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PACEs in Early Childhood

Some 350 Florida Leaders Expected to Attend Think Tank with Dr. Vincent Felitti, Co-Principal Investigator of the ACE Study; Expert on ACEs Science


Leaders from across the Sunshine State will take part in a “Think Tank” in Naples, FL, on Monday, August 6, to help create a more trauma-informed Florida. The estimated 350 attendees will include policy makers and community teams made up of school superintendents, law enforcement officers, judges, hospital administrators, mayors, PTA presidents, child welfare experts, mental health and substance abuse treatment providers, philanthropists, university researchers, state agency heads, and faith-based leaders. 

Hosted by Florida State University's Center for Prevention, the Think Tank features Dr. Vincent Felitti, who was principal investigator with Dr. Robert Anda of the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study. The study of 17,337 mostly white, middle-class and college-educated Kaiser patients in San Diego, asked participants 10 questions about abuse, neglect and family dysfunction, including violence, drug or alcohol addiction, divorce or separation, mental illness, or having someone in the immediate household jailed. The number of these “adverse childhood experiences” became known as a person's ACE score.

"ACEs science became a public health phenomenon over the past 20 years because it proves the relationship between adverse childhood experiences and the increased likelihood of cancer, heart disease, mental illness, drug or alcohol addictions, criminality, and more," Felitti said.

The study found that almost two-thirds of those questioned had at least one ACE. The higher the score, the higher the risk of consequences. For example, people with four or more ACEs have a 700 percent increased risk of alcoholism, and a 1200 percent increased risk of attempted suicide. (Got Your ACE Score?)

ACEs are not limited to the original 10 in the ACE Study. Subsequent ACE surveys include other types of childhood adversity, such as: racism, sexism, bullying, witnessing violence outside the home, and living in an unsafe neighborhoods, to name just a few. 

The ACE Study is one part of ACEs science, which also includes:

  1. Brain science (neurobiology of toxic stress) — how toxic stress caused by ACEs damages the function and structure of kids’ developing brains.
  2. Health consequences — how toxic stress caused by ACEs affects short- and long-term health, and can impact every part of the body, leading to autoimmune diseases, such as arthritis, as well as heart disease, breast cancer, lung cancer, etc.
  3. Historical and generational trauma (epigenetic consequences of toxic stress) — how toxic stress caused by ACEs can alter how our DNA functions, and how that can be passed on from generation to generation.
  4. Resilience research and practice — Building on the knowledge that the brain is plastic and the body wants to heal, this part of ACEs science includes evidence-based practice, as well as practice-based evidence by people, organizations and communities that are integrating trauma-informed and resilience-building practices. This ranges from looking at how the brain of a teen with a high ACE score can be healed with cognitive behavior therapy, to how schools can integrate trauma-informed and resilience-building practices that result in an increase in students’ scores, test grades and graduation rates.

A study by the Florida Department of Juvenile Justice found that early adversity increased delinquency. While at the same time all youths involved with the agency had at least one ACE,  the study showed that half had experienced four or more ACEs.

Subsequent studies also found that resiliency or protective factors, such as having a caring adult in one's life, could buffer the negative impact of ACEs. 

“Our work as judges, teachers, doctors, therapists, officers and community leaders must be infused with an understanding of ACEs and trauma.  We can end the cycle of abuse, addiction, jail and chronic illness for this generation and the next, one individual at a time,” said Judge Lynn Tepper, whose court became a nationally ranked trauma-informed court as a result of ACEs science. It was Tepper who invited Felitti to Florida to lead the Think Tank.

Dr. Mimi Graham, the director of the FSU Center for Prevention, who spearheaded the event, said the idea is to create statewide momentum to build Florida’s trauma initiatives into a collective effort that can reduce some of the state’s most intractable problems. 

Concurrent with the Think Tank, the FSU Center for Prevention is releasing a book, Creating a Trauma Informed State - A Showcase of Florida's Cutting Edge Trauma Initiatives, which features 50 innovations from many of the attendees at the event. Those initiatives include programs such as trauma-informed courts and schools, partnerships between sheriffs and doctors, classes in yoga in women’s jails, ACE screenings in pediatric clinics, resiliency efforts for college students, and pet therapies to help traumatized kids.

Thanks to the Charles & Margery Barancik Foundation, each of the attendees will receive a copy of the book. A PDF of the book is attached to this post.  

The book is designed to help other communities see the benefits of cross-sector teams working together to prevent trauma, heal trauma, and build resilience, Graham said. This collection of actual 'boots-on-the-ground' programs that are in various stages of implementation in Florida is the first collection of its kind.

“We believe that many of Florida’s most costly, intractable social problems, including our opioid and substance abuse crisis, our growing public health costs, tragic school failures, and the multigenerational cycle of families into our criminal justice and child welfare systems, can be decreased by addressing early trauma,” Graham said.

Supreme Court Justice Barbara Pariente said, “Our courts see the effects of trauma every day, most importantly in cases involving children and families from dependency to delinquency to dissolution of marriage to domestic violence. Our ability to view the children and families with a trauma-informed lens, especially for the youngest and most vulnerable children, can help to change the trajectory of that child and family’ lives.” 

“Our vision is that through Dr. Felitti’s inspiration, our Think Tank and showcase of Florida’s trauma initiatives will create statewide momentum for replication and expansion of trauma work to achieve collective impact," Graham said.

Details: Felitti Think Tank:  Creating A Trauma-Informed State

Monday August 6, 2018 1:30-6:00 pm. Naples Grande Beach Resort, Orchid Ballroom. 475 Seagate Drive, Naples FL 34103

For live streaming of the event, go to:

To download Creating a Trauma Informed State — A Showcase of Florida's Cutting-Edge Trauma Initiatives, go to:

For further information, contact: Mimi Graham, FSU Center for Prevention & Early Intervention Policy ( or cell: 850-510-7770. 


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