Peer-reviewed article

Expanding ACES in child and family service systems: Incorporating context and resilience

Ana Maria Meléndez Guevara, Stephanie Cottam, Charlie Wall, Sarah Lindstrom Johnson · 30 Sept 2024

Abstract

The Adverse Childhood Experiences (ACEs) framework has been instrumental in illustrating the profound and long-term impact of early-life stressors in the developmental trajectories of children and families and well-being of our communities. However, despite its groundbreaking contributions, the ACEs framework predominately adopts a deficit-oriented lens, focusing on risk factors while often neglecting the protective and positive experiences children and families also experience. In the United States, communities that have been historically marginalized, including racial and ethnic minorities, are disproportionately impacted by ACEs due to systemic inequities and historical injustices, leading to persistent sociodemographic health and social disparities. Recent advances to the ACEs framework argue that the traditional ACEs model inadequately addresses the broader socio-structural, political, and economic contexts that influence adversity, including living in under-resourced communities, ongoing community violence and poor access to service systems. As a result, child, and family service systems (CFSS) may fail to consider how socio-structural factors, may potentially reinforce disparities in service access, delivery, and outcomes. This paper discusses the limitations of the traditional ACEs framework and advocates for a more comprehensive approach that incorporates socio-ecological and strengths-based perspectives like the Social Determinants of Health Framework and the Protective and Compensatory Experiences (PACEs) Framework. By shifting towards this holistic perspective, researchers and practitioners alike can better understand the interplay of systemic inequalities and socio-structural conditions in shaping ACEs exposure and outcomes, and, therefore, inform more effective practices, policies and services that can address both the immediate impact and root causes of adversity. • A socio-ecological approach to ACEs explains the burden faced by marginalized communities. • Strengths-based perspectives elucidate intervention opportunities. • Child and Family Service Systems need to go beyond an assessment of ACEs.