Addressing ACEs

There is a considerable body of work in place in Highland to address childhood adversity and trauma, and much more that needs to be developed and “joined up”.  This page provides some of the research and theoretical background that informs this and can ground future developments.

For a list of supporting references, click here

To go straight to a list of some of the work and interventions, then click here


The Philosophy

Addressing Adverse Childhood Experiences is both possible and effective.

In Highland, our work takes place within the framework of the Highland Practice Model. What the research tells us is that if children have consistent experiences of being Safe, Healthy, Active, Nurtured, Achieving, Respected, Responsible and Included, then they will develop the skills and brain systems that provide resilience to stressors.

It is important to ensure this for all children as human life inevitably involves stress and adversity. Even children who seem to be “OK” need to experience consistent positive relationships in order to be able to cope in the future.  Similarly, we cannot assume that children in particular groups are more or less vulnerable to adversity and trauma and their effects – these things can affect anybody and can often be hidden from view.

In Highland, therefore, we try to balance two key principles:

  • proportionate universalism – building ACE-aware elements into services that are experienced by all children and families (such as schools, Health Visiting, etc)

  • individualised intervention – that is adapted to the specific needs of each child, depending on how adversity is impacting on them and their family

The Rationale

Providing both of these depends on a clear understanding of how adversity impacts on health, emotional wellbeing and behaviours.  Over the last twenty years there has been a huge growth in our knowledge of the brain systems that underpin resilience, and whose growth and development can help buffer children against the effects of adversity.

The following figure shows some of the most important ones:


The complexity shows why “one size fits all” approaches will have limited returns!

But intervention is quite simple – essentially, these brain systems develop if children experience:

  • positive relationships from adults
  • experiences of mild and resolved stress
  • developmentally appropriate experiences – stimulation, learning, etc
  • care for key physical needs such as food, sleep and warmth

Intervention in Highland is designed around ensuring that all children experience these processes.

There are several national resources which are very helpful and well worth reading for more information: