Editor's Note: Whether physical or emotional, benign or malicious, neglect alters the developing brain's architecture and circuitry in profound ways that often lead to physical and behavioral problems throughout life. In Part 2 of our series on The Neglected Brain we explore how childhood neglect effects areas of the brain that govern emotions and impulse control. Read Part 1, Part 3 and Part 4.
If Danielle Goodwin had taken the Adverse Childhood Experiences Test as a teenager, she would have scored a perfect 10.
The ACES test was developed in 1998 by researchers from the Centers for Disease Control in Atlanta and Kaiser Permanente in San Diego who were trying to find out whether childhood stress led to health problems later in life. The test consists of 10 “yes or no” questions designed to screen for exposure to violence, sexual abuse and neglect: “Did a parent or other adult in the household often or very often … act in a way that made you afraid that you might be physically hurt? Did an adult or person at least 5 years older than you ever touch or fondle you or have you touch their body in a sexual way? Did you often or very often feel that you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? Or your parents were too drunk or high to take care of you?”
Each “yes” response counts for one point. The higher the score, the greater the likelihood that the test taker will experience heart disease, obesity, depression, substance abuse or some other downstream health and behavioral problem.
The ACES test is a blunt instrument. It doesn't add any additional points for neglect if, say, the neglect involved not being protected from sexual abuse committed by your mother's boyfriends, which resulted in your pregnancy at age 14, which is what happened to Danielle Goodwin. Perhaps some trauma can't be quantified.
Neurology of neglect
Like too many children, Danielle was a victim of abuse and neglect. Both are considered forms of “child maltreatment.” Both are clearly negative experiences and both affect development, but only abuse qualifies as trauma. “Traumatic events involve significant threats to one’s physical integrity (in an acute way), like being assaulted, sexually abused or exposed to other forms of violence,” explains Dr. Kate McLaughlin, assistant professor of psychology at the University of Washington and a member of the landmark Bucharest Intervention Project, which studied the impact of neglect on children in Romanian orphanages. “We have solid evidence that neglect and trauma impact brain development in fundamentally different ways. They are not the same type of experience.”
Though this series touches on the impacts of many forms of childhood maltreatment, neglect is the focus. Its impacts, though less publicized, are just as detrimental.
Experienced early on, neglect can create changes in the brain that contribute to a cascade of unrelenting problems for teenagers and young adults. It impairs the brain’s natural wiring process, retarding communication among the brain’s many cells, and it switches the brain into a kind of permanent high-stress mode.
