Adverse Childhood Experiences (ACEs) and Impact on Child Outcomes

PUBLISHED

24 May 2024

A sad child sitting on the couch

What are Adverse Childhood Experiences?

Adverse Childhood Experiences (ACEs) are traumatic experiences faced during childhood (0-17 years). These typically fall under three categories: abuse, neglect and household dysfunction. 

Source: Robert Wood Johnson Foundation
Image source: KK Women’s and Children’s Hospital

The first Singapore study on ACEs conducted by IMH1 revealed that every two in three adults in Singapore’s resident population had experienced at least one ACE in their first 18 years of life. 

The Impact of Adverse Childhood Experiences

In early childhood, ACEs, when combined with challenges such as low income or food insecurity, can lead to “toxic stress” — a form of prolonged stress that disrupts brain development and social growth, weakens the immune system, and promotes unhealthy coping behaviours.

As these children grow into adults, those who experienced four or more ACEs are at a heightened risk of indulging in unhealthy behaviours, such as smoking, alcoholism, drug use, lack of physical activity and missed work. 

These adults are also at risk of developing significant health issues, including chronic diseases (like obesity, cancer, diabetes, heart disease), mental health problems, and suicide.

Stress during pregnancy may affect fetal development, which may result in health and emotional problems for the child later in life. Babies born to mothers who faced four or more adversities during childhood are more likely to suffer from poor health.

Besides health issues, ACEs may impede education achievements and result in lower job and income opportunities, leading to significant yearly economic and social costs for families, communities, and society.

Can ACEs Be Prevented?

Yes, ACEs and their detrimental effects are preventable. Establishing and maintaining safe, stable, and nurturing relationships and environments for all children and families can prevent ACEs and help children achieve their full potential. 

Strategies like early intervention, changing social norms, and creating supportive environments can prevent ACEs and reduce their immediate and long-term effects. 

Here are some ways NTUC First Campus works with at-risk families to prevent or mitigate the risk of ACEs. 

1. Providing Economic Support for Families:

Economic support for families (such as housing, childcare, or healthcare support) can reduce stress by enhancing economic stability, thereby making them more resilient to ACEs. 

At NTUC First Campus, our Child Support Model assists low-income families with school fees, school uniforms, infant nutrition, groceries and food packs.

EligibilityProgrammeBenefits
Monthly gross household income of $4,500 or less or $1,125 per capita or less for 5 or more members in the family:BHF Financial Assistance (School Fees)Start-up grant that pays for costs of starting school (e.g. registration fee, deposit, insurance), and/or monthly school fee subsidies.
BHF Financial Assistance (School Going Needs)Assistance includes the following funding:
New school uniforms (up to 4 sets per child yearly), and/or subsidy for field trip expenses (up to $80 per child yearly), and/or subsidy for K2 graduation expenses.
OCBC-NTUC First Campus Bridging ProgrammeMonies in the Child Development Account can be used at approved Baby Bonus institutions for:
Preschool fees, Learning support programmes and Healthcare costs.
Sponsored NTUC Membership Programme (SNM)With the NTUC membership, members can:
Offset cost of groceries at FairPrice supermarkets with NTUC LinkPoints; receive digital vouchers for basic necessities and child’s school expenses; receive funding support for bursaries and scholarships, and upskill through subsidised training.
Infant Nutrition Programme (INP)The programme enables children registered at My First Skool (aged 2 months to 3 years old) from low-income families from low-income families to afford a wide range of infant nutritional products. Successful applicants are given FairPrice vouchers which can be used to purchase:
Stage 1 to 3 Formula Milk; Unflavoured Full Cream Milk; Baby Food, and Diapers
These basic items cost a fairly large amount for a low-income family every month, and NTUC First Campus actively works to ensure that all eligible families apply for this benefit so that infants are supported in their growth and development.
Monthly gross household income of $2,500 or less or $650 per capita or less:Food Pack Programme The food rations serve to supplement their meals and ease financial burdens faced by low-income families.

2. Early Intervention Programmes: 

Early intervention programmes can help to ensure that children have a strong start with healthy child development and resilience. 

The KidSTART programme at My First Skool provides early childhood visitation from Child Enabling Executives (CEEs) who assess and manage those at risk for ACEs.

EligibilityProgrammeBenefits
Monthly gross household income of $2,500 or less or $650 per capita or less:KidSTART Programme At these centres, KidSTART families are supported by Child Enabling Executives (CEEs) who engage parents on child growth, development, health and nutrition. The CEEs also collaborate with My First Skool teachers, social workers, and other stakeholders in the community to ensure that the appropriate support and intervention are provided in the best interests of the child.

In addition, the Classroom Support Programme (CSP) and the Read-to-REACH programme (RTR) offer in-class support to children with mild language, literacy and numeracy learning needs. 

EligibilityProgrammeBenefits
Monthly gross household income of $6,000 or less or $1,500 per capita or less for 5 or more members in the family:Classroom Support Programme (CSP)Classroom Co-Facilitators (CCF), provide additional in-class support to N2 to K2 children with mild learning needs in language, literacy and numeracy. Using a variety of techniques to engage the children, the CCFs conduct small-group activities to strengthen children’s understanding in the classroom.
Read-to-REACH Programme (RTR)Offering support to K1 children who are weak in English literacy, RTR has produced good learning outcomes. More than half of K1 children who attend RTR do not need literacy intervention in K2. This improved confidence in both spoken and written English prepares children well for formal schooling.
Monthly gross household income of $4,500 or less or $1,125 per capita or less for 5 or more members in the family:CapitaLand-Bright Horizons Fund Ready-For-School Programme (RFS)This programme is offered to children from low-income families at My First Skool, in partnership with CapitaLand Hope Foundation. Under this programme, NFC’s Classroom Support Programme has been expanded to reach an additional 220 preschool children from the 7 My First Skool centres who require learning support in language, literacy and numeracy.

3. Teaching Skills to Parents to Handle Stress and Manage Emotions

Another critical aspect is teaching parents skills to manage stress, handle emotions, and tackle everyday challenges, thus reducing the likelihood of experiencing ACEs.

Two programmes offered by My First Skool are:

Caregiver Conversations

This programme aims to build resilience in parents and equip them with skills to manage anger, defiance, and aggression in children, allowing them to better support their children’s development.

Healthy Body, Healthy Mind (HBHM)

This series shares tips and strategies for developing good eating habits in children and helping caregivers care for their well-being. Fun interactive workouts are also included.

EligibilityProgrammeBenefits
Monthly gross household income of $6,000 or less or $1,875 per capita or less for 5 or more members in the family:Caregiver ConversationsWhile it is challenging to learn to handle difficult behaviors in kids, and listening skills, doing so makes a difference for kids. Parents will apply those skills in their journey to be calm, consistent and confident parents.
Healthy Body, Healthy Mind Workshop (HBHM)Parents will be better equipped with nutritional knowledge as well as self-care tips.

Families will enjoy quality bonding time together with the interactive workouts conducted during the workshops.

Summary

As a social enterprise in Singapore, NTUC First Campus is committed to making a difference and lessening the impact of ACEs on the community.  By focusing on prevention, early intervention, and support, our programmes address immediate needs and build a foundation for long-term resilience in children and families at risk. 

Learn more about our Child Support Model. For more information about Childcare and Infant Care Subsidies and other support programmes, visit our Subsidies page. 

Author information: 

Ong Mian Li, Ph.D., is a clinical child and adolescent psychologist, trainer and consultant with over a decade of experience training medical professionals, graduate students, and families with young children in inpatient, outpatient and school settings. He received his Masters and Ph.D. in Clinical Psychology from the University of North Carolina in 2018 and completed his postdoctoral fellowship at the Mayo Clinic in the United States. Dr. Ong has spoken at over 70 international conferences and has numerous peer-reviewed publications in child and adolescent psychology. In the United States, Dr. Ong is well known as a teacher for medical professionals and graduate students in the United States. He is also the co-founder of Helping Give Away Psychological Science, a 501c(3) non-profit organisation. In Singapore, Dr. Ong lectures and runs workshops around child and adolescent psychology and consults for hospitals, social enterprises and corporations locally. Finally, Dr. Ong runs a private practice (Lightfull Psychology and Consulting) focused on assessing and treating children, adolescents and adults with mood, anxiety and behavioural issues.

References
  1. Prevalence, socio-demographic correlates and associations of adverse childhood experiences with mental
    illnesses: Results from the Singapore Mental Health Study
    . Child Abuse & Neglect Volume 103. May 2020 ↩︎

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