Impact of Adverse Childhood Experiences on Language Skills and Promising School Interventions

ACEs and the Brain

While isolated traumatic incidences can produce short-term biological and behavioral responses, ACEs that are prolonged and repeated and present with more pernicious effects across multiple developmental domains (e.g., Streeck-Fischer & van der Kolk, 2000). The intensity of these effects is explained in part by the brain becoming wired into survival mode, even when there is no actual danger present; specifically, measures of increased cortisol, a hormone responsible for hyperarousal, have been noted in response to perceived stress (Tsigos & Chrousos, 2002).

The brain’s reaction to trauma also involves changes to the emotional processing areas of the brain in the ventromedial prefrontal cortex (De Brito, Viding, Kumari, Blackwood, & Hodgins, 2013) responsible for executive functioning. Executive functions encompass an array of skills responsible for self-regulation and engagement in goal-directed behavior, which when affected by ACEs, elicit excessive stress and overreactivity.

ACE-related disruptions additionally span numerous other cognitive skills, including sensory processing. For instance, the primary auditory cortex, located in the temporal lobe of the brain, tends to experience difficulty processing auditory information in maltreated children (Ge, Wu, Sun, & Zhang, 2011). Children’s occipital lobes are also sensitive to trauma, often resulting in difficulties completing visual processing tasks (Mueller-Pfeiffer et al., 2013). ¹

It stands to reason that when the brain functions in this manner, thinking and learning areas are bypassed. Thus, it is not surprising that children who have endured ACEs tend to have difficulty meeting academic and behavioral expectations within classrooms. Moreover, the altering of neurological functioning can be so severe as to elicit irreversible hormonal and morphological changes that further negatively impact short- and long-term learning potentials (e.g., Streeck-Fischer & van der Kolk, 2000). Processing challenges can also be displayed on multiple fronts including difficulty attending to instructions with competing noises in a busy classroom and completing visual processing tasks such as copying from a blackboard.

ACEs and Language Skills

The experience of abuse and/or neglect profoundly influences children’s developing communication skills even before school entry; namely, increased reports of phonological pre-reading deficits have been reported with young children in foster care (Pears et al., 2014). Phonological skills involve the ability to engage with language at an auditory level (e.g., rhyming) and significantly predict later reading proficiency.

When children proceed to learn to read, the ability to decode language (read) accurately and with comprehension involves the need to coordinate multiple executive functioning skills (e.g., attention, working memory, self-regulation). For example, sustained attention is needed to attend to letters and words in print for accurate decoding. A case in point, a child who does not amply attend to letter in print might confuse the word “not” and “nod,” which would affect the ability to comprehend the intended text. Working memory is also tapped into as students need to dually hold onto what was read while proceeding to read further. For instance, if a child reads “Joe crossed the road,” followed by “He saw his mom there,” the first sentence must be retained in working memory to infer that the word “there” in the second sentence refers to “across the street.” Finally, self-regulation facilitates integration of emotions when completing what can be a daunting task; English written language is particularly difficult to master. A case in point, different letter combinations can make the same sounds as in the homophones “bear” and “bare,” with neither word spelled as they sound (i.e., /bɛr/). Thus, learning to read and write in English can be especially taxing for children with emotion regulation limitations, leading them to become overstimulated and unready to perform (Manly, Lynch, Oshri, Herzog, & Wortel, 2013), thereby further negatively impacting their language development.

Unfortunately, as children enter Kindergarten and lower elementary grades, reading ability remains significantly impacted, and prognoses often remain bleak as reading challenges tend to remain stable over time (Stanovich, 1986). Attempts at counteracting ACE-related effects become especially important considering the educational implications of the Matthew Effect, wherein “the rich get richer and the poor get poorer” (Stanovich, 1986). Specifically, not only does the development of poor readers progressively decline but the gap continues to widen between them and good readers. This disparity becomes of growing concern as longitudinal research supports associations between reading failure with several risk factors including delinquency and school dropout (Plumb et al., 2016). Concerning findings such as these have served as impetuses for delivering evidence-based trauma-informed programs in schools that dually target academic skills and the underlying contributing sources of adversity.

Trauma-Informed Practices

A small body of trauma-informed initiatives have responded to the pressing issues child survivors of ACEs face and the concerns for their futures. One such initiative was proposed by The Complex Trauma Task Force of the National Child Traumatic Stress Network (NCTSN) involving the Attachment, Regulation, and Competency (ARC) model; this multifaceted approach comprises interventions not only at the level of the child but at familial and systemic levels (e.g., school) as well (see Kinniburgh, Blaustein, Spinazzola, & van der Kolk, 2005).

While interventions targeting familial functioning include incorporating important approaches such as routines for meal and bedtimes and supporting appropriate limit-setting (Kinniburgh et al., 2005), cases of complex trauma frequently involve caretaker transitions that impact the feasibility of their involvement in intervention protocols. Considering this, systemic initiatives, such as trauma-informed school programs, have been implemented in hopes of drawing upon the consistent presence of teachers for attachment and delivery of trauma-sensitive practices (Pears et al., 2014). Systemic-level interventions include building milieu consistency and predictability and training staff in trauma-informed care (Kinniburgh et al., 2005). Several trauma-informed teacher training initiatives (e.g., Healthy Environment and Response to Trauma in Schools [HEARTS] Model, Dorado, Martinez, McArthur, & Leibovitz, 2016; The Kids in Transition to School [KITS] program; Pears et al., 2014) have reported promising student gains in managing behaviors, incidences of violence, and school attendance. Thus, findings support teachers being able to effectively deliver trauma-based programs, allowing for considerable positive effects on students’ school functioning.

Research conducted in school settings support that, much like securely attached parents and children, teachers can modulate children’s stress regulation within a calm, safe, and de-escalated environment (Substance Abuse and Mental Health Services Administration, 2014). To this end, a primary goal of trauma-informed teacher training, involves gaining an understanding of the sources of maladaptive behaviors (e.g., outbursts, avoidance behaviors) to better inform teachers’ reactions (e.g., sending children to the office, suspensions, expulsions). In adopting trauma-informed care, reprimand is replaced with informed and compassionate instruction along with positive behavioral supports to build resilience.

Despite these sound intentions, extant school programs, have some noteworthy limitations. First, interventions have been implemented with children in middle school and older, who have potentially endured years of trauma leading up to receiving trauma-informed care; based on long-standing early intervention research (e.g., Campbell & Ramey, 1994), program success and children’s developmental gains would predictably be more profound if delivered earlier. Second, caretaker involvement has been an integral component of current trauma-informed care initiatives (e.g., Pears et al., 2014). From a practical standpoint, caregiver participation is often unfeasible. Consequently, more attention must be placed on teacher training as teachers may be the only stable adult figures in lives of children impacted by ACEs. Third, a substantial corpus of research has amassed supporting significant negative associations between language skills and ACEs (e.g., Manly et al., 2013; Pears et al., 2014). Bearing in mind the importance of language proficiency for academic and general functioning, an important implication presents to incorporate trauma-informed language training into teaching training programs. Indeed, all children can benefit from developing skills such as reflecting on mental aspects of texts and responding to text events, and especially those impacted by ACEs.

Conclusion

The present review contributes valuable insight into academic sequelae of ACEs, trauma-informed programs, and next steps to explore in ACE-related services. Broadly, the review documents the multifaceted impact of complex trauma on children’s development, with specific foci on comorbid executive functioning and academic challenges, as well as neurodevelopmental considerations. Findings support the need to go beyond simple behavior modification and remediation protocols to better meet the needs of children exposed to ACEs. To this end, growing numbers of school-based initiatives have been set in place in hopes of improving these children’s developmental outcomes; the rationale in doing so involves providing a consistent figure in children’s lives who is well-informed of the impact of trauma on behaviors (e.g., executive functions) and who also integrates this knowledge to effectively enhance skills that are critical for functioning within society. Although findings to date are promising, gaps in the literature nonetheless remain, which merit attention in future trauma-based intervention protocols.