i finished the wire yesterday.

i was so disappointed in so many of the people in power.

i can't stop thinking about the kids from season 4 - dukie, randy, michael, bug, namond. even wallace from season 1.

reading about ACEs and their impact and how that was portrayed

thread.

According to Corcoran and McNulty (2018), adverse childhood experiences are “traumatic events (e.g., sexual abuse, physical abuse, emotional abuse) or chronic stressors (e.g., neglect, parental separation) that are uncontrollable to the child”

They can include:
- all kinds of abuse
- household challenges
- DV towards mum
- parental separation
- criminal household member
- mental illness
- substance abuse

The theory behind ACEs is that they lead to neurobiological impacts and health risks, which in turn lead to long-term social and health problems. The greater the neurobiological impacts and health risks, the more serious the lifelong consequences to health and wellbeing.

In a systematic review specifically examining school-related outcomes of traumatic event exposure, Perfect et al (2016) identified 44 studies that examined cognitive functioning, 34 that examined academic functioning and 24 that examined social-emotional-behavioural functioning.

Their findings suggest youth who have experienced trauma are at significant risk for impairments across various cognitive functions, including IQ, memory, attention and language/verbal ability; poorer academic performance and school-related behaviours

such as discipline, dropout and attendance; and higher rates of behavioural problems and internalizing symptoms

So what to do about it?

There have been a few studies looking at this including Dingwall, N and Sebba, J (2018) Evaluation of the attachment aware schools programme: final report. Rees Centre, University of Oxford

This mixed-methods study looks at the impact of an Attachment Aware Schools Programme run by Bath and NE Somerset Council, Bath Spa University and Kate Cairns Associates between October 2015-July 2016.

Participants in the training were 25 participants from 16 schools (6 secondary, 7 primary, 1 middle and two special schools), who were mainly teachers, with two teaching assistants and two family support workers (with a social work background)

Using surveys, documentary analysis, data analysis, observation and interviews, the researchers found evidence to suggest that the training had an impact on whole staff understanding of attachment, the meaning behind behaviour and emotional well-being

However, only 6/10 schools provided attainment data for
these students which means the extent of the impact is unclear. It is not clear if the change in attainment can be attributed to this programme or if these 6 were also investing in other activities that supported attainment.

The pre- and post-intervention surveys of teachers from the six out of 16 returned sets of data indicated reductions in emotional 14 problems, conduct problems, hyperactivity and peer problems. Pro-social behaviour scores increased.

Despite the limitations of the methodology and analysis of the data available, this report is an example of the potential impact of attachment informed schools in the UK and connects qualitative evidence from participants to
quantitative findings which may provide useful insights

as a community paediatrics trainee working in a relatively deprived area, i see lots of these factors at play.

to have any long lasting effect on health, we need to work with education and social care to give these kids the support they need

(and for that we need adequate £££)