Adverse Childhood Experiences

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Adverse childhood experiences

What are ACEs?

ACEs (adverse childhood experiences) can have a tremendous impact on future violence, victimization, perpetration, and lifelong health and opportunity. We will identify the ten types of childhood trauma in the CDC-Kaiser Permanente adverse childhood experiences (ACE) study and examine how a person’s ACE score correlates with future health risks and social interactions. 

In a later blog post, we will talk about resilience and how the CDC works to understand ACEs and prevent them.

10 types of Trauma

The ten types of childhood trauma measured in the Kaiser Permanente Adverse Childhood Experiences Study are listed here: physical abuse, verbal abuse, sexual abuse, physical neglect, emotional neglect, a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and experiencing parents’ divorce. 

As seen above, the first five types of trauma are associated with abuse suffered by the person being assessed. In contrast, the second five are related to abuse directed at or experienced by a family member. 

Each type of trauma counts as one. So a person who’s been physically abused, with one alcoholic parent, and a mother who was beaten up has an ACE score of three.

There are, of course, many other types of childhood trauma — racism, bullying, watching a sibling being abused, losing a grandmother or grandfather, homelessness, surviving and recovering from a severe accident, witnessing a father being abused by a mother, involvement with the foster care system, involvement with the juvenile justice system, etc. The ACE Study included only those ten childhood traumas because those were mentioned as most common by a group of about 300 Kaiser members; those traumas were also well studied individually in the research literature.

The most important thing to remember is that the ACE score is meant as a guideline. If you experienced other types of toxic stress over months or years, those would likely increase your risk of health consequences.

Finding your ACE Score

While you were growing up, during your first 18 years of life:

1. Did a parent or other adult in the household 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?

Yes or No    If yes, enter 1 ________

2. Did a parent or other adult in the household often … Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?

Yes or No    If yes, enter 1 ________

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 Try to or actually have oral, anal, or vaginal sex with you?

Yes or No    If yes, enter 1 ________

4. Did you 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?

Yes or No    If yes, enter 1 ________

5. Did you 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?

Yes or No    If yes, enter 1 ________

6. Were your parents ever separated or divorced?

Yes or No    If yes, enter 1 ________

7. Was your mother or stepmother: Often pushed, grabbed, slapped, or had something thrown at her? or Sometimes or 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?

Yes or No    If yes, enter 1 ________

8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?

Yes or No    If yes, enter 1 ________

9. Was a household member depressed or mentally ill or did a household member attempt suicide?

Yes or No    If yes, enter 1 ________

10. Did a household member go to prison?

Yes or No    If yes, enter 1 ________

Now add up your “Yes” answers: _______ This is your ACE Score

Now that you know your ACE score, what does it mean?

The original ACE study uncovered a stunning link between childhood trauma and the chronic diseases people develop as adults, as well as social and emotional problems. Included are heart disease, lung cancer, diabetes, many autoimmune diseases, depression, violence, being a victim of violence, and suicide.

The first research results were published in 1998, followed by more than 70 other publications through 2015. 

The studies showed that:

  • Childhood trauma was prevalent, even in employed white middle-class, college-educated people with great health insurance;
  • There was a direct link between childhood trauma and adult onset of chronic disease, as well as depression, suicide, being violent or a victim of violence;
  • More types of trauma increase the risk of health, social and emotional problems.
  • People usually experience more than one type of trauma – rarely is it only sex abuse or only verbal abuse.

Of the 17,000 people in the ACE study, two-thirds had an ACE score of at least one, while 87% had more than one! 

The study’s researchers came up with an ACE score to explain a person’s risk for chronic disease. Think of it as a cholesterol score for childhood toxic stress. You get one point for each type of trauma—the higher your ACE score, the higher your health, and social problems risk. 



What’s Your ACE Score? Adverse Childhood Experiences (ACE) Questionnaire

CDC – Adverse Childhood Experiences (ACEs)

What ACEs/PCEs do you have?

New Method Wellness – Adverse Childhood Experiences (ACE) Self-Test


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