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ACEs: Everything You Need to Know About Adverse Childhood Experiences

Updated: Nov 14, 2023

Most people acknowledge the close link between childhood trauma and social-emotional problems later in life.

Studies have also shown that adverse childhood experiences contribute to a person’s risk of chronic illness—and the correlation between ACEs and various other issues is astonishing.

In this article, you’ll learn:

  • What are ACEs?

  • How to determine an “ACE score”

  • The correlation between ACEs and various problems

  • Why learning about ACEs is important

What are ACEs?

The acronym ACE stands for Adverse Childhood Experiences. By breaking down childhood trauma into sets of experiences, we can measure trauma and assess risk. This method is especially helpful in clinical settings where research studies can be replicated.

Some of the most common ACEs are:

  • physical abuse

  • verbal abuse

  • sexual abuse

  • physical neglect

  • emotional neglect

  • a parent is an alcoholic

  • a parent is a victim of domestic violence

  • a family member is in jail

  • a family member has a mental illness

  • parents getting divorced

How do we measure ACEs?

You can assess your own ACE score by adding up the number of adverse childhood experiences you’ve had before age 18.

The ten ACEs listed above are not the only possible ACEs. Any type of lasting toxic stress can be considered an ACE, including:

  • racism

  • bullying

  • witnessing a sibling or caregiver being abused

  • losing a caregiver, loved one, or friend

  • homelessness

  • recovering from a severe accident or illness

  • being in the foster care system

  • being in the juvenile justice system

So, if you had an alcoholic parent who failed to support you emotionally, you would have an ACE score of 2. If that parent were also a victim of domestic violence and often verbally abused you, your ACE score would be 4.

The Impact of ACEs

Measuring ACEs helps us study them. In 1995, the Centers for Disease Control and Prevention teamed up with Kaiser Permanente to begin one of the largest investigations into the impact of childhood trauma through the CDC-Kaiser ACE Study.

This study is ongoing; however, several significant findings were published in 1998. Over 70 other studies followed between 1998 and 2015.

Through this research, we learned that childhood trauma is common across all socio-economic categories. Previously, people assumed that trauma didn’t impact middle or upper-class white people.

Most of the 17,000 participants in the CDC-Kaiser Permanente study were employed, white, middle-class citizens from San Diego—which disproved theories that trauma only affected lower-class, minority groups. However, it is important to note that certain minority groups, such as POCs and LGBT+ youth, are at a higher risk.

We also learned that there is a direct link between childhood trauma and chronic disease, and individuals with a higher ACE score experienced increased risks of physical, social, and emotional problems.

Most individuals who experienced childhood trauma at all tended to experience various types of trauma. Of the 10,000+ individuals who reported ACEs, 87% reported more than one.

As the number of ACEs increases, individuals are at higher risk of:

  • adult alcoholism & smoking

  • chronic depression & prescription antidepressant use

  • other mental health diagnoses

  • perpetrating domestic violence

  • becoming a victim of domestic violence

  • liver disease

  • attempting suicide

  • teen pregnancy

  • absenteeism & impaired performance at work

  • chronic obstructive pulmonary disease

How does childhood trauma impact physical health?

When children experience trauma, it alters how their brains function. Since young brains are still developing, trauma can create permanent changes that determine how they respond to future stress.

Imagine a child overloaded with toxic stress from their life at home. They’re in a near-constant state of fight, flight, or freeze. They struggle to learn in school, develop healthy friendships, or cope with stress.

Then, they discover quick-fix solutions that temporarily relieve their pain, anxiety, guilt, or shame: alcohol, nicotine, marijuana, methamphetamines, sex, overachievement, or high-risk activities.

After falling into a pattern of substance abuse or self-harm, their physical body suffers the consequences—like liver and lung problems.

On top of these unhealthy coping skills, research suggests that chronic stress contributes to inflammation, which can lead to disease. And epigenetics shows us that trauma can be passed down through generations.

Trauma has lasting effects that can’t be ignored, although these effects can be difficult to see in the people we interact with every day.

This is why it’s essential to implement a trauma-informed approach to life, especially if you are someone who’s experienced trauma or if you work in the public health or education sectors.

ACEs Are a Major Public Health Concern

Adverse Childhood Experiences are pervasive and damaging. The CDC estimates that a 10% reduction of ACEs in North America would save $56 billion annually.

The good news is that our minds are flexible, and with awareness and intention, we can unlearn many of the habits we created to cope with our trauma. Human beings can be—and are—resilient.

If you want to embody trauma-informed values into your everyday life, consider enrolling in my Intentional Me Series, A Journey to Wellness, which focuses on creating lasting change through intentional living.

And stay tuned for next week’s blog, where we’ll discuss Positive Childhood Experiences and the significance of preventing ACEs.


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