Adverse Childhood Experiences and Chronic Absenteeism

Hania Marien's profile
Hania Marien

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:


ACEs Science 101 « ACEs Too High.” ACEs Too High. Accessed February 3, 2017.

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.

Healthy Schools Campaign. “Addressing Chronic Absenteeism and Trauma in Oregon.” Healthy Schools Campaign. Last modified August 31, 2016.

Oregon Pediatric Improvement Partnership. “Adverse Childhood Experiences (ACEs) / Trauma-Informed Care.” Oregon Pediatric Improvement Partnership. Accessed February 3, 2017.


Rosetta Herkshan's profile
Rosetta Herkshan

Thank you for sharing this information! We learn a lot about Trauma Informed Practices and even “Lateral Suppression” but this casts a light on a more specific point that seems to have been overlooked. I appreciate this information so much!

The school I work in has 670 students and a great number are experiencing some form of this. I hope this information can lead to a proactive approach to the way we work with our students.

Hania Marien's profile
Hania Marien

Hi Rosetta,

I apologize for not replying sooner, I am just now realizing that I need to go to the individual posts to see that someone commented. I’m glad you enjoyed the post. Would you be able to explain “Lateral Suppression” to me? Based on your understanding, how might it impact your students?

Rosetta Herkshan's profile
Rosetta Herkshan

“Lateral Suppression” is often referred to when we see intent to dominate instead of lead among our leaders and people. Even “self-hate” displayed by shame of being identified as Native American or ashamed of the way our people are stereo typed in modern times.

Sadly, we see this in many of our leaders. The adverse control and dominance displayed by the government, education being one of the weapons used against our people, years ago has trickled down into our leadership today. Decisions being made that are not in the best interest of the people for personal gain can cause the community to feel dominated and suppressed. In effect the oppressed become the oppressors.

This attitude can definitely impact the students on a community level. We live on a reservation, many are closely related or closely acquainted, so the general attitude displayed by leadership and the effect it has on the members of the community does have a daily impact on the students. The ripple effect so to speak: suppressed by the government, leaders suppress the people, the people suppress their children. It’s an unfortunate cycle but having information about topics such as this will help to combat that attitude and see where we can do our part to break that cycle.

I strongly believe, based on the work we’ve been doing, that being in the “Family Advocate” position has created a unique opportunity to begin to mend the relationships between the Native American community and also creating steps to create a more positive relationship with the school system.

Cheng-Fei Lai's profile
Cheng-Fei Lai

House Bill 4002 (2016) directed the Chief Education Office in partnership with the Oregon Department of Education and the Oregon Health Authority to pilot a 3-year pilot using trauma-informed approach to improving the delivery of education, health services, and interventions in two high schools: Central High School in Polk County and Tigard High School in Washington County.

In this pilot, we strive towards (1) creating physically and psychologically safe environments for all staff and students; (2) realizing both the widespread impact of trauma and the role of schools in promoting resiliency; (3) recognizing the signs and symptoms of trauma in students, family, and staff; (4) responding to fully integrating knowledge about trauma into policies, procedures, and practices; and (5) resisting re-traumatization of students and staff and fosters resiliency.

Based on results from other studies, this pilot has been collecting information from a variety of educational and health sources to better understand and articulate a plan for Trauma Informed education, including student attendance and school attendance (Bethell, Newacheck, Hawes, & Halfon, 2014; Blodgett, et al., 2015), behavioral and health data (Blodgett, et al., 2015). Even though these student-level data will be examined throughout the pilot study, we do not anticipate seeing the effects of trauma-informed practices influencing students until towards Year 3. We are anticipating intermediate changes such as a positive shift in attitudes toward trauma-informed approaches as a result of enhanced understanding by teachers, staff, and providers about signs/symptoms of trauma and the broader adoption of a trauma-informed approach earlier in this study.

Hania Marien's profile
Hania Marien

Thank you all for sharing your thoughts. It’s wonderful to have a space to draw on each others’ experiences.

I would like to share one more related resource that Ramona sent along from Education Northwest: A Practitioner’s Guide to Educating Traumatized Children

Ramona Halcomb's profile
Ramona Halcomb

Thank you all for sharing. One of my favorite quotes that I try and live by is to remember…”Hurting People - Hurt People” I am attaching a blog that goes into detail about this and has a lovely picture that I usually keep at my desk. I tried to post the link but it was flaged as spam, if you google Vivadivine.blogspot hopefully you’ll find it. Make it a great day! Ramona