Class 7 - Adverse Childhood Experiences

Question 1

What are the patterns of adversity for adverse childhood experiences (ACE)? (5)

Answer 1

1. neglect (harm or risk of harm) (34%)
2. Exposure to intimate partner violence (34%) ie. child saw it
3. Physical abuse (20%)
4. Emotional maltreatment (9%)
5. Sexual abuse (3%)

Question 2

What are the risk factors to ACE? (3)

Answer 2

1. Sociocultural factors (ie. physical abuse morally right)
2. Characteristics of the child
3. Characteristics of the abuser (people who were abused are more likely to abuse their child)
4. Household stressors (ie. moving a lot, weapons, drugs)

Question 3

What can neglect lead to? (2)

Answer 3

• physical and chemical disruptions in the brain that can last a lifetime
• disrupt emotions, cognition and behaviour

Question 4

What is neglect associated with?

Answer 4

wider range of damage than active abuse, but receives less public attention, policy or practice

Question 5

What can neglect run the risk of? (2)

Answer 5

• emotional and interpersonal difficulties
• learning difficulties, poor school achievement

Question 6

What are the interventions to neglect? (4)

Answer 6

• Interventions need to be appropriate and timely to reverse or reduce the negative consequences
• Merely removing a child from neglect does not guarantee positive outcomes
• therapeutic intervention and highly supportive care is needed to mitigate adverse effects and assist with recovery
• Children in these environments need to have their safety, control, and predictability restored

Question 7

What should a nurse know about neglect when looking out for it?

Answer 7

• at the stage right now, we should just know the signs and symptoms while also supporting each other and seek help from management for reporting pathways

Question 8

For ACEs, no single factor contributes, but rather the presence of multiple variables increases chances. What are the 2 outcomes of this? (2, 4)

Answer 8

1. Exposure effect
   - the degree of intensity and duration of a stressor is related to the intensity of the response
2. Toxic stress response
   - Persistently elevated physiological arousal caused by strong, recurring, and/or unabated adversity (environment where you are always in fight or flight)

Question 9

How can ACEs be prevented? (4)

Answer 9

• Begins with education
• identification for at-risk families
• vigorous enforcement of existing child abuse laws
• reporting of abuse is mandatory in all provinces and territories