What are Adverse Childhood Experiences (ACES)?

Adverse childhood experiences (ACEs) are potentially traumatic events in a child’s life that can have negative and lasting effects on health and well-being. These experiences occur before the age of 18 and are remembered by that child as an adult. Such traumatic events may include psychological, emotional, physical, or sexual abuse; violence against the mother; or living with household members who were substance abusers, mentally ill, suicidal, criminal, or imprisoned. Maltreatment (child abuse, sexual abuse, neglect, bullying, etc.) causes chronic stress that can disrupt early brain development and the development of the nervous and immune systems.

EFFECTS & LIFE OUTCOMES FROM ADVERSE CHILDHOOD EXPERIENCES

Adverse Childhood Experiences have a strong and cumulative impact on the health and functioning of adults. Children who are abused or neglected are at higher risk for health and social problems than adults. The toxic levels of stress or trauma experienced by a child are linked to poor physical and mental health throughout life. These problems include lower educational achievement, lower economic success, impaired social success in adulthood, alcoholism, depression, drug abuse, eating disorders, obesity, high-risk sexual behaviors, smoking, suicide, and certain chronic diseases.

ABOUT THE ASSESSMENT

ACES quiz asks a series of questions (see below) about common traumatic experiences that occur in early life. Since higher numbers of ACEs often correlate to challenges later in life, including higher risk of certain health problems, the assessment is intended as an indicator of how likely a person may be to face these challenges. The assessment score is based on ten types of childhood trauma measured in the ACE Study. Five are related to personal experiences — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. The other five are related to other family members such as 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 the disappearance of a parent through divorce, death or abandonment. One point is given for each type of trauma. The higher your ACE score, the higher your risk of health and social problems. As your ACE score increases, so does the risk of disease, social and emotional problems. With an ACE score of 4 or more, things start getting serious. The likelihood of chronic pulmonary lung disease increases by 390 percent; hepatitis, 240 percent; depression 460 percent; suicide, 1,220 percent. 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, then those would likely increase your risk of health consequences. Fortunately, our brains are resilient, which means our mental and physical health can improve. The appropriate integration of resilience factors born out of ACE concepts — such as asking for help, developing trusting relationships, forming a positive attitude, and listening to feelings — can help people improve their lives. The ACES assessment does not give insight into whether or not an individual child might be more or less sensitive to adversity. The ACES assessment does not ask questions about whether there may have been any protective relationships in place to help shield the child from stress. So the ACES assessment can only give insight into who might be at risk—not who is at risk—for certain later-life challenges.

WHAT ISN’T ACCOUNTED FOR:

ACES assessment does not account for stressors outside the household such as violence, poverty, racism, other forms of discrimination, isolation, a chaotic environment, and lack of services. Protective factors such as supportive relationships, community services, and skill-building opportunities. Individual differences, not all children who experience multiple ACEs will have poor outcomes and not all children who experience no ACEs will avoid poor outcomes—a high ACEs score is simply an indicator of greater risk only.

INSTRUCTIONS:

Complete the questions below. Should you have any questions, or concerns, or if you wish to share more information. All questions and concerns will be addressed with your counselor during your intake appointment at Mending Hearts Counseling.

This assessment is for It is not for diagnostic purposes.

Disclaimer:

The content of this website is for informational purposes only and should not be used as a substitute for professional medical or psychological advice, diagnosis, or treatment. If you need mental health services, please contact a qualified mental health provider. If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or text "START" to 741-741.

About the author: Jennifer Hillier, LPC, is a Licensed Professional Counselor and Certified Clinical Trauma Professional who has over 10 years of experience working with survivors of trauma. She provides individual and group counseling services in San Antonio, Texas. She also offers online counseling services for out-of-state clients in Florida and Vermont. For more information about her practice, please visit www.jenniferlhillier.com.