Q: What are the questions we should be asking about childhood adversity and trauma?

Understanding a problem starts with good questions. As you know, the Adverse Childhood Experience (ACEs) Survey has been used across the country, and to nobody’s surprise, we find significant parts of the population likely suffering some sort of trauma after enduring three or more adverse childhood experiences.

If you stood in front of a kindergarten classroom, you could estimate that every fourth child–more than a quarter of the students (and their parents)–would endure at least three adverse childhood experience, which means living in households where adults misuse substances, are threatening or violent, have untreated mental health challenges, are abusive and neglectful, are dissolving marriages or are incarcerated. Again, the more ACEs people have, the more negative health and wellbeing outcomes we can expect. And people have a lot.

In our book Anna, Age Eight, we ask questions that need answers:

What percentage of those who reported more than one ACE sought mental health care and engaged in trauma-informed counseling?

How many of those parents reporting ACEs would acknowledge that their children also experienced ACEs?

Why might states or cities differ in their response to ACEs?

What can we learn from those communities with the lowest reported ACEs?

If we drilled down deeper into the numbers, would we find that certain populations or geographical areas are more at risk for ACEs? Would we then be able to target our efforts at prevention and treatment of those populations?

Would our prevention strategies be data-driven or based on hunches?

I leave you with perhaps one of the most important questions. Who has the job of asking and answering these questions? A governor’s task force on children? The mayor and city council? County executives? School Boards? Child Welfare’s prevention department? A coalition of behavioral health care providers?

We can’t shy away from asking questions, which is why the last chapter in our book is, “Experience being courageous preferred, but not essential.”