Resources
Module 1: ACEs Overview
Lesson 1: Adverse Childhood Experiences, Brain Development, and Toxic Stress

"How Brains are Built" Video
The Alberta Family Wellness Initiative developed this video with considerable input from the Harvard Center on the Developing Child and the FrameWorks Institute. Using metaphors developed by FrameWorks and tested with audiences both in the US and in Alberta, "How Brains are Built" infuses core story concepts with energy, accessibility, and high fidelity to the science.

Harvard Center on the Developing Child
The Center on the Developing Child at Harvard University was established in 2006 by director Jack P. Shonkoff, M.D. "Our founding mission was to generate, translate, and apply scientific knowledge that would close the gap between what we know and what we do to improve the lives of children facing adversity.

Harvard Center on the Developing Child: Toxic Stress
This article provides an overview of toxic stress and some additional resources for further learning.
Lesson 2: The ACE Study

The ACE Study
This CDC webpage includes information about and links to the ACE Study and related resources.

The Behavioral Risk Factor Surveillance System (BRFSS)
Many states collect information about Adverse Childhood Experiences (ACEs) through the Behavioral Risk Factor Surveillance System (BRFSS), an annual, state-based, random digit dial survey of adults that collects data related to health conditions and risk factors. This CDC webpage includes information about the BRFSS.

Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences Study
Landmark journal article from the original ACE Study.
Lesson 3: Prevalence and Consequences of ACEs

VetoViolence: ACE Infographic
This infographic illustrates the prevalence and consequences of ACEs.

Child Abuse and Neglect: Risk and Protective Factors
This CDC website includes information about risk and protective factors related to child abuse and neglect.

Juvenille Justice Bulletin: "The Prevalence of Safe, Stable, Nurturing Relationships Among Children and Adolescents"
This bulletin describes the study of safe, stable, nurturing relationships (SSNRs) among children and youth in the United States using a nationally representative sample. The authors provide a comprehensive assessment of SSNR factors; examine interrelationships among different indicators of safe, stable, nurturing relationships; and investigate the consequences of SSNRs for child and adolescent mental health.

Child Trends: "National Survey of Children's Health"
Dataset providing information about the prevalence of ACEs.

"Prevalence of Childhood Exposure to Violence, Crime, and Abuse: Results From the National Survey of Children's Exposure to Violence"
The objective of this publication is to provide health care professionals, policy makers, and parents with current estimates of exposure to violence, crime, and abuse across childhood and at different developmental stages.
Module 2: The Public Health Approach to Preventing ACEs
Lesson 1: Risk and Protective Factors

VetoViolence: Social-Ecological Model
This section of VetoViolence provides information on the social-ecological model and how to prevent child abuse and neglect at the individual, relationship, community, and societal levels of our social ecology.

VetoViolence: Preventing Child Abuse and Neglect
This section of VetoViolence provides a variety of resources on violence prevention, with an emphasis on resources related to the prevention of child abuse and neglect.

Children and Youth Services Review: "Adverse childhood experiences and life opportunities: Shifting the narrative"
This publication provides analysis of data from 10 states and the District of Columbia that used the adverse childhood experiences (ACE) module in the 2010 Behavioral Risk Factor Surveillance System to examine the association between ACEs and adult education, employment, and income. The authors discuss findings within the context of structural policies and processes that may further contribute to the intergenerational continuity of child abuse and neglect and poverty.

VetoViolence: Connecting the Dots
A training based on the CDC publication that illustrates the connections between risk and protective factors across violence types.
Lesson 2: Essentials for Childhood

Essentials for Childhood: Steps to Create Safe, Stable, Nurturing Relationships and Environments for all Children
CDC document which proposes strategies communities can consider to promote healthy relationships and environments that help children grow to be healthy and productive citizens so that they, in turn, can build stronger and safer families and communities for their children.

Child Abuse and Neglect Prevention Resource for Action: A Compilation of the Best Available Evidence
The child abuse and neglect Resource for Action helps states and communities identify strategies and prioritize prevention activities based on the best available evidence.

"We Can Prevent ACEs" Video
Childhood experiences, both positive and negative, have a tremendous impact on future violence victimization and perpetration, and on lifelong health and opportunity. As such, adverse childhood experiences (ACEs) are an important public health issue. Watch this video to learn how everyone can help prevent ACEs by using strategies to create safe, stable, nurturing relationships and environments for all children.

The Raising of America
The acclaimed five-part documentary series and companion tools illustrate how a strong start for all kids can lead to better individual outcomes AND a healthier, safer, more prosperous and equitable America.

CDC Case Study: Learning from Washington's Adverse Childhood Experiences (ACE) Story
Washington was one of the first states to add the ACE module to its Behavioral Risk Factor Surveillance System (BRFSS) in 2009 to assess the prevalence of ACEs in its adult population and inform prevention action. This case study highlights how Washington supported state-specific ACE data collection, describes how the state used its data to inform prevention efforts, and provides examples of Washington’s next steps in child maltreatment prevention work.

CDC Case Study: Learning from Oklahoma’s Adverse Childhood Experiences (ACE) Story
This case study briefly highlights how the state of Oklahoma supported ACE data collection and used its data to inform child maltreatment prevention efforts. It also provides examples of Oklahoma’s next steps in its child maltreatment prevention work.

CDC Case Study: Learning from Wisconsin’s Adverse Childhood Experiences (ACE) Story
Wisconsin collected ACE data using its Behavioral Risk Factor Surveillance System (BRFSS) for the first time in 2010. Since then, the state has made great strides increasing awareness about the long-term negative health effects of ACEs and using its ACE data to inform child maltreatment prevention action. This case study briefly highlights how Wisconsin initiated ACE data collection and used data to inform prevention. It also outlines the state's next steps in its efforts to reduce child maltreatment.

VetoViolence: Social Norms
This CDC resource provides information that supports communities as they seek to change norms related to violence. It also introduces a step-by-step process to develop a social norms campaign.

Promoting Positive Community Norms
This resource is a supplement to CDC’s Essentials for Childhood. It provides a guide to creating community norms that increase understanding and promotion of safe, stable, nurturing relationships and environments for children and families.

Boost Your Competitive Edge: Actions for a Healthy, Productive Workforce
Actions for a Healthy, Productive Workforce outlines steps employers can take to ensure that today’s children grow up to be healthy employees and citizens.

Health Equity Guide
This website provides strategic practices for health departments and other organizations that want to address health inequities.
Mental Health Provider Module: For professionals and students who provide mental health care and services to children and familes
Lesson 1: The Role of Culture and Diversity in Working with Families

Harvard Center on the Developing Child
The Center on the Developing Child at Harvard University was established in 2006 by director Jack P. Shonkoff, M.D. "Our founding mission was to generate, translate, and apply scientific knowledge that would close the gap between what we know and what we do to improve the lives of children facing adversity."
National Association for the Education of Young Children
The National Association for the Education of Young Children (NAEYC) is a professional membership organization that works to promote high-quality early learning for all young children, birth through age 8, by connecting early childhood practice, policy, and research. We advance a diverse, dynamic early childhood profession and support all who care for, educate, and work on behalf of young children. The association comprises nearly 60,000 individual members of the early childhood community and more than 50 Affiliates, all committed to delivering on the promise of high-quality early learning. Together, we work to achieve a collective vision: that all young children thrive and learn in a society dedicated to ensuring they reach their full potential.

Teaching Tolerance
Teaching Tolerance provides free resources to educators—teachers, administrators, counselors and other practitioners—who work with children from kindergarten through high school. Educators use our materials to supplement the curriculum, to inform their practices, and to create civil and inclusive school communities where children are respected, valued and welcome participants.

National Association of School Psychologists
The National Association of School Psychologists (NASP) is a professional association that represents more than 25,000 school psychologists, graduate students, and related professionals throughout the United States and 25 other countries. The world's largest organization of school psychologists, NASP works to advance effective practices to improve students' learning, behavior, and mental health. Our vision is that all children and youth thrive in school, at home, and throughout life.

Addressing the Mental Health Needs of Racial and Ethnic Minority Youth: A Guide for Practitioners
Summarizes factors that contribute to or protect against the onset and maintenance of mental health disorders for ethnic and racial minority youth.

Multicultural Guidelines: An Ecological Approach to Context, Identity, and Intersectionality
Considers diversity and multicultural practice within professional psychology, with intersectionality as a primary focus. Incorporates developmental and contextual antecedents of identity and how they can be acknowledged, addressed and embraced to engender more effective models of professional engagement.

SAMHSA Substance Abuse and Mental Health Services Administration
The five-step Strategic Prevention Framework guides you in selecting, implementing, and evaluating effective, culturally appropriate, and sustainable prevention activities.

The Harvard Clinical and Translational Science Center
Harvard Catalyst works with Harvard University’s schools and affiliate academic healthcare centers to build and grow an environment focused on team science – where discoveries are rapidly and efficiently translated to improve human health. We catalyze research across all clinical and translational domains by providing investigators with opportunities such as pilot funding, free resources such as biostatistics consultations, training and mentoring programs, and numerous courses. To facilitate communication, collaboration, and data collection, our informatics team develops a range of open-source tools available to the community within Harvard University and beyond.
Lesson 2: Identifying Risk and Protective Factors

Child Abuse and Neglect Risk and Protective Factors
This CDC website includes information about risk and protective factors related to child abuse and neglect.

Child Maltreatment
The World Health Organization definition of child maltreatment.

Connecting the Dots
A CDC publication that illustrates the connections between risk and protective factors across violence types.

Healthy Cities/Healthy Communities Assessment Tool
The US Department of Housing and Urban Development Healthy Communities provides an Assessment Tool offering a comprehensive approach for evaluating factors that contribute to community health.

Protective Factors Surveys
FRIENDS protective factors surveys assess multiple protective factors to prevent child abuse and neglect and are designed for use with parents and caregivers participating in family support and child maltreatment prevention services.

Protective Factors in Practice Vignettes
These vignettes illustrate how multiple protective factors support and strengthen families who are experiencing stress.
Lesson 3: Providing ACE Prevention Programs and Services

Child Abuse and Neglect Prevention Strategies
CDCs Resources for Action provide a variety of strategies to prevent violence across the social ecology.

Resources for Action for Violence Prevention: Using Evidence-based Strategies in Your Violence Prevention Efforts
The Child Abuse and Neglect Resource for Action and the Youth Violence Resource for Action offer a list of evidence-based and promising practices to prevent ACEs.

ACEs Connection
ACEs Connection is a social network that supports communities to accelerate the global ACEs science movement, recognizes the impact of adverse childhood experiences (ACEs) in shaping adult behavior and health, and promotes trauma-informed and resilience-building practices and policies in all communities and institutions -- from schools to prisons to hospitals and churches -- to help heal and develop resilience instead of traumatizing already traumatized people.

Mobilizing Action for Resilient Communities
The Mobilizing Action for Resilient Communities (MARC) program brings together 14 sites actively engaged in building the movement for a just, healthy and resilient world. A mix of cities, counties, regions, and states, these communities are all building a culture of health by translating the science of Adverse Childhood Experiences (ACEs) into practices and policies that foster resilience.Test

2019 Prevention Resource Guide
Focuses on protective factors that build family strengths to foster healthy child and youth development.

ACT Raising Safe Kids Program: Building Strong and Safe Families
This program teaches positive parenting skills to parents and caregivers of children from birth through age 10.

The California Evidence-based Clearinghouse for Child Welfare
Searchable database of evidence-based prevention and intervention programs.
Lesson 4: Providing Intervention Services for Children and Families

The National Child Traumatic Stress Network
This site is a supportive resource for selecting screening and assessment tools and intervention services.

Society of Clinical Child and Adolescent Psychology
This organization provides supportive resources for selecting intervention services.

Multiplying Connections
This organization works with and through the people in public, private and government institutions that serve children and families. Through our cross-disciplinary training institute, we train professionals in trauma-informed techniques that build resilience and reduce harm. We collaborate with administrators and managers to change practices and policies in organizations and systems.

CAP4Kids
CAP4Kids (The Children’s Advocacy Project) was developed in 2005 as a way for healthcare providers, social workers, child advocates and parents and teens to find reliable, up-to-date information on community resources to help improve and enhance the lives of children and families. Each CAP4Kids city has its own content with local community resources organized into easy to locate Parent Handouts. These handouts are the backbone of CAP4Kids. They allow parents and families to find resources on a wide range of topics, ranging from after school programs and camps, to education resources or resources for children with special needs. There are resources for pregnant mothers, infants, school-aged children and teens.

Children, Youth and Families (CYF News) November 2018 Issue-Adverse childhood experiences: Current research and practice applications
CYF News is the newsletter for the Children, Youth and Families Office (CYF). CYF supports the work of the APA Committee on Children, Youth and Families and liaisons with interested divisions, state associations, other organizations and federal agencies. The programs work to ensure that children, youth and families receive the full attention of the association, promotes knowledge development and dissemination, engages in policy analysis and advocacy, and provides information and referral and consultation to members and the public.

Evidence-Based Practices Resource Center
SAMHSA’s resource for providing the information and tools needed to incorporate evidence-based practices into community and clinical settings.

Blueprints for Healthy Youth Development
Data base of evidence-based programs that help young people reach their full potential.

Child and Family Research Unit at Washington State University
As a part of WSU Extension, the Child and Family Research Unit (CAFRU) works with community allies to promote health and wellness for underserved and at-risk populations through research, community development, and education.
While we work with a range of challenges facing families and communities, our principal focus is on working with community systems to address the public health challenge of adverse childhood experiences (ACEs) and resulting trauma. Specifically, we focus on how systems help individuals of all ages build resilience and recover from adversity.
Lesson 5: Educating Others and Raising Awareness

Sesame Street in Communities
Resources that help kids (and parents!) with what matters most in young lives: health and wellness, social-emotional skills, and school readiness. All are critical to children’s healthy development…and together they build the foundation for a happy, healthy life.

Robert Wood Johnson Foundation-Adverse Childhood Experiences
The Robert Wood Johnson Foundation (RWJF) is the nation’s largest philanthropy dedicated solely to health. Since 1972, we’ve supported research and programs targeting some of America’s most pressing health issues—from substance abuse to improving access to quality health care.

ChildTrauma Academy
The ChildTrauma Academy (CTA) is a Community of Practice working to improve the lives of high-risk children through direct service, research and education.
A major activity of the CTA is to translate emerging findings about the human brain and child development into practical implications for the ways we nurture, protect, enrich, educate and heal children. The “translational neuroscience” work of the CTA has resulted in a range of innovative programs in therapeutic, child protection and educational systems.

American Psychological Association-Children and Trauma Resources
APA is the leading scientific and professional organization representing psychology in the United States, with more than 118,000 researchers, educators, clinicians, consultants and students as its members.

The Raising of America: Early Childhood and the Future of our Nation
Documentary, discussion guides, and toolkits for engaging communities to talk about strengthening families.
Pediatric Medical Provider Module
Lesson 1: The Biological Impact of ACEs

Epigenetics in Pediatrics
The Pediatrics in Review article defines epigenetics and the different epigenetic mechanisms, explains the role of epigenetics in disease prevention and the potential for epigenetics in disease prevention and treatment.

Epigenetics and Primary Care
The Pediatrics article reviews the basic principles of epigenetics, the role of epigenetics in genetic disorders, and how epigenetics influences pregnancy and the subsequent health impact of the child.

The Lifelong Effects of Early Childhood Adversity and Toxic Stress
The AAP technical report presents an ecobiodevelopmental framework that illustrates how early experiences and environmental influences can leave a lasting signature on the genetic predispositions that affect emerging brain architecture and long-term health. The report also examines extensive evidence of the disruptive impacts of toxic stress, offering intriguing insights into causal mechanisms that link early adversity to later impairments in learning, behavior, and both physical and mental well-being. It supports the guidance and recommendations in the AAP policy statement, Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science Into Lifelong Health.

Epigenetics: Changing Destinies
This AAP resource provides information about epigenetics and the role it plays in children's health, and includes case scenarios, answers to frequently asked questions and links to additional resources.
Lesson 2: The Role of Pedatric Medical Providers Across the Social Ecological Model

The AAP Screening Technical Assistance and Resource Center
The Screening Technical Assistance & Resource Center (STAR Center) provides evidence-informed technical assistance and resources to assist practices in implementing effective screening, referral, and follow-up for developmental milestones, maternal depression, and social determinants of health.

AAP Bright Futures Guidelines
The Bright Futures Guidelines provide theory-based and evidence-driven guidance for all preventive care screenings and well-child visits. Materials developed especially for families are also available.
Lesson 3: The Role of the Pediatric Medical Provider in Preventing ACEs

Bright Futures Child Health Tracker App
The Apple app allows parents to track their children's visits to the pediatrician, get notifications for upcoming visits and milestones, and gives access to previsit questionnaires and handouts to guide discussions during appointment.

AAP Bright Futures Toolkit
The toolkit accompanies the Bright Futures Guidelines and provides health care professionals with an organized compilation of current forms and materials that relate to preventive health supervision and health screening for infants, children, and adolescents.

The AAP Screening Technical Assistance and Resource Center
The Screening Technical Assistance & Resource Center (STAR Center) provides evidence-informed technical assistance and resources to assist practices in implementing effective screening, referral, and follow-up for developmental milestones, maternal depression, and social determinants of health.

The National Child Traumatic Stress Network
This site is a supportive resource for selecting screening and assessment tools and intervention services.

Trauma Informed Systems – The National Child Traumatic Stress Network
The resource provides guidance on developing a trauma informed system.

Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science Into Lifelong Health
The AAP policy outlines the role of a pediatric medical home in taking an ecobiodevelopmental framework to address early childhood adversity and prevent toxic stress in children.The supporting technical report, The Lifelong Effects of Early Childhood Adversity and Toxic Stress,presents an integrated ecobiodevelopmental framework to assist in translating these dramatic advances in developmental science into improved health across the life span.

Center for Youth Wellness
The Center for Youth Wellness is part of a national effort to revolutionize pediatric medicine and transform the way society responds to kids exposed to significant adverse childhood experiences and toxic stress.

Child Abuse and Neglect Prevention Resource for Action: A Compilation of the Best Available Evidence
The child abuse and neglect Resource for Action helps states and communities identify strategies and prioritize prevention activities based on the best available evidence.

Preventing Adverse Childhood Experiences (ACEs): Leveraging the Best Available Evidence
This is a resource to help states and communities leverage the best available evidence to prevent ACEs from happening in the first place as well as lessen harms when ACEs do occur. It features six strategies drawn from the CDC Resources for Action to Prevent Violence.

Aspen Institute Two-Generation Playbook
Two generation approaches provide opportunities for and meet the needs of children and their parents together. They build education, economic assets, social capital, and health and well-being to create a legacy of economic security that passes from one generation to the next.

CDC Essentials for Parenting Toddlers and Preschoolers
This website will help you handle some common parenting challenges such as communicating with you child, creating structure and rules, giving directions, using discipline and consequences, time out andparenting skills, so you can be a more confident parent and enjoy helping your child grow.

AAP Early Brain and Child Development Resources
These resources help pediatric practices promote early brain child development with families.

AAP Trauma Toolbox for Primary Care
This six part series of information sheets provides information about adverse childhood experiences (ACEs) and the process of asking families about exposure to ACEs or other traumatic events.Two of the sheets are for families specifically and all sheets are provided in Spanish as well.

AAP Addressing ACEs and Other Types of Trauma in the Primary Care Setting
Part of the AAP Trauma Toolbox for Primary Care, this informational sheet provides step-by-step guidance on how to start addressing ACEs and trauma in children in the primary care setting.
Lesson 4: The Role of Pedatric Medical Providers in Intervention

The AAP Screening Technical Assistance and Resource Center
The Screening Technical Assistance & Resource Center (STAR Center) provides evidence-informed technical assistance and resources to assist practices in implementing effective screening, referral, and follow-up for developmental milestones, maternal depression, and social determinants of health.

AAP The Resilience Project
The AAP Resilience Project website provides information and resources on addressing different types of violence in primary care and includes webinar recordings and video vignettes as part of a training toolkit.

ACEs Pediatric Healthcare Toolkit
Toolkit for integrating ACEs into your Pediatric Practice.

National Pediatric Practice Community on Adverse Childhood Experiences
The NPPC embraces a co-designed approach that ensures that materials and training are responsive to member needs and that lessons learned as a community are disseminatedwidely to advance medical practice. NPPC is working with a select number of medical practices to help us better understand the experience and process of integrating ACEs screening into clinical settings. Data, insights and learnings from these “pilot sites” will be shared with NPPC members.

AAP Bright Futures Toolkit
The toolkit accompanies the Bright Futures Guidelines and provides health care professionals with an organized compilation of current forms and materials that relate to preventive health supervision and health screening for infants, children, and adolescents.

Clinical Considerations Related to the Behavioral Manifestations of Child Maltreatment
The AAP clinical report provides describes the behavioral manifestations of child maltreatment and provides guidance on the clinical approach to identifying and treating childhood trauma.

Connected Kids
Connected Kids: Safe, Strong, Secure offers child healthcare providers a comprehensive, logical approach to integrating violence prevention efforts in practice and the community, taking an asset-based approach to anticipatory guidance, focusing on helping parents and families raise resilient children.Connected Kids Includes a Clinical Guide and 21 handouts for parent and teen topics such as bullying, discipline, interpersonal skills, parents, suicide and television violence; some materials are available for purchase at ShopAAP.org.

AAP Early Brain and Child Development Resources
These resources help pediatric practices promote early brain child development with families.

Healthcare Toolbox
Provides information on Trauma-Informed Care across screening, assessment and treatment.

Child Welfare Information Gateway
Promotes the safety, permanency, and well-being of children, youth, and families by connecting child welfare, adoption, and related professionals as well as the public to information, resources, and tools covering topics on child welfare, child abuse and neglect, out-of-home care, adoption, and more.

AAP Screening in Practices
The AAP Screening in Practices initiative provides some resources and guidance on how to code and bill when screening for SDOH, maternal depression and developmental delays.

AAP Mental Health Initiatives
This special article from the AAP and the American Academy of Child and Adolescent Psychiatry outlines the barriers to providing collaborative mental health care. For those who want to learn more, the authors have also written a background paper, which delves into the issues and the need for collaboration.

AAP Physician Health and Wellness
This site aims to equip pediatric health professionals with skills, tools, and resources needed to nurture individual resilience, advocate for organizational supports in their practice, and develop the next generation of pediatric medical professionals.

ACEs Connection – ACEs in Pediatrics Community
A place to share resources and best practices in pediatrics to address ACEs in children and their parents or caregivers.
Lesson 5: Educating Others and Raising Awareness

CDC Essentials for Parenting Toddlers and Preschoolers
This website will help you handle some common parenting challenges such as communicating with you child, creating structure and rules, giving directions, using discipline and consequences, time out andparenting skills, so you can be a more confident parent and enjoy helping your child grow.

Parent Handout from the Trauma Toolkit
This handout is part of the AAP Trauma Toolkit and can be given to parents toprovide guidance on discipline and help when their child's behavior is challenging.

AAP Connected Kids
The AAP Connected Kids Clinical Guide provides an overview to the entire Connected Kids program and its component parts. The Guide describes some details of its development and its rationale.

Preventing Adverse Childhood Experiences (ACEs): Leveraging the Best Available Evidence
This is a resource to help states and communities leverage the best available evidence to prevent ACEs from happening in the first place as well as lessen harms when ACEs do occur. It features six strategies drawn from the CDC Resources for Action to Prevent Violence.

Child Abuse and Neglect Prevention Resource for Action: A Compilation of the Best Available Evidence
The child abuse and neglect Resource for Action helps states and communities identify strategies and prioritize prevention activities based on the best available evidence.

Intimate Partner Violence Prevention Resource for Action: A Compilation of the Best Available Evidence
The Centers for Disease Control and Prevention (CDC) has developed Resources for Action to help states and communities take advantage of the best available evidence to prevent violence. This one is specifically on preventing intimate partner violence.

AAP Policy Statement and Resources on Poverty
This site provides the AAP policy on addressing poverty in children and families and related resources.

Protecting Physician Wellness: Working with Children Affected by Traumatic Events
The resource, part of the AAP Trauma Toolkit, reminds pediatricians about the related stress of taking care of children who have experiences trauma and provides suggestions on addressing their own wellness.

ACEs Connection Parent Handouts
Handouts offer information on how to respond to and promote healing from ACEs for parents. Offered in several languages including English, Spanish, and Dari.
Educator Module
Introduction:

Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences Study
This landmark journal article from the original ACE Study links exposure to abuse or household dysfunction during childhood to several of the leading causes of death in adults.
Lesson 1: Overview of ACEs

Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences Study
This landmark journal article from the original ACE Study links exposure to abuse or household dysfunction during childhood to several of the leading causes of death in adults.

The Truth About Adverse Childhood Experiences Infographic
This infographic gives viewers a high-level overview of ACEs and the impact they may have on health outcomes.

We Can Prevent Adverse Childhood Experiences
This CDC webpage explains what ACEs are, the problems they can lead to, and what we can do to prevent ACEs.

Prevalence of Adverse Childhood Experiences from the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States
This 2018 study provides an updated prevalence estimate of ACEs in the United States.

Trauma Types
This National Child Traumatic Stress Network webpage describes the range of traumatic events or trauma types to which children and adolescents can be exposed.

An Introduction to Adverse Childhood Experiences (ACEs) and Trauma-Informed Practice
This recorded webinar from the West Midlands Violence Reduction Unit provides a comprehensive introduction to ACEs and an overview of trauma-informed organizations.

Fast Facts: Preventing Adverse Childhood Experiences
This CDC webpage defines adverse childhood experiences (ACEs), presents a breakdown of important facts about ACEs, and shares strategies for prevention.

Fast Facts: Preventing Child Abuse & Neglect
This CDC webpage provides facts about child abuse and neglect and how to prevent them.

Intimate Partner Violence
This CDC video explains the problem of intimate partner violence and how to prevent it.

ACEs Infographic
This infographic uses data from the CDC-Kaiser Permanente Adverse Childhood Experiences (ACEs) Study and recent findings to show how ACEs and prevention can affect people's lives and society.

Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017
This publication presents Behavioral Risk Factor Surveillance System data collected from 25 states that included state-added adverse childhood experience items during 2015–2017. Findings demonstrate that efforts to prevent adverse childhood experiences could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes.

Trauma-Informed Schools
This National Education Association (NEA) resource is designed to help schools and educators address trauma and its implications for learning, behavior, and school safety.

The National Survey of Children's Health
The National Survey of Children's Health provides rich data on multiple, intersecting aspects of children's lives—including physical and mental health, access to quality health care, and the child's family, neighborhood, school, and social context.
Lesson 2: Understanding the Impact of ACEs

Early Brain Development and Health
This CDC webpage explains the importance of early childhood experiences for brain development.

Why Early Childhood Matters
This First Things First webpage includes videos explaining the critical importance of brain development in early childhood.

ACEs Online Training Module
This CDC video presents the impacts of toxic stress on brain development, specifically in early childhood.

Fast Facts: Preventing Adverse Childhood Experiences
This CDC webpage defines adverse childhood experiences (ACEs), presents a breakdown of important facts about ACEs, and shares strategies for prevention.

Child Well-Being
This white paper focuses on identifying the constructs used to measure child well-being and risk and protective factors that affect the development of young children.

Risk and Protective Factors for ACEs
This CDC webpage lists the risk and protective factors associated with ACEs.
Lesson 3: ACEs in the School Environment

Trauma-Informed Schools
This National Education Association (NEA) resource is designed to help schools and educators address trauma and its implications for learning, behavior, and school safety.

Unlocking the Door to Learning: Trauma-Informed Classrooms & Transformational Schools
This document developed by the Education Law Center discusses how educators can begin to understand the role of trauma, its effect on children and learning, and how educators can change methods of interacting with and responding to children impacted by trauma.

Recognizing and Attending to Intergenerational Trauma
This document provides information for recognizing trauma-related patterns within families and how they can be interrupted in the presence of nurturing relationships, enriching activities, and safe environments.

Trauma: What Child Welfare Attorneys Should Know
This document from the National Child Traumatic Stress Network provides tips for incorporating trauma-informed skills and principles into everyday legal practice.

Identifying Chronically Hungry Children
The Montana Food Bank Network developed this resource to help individuals and organizations define and identify a “chronically hungry” child, including information on how to respond or potentially intervene.
Lesson 4: Preventing ACEs and Reducing their Effects

Preventing Adverse Childhood Experiences (ACEs): Leveraging the Best Available Evidence
This resource developed by CDC provides evidence-based strategies and corresponding approaches for preventing ACEs.

Education Brief: ACEs for Educators and Stakeholders
This brief developed by the Illinois ACEs Response Collaborative provides important background information about ACEs and their impact on education, as well as examples of evidence-based prevention programs and practices.

Safe and Supportive Schools Framework
This resource provides example legislation that defines the meaning of safe and supportive schools.

Trauma Smart
This evidence-based program developed by The Crittenton Children's Center of St. Luke's Hospital of Kansas City helps children and the adults who care for them address the negative impact of violence and trauma.

Videos Featuring the Whole School, Whole Community, Whole Child (WSCC) Model
These videos explain and encourage adoption and implementation of the WSCC model.

Mental Health - Trauma Sensitive Schools
This Online Professional Learning System was created by the Wisconsin Department of Public Instruction to support schools as they begin the process of becoming a trauma-sensitive school.

Wisconsin's Approach to Trauma Sensitive Schools
This presentation was developed by the Wisconsin Department of Public Instruction to provide information on the state's trauma sensitive schools initiative as well as an implementation guide.

Trauma-Sensitive Schools Help Children Feel Safe to Learn
This resource developed by the Trauma and Learning Policy Initiative (TLPI) outlines the core attributes of a trauma-sensitive school and includes the voices of school's leaders, teachers, and other staff members who worked together to create significant changes in their school's culture.

Trauma Sensitivity Requires a Whole-School Effort
This resource developed by Trauma and Learning Policy Initiative (TLPI) provides information on how to implement a whole school approach to create a school-wide environment where all children, including those who have been traumatized, can be successful.

ACEs and Resilience: What Can We Do?
This document provides information for educators about helping children build resilience to moderate the impacts of ACEs, come to school, and graduate with a chance at a healthy and productive future.

Safe, Stable, Nurturing Relationships as a Moderator of Intergenerational Continuity of Child Maltreatment: A Meta-Analysis
This study published in the Journal of Adolescent Health explores the intergenerational continuity of child maltreatment and the potential moderating effects of safe, stable, nurturing relationships (SSNRs).

Social and Emotional Learning Competencies
The Wisconsin Department of Public Instruction developed this social and emotional learning competencies resource for schools and families to support comprehensive social and emotional learning opportunities for students.

Social and Emotional Learning Coaching Toolkit
This toolkit created by the American Institutes for Research supports teachers, coaches, and administrators as they observe practices that support the development of social and emotional skills in classrooms and hold critical conversations that include social and emotional learning (SEL).

Supporting Students Experiencing Childhood Trauma - Tips for Parents and Educators
This resource created by the National Association of School Psychologists provides tips for parents and educators to ensure that school is an environment where students feel safe disclosing traumatic experiences, and to ultimately help children feel supported and safe.

Trauma, Resilience, and the Impact on Learning
The American Bar Association prepared this article to help attorneys forge a strong connection with the child they represent and understand the brain science behind trauma.

Trauma Care in Schools: Creating Safe Environments for Students with Adverse Childhood Experiences
This article prepared by the American Federation of Teachers, excerpted from their book Creating Trauma-Informed Schools: A Guide for School Social Workers and Educators, explores safety, connection, and emotional and behavioral regulation as the foundational pillars of a trauma-informed school environment.
Lesson 5: Raising Awareness and Educating Others

Whole School, Whole Community, Whole Child (WSCC)
This resource provides information about the Whole School, Whole Community, Whole Child, or WSCC model, which is CDC's framework for addressing health in schools.
Conclusion:

“There's No Big Book on How to Care”: Primary Pre-Service Teachers' Experiences of Caring
This study from the Australian Journal of Teacher Education investigated primary, pre-service teachers' experiences regarding their caring role and the barriers they face when caring for students.

The Cost of Caring: The Impact of Secondary Trauma on Assumptions, Values, and Beliefs
This study published in Counseling Psychology Quarterly looks at the impact of psychology professionals' work with distressed and traumatized patients.

Preservice Teacher Burnout: Secondary Trauma and Self-Care Issues in Teacher Education
This study published in Issues in Teacher Education examines preservice teacher coursework and interview data related to encountering student trauma, secondary trauma, and the role of self-care during clinical placement experiences.

8 Ways People Recover from Post Childhood Adversity Syndrome
This article explores a range of promising approaches to help reset the stress response so that individuals may have more success recovering after ACEs.
Additional Resources:

Tools for Supporting Emotional Wellbeing in Children and Youth
This resource was developed by the National Academies of Sciences, Engineering, and Medicine with funding from CDC to teach skills that can help children and youth cope with some of the challenges associated with the COVID-19 pandemic.

National Conference of State Legislatures
This webpage by the National Conference of State Legislatures (NCSL) presents ACEs research and resources, as well as state strategies aimed at preventing and reducing the occurrence and negative consequences of ACEs.

Transforming Schools: A Framework for Trauma-Engaged Practice in Alaska
This webpage from the Alaska Department of Education and Early Development (DEED) highlights the Transforming Schools Framework. The framework was developed to help Alaska schools and communities integrate trauma-engaged practices and policies into their everyday activities in order to improve academic outcomes and well-being for all students.

School Health Policy Resources | Adolescent and School Health
This CDC webpage provides health policy-related resources for HIV, STDs, and teen pregnancy, general prevention resources, and schools.

Why Schools? | Adolescent and School Health
This CDC webpage focuses on the roles of schools in adolescent health.

School Connectedness | Adolescent and School Health
This CDC webpage offers information about school connectedness, the belief held by many students that adults and peers in the school care about their learning as well as about them as individuals. Fact sheets are available for school districts, school administrators, teachers, other school staff, parents, and families.

Healthy and Supportive School Environments
This CDC webpage includes information on healthy and supportive school environments to both schools and parents. Content includes strategies school professionals can use to create these environments and describes ways parents can learn to support skills for social and emotional development at home and at school.

Children's Mental Health
This CDC webpage discusses symptoms, treatment, statistics, and research related to children's mental health.
Faith, Spiritual, and Religious Communities Module
Lesson 1: Defining Adverse Childhood Experiences

Fast Facts: Preventing Adverse Childhood Experiences
This CDC webpage defines adverse childhood experiences (ACEs), presents a breakdown of important facts about ACEs, and shares strategies for prevention.

Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences Study
This landmark journal article from the original ACE Study links exposure to abuse or household dysfunction during childhood to several of the leading causes of death in adults.

Trauma Types
This National Child Traumatic Stress Network webpage describes the range of traumatic events or trauma types to which children and adolescents can be exposed.

Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017
This publication presents Behavioral Risk Factor Surveillance System data collected from 25 states that included state-added adverse childhood experience items during 2015–2017. Findings demonstrate that efforts to prevent ACEs could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes.

The National Survey of Children's Health
The National Survey of Children's Health provides rich data on multiple, intersecting aspects of children's lives, including physical and mental health; access to quality health care; and the child's family, neighborhood, school, and social context.

Prevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 States
This 2018 study provides an updated prevalence estimate of ACEs in the United States.

The Truth About Adverse Childhood Experiences
This Robert Wood Johnson Foundation webpage provides a high-level overview of ACEs and the impact they may have on health outcomes.

An Introduction to Adverse Childhood Experiences (ACEs) and Trauma-Informed Practice
This recorded webinar from the West Midlands Violence Reduction Partnership provides a comprehensive introduction to ACEs and an overview of trauma-informed organizations.

ACEs Infographic
This infographic uses data from the CDC-Kaiser Permanente Adverse Childhood Experiences (ACEs) Study and recent findings to show how ACEs and prevention can affect people's lives and society.
Lesson 2: Toxic Stress and Intergenerational Trauma

Fast Facts: Preventing Adverse Childhood Experiences
This CDC webpage defines adverse childhood experiences (ACEs), presents important facts about ACEs, and shares strategies for prevention.

ACEs Online Training Module Video
This CDC video presents the impacts of toxic stress on brain development, specifically in early childhood.

Harvard Center on the Developing Child: Toxic Stress
This Harvard University Center on the Developing Child website provides information and resources on how toxic stress impacts human development.

Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017
This publication presents Behavioral Risk Factor Surveillance System data collected from 25 states that included state-added adverse childhood experience items during 2015–2017. Findings demonstrate that efforts to prevent ACEs could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes.

Generational Trauma, Attachment, and Spiritual/Religious Interventions
This article from the Journal of Loss and Trauma examines generational trauma as a secondary form of trauma that may be passed down to later generations through psychological transference. The article also explores whether spiritual/religious interventions may help mitigate the harmful consequences of severe trauma in the lives of trauma survivors.

Early Brain Development and Health
This CDC webpage explains the importance of early childhood experiences for brain development.

Why Early Childhood Matters: Brain Development
This First Things First webpage includes videos explaining the critical importance of brain development in early childhood.

ACEs Infographic
This infographic uses data from the CDC-Kaiser Permanente Adverse Childhood Experiences (ACEs) Study and recent findings to show how ACEs and prevention can affect people's lives and society.
Lesson 3: Risk and Protective Factors

Risk and Protective Factors of ACEs
This CDC webpage lists the risk and protective factors associated with ACEs.

OnBeing: “Rachel Yehuda: How Trauma and Resilience Cross Generations”
The training includes a story from this episode about a girl whose faith community stepped in to help her father with caregiving after the girl's mother passed away. This story was borrowed with permission.
Lesson 4: Prevention Strategies: Building Trauma-Informed Communities

ACEs Information for Faith-Based Organizations
This Live Well Washington County resource provides guidance on how Faith-Based Organizations and the public health sector can work together to serve community members who may be affected by ACEs.

Preventing ACEs: Leveraging the Best Available Evidence
This resource developed by CDC provides evidence-based strategies and corresponding approaches to preventing ACEs.

SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach
This guide for implementing a trauma-informed approach from the Substance Abuse and Mental Health Services Administration (SAMHSA) presents insights from research, practice-generated knowledge on trauma interventions, and survivor knowledge.

Trauma-Informed and Affirmative Mental Health Practices With LGBTQ+ Clients
This article from Psychological Services describes the principles of SAMHSA's trauma-informed care (TIC) framework and offers approaches for applying TIC through affirmative practice for LGBTQ+ patients receiving mental health counseling and social services.

HHS Center for Faith and Opportunity Initiatives: Compassion in Action
This guide from the Center for Faith and Opportunity Initiatives at the U.S. Department of Health and Human Services provides information to help faith leaders and communities leverage their existing strengths and resources to support people facing mental health challenges and people who care for others with these challenges.
Lesson 5: Managing Secondary Trauma Conclusion

Secondary Traumatic Stress
This Administration for Children and Families webpage on secondary traumatic stress describes common symptoms and relevant interventions and approaches.

The Unseen Cost: A Discussion of the Secondary Traumatization Experience of the Clergy
This article in Pastoral Psychology investigates the impact of secondary trauma on clergy working with congregants addressing trauma.

Addressing Compassion Fatigue and Stress of Special Education Teachers and Professional Staff Using Mindfulness and Prayer
This article in The Journal of School Nursing discusses secondary trauma and compassion fatigue, and how prayer and mindfulness can lessen their impacts.

Secondary Traumatic Stress and Burnout Among Muslim Nurses Caring for Chronically Ill Children in a Turkish Hospital
This article from the Journal of Transcultural Nursing focuses on secondary trauma and burnout in nurses caring for chronically ill children, and examines the impact of spiritual practices and social supports on coping.

The Effect of Prayer on Depression and Anxiety: Maintenance of Positive Influence One Year after Prayer Intervention
This article from The International Journal of Psychiatry in Medicine found that patients who completed a prayer program experienced less anxiety and depression and more optimism up to one year after the program ended.
