Dr Alan Meehan So, moving then to how we  can prevent ACEs and treat their negative   consequences. So, the first thing to say  here is that people who’ve experienced   significant adversity in their childhoods are  not irreparably damaged. So, there’s always the   possibility of improving their circumstances  and opportunities where there are sufficient   supports and treatments in place. So, with that in  mind, efforts to target ACEs have focused both on   preventing their occurrence and where they’ve  already occurred, minimising their potential   harmful effects on health and wellbeing. So, I’ll  briefly discuss each of these strategies here now. So, first, then, the optimal approach to  addressing ACEs would be an approach that   removes the need for treatment entirely by simply  preventing ACEs from occurring altogether. So,   for those kinds of strategies to be truly  successful, we would need to adopt targeted,   kind of, policy driven approaches that cross  multiple areas of society. So, we’d be thinking   across health, social and education services and  other, kind of, services in society, in a way that   we could collectively address and reduce those  societal issues and the sources of stress that   can increase the risk of ACEs taking place.  So, that includes things like child poverty,   housing instability, food insecurity  and also, more support for families who   are dealing with particular problems,  like mental illness, substance abuse,   domestic violence or any other factors that can  deprive children of safe and nurturing childhoods. So, those types of primary prevention initiatives  are likely to require widespread change and   big – and buy-in at a political and economic,  kind of, level. But even putting aside the,   kind of, clear help consequences of ACE exposure,  we also know that there’s substantial long-term   economic burdens associated with ACE exposure  on things like our healthcare systems and our   social care services. So, if nothing else,  those significant economic costs hopefully   provide good justification for developing  preventative interventions in that area.  Now, for young people who have already been  exposed to ACEs, Researchers have devised and   tested several different levels of responses  to help reduce their risk of experiencing   further harm or help them recover from potentially  traumatic symptoms. At the more intensive end of   that spectrum are therapeutic interventions.  So, these usually involve regular sessions   with a mental health professional and they’re  generally based around established approaches,   such as cognitive behavioural therapy or  interpersonal psychotherapy, for example. Less intensive approaches have also been  put forward and those have drawn on a range   of different techniques, including  things like mindfulness, meditation,   breathing and physical exercises,  spending more time in nature and   encouraging social support from the  people who are close to the child. Many treatment strategies also focus on  helping children and adults build core life   skills that ae known to protect against  the harmful consequences of adversity,   such as planning and coping skills,  self-esteem and self-regulation and also,   fostering that strong responsive relationship  between child and caregiver. And all of those   skills can potentially provide building  blocks for resilience, which might protect   a child from some of the harmful long-term  effects of adversity, trauma and stress. One important avenue, as well, that’s been  developed in an effort to improve treatment   of ACE-related mental health problems  has been trauma-informed care. So,   this approach aims to support frontline workers,  whether they’re in healthcare, social work,   education or elsewhere, in their ability to  understand and recognise the impact of ACEs in   the people they’re coming into contact with. So,  those practitioners can then take that knowledge   into account when they’re working with children  and young people who’ve reported ACEs, in order   to avoid the potential for re-traumatisation that  can occur through discussing their experiences. Some examples of trauma-informed approaches have  included things like awareness initiatives around   the potential impact of trauma, traumatic  experiences, training and guidance for   practitioners on how they can foster a more safe,  trusting relationship with patients and also,   redesigning services to create a sense of  safety and choice among clients and patients. As a final note of caution here, despite  some promising findings from various   prevention and intervention approaches  and strategies that have been used,   the formal evidence base for the efficacy  of most of these ACE-related interventions   remains somewhat inconclusive and unclear.  So, there’s still a real need for more   targeted research in this area to identify  the most promising intervention designs and   ultimately, reach a better consensus on  what the best approach is to prevent ACEs   and also limit their negative impacts  on young people’s health and wellbeing.