Adverse Childhood Experiences, Intergenerational Trauma, and Historical Trauma: A Child's Story

The prevalence of adverse childhood experiences (ACEs) is increasing and is highest in minoritized ethnic/racial groups, most notably in Indigenous populations in the United States and Canada. Beyond ACEs, minoritized ethnic/racial groups have also experienced historical oppression, discrimination, and economic inequalities that can perpetuate ACEs and initiate intergenerational cycles of adversity. Children who have experienced multiple ACEs are at risk for learning and communication impairments that would qualify them for speech and language services. The purpose of this case study is to: (a) define ACEs, intergenerational and historical trauma, as well as describe the causes, consequences, and relationships among these three types of trauma; (b) describe the use of the International Classification of Functioning, Disability and Health (ICF) for assessment of an Indigenous child who has experienced multiple ACEs that may be associated with historical trauma; and (c) describe implementation of the Attachment, Regulation, Competency intervention for children with complex posttraumatic stress disorder adapted for an Indigenous child.

The concept of historical trauma arose with Indigenous populations, but it has been extended to many other populations that have experienced chronic trauma associated with oppression based on their ethnicity, race, or culture. The ICF provides a framework for conducting a comprehensive assessment and developing an intervention plan for a child who has experienced multiple ACEs, possibly related to intergenerational and historical trauma. To understand the child's strengths and needs, it is essential that clinicians consider the child's unique personal and environmental contextual factors. By considering these contextual factors, clinicians can identify which attributes serve as barriers or facilitators to children's functioning and how intervention programs may need to be adapted for the child's culture.