At some point, we all fell down and probably scraped a knee or an elbow. But what happened next determined how well we handled our next fall and eventually how successful we were at riding a bike.

"Likewise, life can be tough sometimes. We don't always realize our day-to-day struggles as parents can have lifelong effects on our children?," said Anu Partap, M.D., director for the Center for Prevention of Child Abuse and Neglect at Cook Children's. "It can be a hard fall if we don't actively protect and nurture our children through those tough times."

What kind of tough times can have such a long-standing impact?

The Centers for Disease Control and Prevention (CDC) released a new report Tuesday that found that people who experienced abuse or neglect as a child were at higher risk of dying from five of the top 10 leading causes of death.

Such traumas are called Adverse Childhood Experiences, or ACEs. They can include:

• Sexual abuse
• Physical abuse
• Emotional abuse
• Physical neglect
• Emotional neglect
• Domestic violence
• Divorce
• Community violence
• Having a parent with substance abuse or mental health issues.
• Having a parent incarcerated.

Trauma, and more specifically, the toxic stress connected to trauma, is the link between not only chronic health issues (asthma, cancer, kidney disease, diabetes, obesity, and heart disease), but also mental health issues and risky health behaviors. These issues can include depression, anxiety, alcoholism, smoking, substance abuse and suicidal attempts or ideation.

How people are affected by ACEs?

The CDC's recent report gives the first estimate of how many American citizens are impacted by adverse childhood experiences and stresses the importance of preventing these traumas. The report, based on a survey of more than 144,000 adults from 25 states, found that almost 60% of Americans faced at least one adverse experience during childhood, with 15.6% experiencing four or more different types.

"A stressful home can leave children feeling scared or alone, and that stress can trigger pathways to disease," Dr. Partap said. "What stresses one child dramatically may be less stressful for another. Part of that is our personality, but a large part may also be how nurtured and protected a child feels. So when life is tough, the child who feels alone will respond much worse than a child who knows loving people protect them."

Jamye Coffman, M.D., medical director of the Cook Children's Center for Prevention of Child Abuse and Neglect and the CARE Team, knows a report on trauma can be overwhelming, even depressing. But she offers hope for anyone who has gone through trauma as a child.

"Childhood trauma impacts how you parent and your mental health," Dr. Coffman said. "It impacts how you respond to stress and even how you bond with your child. Trauma impacts all of those things. But it doesn't mean you can't become a loving, caring adult. It is about your own introspective as an adult and receiving the counseling or parenting coaching you need to become a productive grownup. It's never too late for any of us. But you have to identify the issue; then you can fix it and have a better, more productive life."

Another positive takeaway from this information is that the effects of trauma are reversible. Communities that promote resiliency within the family, schools and the community can alleviate the debilitating effects of toxic stress and help children and families bounce back from adversity.

"It is critical to continue to study the link between adverse childhood experiences and serious chronic health issues," said Denise Coover, LCSW, trauma-informed care specialist at Cook Children's. "The more we understand this link, the better that public and mental health programs can plan and provide interventions and resiliency strategies to curb the onset of later costly health issues."

The experts interviewed for this article agree that parents and adults are the mitigating factor between toxic stress and resiliency. What makes the trauma experience so toxic, is many times children are left to manage high levels of stress on their own. If parents or other adults in a child’s life can provide a low-stress, loving environment, then the child is more likely to build the resiliency they will need to thrive.

"My recommendation is always that it is not about what you can buy for your child, but the quality of the love, listening and attention that is important," Coover said.

Dr. Partap wants this study to draw attention to ACEs. She hopes people in the health care community who can make a difference will be able to connect the dots from adult concerns back to the trauma many youth experience.

"Childhood is such a precious time," Dr. Partap said. "This connection that what happens in childhood matters forever is powerful for everyone to embrace. It affects me as a mom every day. Sometimes life gives us challenges we didn't ask for, and it may be depression or a loved one who struggles with addiction. Some folks lose their homes, but we have to know the strongest prevention act is asking for help.”

Dr. Partap continues, “That's how we prevent or help reduce the impact of these tough times on our child's life-long health. Sometimes help is a neighbor, a relative and sometimes it's a service like therapy, addiction treatment, or a shelter. Anything that helps parents be more present for their child prevents the impact of toxic stress on a child's health."

Resources Available

We all need help and there are many resources available. You shouldn't feel alone when you're raising children. Tarrant Cares and Aunt Bertha are web-based resources anyone can check out. Visit the website 211texas.org, which even has a staffed phone line. Try not to feel alone through difficult experiences, especially when you're raising children.

The ACEs Task Force, chaired by Cook Children’s, aims to reduce adversities for children starting before they are even born. Their work is based on a study conducted between 1995 and 1997 by Kaiser Permanente and the CDC. The study, which involves 10 questions about what a person experienced before the age of 18, shows ACEs are associated with high risk behaviors, chronic disease and reduced quality of life in adulthood. The task force is focusing their efforts on the signs of stress or difficulties that show up in early childhood.