Adverse Childhood Experiences (ACEs)

Adverse Childhood Experiences (ACEs) are a collection of potentially traumatic events, such as violence, abuse, or neglect, that occur in childhood.

Childhood exposure to prolonged traumatic events may result in a toxic stress response, negatively affecting a child’s brain development. These disruptions increase the risk of poor physical health, coping skills, or other long-term cognitive impairments. Researchers and practitioners across many disciplines (e.g. development psychology, pediatrics, social work) had general knowledge of the connection between trauma and healthy development, however the 1998 landmark study by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente (ACEs Study) deepened this understanding.

The ACEs Study examined the effects of childhood trauma and stress on adult health outcomes. In this study, adverse childhood experiences were defined within ten categories: physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, violence against a mother, parental divorce, household member with substance use/abuse issues, household member with mental illness, and incarcerated household member. Overall, the researchers found that child adversity is common and exposure to one or more ACEs increases an individual’s risk of physical health, psychological, and social problems in adulthood. The pervasiveness of ACEs and their impact on various aspects of an individual’s life initiated a public health response to address this problem.

Since the original study, we have since learned that these 10 ACEs are not the only kind of adversities children face. These also include: discrimination, poverty, racism, etc. These experiences can have similar impacts as ACEs.

To learn more about ACEs:

Toxic Stress

ACEs can cause children to develop a toxic stress response. To learn more about childhood adversities and how they increase children's risk for toxic stress, click here.

Parents, caregivers, and other adults who care about children should know they can support kids who are experiencing adversity. To learn more about how to help kids, click here.

Preventing ACEs

Resilience is a powerful weapon in the fight against ACEs. It is defined as the ability to bounce back from life's difficulties.

ACEs are only one half of any equation to try and predict a child’s future course. While each child is exposed to different degrees of trauma, they also have their own unique set of characteristics that can protect them against that trauma. A high ACE score is not a guarantee of negative outcomes in life. It’s a big warning sign but no child is doomed by their ACE score.

Two crucial factors are at play: 1.) The child’s own biological and developmental characteristics (their “nature”) and 2.) external influences from their family, community, and support systems. When these influences are positive, we call them “protective factors”. Protective factors help explain why some people who have sustained a great deal of adversity as children fare relatively well in adulthood.

Like a balancing scale, resilience is the result of interactions between a person’s ACEs on one side and his or her protective factors on the other.

(Source: The Center for Child Counseling)

Strategy	Approach
Strengthen economic supports to families	strengthening household financial security family-friendly work policies
Promote social norms that protect against violence and adversity	public education campaigns legislative approaches to reduce corporal punishment bystander approaches men and boys as allies in prevention
Ensure a strong start for children	early childhood home visitation high-quality child care preschool enrichment with family engagement
Teach skills	social-emotional learning safe dating and healthy relationship skill programs parenting skills and family relationship approaches
Connect youth to caring adults and activities	mentoring programs after-school programs
Intervene to lessen immediate and long-term harms	enhanced primary care victim-centered services treatment to lessen the harms of ACEs treatment to prevent problem behavior and future involvement in violence family-centered treatment for substance use disorders

Raise Awareness about ACEs! Let's help all children reach their full potential and create neighborhoods, communities, and a world where every child thrives.

(source: Centers for Disease Control and Prevention)

Adverse Childhood Experiences (ACEs)