Should Exposure to Gun Violence be Classified as an ACE Score?

Over 3 million children are exposed to some form of gun violence each year in America. This means they have seen guns that have been discharged, or they’ve seen people wounded and may even have seen individuals close to them killed. When we think of the post-traumatic stress, the fear, the high threat memories, and the trauma that these episodes create in the brain of a child, we must acknowledge how the impact of gun shootings can identify the level of trauma that affects a person’s physical and mental health. If childhood violence, maltreatment and household dysfunction has that kind of effect on children, it would be predictable that gun violence would do the same.

Some research was conducted and published in 2019 on this issue in the Journal of Behavioral Medicine. I thought their results were compelling on this topic. Here is the abstract to this research:

Adverse childhood experiences (ACEs) have historically included child maltreatment, household dysfunction, and other critical issues known to impact children negatively. Although youth experiences with violence are broadly captured in some ACE measures, youth exposure to violence involving a gun has not been included specifically in the operationalizing, and therefore scientific study, of ACEs. There are numerous implications of this omission, including limiting access to ACE interventions that are currently available and resources for individuals who have been exposed to gun violence. Thus, and given the persistent prevalence of gun violence in the US, we conducted a systematic review of the literature over the past two decades on the assessment of and response to ACEs and gun violence. Eighty-one journal articles across four search engines met our inclusion criteria. Our findings provide evidence that youth gun violence exposure should be classified as an ACE. In addition to increasing access to resources for youth affected by gun violence, these findings may improve the likelihood of funding and research into gun violence, with direct implications for prevention and intervention efforts.

It is clear that these researchers are convinced that youth gun violence exposure should be included as another ACE score that now includes 3 million children and teenagers. I have to believe that this reality is a contributor to the intense mental health crisis that we are currently experiencing in our country. I also believe that as we deal with this mental health crisis, we should be including gun violence exposure as one of the trauma-inducing experiences that have been a part of what happened to so many of our children. It is something that teachers, mental health workers and healthcare workers should be cognizant of when treating children who have lived in environments where there has been significant gun violence.

As tragic as this is, we now know that we should be including this in our treatment protocols when dealing with youth who are demonstrating post-traumatic stress. It gives us another level of sensitivity and discovery about how their memories and stress responses have been impacted by gun violence exposure. It should inform our conversation, our care and our compassion for children as they recover from the violence that may have been part of their lives.

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