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Positive and Adverse Childhood Experiences (PACEs): What Happens in Childhood Matters


From A PACEs and HOPE Live Event
Friday, March 26, 2021
Noon PT / 1pm MT / 2pm CT / 3pm ET
Duration: 1 hour

At PACEs Connection, we believe in following the research. The last 25 years have been rich with breakthroughs about the impacts of childhood adversity on health and well-being. Researchers have defined adverse childhood experiences (ACEs), explored their short- and long-term impacts on health, uncovered the biological mechanisms that mediate these processes, and discovered genetic changes that result from toxic stress. As a consequence of this work, pioneers in many sectors have made great progress in integrating ACEs to solve some of our most intractable problems, including domestic violence, school suspensions and expulsions, and child abuse.

Safe Babies Courts show that one year after participating, 99 percent of the children suffer no further abuse. In a community that integrated PACEs, youth suicide drops 98 percent. In a U.S. county where practices based on ACEs science are used, deaths from opioids drop 26 percent while deaths in an adjacent county that doesn’t integrate ACEs science increase 84 percent. Batterer intervention programs reduce recidivism from 30-60 percent to just one percent. Staff turnover in organizations decreases from 21 to 3 percent. Schools eliminate suspensions and expulsions.

Although there is still much to learn about ACEs and how to prevent and mitigate their effects, we also all know that childhood experiences are not limited to those that involve adversity. All childhood experiences matter. In the last few years, researchers have started to examine the impacts of positive childhood experiences (PCEs) on children and adults. We at PACEs Connection are particularly interested in the interplay between positive and adverse childhood experiences. Here’s some of the relevant research:

In terms of research, these are still early days, says Dr. Robert Whitaker, director of Research and Research Education at the Columbia-Bassett Program and professor of Clinical Pediatrics in the Vagelos College of Physicians and Surgeons at Columbia University: “This area of PACEs research is emerging, but the boundaries of that research have not really been defined, particular as complement to the well-established body of research on resilience.”


From  Brains: Journey to Resilience”, Alberta Family Wellness Initiative.



“PCEs may have lifelong consequences for mental and relational health despite co-occurring adversities such as ACEs,” noted Dr. Christina Bethell in Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels. Bethell is professor at Johns Hopkins University in the Bloomberg School of Public Health and founding director of the Child and Adolescent Health Measurement Initiative. “In this way, they support application of the World Health Organization’s definition of health emphasizing that health is more than the absence of disease or adversity. The World Health Organization’s positive construct of health is aligned with the proactive promotion of positive experiences in childhood because they are foundational to optimal childhood development and adult flourishing.”

We’ll be addressing PACEs, flourishing, resilience and other topics during our next Better Normal webinar, PACEs and HOPE, which features Bethell and Sege, professor of pediatrics and director of the HOPE National Resource Center at Tufts University. Please join Friday’s Better Normal at noon PT/ 3 pm ET, Friday, March 26.

>>Click here to register<<

However, in terms of integrating what we know about PACEs, we have enough information to continue integrating the science into our work. If we want to change individuals, organizations, communities, and systems we need to talk about both positive and adverse childhood experiences — PACEs — and how they intertwine throughout our lives….

  • At the individual level, learning about ACEs helps us understand why we behave the way we do, and that our coping behavior is normal…a normal response to abnormal circumstances. Learning about PCEs provides direction to heal. The key concept about PACEs is that learning about both, together, can help improve our health and well-being. It gives us hope.
  • At the organizational level, staff and leaders can use knowledge of PACEs to create healing-centered work environments and programs in all sectors.
  • At the community level, educating the public about PACEs can provide hope and foster the development of innovative ideas about how to support families, organizations and communities. Understanding the interplay between positive and adverse experiences offers opportunity for engagement with all sectors. Communities can use this new lens to create mindful, healing-centered, research-informed approaches to prevent adversity and encourage connection and healing.
  • At the system level, policymakers and leaders can use research about PACEs to find common ground across fields and to support policies that promote the understanding of PACEs and how adversity and positive experiences work together.

At least two organizations are taking this approach and doing research to guide their actions:

  • The Healthy Outcomes from Positive Experiences (HOPE) team at Tufts Medical Center have identified four building blocks that lessen the negative effects of ACEs: relationships, environments, engagement, and social emotional development. HOPE – Healthy Outcomes from Positive Experiences
  • The Hope Research Center at the University of Oklahoma, Tulsa, focuses its research on the “science and power of hope as a psychological strength, especially among those experiencing trauma and adversity.” The Center defines hope as “the belief that the future will be better and you have the power to make it so.” Hope Research Center (

The HOPE project at Tufts is hosting its first annual summit April 9, 2021. The summit is virtual, free, and features morning livestream plenary sessions, with breakout groups in the afternoon. Sign up soon! Although the morning sessions have unlimited attendance, the afternoon breakouts can accommodate a limited number of people. They will be offered twice, so that people can attend at least two.

Over the next few months, we’ll be doing more blog posts about PACEs, about the two Hope projects (HOPE and Hope) as well as more Better Normal webinars that address the topic. If you have any ideas or questions to address about PACEs, please join Friday’s Better Normal at noon PT/ 3 pm ET, Friday, March 26.

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