and There’s also a tricky thing on how you view the world – some people will see the world through the ACE lens, some through different lens. Of course early years matter, primary, secondary and tertiary prevention. Nobody is arguing with the fact that poverty, poor housing etc isn’t important, and more important. Most are not only rigidly sticking to what ACEs were identified in the original studies. The same issues are inherent in many other concepts that are framed as big threats. As with many simplified concepts, ACEs present limitations. Epidemiology and the web of causation: has anyone seen the spider? 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Close this message to accept cookies or find out how to manage your cookie settings. They include diverse types of exposures, are often considered cumulatively, can be identified using prospective and retrospective approaches, and their multidimensional nature may lead to greater measurement error. Sunderland‐Evans, Wendy One of the main criticisms of the ACEs model is that its biomedical focus “might lead to the importance of socioeconomic conditions being overlooked” (Taylor-Robinson et al 2018, see also Edwards et al 2017, Kelly-Irving and Delpierre 2019, Anderson 2019). Pinto Pereira, Snehal M. As the ACEs concept becomes popular in the context of policy interventions, concerns have emerged. Responses to Edwards et al.’s submission to the House of Commons Science and Technology Select Committee Inquiry into the evidence-base for early years intervention (EY10039). Often that’s a problem inherent with the paradigm and evidence question generating processes and a reflection of the social complexity (and thus difficulty of succinctly summarising evidence of what do “do”). All risk factors are unevenly distributed. This shouldn’t exclude judicious enquiry, followed by appropriate response. and Change ), You are commenting using your Google account. As a probabilistic and population-level tool, it is not adapted to diagnose individual-level vulnerabilities, an approach which could ultimately exacerbate inequalities. People being critical of the ACE framework seems increasingly common. Davies, Mike The criticism comes from several perspectives, often well founded. The negative consequence of using this as a diagnostic framework often not acknowledged. Nobody arguing otherwise. Ward, Michael R.M. Of the ACE study participants who experienced one ACE category, 87 percent experienced others and over 50 percent experienced four or more. Its really rather complicated in some respects, but paradoxically simple in others. But the early years ARE the most impactful. Walsh, David 2020. Lacey, Rebecca E We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Over hope in rapid results, magic bullets and simplistic solutions. Its an explanatory factor not a diagnosis. I do see a lot of the narrative, and evidence summaries for interventions, seemingly over focus on interventions delivered to individuals rather than creating environments, communities and contexts that support well being. McCartney, Gerry Implementation without critical analysis is a mistake. He brings together brain development, early years, trauma and ACEs research and the key protective factor being the quality of relationships, particularly in the first year of life, and why we need to be careful in how we offer support in the aftermath of traumatic events. Those with 4+ ACEs were more likely to live in deprived areas, be unemployed/on long-term sickness and have no qualifications. Lacey, Rebecca E. Again, all valid. Early good work can be undone by toxic influences later in life. I’m also aware of a prominent criticism from Prof White and others. However the framework and thinking that ACEs can give us can certainly open up new responses to (and reasons for) improving our primary prevention and improving resilience and our response across multiple settings and across a whole life course. Can lead to medicalisation of social construct & There is often enthusiasm as an answer to all social ills. ACEs is an explanatory factor at cohort level. included the ACE Study questionnaires as an addendum to the document Preventing Child Maltreatment: A Guide to Taking Action and Generating Evidence. O'Halloran, Aisling M Full text views reflects the number of PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views. 2020. Kelly-Irving, Michelle and See here (plus tables with supporting evidence) for an excellent summary from Prof Bellis and others. View all Google Scholar citations I’m aware it may get me into hot territory. Li, Leah Specifically, the ACE Study model relies strongly on the idea that adverse childhood experiences create a burden of psychological stress that changes behavior, cognitions, emotions, and physical functions in ways that promote subsequent health problems and illness. and 3. ACEs have a dose-response relationship with many health problems. Change ), You are commenting using your Facebook account. Iob, Eleonora Spratt, Trevor Jones, Sara 22 Among the hypothesized pathways, adverse childhood experiences lead to depression and posttraumatic stress disorder, which in turn can …

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