Adverse Childhood Experience and ACEs

What does it mean?

Childhood experiences, whether positive or negative, have a large impact on one’s future development, mental health, and lifelong physical health. Children who witness or experience violence, intense amounts of stress, or any type of abuse may experience profound effects that manifest years later, resulting in chronic illness, depression, mental health issues, violent behavior, or they may become a victim of violence. These are called Adverse Childhood Experiences (ACEs).

According to the CDC’s Adverse Childhood Experience Study, as the number of ACEs increase, so does the risk for outcomes, such as risky health behaviors, chronic health conditions, low life-potential, and early death. For example, an individual with an ACE score of 4 or more is 460% more likely to have depression according to ACEs Too High.

What are the adverse childhood experiences that may influence one’s ACE score?

Below is a list of possible Adverse Childhood Experiences that in total create one’s ACE score. However, these are meant as a guideline and do not encompass all types of toxic stress that someone may experience.

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, 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, 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 five years older than you ever
touch or fondle you or have you touch their body in a sexual way? 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? 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? 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? Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? 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.

Can you prevent or treat high ACE scores?

Adverse Childhood Experiences (ACEs) are very common. Almost two-thirds of study participants reported at least one ACE, and more than one in five reported three or more ACEs. However, ACEs are preventable and treatable. Children build resilience to ACEs through fostering healthy relationships with adults, being able to openly discuss emotions, and having individuals in their lives they can talk and turn too. Due to the wide range of adverse childhood experiences and the ways it can manifest in someone’s life, treatment options vary from individual to individual.

However, speaking to a healthcare professional is the first step to recovery. If you are looking for more information about your ACE score and how this can relate to your health, be sure to ask specifically for trauma informed care or a provider who specializes in supporting those with trauma transformation.

Additional Resources

ACES Too High

Center for the Study of Social Policy

Centers for Disease Control and Prevention: Adverse Childhood Experiences

Veto Violence: Adverse Childhood Experiences

National Council for Behavioral Health