NURS 406 Discussion 2 Essay
NURS 406 Discussion 2 Essay
NURS 406 Discussion 2 Essay
Adverse Childhood Experiences
The ACE Calculator
The ACE (Adverse Childhood Experiences) score is a measure employed to assess a child’s level of adversity throughout their childhood (Briggs et al., 2021). The score is calculated by giving one point for each form of adversity encountered and then totaling the points. Garrett’s ACE score based on the information provided:
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- Divorce or separation of a parent (Garrett is a four-year-old who recently moved to Minnesota with his mom following his parents’ divorce.)
- Mental illness of a household member (His mother was diagnosed with ADHD at age 10 and grew up living with a father who is an alcoholic and still drinks.)
- Problematic drinking or alcoholism of a household member (Garrett often spends time at his grandparents’ house (his mother’s family) when his mother works late. His mother was diagnosed with ADHD at age 10 and grew up living with a father who is an alcoholic and still drinks)
- Domestic violence towards a parent (His father grew up in a home with domestic violence.)
Garrett has an ACE score of 4 based on the Minnesota ACE survey. The rationale for this score is that Garrett has experienced four out of the nine ACEs listed in the survey, as listed above. Garrett’s parents had just divorced, and he had to go with his mother to a new state without his father. At the same time, Garrett’s father grew up in a household where there was domestic violence, which can expose Garrett to violence in his home environment, especially from his father. Mental illness also affects the parenting environment. Garrett’s mother was diagnosed with ADHD at 10 years, which hampers her capacity to maintain a stable and consistent home environment for Garrett. This might explain why he is always in daycare, before and after moving to a new state, and the fact that he is at his grandparents’ house when his mother is working. This brings another ACE point, where Garrett’s maternal grandfather is an alcoholic who still drinks, and Garrett stays with him often. This can produce an unstable home environment and expose him to alcoholism.
Risks To Garrett’s Health And Well-Being
In addition to his ACE score of 4, there are other risks to Garrett’s health and well-being: Garrett’s mother works in a demanding setting, and she has difficulties sleeping at night. This can impact Garrett’s physical and mental health as a result of a stressful home environment. The changing environment also impacts children’s mental and emotional health. Garrett recently relocated to Minnesota with his mother following his parents’ divorce. Children may experience emotions of instability and insecurity in new and alien environments, therefore, explaining Garrett’s “acting out” in daycare and often complaining of a stomachache. Acting out can also be a sign of stress and anxiety and may be related to other risks to his health and well-being (Felitti et al., 2019). Garrett spending little time with his father and only seeing him on weekends could lead to emotions of loss and separation.
Protective Factors
Protective factors help a child feel safe and supported. Garrett often spends time at his grandparents’ house when his mother works late. This can provide him with a stable and supportive environment and love, care, and protection. This can help to mitigate the stress experienced at home. Although Garrett’s father lives two hours away, Garrett sees him every other weekend, providing him with a sense of continuity and stability and helps to strengthen his relationship with his father. Attending daycare is also a potential protective as it provides him opportunities to socialize with other children and adults, and a sense of routine. Financial stability is important to a loving home environment (Briggs et al., 2021). Although Garrett’s mother’s job is stressful, her employment can provide financial stability and security for the family, which can be an important protective factor.
Evidence-Based Strategies That Prevent or Lessen The Harm of ACEs
Promoting resilience and social support: Building resilience and social support does help children and families cope with stress and adversity and further aids in mitigating the negative effects of ACEs. Examples of resilience-promoting strategies include fostering positive relationships between children and caregivers, promoting self-regulation skills, and building connections with social support in the community (Minnesota Department of Health, 2021). An example of a program that uses this strategy is the Strengthening Families Program, which is designed to build protective factors in families with children aged 3-17 who are at risk of ACEs (Crouch et al., 2020).
Providing trauma-informed care also aids in lessening ACEs. According to Menschner and Maul (2016), trauma-informed care involves recognizing and responding to the impact of trauma on individuals and families and providing care in a way that is sensitive to their needs. Trauma-informed care can help to mitigate the impact of ACEs and promote healing and resilience. Examples of trauma-informed care strategies include using trauma-informed screening and assessment tools, providing trauma-focused therapies, and creating safe and supportive environments for children and families (Menschner & Maul, 2016). An example of a program that uses this strategy is the Attachment and Biobehavioral Catch-up program, which is a parent-coaching program designed to promote positive parenting and attachment for children who have experienced early adversity (O’Byrne et al., 2023).
Systemic inequities, such as poverty, racism, and other forms of social injustice, can contribute to the occurrence and impact of ACEs. According to CDC (2022), addressing these systemic inequities aids to prevent ACEs and promote resilience and well-being in children and families. Strategies for addressing systemic inequities include increasing access to high-quality education and healthcare, promoting economic opportunity and stability, and implementing policies that reduce discrimination and promote equity. The Nurse-Family Partnership is a home-visiting program that provides support to first-time mothers living in poverty (Olds & Yost, 2020).
Additional Information Garrett’s Family
Based on the information provided, it is important to inquire about Garrett’s family dynamics, including substance use, patterns of communication, and trauma. Of importance is to further inquire about Garrett’s relationship with his father and the quality of his time spent with his grandparents, not forgetting any possible sources of social support for Garrett and his mother.
Strategy Based On Trauma-Informed Principles In Obtaining Additional Information From The Family
Trauma-informed care is an approach that recognizes the prevalence of trauma and its effects on health and well-being. The principles of trauma-informed care provide a framework for nurses to create a safe and supportive environment for patients who have experienced trauma (Duquesne University School of Nursing, 2020). The nurse should create a safe and supportive environment where the family feels comfortable sharing their experiences. This includes ensuring privacy, making sure the conversation takes place in a comfortable setting, and using language that is clear and easy to understand. Additionally, the nurse must take a non-judgmental approach and build trust with the family by acknowledging their experiences and expressing empathy. The nurse should also collaborate with the family by actively engaging them in the conversation and asking for their input to help them feel empowered and more in control of the situation (Duquesne University School of Nursing, 2020). This also empowers voice and choice decisions by allowing the family to express care and treatment choices.
References
Briggs, E. C., Amaya-Jackson, L., Putnam, K. T., & Putnam, F. W. (2021). All adverse childhood experiences are not equal: The contribution of synergy to adverse childhood experience scores. The American Psychologist, 76(2), 243–252. https://doi.org/10.1037/amp0000768
CDC. (2022). Adverse Childhood Experiences. Cdc.gov. https://www.cdc.gov/violenceprevention/aces/prevention.html
Crouch, E., Radcliff, E., Probst, J. C., Bennett, K. J., & McKinney, S. H. (2020). Rural-urban differences in adverse childhood experiences across a national sample of children. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 36(1), 55–64. https://doi.org/10.1111/jrh.12366
Duquesne University School of Nursing. (2020). What are the 6 principles of trauma-informed care? Duquesne University School of Nursing. https://onlinenursing.duq.edu/blog/what-are-the-6-principles-of-trauma-informed-care/
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (2019). REPRINT OF: Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 56(6), 774–786. https://doi.org/10.1016/j.amepre.2019.04.001
Menschner, C., & Maul, A. (2016). Key ingredients for successful trauma-informed care implementation. Chcs.org. http://www.chcs.org/media/ATC_whitepaper_040616.pdf
Minnesota Department of Health. (2021). Adverse childhood experiences (ACEs) in Minnesota. State.Mn.Us. https://www.health.state.mn.us/communities/ace/index.html
O’Byrne, E., McCusker, C., & McSweeney, S. (2023). The impact of the “Attachment and Biobehavioural Catch-Up” program on attachment-related parent behavior-A systematic review. Infant Mental Health Journal, 44(1), 76–91. https://doi.org/10.1002/imhj.22025
Olds, D., & Yost, E. (2020). Developing the nurse-family partnership. In Designing Evidence-Based Public Health and Prevention Programs (1st Edition, pp. 173–193). Routledge.
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NURS 406 Discussion 2 Essay
Review information in the following links related to Adverse Childhood Experiences (ACEs) and trauma informed care:
https://www.health.state.mn.us/communities/ace/index.html
https://www.cdc.gov/violenceprevention/aces/index.html
http://www.chcs.org/media/ATC_whitepaper_040616.pdf
Read the following case scenario:
Garrett is a four-year-old who recently moved to Minnesota with his mom following the divorce of his parents. His mother recently started working full-time. Garrett often spends time at his grandparents’ house (mother’s family) when his mother works late. His father lives two hours away and Garrett sees him every other weekend. His father grew up in a home with domestic violence. His mother was diagnosed with ADHD at age 10 and grew up living with a father who is an alcoholic and still drinks. His mother’s job is stressful and she has trouble sleeping at night. Garrett misses his old daycare center and is “acting out” in daycare and often complains of having a stomachache.
Based on the information given, utilize the ACE calculator listed under this assignment to compute Garrett’s ACE score. Use only the information provided above to compute Garrett’s score.
Answer the following questions and post under Discussion Post #2.
What ACE score did you assign Garrett? Provide rational.
What other risks to his health and well-being did you identify and why are they risks?
Are there any current protective factors that may be helping Garrett feel safe?
Based on the readings, describe three evidence-based strategies that may prevent or lessen the harm of ACEs and/or risks in this scenario. Give an example of each strategy. Include citations.
What additional information would you like to learn about Garrett’s family?
Describe a strategy, based on trauma informed principles, in obtaining additional information from this family.
Respond to two peers’ posts with additional information from the readings (citations included) or from your own professional experience.
Include citations and a reference list in APA format.
