Adverse experiences in childhood (ACEs) and anxiety

DEFINITION: Anything that is highly stressful and traumatic for a child that threatens their physical or mental safety

When I refer here to adverse experiences in early childhood, I’m referring mostly to previous abuse – whether emotional, physical, sexual or neglect.

This is the usual meaning of Adverse Childhood Experiences or ACEs that have been mentioned a lot in recent years.

I stress "previous" because I’m not thinking anyone who visits this site will be behaving in this way to their child.

It’s more likely you've fostered or adopted a child and their early experience was not good.

Or – possibly – you're here because you're concerned about a grandchild or other child member of your wider family.

There might be a connection to an alcohol/drug addiction problem or a mental health issue in one parent – I've seen this too often, when working with children and their parents, to ignore the possibility.

But let’s start at the beginning and look at what a child needs from birth – because although NOT getting their needs met is serious, the brain is plastic. And with enough care, the proper development can be put back on track.

This will lead to at least “good enough” development in future and a lowering of "extra" anxiety levels in different situations.

ACEs2 adverse experiences

What a baby needs v. adverse experiences in early childhood

  • Their physical needs met – so they’re sure of survival – otherwise they shut down in despair.
  • Their stress/alarm/danger responses soothed – which helps them learn to do this themselves. Elevated stress for long periods damages brain development and stays in their body memory.
  • A sense of belonging – for confidence and trust. They can do so little for themselves, so they learn to do without.
  • Early communication – sounds, gestures, facial expressions, peekaboo etc, all reflected like ping-pong, so they become socially adept even before they can speak. Otherwise their social development is damaged.
  • Play – their only means of learning how the world works. This grows their thinking ability, their more mature brain. Without someone to play with, they simply don't learn to play.
  • Time with focused adult attention – so they learn that they matter and feel psychologically safe. Being classed second to a phone fosters rejection and depression.

You can immediately see that if your child has suffered a lack of any of these good experiences in a former home situation, they’re going to have problems now – many of which will bring on anxiety.

And, specifically with these children who've suffered adverse experiences, much of that anxiety will be acted out as "bad" behaviour and anger, or withdrawal and lack of trust.

It looks like a refusal to be sociable in the way we expect in family relationships: empathy, concern, give-and-take behaviour.

They simply cannot do better until they have help. They don’t have the brain-body groundwork that was required from birth onwards.

As Suzanne Zeedyk says on her Connected Baby website: "Every single experience a baby has leaves an emotional trace, and the emotional patterns of their life are being woven into the neural pathways of their brain." 

If we consider a child who's been sexually assaulted, then they'll have physical and emotional problems as well as the sexual damage. 

But it would be wrong to definitely say these sexually abused children have been neglected, whatever an instant judgement might look like. 

Some will have been, of course, if their parents have (perhaps) invited drug addicts and alcoholics into the house and left the children untended. Or gone out to a nightclub and left them with an unreliable babysitter. 

But many children in good homes cover up abuse due to threats from the abuser to harm their loved ones. Or they’ve been told to “keep this a secret or you’ll lose your special status”.

A parent may therefore genuinely have no idea what’s been happening. This is not the same as being neglectful.

What causes birth parents to allow these adverse experiences?

That’s a million dollar question for those of us who can’t imagine giving a child such adverse experiences. But you can probably lay most of the causes at the door of a few select things that, as a therapist, I've seen when working with parents. For example:

  • lack of proper parenting themselves, so they simply don’t understand what’s needed
  • addiction and/or violence in the home that takes precedence over the needs of the child
  • mental illness in the parent that prevents them being able to do what they know they ought to

How do these adverse experiences affect health in your adopted or fostered child?

We’re interested in anxiety here. And understanding and dealing with what lies beneath the "anxious surface behaviour".

But on the whole, with no extra help, children who've had adverse experiences in childhood are likely to develop mental health and physical health problems as they grow up.

For example:

  • They may suffer generalised anxiety (whether classified as a "disorder" or not).
  • Or perhaps they will develop depression or take to self-harming as means to really feel something and not feel "dead".
  • They may not develop the close friendships along the way and therefore become unable to socialise.
  • Another possibility is having toxic levels of stress which affect their bodily development and lead to health problems. For instance, a US study in 2015-2017 found that adults who reported the highest levels of ACEs were more likely to have chronic health problems and depression, to smoke and drink, and be unemployed
  • They may get involved in drink, drugs and crime as a response to not having got what they needed when younger. This might be to cover up their pain. Or because their brain simply doesn’t understand what’s wrong or right. But the substances affect their brain and mental health.

All this is a good reason to start looking underneath the anxiety you see in your child NOW and consider whether they've had a poor start in a former home.

How can we help an anxious child who's had a poor start?

If we look at my earlier list of what might be missing for these children who've had adverse experiences in childhood, the answer to "How?" is that we'll need to supply those things now.

OK, this is later than the optimum time – but better late than never.

If they’re now in a good home – your home – and therefore safe and secure, we have to help them feel this change of circumstance in their bodies, believe it, act on it, and understand they're not being left to fend for themselves any more.

Easier said than done, I know. But if you're here, you're obviously ready to try.

Perhaps the best thing I can suggest is that it's important to remember that they need from you NOW all the things that younger children in good homes will already have received.

It’s going to be harder to re-parent than to parent. But it’s doable.

So try to offer all these things as and where you see them lacking:

Graphic showing 6 ways of helping a child with adverse experiences in childhood

It's sometimes hard to do all these things for an anxious child while NOT denouncing their birth parents and how those parents failed them. But try to avoid this as you don't want your child to experience split loyalties as well as all their other problems.

When they’re older they'll ask and start to understand. For now, it’s enough to help them receive what they need. 

Because beneath any anxiety they show (and/or poor behaviour) will be layers of not having had enough of something – as well as the “normal” anxiety another child might experience.

But you’re up for it, aren’t you? Or you wouldn’t have taken them into your family.

Browse round the symptoms and types pages and the special strategies sections. See which activities might help you improve things for your child – always remembering what might lie underneath the surface from past adverse experiences, and continuing the ideas in the diagram above.

If you need professional help at any point, have a look at this page. You'll know how much you can manage on your own and recognise when you need some extra help. That page helps you find professional help safely.

I also wrote a blog post on finding a counsellor here.

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