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Applied Human Behavior Program Rationale:

Part One

Wendy Smith Traslavina

Applied Human Behavior, Northern Arizona University

AHB 495C: Applied Human Behavior Portfolio Capstone

Dr. Margaret Boatright

March 20, 2023

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Pre-Research Discussion

After having the opportunity to be a foster parent, I personally witnessed firsthand the

pain and struggles for children and parents who have experienced adverse childhood events. This

is why I have chosen this topic. Additionally, after graduation, I have chosen to pursue a career

that involves working with families involved in the Department of Child Safety system in some

capacity. Many career fields in child welfare require case management. This includes the creation

of a case plan that requires identifying and addressing issues that cause stress in the family and

making appropriate referrals to address needs. It is important to gain understanding of what

could possibly be contributing to familiar issues and insecurities. This paper will aim to review

prevention and intervention of adverse childhood experiences (ACEs). The sources used for this

research been helpful in connecting risks with academic, health, and social outcomes. The reality

is two thirds of children from birth until their 18th birthday experience one or more adverse

events (Burkhart et al., 2022). Adverse childhood experiences are traumatic events experienced

in childhood that can lead to an array of different negative health outcomes and greatly reduce

life chances, and untreated trauma from ACEs is likely to lead to a cycle of intergenerational

trauma. (Burkhart et al., 2022) These negative health outcomes are often the result of extreme

stress as child that impacted brain development (Herzog et al., 2018). Intervention is imperative

and reviews of existing studies found that cognitive behavioral therapy had the best outcomes

when addressing the area of mental trauma as a result of adverse childhood experiences (Lorenc

et al., 2020). Additional research shows that having a trusting adult present in childhood can less

the negative impacts associated with ACEs (Webster, 2022). Because this line of work requires

collaboration with other professionals, it can be valuable to have insight on best practices for

treatment of ACEs in a primary care setting (Kalmalkis et al.,2015).

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Burkhart, K., Ievers-Landis, C. E., & Huth-Bocks, A. (2022). Introduction to the special issue on

adverse childhood experiences (ACEs): Prevention, intervention, and access to

care. Children (Basel, Switzerland), 9(8), 1205.

http://dx.doi.org/10.3390/children9081205

This journal article examines many aspects of Adverse Childhood Experiences (ACES).

This source seeks to spread awareness on the prevalence of adverse childhood

experiences, with two-thirds of children from birth until their 18th birthday experiencing

one or more adverse experiences. It highlights the long-lasting impact that childhood

trauma can have on many different facets of life, include mental health, physical health,

and social health. It also explores the increased likelihood of intergenerational

transmission to childhood trauma. Additionally, this source reviews best practice for

prevention and intervention. The source does not appear to be biased and was found to be

a part of the National Library of Medicine, which is generally reliable database for

sources. This article was originally published in the peer-reviewed journal Children.

Overall, this does a well-rounded evaluation of ACES, the impact it has on life chances,

and the best practices for prevention and intervention.

Herzog, J., & Schmahl, C., (2018). Adverse childhood experiences and the consequences on

neurobiological, psychosocial, and somatic conditions across the lifespan. Frontiers in

Psychiatry, 9, 420. http://dx.doi.org/10.3389/fpsyt.2018.00420

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This article reviews existing studies and literature to better understand the

neurobiological impact of ACEs. The research article notes that adverse childhood

experiences (ACEs) are frequent in childhood and a massive stressor. The study looks to

present an accurate overview of the long-lasting negative effects on the many

components of health including the brain, mental and physical health throughout a life

span. During childhood development, exposure to certain stressors impacts the brian and

can lead to damage and suppression. Throughout life, ACEs has many cooccurring

conditions which includes depression, post-traumatic stress disorder, obesity, and

diabetes. This source provides valuable information regarding best practice to implement

interventions that can reduce long-term risk for mental illness in individuals after ACE

and to develop specific treatments for children and adults with psychopathology. This

source appears reliable and nonbiased. The review was found in a well-established peer

reviewed journal.

Kalmalkis, K. A., & Chandler, G. E. (2015). Health consequences of adverse childhood

experiences: A systematic review. Journal of the American Association of Nurse

Practitioners 27(8), 457-465. http://dx.doi.org/10.1002/2327-6924.12215

This journal article takes a closer look at the negative adult health outcomes known to be

associated with adverse childhood experience. Different health conditions impacted

include physical and psychological conditions, and risk behaviors. The purpose of this

research was to not only determine how ACES impacted health outcomes but to explore

how primary care physicians can better assist patients who are experiencing negative
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health implications associated with childhood trauma. The study recommends

incorporating a brief childhood history assessment for all patients. While the main

purpose of this research article was to support best practices in a primary care setting, it

provides valuable information regarding the relationship between childhood trauma

experiences and adult health outcomes. This source is from a scholarly database, and the

origin of the article is a medical journal that is well established. The information included

is not biased and presented with supporting evidence and research studies that are

relevant to the problem.

Lorenc.T., Lester, S., Sutcliffe, K., Stansfield, C., & Thomas J. (2020). Interventions to support

people exposed to adverse childhood experiences: systematic review of systematic

reviews. BMC Public Health, 20(657). http://dx.doi.org/10.1186/s12889-020-08789-0

To best understand the effectiveness of specific interventions, this source does a

systematic review of existing systematic reviews of Adverse Childhood Experience. The

reviews being evaluated had to meet certain criteria and have an AMSTAR quality score

of at least 5.5. In all, 25 reviews spanning an 11-year period were used in this journal

article. Due to the startling number of individuals who have traumatic childhood

experiences, it is important to understand what interventions were effective, improve

outcomes, and stop the cycle of intergenerational trauma. Overall, this systematic review

found that cognitive behavioral therapy had the best outcomes when addressing mental

trauma as a result of ACES. This article was published on the website for the peer

reviewed scientific journal BMC Public Health. This journal is a well-known and often
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used site for research, therefore giving this article credibility. Additionally, the article uses

references and studies to back up the information and claims made. Overall, the

information presented in this article helps to analyze current interventions for ACES and

determine best practices.

Webster, E.M, (2022). The impact of adverse childhood experiences on health and development

in young children. Global Pediatric Health, 9.

http://dx.doi.org/10.1177/2333794X221078708

This source offers a comprehensive overview of how adverse childhood experiences

impacts health and development of children under the age of six. There is an extensive

amount of research regarding the health implications. This article includes several

revealing statistics that show the relationship between ACEs and outcomes. One of those

includes that children that have had at least two adverse childhood experiences are more

likely to have attention deficit hyperactivity disorder (ADHD), and to bully others.

Another interesting aspect of this article is that is examines parent child relationships.

The information included is not biased and presented with supporting evidence and

research studies that are relevant to the topic. Additionally, it has helpful information to

help combat the implications of ACEs. This source is from a scholarly database, and the

origin of the article is a medical journal that is well established.

Post-Research Discussion

The completed research shows the complexity and severe implications associated with

adverse childhood experiences. Adverse childhood experiences include neglect, abuse, and
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exposure to household dysfunction. ACES is often a vicious cycle that is passed from generation

to generation (Lorenc et al., 2020). Experiencing toxic stress as a child can have serious

consequences on the developing brain and alter normal development (Kalmalkis et al.,2015).

ACEs can have a tremendous impact on many facets of life, including finances, and cognitive,

social, and emotional functioning. Children who have experiences adverse childhood events are

more likely to have academic issues, and behavior problems (Webster, 2022). Adults with a

history of exposure at least four ACEs are more likely to participate in risky behaviors including

smoking, drug use, alcohol abuse, and sex practices (Burkhart et al., 2022). Additionally, ACES

often is associated with a wide range of mental and physical health conditions. There is no one

size fits all cure or intervention for ACEs, and treatment is usually a collaborative effort due to

the extent of negative consequences and outcomes associated with ACEs (Herzog, 2018).

Intervention and prevention of ACEs is possible through education and collaboration. It can be

difficult to talk about parenting challenges or for parents to admit they are struggling. The topic

of child abuse and neglect is heartbreaking and can lead to difficult conversations. However, it is

necessary to normalize discussing parenting challenges and bring awareness to the negative

lifelong implications associated with child abuse, neglect, and household dysfunction. As the old

African proverb goes “It takes a village to raise a child”, and this is very true. Community

collaboration and solutions can help prevention and intervention of the complications arising

from ACEs. Researching ACEs has been beneficial and preparing for my future career. Working

with the Department of Child Safety is not only about protecting children but also recognizing

necessary interventions and providing all around family support.