Adverse Childhood Experiences

ACEs are only one part of your story. They are NOT destiny. Knowing your ACE score and how it may have contributed to your health can be important, but remember that trauma can be overcome through resilient skills and support from others.

ACE stands for Adverse Childhood Experiences which occur prior to your 18th birthday. Examples of adverse childhood experiences are physical, sexual, and emotional abuse, and physical or emotional neglect. They also include having a parent/caretaker or someone else in the home who is mentally ill, an alcoholic or substance abuser, in jail, or a victim of domestic violence. Absence of a parent through divorce, death, or abandonment counts, too. Racism, poverty, discrimination, and community violence can also contribute heavily to trauma and ACEs.

ACEs are just one part of a person’s story. They are NOT the end of the story. They can lead to some bad things happening by disrupting brain development, but they don’t have to. Having support and resilience can make the negative effects go away.

This Information is REAL.

Since the original ACE study in 1998, more and more have been conducted. Similar results have been found every time with more than 200 different studies. No part of the population is free of ACEs, and they are common in all classes and across gender and race. Certain environments may make ACEs more likely, but anyone can have these unfortunate experiences.

Your health could be affected by your childhood experiences.

These experiences don’t go away as adults without support. Many stressful events in childhood may come back up in adulthood. The ACE Study found a link between having stressful events in childhood (ACEs) and chronic diseases. It can also cause social, emotional and behavioral problems. These problems included heart disease, lung cancer, diabetes, autoimmune diseases, depression, mental illness, suicide, and being a victim of violence.

Knowledge is power. Knowing this information can help you be aware and reduce some of these affects and outcomes.

Your ACE Score

Each type of trauma counts as one. At least 50-70% of our population has an ACE score of at least one. As your ACE score increases, so does the risk of disease, social and emotional problems.

The ACE Study has existed and been used in many different forms since 1998. Originally it included 7 factors that counted as ACEs. Most of the research that has been already done has 10 types of ACEs which are some of the ones listed below. Find a handout of the 17 point questionnaire used by Dr. Nadine Burke Harris and the San Fransisco Center for Youth Wellness HERE.

If you’re interested in sharing this information with others and want to use this questionnaire, feel free to change the wording to best explain it to your audience.

Some are Personal

• emotional abuse (being cursed at, insulted, or put down frequently)
• physical abuse (being hit, assaulted, or mugged by someone)
• sexual abuse (being touched inappropriately or forced to do a sexual act by someone)
• emotional neglect (feeling unloved at home or that nobody looked out for you)
• physical neglect (sometimes not having enough food or clothes, or feeling like nobody protected you)
• being severely sick or injured
• experiencing homelessness or foster care
• getting pregnant/getting someone pregnant

Some are Related to Other Family or People Close to Us

• absence of a parent though divorce or abandonment
• death of a close friend or family member
• a parent or caretaker who was treated violently (ex: parent being hit, pushed, or something else bad enough to be hurt or leave a mark, seeing this happen)
• somebody in the house who abused alcohol or drugs (seeing this, not being taken care of because of this)
• somebody in the house who was mentally ill (depressed, attempted suicide, other mental illness)
• a household member who went to jail or prison or who was deported
• having to move or change schools lots of times
• other experience you feel that deeply affected you in a very negative way


Some of the newer studies have looked at community-based experiences and have given evidence that poverty, experiencing racism, having violence in your childhood community, and more can all either be ACEs themselves or at least contribute to the likelihood of experiencing them. When children are raised in situations where the community is not supportive of a family, those things can create an environment where ACEs are more likely to happen. This means that although many of these experiences happen at a personal level, the community can create support for families to prevent them.

This image is like the tree. The pyramid on the left is like the branches and it talks about all the common aces. The pyramid on the right adds two layers that are like the roots and soil. These account for community environments like racism and discrimination or high crime that can lead to ACEs being more common in that area.

Possible Health Outcome Risks

The higher the ACE Score is, the more likely a person is to experience an increased risk for the following health problems and more
(A reminder that these are the things that can happen if nobody does anything about the trauma, but they can be stopped with resilience and community support):

• Alcoholism and Alcohol Abuse
• Illicit Drug Use
• Early Initiation of Smoking
• Smoking
• Early Initiation of Sexual Activity
• Adolescent Pregnancy
• Multiple Sexual Partners
• Sexually Transmitted Diseases (STDs/STIs)
• Diabetes

• Unintended Pregnancies
• Fetal Death
• Risk for Intimate Partner Violence
• Depression
• Suicide Attempts
• Health-Related Quality of Life
• Chronic Obstructive Pulmonary Disease (COPD)
• Ischemic Heart Disease (IHD)
• Liver Disease
• Alzheimer’s Disease

I know my ACE Score… What Do I Do Now? Find out more HERE.