The ACE effort was initiated in 1985 in an era before epigenetics was well-studied. Its artifacts include the ACE pyramid:
Current official depictions of the ACE pyramid assign an expanded view of ACE as the pyramid’s base. The viewer’s attention is directed to “Scientific Gaps” between pyramid layers, but the largest gap remains: the continuum starts at conception but the pyramid still starts at childhood.
Disrupted Neurodevelopment is omitted from the current official ACE pyramid and discussion altogether, but the narrative claims:
“To provide scientific information that would be useful for developing new and more effective prevention programs.”
The current official ACE pyramid doesn’t accurately reflect current science, in my opinion. By downplaying Disrupted Neurodevelopment that may begin at conception, it also implicitly endorses approaches that fail to address prenatal causes for later-life adverse effects.
If the ACE diagram was drawn in 2015 to incorporate evidence for epigenetics, Disrupted Neurodevelopment wouldn’t be a consequent layer to an ACE base. Disrupted Neurodevelopment would be represented by a triangle based at conception:
What’s an example of current ACE-related scientific evidence that wasn’t present three decades ago and also isn’t represented in the official ACE pyramid?
Prenatal Disrupted Neurodevelopment may be considered today as a possible consequence of a “Yes” answer to half of the original ACE questions:
- Were your parents were too drunk or high to take care of you or take you to the doctor?
- Were your parents ever separated or divorced?
- Was your mother often or very often pushed, grabbed, slapped, or had something thrown at her?
- Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?
- Was a household member depressed or mentally ill?
These threats and other stresses cause a fetus to biologically adapt. Because such adaptations occur at the earliest and most important stages of development, they usually:
- Have much larger impacts and
- Cause Biological Impairments that
- Don’t unassistedly disappear over time.
Restoring ACE emphasis on Disrupted Neurodevelopment would encourage:
- Research that’s directed toward producing causal evidence for adaptations that largely occur during the early periods of an individual’s lifespan; and
- Research on how these adaptations consistently influence our later-life ideas, biology, and behavior.
The above recommendations for research are neither the current focus of ACE research nor the direction of related efforts to assist affected individuals. Relevant studies that I’ve curated on this blog often only produced symptomatic evidence. If a study couched its findings in non-etiologic phrases such as “is associated with” or “is linked to” or “may relate to,” it didn’t address ACE originating causes.
“New and more effective prevention programs” seldom address Biological Impairments with efforts to reduce the source of the damage. At best, they only alleviate the symptoms. If a program’s presentation showed multivariate analyses with ACE score probabilities and percentages, it didn’t address originating causes.
So, what does it take to empathetically understand, to make a part of oneself, to grok a person’s ACE score?
It’s best to avoid the advice of studies such as:
- Problematic research: If you don’t feel empathy for a patient, is the solution to fake it? People who are helped may not recognize it at first, but over time, they’ll sense whether the helper’s feelings are genuine; and
- If a study didn’t measure feelings, then its findings may not pertain to genuine empathy.
I feel that people first need to ameliorate the origins of their own problems. Then they may be able to help others therapeutically address causes for ACE symptoms.
Need proof? Think of someone you’ve met whose thoughts and feelings and behavior were caught up in and motivated by their own problems:
- Did you feel they could empathetically understand others?
- Wasn’t the welfare of the people who may have been helped truly incidental and secondary to someone who was acting out their own problems?
See my Welcome page for additional discussion of ACE. See Transgenerational epigenetic programming with stress and microRNA for an example of how Disrupted Neurodevelopment that caused epigenetic Biological Impairments can begin immediately after conception. That study didn’t observe the resultant effects of Health and Social Problems until the subjects were adults!