or other adult in the household often push, grab, slap, or throw something at you or ever hit you so hard that you had marks or were injured?If yes, add 1 __
3. Did an adult or person at least five years older than you ever touch or fondle you or have you touch their body in a sexual way or attempt or have intercourse with you?If yes, add 1 __
4. Did you often feel that no one in your family loved you or thought you were important or special, or your family didn’t look out for each other, feel close to each other, or support each other?If yes, add 1 __
5. Did you often feel that  you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you, or that your parents were too drunk or high to take care of you or take you to the doctor if you needed it?If yes, add 1 __
6. Were your parents ever separated or divorced?If yes, add 1 __
7. Was your mother or stepmother often pushed, grabbed, slapped, or had something thrown at her, or sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard, or ever repeatedly hit over at least a few minutes or threatened with a gun or knife?If yes, add 1 _
8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?If yes, add 1 __
9. Was a household member depressed or mentally ill, or did a household member attempt suicide? If yes, add 1 __
10. ​Did a household member go to prison?If yes, add 1 __

Now add up your “yes” answers: ____ This is your score. This is an edited version of the test. Scores of four or higher might indicate health risks.