Adverse Childhood Experiences and Chronic Absenteeism
Much of our work “revolves around advocating for state and national policies that seek to address chronic absenteeism, particularly those that address the underlying health issues that so often cause excused absences,” wrote the Illinois-based Healthy Schools Campaign in 2014. “If policies are in place that support schools and communities in effectively tackling students’ chronic and acute health problems, then we can make sure that students are in school and ready to learn.”
So what are these “chronic and acute health problems” that impact student attendance?
In 1995, the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente launched a study to investigate the impact of childhood abuse and neglect on later-life health and well-being. “Childhood experiences, both positive and negative, have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity,” writes the CDC. ACESTooHigh, a news site that reports on research about Adverse Childhood Experiences (ACEs), explains that ACEs “harm children’s developing brains so profoundly that the effects show up decades later; they cause much of chronic disease, most mental illness, and are at the root of most violence.”
The 1995 – 1997 study conducted by CDC and Kaiser Permanente generated what is called the “ACE Pyramid” to illustrate how trauma can lead “to the adult onset of chronic diseases, depression and other mental illness, violence and being a victim of violence,” ACESTooHigh continues. The “ACE” Pyramid shows how Adverse Childhood Experiences influence health and well-being throughout the lifespan. According to the pyramid, ACEs disrupt neurodevelopment which can result in social, emotional and cognitive impairment and the adoption of Health-risk Behaviors; in turn this can lead to disease, disability and social problems; and ultimately, early death.
Attendance Works is a national and state initiative that “promotes awareness of the important role that school attendance plays in achieving academic success starting with school entry.” One of their reports (cited below) elucidates that a myriad of factors can contribute to chronic absenteeism among students, including, but not limited to the relative promotion of school attendance, parent outreach and engagement, as well as social, health and economic conditions in the community. Each of these factors can be influenced by ACEs. According to ACESTooHigh and the Oregon Pediatric Improvement Partnership, “ACEs are responsible for a big chunk of workplace absenteeism” among adults, and studies have since “implicated ACEs in school failure and absenteeism in children.”
Oregon’s Gladstone School District is one district taking steps to learn about and address the Adverse Childhood Experiences their students face. At a symposium in the August of 2012, the school district’s administrators and counselors had the opportunity to listen to presenters Dr. Vincent Felitti and Dr. Chris Blodgett, both experts in the field of childhood trauma. “Their research confirmed what we were already seeing in kids,” says Bob Stewart, Gladstone’s current superintendent. “We have always known that the ‘stuff’ in kids’ lives gets in the way of learning and well-being. We had no idea of the lifetime of health related consequences that ACEs meant for individuals. We came away believing that ACEs were a major issue that we needed to explore and do something about. The question was what could we do?” Stewart learned that addressing ACEs necessitates “creating a school environment and culture that is calming and supportive of all kids,” he says. This includes daily calming and self-regulation strategies and encouraging adults to be mindful of practices and routines that are supportive of all kids, “especially children who have had an accumulation of ACEs.”
“Over 90% of school age children in Oregon attend public schools,” Stewart recalls, “most children have at least one ACE and nearly 1/3 have accumulated three or more. ACEs are pervasive and is a public health crisis. There is no better place to mitigate the damage to children than our public schools.” While many researchers have written about ACEs few have developed strategies to address their consequences in school settings, he explains. To fill this void Stewart’s district received a small grant from Care Oregon: “the purpose of our work was to explore what could be done in a public school setting.”
Gladstone has looked to other districts for guidance and examples. “Lincoln Alternative High school in Walla Walla teaches students about ACEs as a way for students to better understand what is going on inside their bodies,” Stewart says. “I believe that it can also help reduce the likelihood that the cycle will continue when students become parents. Students who have accumulated multiple ACEs are more likely to have significant behavioral issues, perform poorly in school and have poor health/attendance. All of which can further complicate their ability to graduate from high school.”
“A school culture that is safe and secure can do a lot to assist students,” Stewart continues, “the school can be the place where students feel like they belong.” If a school can support and build this environment “using strategies and interventions to support children, particularly adolescents, and mental health supports for the most impacted students,” he says – they’re taking a step in the right direction. “I would encourage educators to study ACEs,” encourages Stewart. “There is too much emphasis on ‘trauma informed practices.’ The difference is that trauma is a term most often used for people who are exhibiting behaviors associated with trauma. ACEs are a significant under-pinning of trauma. Focusing on trauma misses the impacts of ACEs that may not show up until later in life.”
Interested in learning more? Take a look at what some other groups around the country are doing in regard to ACEs and a trauma sensitive approach to education:
Trauma and Learning Policy Initiative (TLPI): A collaboration of Massachusetts Advocates for Children and Harvard Law School
A collection of Huffington Post articles discussing Trauma Informed Classrooms
George Fox University’s Trauma Response Institute
“ACEs Science 101 « ACEs Too High.” ACEs Too High. Accessed February 3, 2017. https://acestoohigh.com/aces-101/.
Attendance Works. “Understanding the Factors Contributing to Chronic Absence in Your School - FACTORS CONTRIBUTING TO CHRONIC ABSENCE: QUESTIONS FOR YOUR SCHOOL OR COMMUNITY.” Attendance Works. Last modified 2010.
CDC. “About the CDC-Kaiser ACE Study Error Processing SSI File.” Centers for Disease Control and Prevention. Accessed February 3, 2017. https://www.cdc.gov/violenceprevention/acestudy/about.html.
Healthy Schools Campaign. “Addressing Chronic Absenteeism and Trauma in Oregon.” Healthy Schools Campaign. Last modified August 31, 2016. https://healthyschoolscampaign.org/policy/education/trauma-and-chronic-absenteeism-collide-in-oregon/.
Oregon Pediatric Improvement Partnership. “Adverse Childhood Experiences (ACEs) / Trauma-Informed Care.” Oregon Pediatric Improvement Partnership. Accessed February 3, 2017. http://www.oregon-pip.org/focus/ACEs_Trauma.html#References.