critique of aces study

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November 29th, 2020

12 December 2017. We forget at our peril that equally (?more) important is the positive presence of good things, the importance of assets, single anchoring relationship, its not what happened to you but how you have managed to process what has happened – quality of relationships it the key buffer. ACEs have a … We do misconstrue epidemiological and direct clinical evidence, that is different. The focus of this review was to identify evidence around ACEs and trauma-informed approaches to education and how ACEs can impact educational outcomes. There IS a need for a different response – what happened to you vs what matter with you etc. Here, we present a critique of the ACEs framework, discussing its strengths and limits. ACEs is an explanatory factor at cohort level. As with many simplified concepts, ACEs present limitations. Darra, Susanne Li, Leah Smith, Michael 2020. Lacey, Rebecca E This shouldn’t exclude judicious enquiry, followed by appropriate response. Briggs, Robert 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”). Adversity in childhood has lifelong impact. Darra, Susanne Devaney, John Most are not only rigidly sticking to what ACEs were identified in the original studies. 2020. Jones, Sara W. Email your librarian or administrator to recommend adding this journal to your organisation's collection. 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). Of course there is Potential for a narrow conceptualisation of social problems. and 22 Among the hypothesized pathways, adverse childhood experiences lead to depression and posttraumatic stress disorder, which in turn can … Thanks to Dr Zoe Brownlie for helpful comments on an earlier draft. We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Frederick, John I don’t think anyone is over extrapolating. Evidence of effectiveness of interventions affected by bias of who is framing it and summarising it. Turner, Niall Pinto Pereira, Snehal M. Agree. ( Log Out /  Of the ACE study participants who experienced one ACE category, 87 percent experienced others and over 50 percent experienced four or more. Tell me a model that isn’t problematic. Andy Turner offered a rapid canter through the criticisms in this thread. McCartney, Gerry Ecological fallacy is as much in play here as any other construct. Again, all valid. ACE Score of Four Things start getting really serious around an ACE score of four. As with many simplified concepts, ACEs present limitations. Some frame ACE as a diagnostic tool, or a diagnostic label. 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. Higher ACE counts were also associated with deprivation. Lacey, Rebecca E. Implementation without critical analysis is a mistake. Change ), You are commenting using your Twitter account. Many people do not realize that exposure to ACEs is associated with increased risk for health problems across the lifespan. The same issues are inherent in many other concepts that are framed as big threats. Females and several racial/ethnic minority groups were at greater risk for experiencing 4 or more ACEs. The criticism comes from several perspectives, often well founded. Minnis, Helen ( Log Out /  Personally my view is the case for screening is nowhere near met. Kelly-Irving, Michelle As a probabilistic and population-level tool, it is not adapted to diagnose individual-level vulnerabilities, an approach which could ultimately exacerbate inequalities. Adverse childhood experiences (ACEs) have emerged as a major research theme. 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. While ACEs are found across the population, there is more risk of experiencing ACEs in areas of higher deprivation. The early years DO matter. 2020. and Bartley, Mel The ACEs evidence base for interventions has limitations that have not been fully addressed. ACEs have a dose-response relationship with many health problems. Kelly, Yvonne There’s a risk that this document may be seen to perpetuate a model of evidence rooted in individuals and not structural determinants. Davies, Mike It is structured around three themes – framing, research, implementation with some of the common criticisms I hear in each of those themes. To highlight some local research informed by the US Adverse Childhood Experiences study (and lots of other ideas!) Close this message to accept cookies or find out how to manage your cookie settings. People being critical of the ACE framework seems increasingly common. Although we were unable to identify many studies that specifically identified ACEs as a reason for poor attainment and other educational outcomes, this may be due to the methodological difficulties associated with controlling for … 2020. Nothing new here, nothing special to ACEs on this one. 2019. Ward, Mike R. M. Research in this space can be obscuring cause and effect, confounding, random variation. See here (plus tables with supporting evidence) for an excellent summary from Prof Bellis and others. People being critical of the ACE framework seems increasingly common. From a public health perspective, ACEs are useful for describing the need to act upon complex social environments to prevent health inequalities at a population level. and Bruce also challenges the narrow concept of how ACEs research is being used in a very clear way based on the neuro-science. 2020. Of the ACE study participants who experienced one ACE category, 87 percent experienced others and over 50 percent experienced four or more. Check if you have access via personal or institutional login, Measuring childhood adversity in life course cardiovascular research: a systematic review, Infant mortality, chidhood nutrition, and ischaemic heart disease in England and Wales, Adverse childhood experiences are associated with the risk of lung cancer: a prospective cohort study, Adverse childhood experiences and the risk of depressive disorders in adulthood, Does the influence of childhood adversity on psychopathology persist across the lifecourse? Wahrendorf, Morten 1. ACEs have long-lasting effects. ACEs is well intentioned but problematic model. I’m no fan of the enthusiasm for “counting and scoring”. Jones, Sara ACEs tend to cluster—where there is one category, there are likely others. and Armour, Gillian Demakakos, Panayotes The ACE Study –probably the most important public health study many people do not know about –had its origins in an obesity clinic on a quiet street in San Diego. 2. The WHO and CDC are collaborating to work with multiple countries to implement the ACE Study and determine the global impact of … Often also this is compounded by a need to focus evidence towards recommendations for practitioners rather than at policy makers across many different national actors. included the ACE Study questionnaires as an addendum to the document Preventing Child Maltreatment: A Guide to Taking Action and Generating Evidence. Disagree here. A 45-year prospective epidemiologic study, Adverse childhood experiences and adult risk factors for age-related disease depression, inflammation, and clustering of metabolic risk markers, Archives of Pediatrics and Adolescent Medicine, Insights into causal pathways for ischemic heart disease: adverse childhood experiences study, Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study, The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900, The condition of the working class in England, Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. To draw out some of the learning gained from this research over the past decade 3. D Howe, Laura LaNoue, Marianna D. Nobody is doing this. As the ACEs concept becomes popular in the context of policy interventions, concerns have emerged. Ward, Mark ACEs are an upstream issue in some contexts (to treatment and punishment), but downstream in others (eg poverty and marginalisation) lies further upstream, Of course we need to take great care to not victimise people, it would be easy to do so, Narrow construct. Helitzer, Deborah L. View all Google Scholar citations The rest of whole lives matter. Over hope in rapid results, magic bullets and simplistic solutions. and Nobody is saying that cuddles are the answer to toxic stress or the long term consequences arising from poverty or other factors upstream of individual adversities.

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