Introduction
Adverse Childhood Experiences (ACEs) can impact a child’s life in a multitude of ways, a significant one being their language development. Research studies have found that children who were subjected to abuse and/or neglect often exhibit delayed language skills compared to their peers. [2] They are also seen to have poorer expressiveness and this impact is more significant in younger children, leading to increased risk of developmental delays and disorders, particularly in communication. [3] Thus, in order to see improvement in the language abilities of children in the child welfare system, it is imperative to employ early intervention methods. [1]
Impact on Language Development and Communication
Young children exposed to five or more significant adverse experiences in the first three years of childhood face a high likelihood of delays in language, emotional, or brain development. [3] The delays in language development affect all areas of language, including expressive, receptive, syntax, semantics, morphology, and pragmatics. [1] Children with ACEs may also exhibit decreased impulse control, limited access to words, and reduced memory capacity. This leads to difficulties in problem-solving and challenges in navigating emotions. [3]
Impact on the Brain
ACEs trigger chronic stress responses in children which can have detrimental effects on brain development and functioning. High levels of cortisol due to chronic stress can shut down the prefrontal cortex, which is responsible for functions crucial to development and communication, such as empathy, emotional regulation, and attuned communication. Furthermore, long-term exposure to cortisol can also damage neurons and inhibit the formation of new ones. [3]
Effect in School
It was seen that children aged under five years, with two or more ACEs were more likely to have trouble calming themselves down in schools. They would tend to be easily distracted, and struggle with making and keeping friends. Studies also showed that students with multiple ACEs were more likely to experience academic failure, behavioral problems, and attendance issues. [3]
This has led to a growing movement towards trauma-informed or trauma-sensitive care and teaching in educational settings. This approach emphasizes understanding and responding to the effects of trauma, ACEs, and toxic stress, with a focus on providing a supportive and safe environment for learning. [1]
Risk Factors from Home
Trauma not only affects the child, but also impacts the emotional availability of the parents and caregivers. This effect is compounded based on the frequency, severity and proximity of the children to the events, as well as the quality of the child’s relationship with the victim or perpetrator. Additional risk factors for speech and language delays include poverty, parental depression, prenatal exposure to drugs. [4]
It was seen that maltreated mothers would be less talkative and responsive during interactions. [2] Mothers who have experienced ACEs also struggled to engage in coherent narrative reminiscing, impacting their children's language and emotional development. [3] Children of mothers who have experienced ACEs themselves may face additional challenges in forming secure attachments and developing effective communication skills. [5] This highlights the need for targeted intervention and support.
Intervention
Unfortunately, abused and neglected children are often under-identified and under-served. [1] To identify red flags for trauma exposure in infants and toddlers, caregivers and teachers must look out for signs of bland affect, lack of responsiveness, and difficulties with attachment to caregivers. [4]
Early referral to speech and language therapists with training in social, emotional, and mental health is crucial for children with ACEs. These children may also benefit from specialized support from other professionals such as counselors, CAMHS (Child and Adolescent Mental Health Services) practitioners, or drama/play therapists. [3]
Role of Speech-Language Pathologists (SLPs)
SLPs may encounter children with ACEs on their caseloads, but may not be able to recognize the multidimensional impact of ACEs. SLPs must collaborate with mental health professionals and other relevant stakeholders to understand the mental health effects of trauma and provide more comprehensive support to children with ACEs. This will help them address not only the language and communication needs of the child but also their emotional well-being. [5]
SLPs can enhance their practice by first understanding the developmental history of the child. This can offer valuable insights into potential underlying factors contributing to language challenges [5]. This will enable them to tailor intervention strategies effectively. Moreover, recognizing the socio-emotional effects of trauma [4] is crucial for providing holistic support.
The Importance of Comprehensive Care
Advocating for interprofessional collaboration is another key recommendation for SLPs working with children with ACEs. Collaborating with professionals from diverse fields such as counseling, psychology, and social work enhances the comprehensive care and support available to these children. Mental health workers need to be aware of the potential communication delays and disorders that may arise in children who have experienced trauma, emphasizing the importance of a collaborative approach in providing holistic care. By fostering interdisciplinary teamwork, SLPs can ensure that the unique needs of children with ACEs are addressed comprehensively and effectively.
References:
Karen Evans, M. (2023b, November 14). On trauma and language development. The Informed SLP. https://www.theinformedslp.com/review/on-trauma-and-language-development
Dolzycka, K., & Stead, A. (2020). Critical review: What impact do adverse childhood experiences (ACEs) have on language-related outcomes? University of Western Ontario: School of Communication Sciences and Disorders. https://www.uwo.ca/fhs/lwm/teaching/EBP/2019_20/DolzyckaStead.pdf
Lynch, Alicia. How aces can affect language development. Home. (2024, June 30). https://www.mabletherapy.com/speech-and-language/2020/01/10/how-aces-can-affect-language-development
Osofsky, J. D. (2019, December 18). The effects of stress and trauma on language development. SpeechPathology.com. https://www.speechpathology.com/articles/effects-stress-and-trauma-on-20323
Westby, C. (2018). Adverse Childhood Experiences: What Speech-Language Pathologists Need to Know. Word of Mouth, 30(1), 1-4. https://doi.org/10.1177/1048395018796520
Author Bio:
Maithree Venkatesan is a recent MPH graduate from the Rollins School of Public Health, Emory University, completing her degree in Healthcare Management. Before entering graduate school, she completed her M.Sc. in Biological Sciences at BITS Pilani, India. Maithree is passionate about working with children on the spectrum, and completed her thesis at the University of California, San Diego specializing in methods for Early Detection of Autism. With an interest in disability studies, she hopes to make an impact in increasing access to tailored interventions for marginalized communities.
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