The Story of How ACE’s Can Become Toxic Stress

From Paul Tough's excellent Fixes column,  Protecting Children from Toxic Stres s, Artwork by Keith Negley

From Paul Tough's excellent Fixes column, Protecting Children from Toxic Stress, Artwork by Keith Negley

By Melissa Daar Carvajal

I remember exactly where I was sitting when Teri Cook at Stuart Foundation took out her pencil and drew 10 squares on a piece of paper – estimating that four out of the ten squares, that is, children, in an average class have experienced ACE’s – Adverse Childhood Experiences. ACE’s are defined as “childhood abuse, neglect, and exposure to other traumatic stressors.” This was shocking information - opening my eyes to how our approach in education had to change – in a big way.

The movement to identify children with ACE’s brought together a broad spectrum of professionals to address this most important discovery of the last decade; in May the Robert Wood Johnson Foundation held the first National Summit on Adverse Childhood Experiences on ACE’s. Programs like Child First in Boston, and the Center for Youth Wellness here in San Francisco’s Bayview, are leaders in developing holistic approaches to heal kids with ACE’s – among many others. I’m hopeful that with their herculean efforts, new “trauma-informed” approaches in health and education will become the norm.

I propose we also need to move to a new language paradigm – to effectively spread the word about ACE’s to parents, teachers, and others outside of our insider circles.

Perhaps it started with my “religious” quest to rid the world of acronyms, but I am more convinced than ever, that by talking about “toxic stress” rather than “ACE’s”, we can tell a more approachable and understandable story to reach a critical wider audience – the adults in kids’ lives.

Here’s the story we could tell about toxic stress – adapted from the Center for Youth Wellness’ website:

Any child can suffer from toxic stress, but children in neighborhoods with concentrated poverty are more likely to experience high doses of toxic stress early in the lives.

Just like being repeatedly exposed to toxic chemicals can make you sick – causing cancerous cells to develop and spread through your body – being exposed to extreme, chronic stress can also be toxic.

We know that toxic stress causes a chain reaction. The chain reaction starts in the body. When someone is repeatedly exposed to stress, your body overproduces chemicals that contribute to chronic heart disease and diabetes.

For young people, this toxic street affects brain development, including parts of our brains responsible for self-control, memory and critical thinking. That means young people exposed to toxic stress will have difficulty sitting still and paying attention, which can lead to failure in schools, discipline problems or both.

Before understanding toxic stress, we only treated individual symptoms. Now, doctors are able to diagnose toxic stress and give help to address the sources of stress in their young patients’ lives.


To close, here are some other reasons why we would talk about toxic stress instead of ACE’s:

  • people experience stress and know what it feels like
  • parents/family members know how stress affects their children
  • people have heard about traumatic stress suffered by soldiers coming home from Iraq
  • toxic = poisonous, giving the term the physicality it entails
  • the word ‘toxic” relates to lead or other poisonous chemicals

What would be the best way to explain it to you?