A small fishing boat floating over calm seas. The boat is full of water even as it remains afloat.
Photo by Norbert Braun on Unsplash

Trauma and resilience–both are words we hear more and more often in education as we better understand the short and long-term impact of trauma on our students. We are becoming trauma-informed schools and leaders. We have implemented SEL programs, restorative justice models, community circles, and professional learning aimed at helping students thrive–all good things!

Yet it feels as though we are trying to plug a hole in a boat even as waves of water continue to crash over the sides. Another news story of violence in a school, another mass shooting that shatters a community, debates about how we create safe schools. On some days, “hopeless” is the word that comes to mind, but we keep showing up for our kids.

What are ACEs?

If you’ve spent any time learning about trauma, you may have come across the term “adverse childhood experiences” or ACEs. In 1998, a CDC-Kaiser Permanente1 study explored the link between 10 different ACEs and health outcomes in adulthood. These included:

  • Physical abuse
  • Physical neglect
  • Emotional abuse
  • Emotional neglect
  • Sexual abuse
  • Depression or mental illness in the home
  • Substance abuse in the home
  • Incarcerated adult caregiver
  • Domestic violence toward the mother
  • Parental separation (divorce or other means)

Some findings of the original study1 were: 

  • Almost 2/3 of surveyed adults reported at least one ACE. They are common experiences.
  • Having at least one ACE was strongly linked to having 2+ ACE scores.
  • Those with 4+ ACEs had 4 to 12x greater risk of depression, alcoholism, drug use, and suicide attempts.
  • Having 4+ ACEs was also linked to 2 to 4x greater likelihood of smoking, having ≥50 sexual partners, and contracting an STD. 
  • A clear “graded relationship” was identified between ACE scores and a wide variety of adult diseases from ischemic heart disease and cancer to lung and liver disease1. In other words, the higher an ACE score, the higher the risk for many adverse physical health outcomes in adulthood.
  • Having 6+ ACEs showed a strong link to a life shortened by 20 years!
  • A connection between ACEs and 5 of the 10 leading causes of death.

Subsequent ACEs studies expanded to include adverse community and climate experiences. Further studies have also more explicitly linked ACEs to specific health outcomes including wound healing2

Felitti3, one of the authors of the first ACEs study, wrote that these ACEs stick around, “like a child’s footprints in wet cement”. What happens in childhood has a profound effect on what happens in adulthood like a vicious cycle that keeps repeating itself. It’s a pretty grim picture.

We hear the phrase, “Kids are resilient, right?” Well, are they?

How do ACEs impact students?

We don’t have to wait until adulthood to see the impact of accumulated toxic stress. Studies connect ACEs to these possible outcomes during childhood or adolescence:

  • Increased rates of school absenteeism4
  • Greater likelihood of grade retention4
  • Lower rates of school engagement5
  • Behavioral or learning problems6
  • Increased risk of obesity6
  • Increased rates of illness6

That’s a lot to digest. Is there a connection between ACEs and the violence that happens in or is carried out against our schools? Maybe. If we can’t prevent ACEs from happening to our students, should we just give up?

Pink flowers growing out of a rocky crevice, a picture of resilience
Photo by K. Mitch Hodge on Unsplash

More than prevention

Since the original ACEs Study released in 1998, much of the response has focused on prevention–an excellent strategy for avoiding all the negative outcomes associated with ACEs–but bad things happen sometimes.

New research started to look through a resilience lens. What if positive outcomes in childhood could provide resilience-building factors even in the presence of ACEs? What if resilience doesn’t happen by accident, but is built by purposeful relational connection?

PCEs flip the script

A study that was released in 2019 says “Yes” to those questions.

A research team out of Johns Hopkins University identified 7 PCEs with “a dose-response association with adult mental and relational health.”7

They are: 

  • Being able to talk to family about how they feel
  • Having a sense that family sticks together during tough times
  • Enjoying and participating in community traditions
  • Feeling a sense of belonging during the high school years
  • Having a supportive group of friends
  • Having at least 2 adults (non-parent) who take interest in them
  • Feeling a sense of safety and protection with an adult at home.7

With 6 to 7 PCEs in place during childhood, the odds of depression and mental health issues in adulthood decreased by 72%7. With 3 to 5 PCEs, the odds were still cut in half7

Those with 6-7 PCEs were also 3.5 times more likely to access the social and emotional support they needed in adulthood, even if they were struggling with depression or mental health issues7

Without stopping the ACEs from happening, the presence of the PCEs helped build resilience.

Ruckus Makers, Step up!

The challenges facing our schools today are complex. Complex issues require multi-pronged solutions. No single thing, short or long-term, will fix everything so we adopt a variety of strategies. PCEs sit in the category of long-term solutions since we may not see an immediate pay off. The road to healing takes time. 

Ruckus Makers have a bias for action so what does all this mean for you and your school? Did you see that list of PCEs?

Schools can take part in more than half of those PCEs! So here’s the challenge:

  • Evaluate your school traditions because community traditions provide identity anchors that foster resilience. Do you have traditions? Do you need more? What are the things you do as a school that say, “This is who we are, and this is what we do here”? Do these traditions really include all your students or do they create another form of othering? Plan for these and make sure every student feels a part of them.
  • Focus on creating a sense of belonging–whatever school level you are at. What ways do you have for students to connect and get involved in each others’ lives? Perspective-taking plays an important part here and asking, “What makes you feel like you belong?” is a great starting point. And by the way, Danny’s bestseller — Mastermind: Unlocking Talent Within Every School Leader — has an entire chapter on belonging.
  • Teach students how to be the kind of friend they want others to be for them. Especially after COVID, students need explicit modeling of social and friendship skills so they can develop a supportive friend network. Don’t assume students develop these skills naturally.
  • Get all your staff involved in connecting with students and sending the message, “Somebody here is really glad that I am here today. They know me, and they believe in me.” Connection is built through tiny, meaningful exchanges. 
  • Do everything within your power to ensure that your students feel physically safe in your school. This will involve evaluating everything from your safety policies and procedures to the way you handle school discipline in an equitable, dependable way.

It’s not hopeless. We can do something about trauma, help our students build resilience, and pave the way for better long-term outcomes for our schools and communities.

What’s next for you?

One of the best places school leaders can go for support through the many challenges of the role is the Ruckus Maker Mastermind™. Since 2016 we’ve been supporting leaders who want to be even more effective in their roles.

This experience is a great professional learning opportunity because we talk in depth about all things related to education and leadership.

Isolation is a choice. Connect with like-minded leaders who are committed to Making a Ruckus!

Learn more about the mastermind and apply when you are ready to take your leadership to the next level.


1 Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., Koss, M.P., & Marks, J.S. (1998). 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 14:245–258.

2 Bryan, R. & Beitz, J. M. (2019). Connections among biologic embedding of childhood adversity, adult chronic illness, and wound care: A review of the literature. Wound Management & Prevention, 65(10),18-28.

3 Felitti, VJ. (2009). Adverse childhood experiences and adult health. Academic Pediatrics, 9(3), 131-132.

4 Crouch, E., Radcliff, E., Hung, P., & Bennett, K. (2019). Challenges to school success and the role of adverse childhood experiences. Academic Pediatrics, 19(8), 899–907.

5 Bethell, C., Forrest, C. B., Stumbo, S., Gombojav, N., Carle, A., & Irwin, C. E. (2012). Factors promoting or potentially impeding school success: Disparities and state variations for children with special health care needs. Maternal and Child Health Journal, 16(1), 35-43.

6 Burke, N. J., Hellman, J. L., Scott, B. G., Weems, C. F., & Carrion, V. G. (2011). The impact of adverse childhood experiences on an urban pediatric population. Child abuse & neglect, 35(6), 408–413.

7 Bethell. C., Jones, J., Gombojav, N., Linkenbach, J., Sege, R. (2019). Positive childhood experiences and adult mental and relational health in a statewide sample: Associations across Adverse Childhood Experiences levels. JAMA Pediatrics 173(11): e193007.

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