Editor’s note: This article is the second in a series exploring how research into adverse childhood experiences – or ACEs – is helping researchers, therapists, parents, educators and the medical community better understand the lasting effects of trauma on mental health.

Childhood trauma can have lifelong health, social and behavioral consequences.

Research shows that different forms of abuse, neglect and related household stressors are unfortunately common among children. These experiences often do not occur as single events, and the risk for long-term outcomes worsens as the number of adversities increase. These experiences can also increase the risk of multiple health problems throughout the lifespan and hinder healthy brain development in children.

Prevention of these and other adverse childhood experiences (ACEs) should be society’s primary goal. However, these experiences continue to be pervasive and are often left unresolved for adult survivors.

The time has come for all systems engaged with the care of children to tackle this problem head-on. By building children’s resilience early in their lives, we can better prepare them to handle past and future trauma and grow into healthy adults.

Healthy attachment starts early in life

For children, building resilience means learning skills that can increase their ability to manage and regulate their emotions and response to stress.

One key way to build resilience is to strengthen families. This can include teaching caregivers about child development, providing concrete help in times of need and bolstering their abilities to manage stress and develop positive social connections.

These are just some of the ways to provide a safe and supportive environment where children can develop a strong bond with their caregivers. Research shows that healthy, securely attached children are less likely to show separation anxiety. Meanwhile, insecurely attached children tend to be avoidant and struggle to express negative feelings.

The quality of caregiver-child attachment can be affected by everything from facial expressions to the type of touch caregivers provide.

Developing healthy attachment early in life helps children learn to better self-regulate. These children will display an ability to express their feelings openly and exhibit less fear and avoidance of the parent. In addition, adults’ attachment style with their own children is highly influenced by the quality of the relationship they once had with their caregivers.

ACEs disrupt the development of healthy caregiver-child attachment. For example, parents with depression or substance use problems may be unavailable to care for their children and provide the support they need. In fact, in a recent study, ACEs were found to be associated with unresolved attachment style in adulthood. These early life events can increase the risk of substance use, which is often used as a coping mechanism.

Helping children cope

The home is not the only place where children can experience trauma. Trauma can be experienced in multiple ways and contexts – from problems at school to natural disasters that hit the community.

For example, when teachers observe a child having behavioral difficulties, they must be prepared to respond in a calm and nonreactive manner. Adults must be aware of their own stresses and triggers in order to avoid potentially retraumatizing the children they care for. Children need to be reassured they are in a safe, supportive and caring environment.

Adults can help children physiologically relax by providing sensory inputs that calm the stress response. For example, listening to sounds that are calming, breathing deeply and taking a walk can help individuals bring the nervous system back to a balanced state. Yoga, creative arts and journaling can also help children relax and process negative emotions.

Increasing awareness

Once a traumatic event occurs, it cannot be undone. But early intervention can help children recover quickly and more successfully. Therefore, the better informed we are about the signs and symptoms of trauma, the better we will be able to recognize them.

Trauma-informed care takes adverse experiences into account. This approach emphasizes safety and encourages empowerment throughout the recovery process. Ultimately, it’s about changing the culture of how we work with children and adults.

To fully embrace trauma-informed care, we must first build awareness that childhood stress and trauma is widespread across the population. Second, anyone who works with child or adult survivors must learn to recognize the symptoms of trauma and stress. Some of these include anxiety, depression, problems with emotional regulation, hyperactivity, substance abuse and eating disorders.

Currently, there is controversy in the public health and medical community over whether we should ever assess for ACEs in adults and children. Some worry that asking about childhood experiences may open Pandora’s box. “What do we do when we find out about trauma?” This is a natural response for individuals working in systems that do not have knowledge, skills or experiences about evidence-based approaches to trauma healing and recovery.

However, if we want to provide trauma-informed care, we need assessments to have a better understanding of the population overall for treatment and recovery. Assessment should only be conducted if there are appropriate programs and treatments to refer individuals or families.

While more institutions, such as schools, are now starting to assess childhood trauma, we must be cautious in reading too much into what that trauma means. Assessment is not a means to diagnose, judge or label individuals. It is a tool that informs us about who we are working with and helps us foster understanding and compassion.

If organizations want to provide trauma-informed care, they will need commitment from leadership and staff to change their organization’s culture. This means implementing policies that focus on safe, supportive and collaborative environments. It means accepting that our society has experienced historical, cultural and gender-related trauma. There must be recognition by everyone that we all come from different backgrounds and experiences, which make us who we are.

All of this may be difficult to embrace. But we must equip our children – the future of society – with the skills for their physiological and psychological resilience so that they can lead healthy, productive lives.

Shanta Dube consults with Montefiore Medical Center. She is affiliated with Vision of Wellness, LLC.