Music With Children Who Have Experienced Adverse Childhood Experiences (ACES)

by Alice Burba

Musick has Charms to sooth a savage Breast,
To soften Rocks, or bend a knotted Oak.
– William Congreve

At the opening of William Congreve’s seventeenth-century play, The Mourning Bride, Almeria is grieving the death of her lover, Anselmo. The curtain opens to soft music playing, and Almeria remarks, "Musick has Charms to sooth a savage Breast." Most misquote this phrase to read, “Music soothes the savage beast,” correlating the phrase with the mythological three-headed creature, Cerebus, who was soothed by music. (J. K. Rowling revisited this in The Sorcerer’s Stone when Harry Potter was able to sneak past Fluffy, the three-headed dog, by playing a flute that lulled Fluffy to sleep.)

While I would never refer to a child as a savage beast, occasionally children’s behaviors begin to look that way. Anxiety in children can bring out those difficult-to-manage behaviors, and as it happens that anxiety is often felt in the breast or chest with a racing heart and shortness of breath. I will assert that a good tune can soothe beasts and breasts alike.

All too often we try to manage children’s behaviors, whether in the home, classroom, or community, with tried and true methods such as taking away privileges, a swat on the bum, turning a card, no recess, etc. But how often do we consider what is behind the behavior and ask why the child is acting in this way? Understanding the origin of the behavior is often the key to addressing it. I once facilitated a training on behavior management where the curriculum stated “behavior is the language of emotion.” It taught me that we have to listen to really understand the child.

That said, this can be a huge challenge. Children progress through numerous developmental stages and often don’t have the vocabulary and coping skills to state, “I hit my sister because I’m angry that I didn’t get to see my dad today.” Children are often unable to recognize the emotions they are feeling and therefore can only express feelings through negative behavior (many adults don’t have this skill either). If the caregiver or teacher understands that this child misses her father, they will take this into consideration when choosing a discipline. For example, they may choose to have her sit at the table quietly, with others nearby, rather than banishing her to her room, which compounds the feelings of separation.

Let’s analyze behavior a little more deeply. In today’s world, many children are exposed to traumas and experiences that impact their coping ability and overall mental and physical health, creating an environment of “toxic stress.” Children then act out in response to this anxiety-filled environment. Since 1998, numerous groundbreaking studies on adverse childhood experiences (ACEs) have helped us to understand the short- and long-term effects of traumatic events during childhood and the toxic stress they create (CDC 2016).

ACEs harm children’s developing brains by changing how they respond to stress and damaging their immune systems so profoundly that the effects show up decades later. Studies show that over 64% of adults have had at least one adverse childhood experience, and 87% of those who have had one, have had two or more. Astoundingly, the more ACEs you have, the greater your risk for developing chronic disease or mental illness, perpetrating violence, and being a victim of violence later in life (CDC 2016). The data is overwhelming on the powerful long-term impact of childhood trauma, calling for all people who care for and work with children to become more trauma-informed in their approach. 

The CDC-Kaiser Permanente ACE Study measures the impact of ten different types of childhood trauma using the following ACE score questionnaire. While there are many other types of childhood traumas, these were the most common traumas identified. Experiencing other types of toxic stress over months or years would likely further increase an individual’s risk of health consequences.

Your ACE Score 
Prior to your 18th birthday:

1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
3. 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? or Attempt or actually have oral, anal, or vaginal intercourse with you?
4. Did you often or very often feel that… No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?
5. 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 or take you to the doctor if you needed it?
6. Were your parents ever separated or divorced?
7. Was your mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
9. Was a household member depressed or mentally ill, or did a household member attempt suicide?
10. Did a household member go to prison?

Add up your “Yes” answers: ________
This is your ACE Score.

Source: AcesTooHigh News 2018

When a young child experiences repeated trauma such as child abuse, neglect, domestic violence, etc., the child’s brain and body produces an overabundance of the stress hormones cortisol and adrenaline, which in turn harm the functions of the developing brain. “If you’re chronically stressed and then experience an additional traumatic event, your body will have trouble returning to a normal state. Over time, you will become more sensitive to trauma or stress, developing a hair-trigger response to events that other people shrug off” (AcesTooHigh News 2017). Teachers see this regularly in the classroom when a child’s behavioral response to a situation does not match the precipitating event. Our first response might be to say to the child, “You’re overreacting!” but for a child whose brain and body is filled with toxic stress, the response is warranted. The child’s ability to regulate their response is impaired.

There is hope, however. The website AcesTooHigh News states

The good news is that the brain is plastic, and the body wants to heal. The brain is continually changing in response to the environment. If the toxic stress stops and is replaced by practices that build resilience, the brain can slowly undo many of the stress-induced changes. There is well-documented research on how individuals’ brains and bodies become healthier through mindfulness practices, exercise, good nutrition, adequate sleep, and healthy social interactions (2018).

And musical interaction helps. For children with ACEs, music has been proven to play a critical role through its unique ability to build resilience by fostering social-emotional development, promoting physical development and thinking skills, and nurturing language. Zero to Three, an advocacy organization focusing on the welfare of babies and toddlers, offers these findings: “Singing a lullaby while rocking a baby stimulates early language development, promotes attachment, and supports an infant’s growing spatial awareness as the child experiences her body moving in space” (Parlakian and Lerner 2016). Music can be quite magical in addressing and mitigating the stress-filled environment caused by childhood trauma.

Social-Emotional Development
One of the key outcomes of playing soothing music with babies and toddlers is that it develops self-regulation, the ability to manage one’s emotional state and physical needs. This is foundational for emotional heath. The well-placed lullaby or gentle humming as a caregiver rocks a child to sleep can act as a pivotal tool that brings calm to a child who is out of sorts. Over time, the child will learn to self-sooth if the caregiver has consistently and predictably nurtured the child.

Beat and rhythm also play a key role in soothing. A child in the womb is soothed by the mother’s heartbeat. When a toddler is fussy, the caregiver often will pick that child up and gently bounce the child, unknowingly, to the same beat of a resting heart rate. The rhythmic nature of music naturally will trigger these same soothing responses through repeated patterns and musical structure. Many of today’s mindfulness strategies incorporate music with 60 beats per minute (BPM) to simulate a resting heart rate, but rhythmic songs and nursery rhymes, regardless of BPM, are excellent tools for soothing and self-regulation. Indeed, just the act of listening to music has been found to reduce stress (Thoma et al 2013).

More importantly, music provides healthy social experiences that can help fill in the gaps left by adverse childhood experiences. Marching around the room of the preschool, singing, or beating drums together encourages positive peer relationships. This shared joy of self-expression nurtures positive self-esteem, self-confidence, and self-efficacy.

Physical Development
When music pairs with movement, gross motor skills are engaged. It is always a delight to see a baby or toddler bouncing to the beat or swaying back and forth. Marching, skipping, twisting, jumping, and dancing will all hone and perfect gross motor skills. These movements to music can also help increase balance and spatial awareness. Fine motor skills are enhanced through doing fingerplays, holding scarves or instruments, and even plunking notes on a piano or playing a toy xylophone with mallets.

Certainly greater body awareness through exercise, action, or even mindfulness or meditative strategies yields positive physical outcomes. The benefits of music’s influence on physical development can help nurture a healthy, active lifestyle, which can combat the long-term health effects of ACEs.

Cognitive Development: Thinking Skills and Language Skills
The cognitive developmental benefits of music are endless, but one of the most profound impacts is on memory. After all, most of us learned countless vocabulary words and simple facts through the use of music. Interestingly, trauma plays a key role in memory as well. When a traumatic event occurs, toxic stress hormones are released in the brain, often searing that experience in one’s memory. This plays out in recurring memories that cause traumatic responses. In children this may be expressed as aggression (fight response) or withdrawal and dissociation (flight or hide response).

TIPS for Working With Traumatized Children

1. Create a safe space for children to experience music. A familiar setting with few distractions and plenty of room will help.
2. Structure and routine help reduce stress and anxiety. Try to use music at the same times during the day or within the same routines.
3. Because consistency and predictability are key, use the same transition song at the beginning and end of music time.
4. Use movement with the songs, but be sensitive to children who may be uncomfortable touching others or who may become anxious in crowded spaces.
5. Familiarity is comforting. Choosing songs the children know is a good place to start.
6. Build in calming or soothing songs, like lullabies or songs that support mindfulness.
7. Watch for cues that children may be feeling anxious and adjust accordingly. Children may become aggressive or may withdraw or “check out.”
8. Be careful with song selection. Songs that talk about loving mothers may alienate the child who was abandoned. Songs that talk about traditional family may not translate for a child in foster care.
9. Building language skills can also serve to help children who suffer from ACEs by helping them express their feelings in positive ways. Children often act out their feelings rather than verbalize them. They just don’t have the vocabulary. Music can help build that vocabulary, especially songs that teach about feelings. Rhythm also plays a role with thinking skills and language. Songs with a steady, consistent beat can assist with language fluency as well as cognitive focus.

To help children deal with adverse life experiences, we, as human beings, musicians, and teachers, must look at the whole child—socially, emotionally, physically, and cognitively. Music, because of its powerful ability to impact the brain and body on multiple levels, also has the power to impact all of these developmental domains. Thus, music can be a pivotal strategy for trauma-informed care with children who have experienced childhood trauma.

If adverse childhood experiences become life’s stumbling “rocks” or “knots,” then Sir William Congreve provided us with excellent wisdom about the power of music to sooth the savage beast...or breast.