Adverse Childhood Experiences

Flowers blooming through concreteWhat Are Adverse Childhood Experiences (ACES)?

Adverse Childhood Experiences (ACE) is the term given to describe all types of abuse, neglect and other traumatic experiences that occur to individuals under the age of 18.

The ACEs Study is one of the largest investigations ever conducted to assess associations between early adversity and health in later-life. A partnership between Kaiser Permanente San Diego and the U.S. Centers for Disease Control and Prevention, the retrospective study looked at multiple categories of physical and emotional abuse and neglect, as well as measures of household dysfunction like domestic violence, parental mental illness, substance abuse and separation/divorce.

What did the study discover?

The results of the ACEs Study revealed two striking findings. First, ACEs are incredibly common – 67 percent of the study population revealed at least one ACE and 12.6 percent of the population had four or more ACEs. The study found found that the presence of four or more serious adverse experiences during childhood greatly increased adults’ risk for alcoholism, drug abuse, suicide attempts, and poor general health.

Secondly, there was a strong response relationship between ACEs and numerous health problems, meaning the more ACEs, the higher the risk of heart disease, chronic obstructive pulmonary disease, depression, heart disease and cancer.

Do ACES last a lifetime?

They can, but they don’t have to because healing can occur, the cycle can be broken and we’ve learned that, stable, nurturing relationships can heal parent and child.

What are ACES that are measured?

Growing up (prior to age 18) in a household with or experiencing:

  • Recurrent physical abuse;
  • Recurrent emotional abuse;
  • Sexual abuse;
  • Emotional or physical neglect;
  • An alcohol or drug abuser;
  • An incarcerated household member;
  • Someone who is chronically depressed, suicidal, institutionalized or mentally ill;
  • Mother being treated violently; or
  • Losing a parent to separation, divorce or other reason.

People have an ACE score of 0 to 10. Each type of trauma counts as one. Each ACE counts as one, no matter how many times it occurs.

What did the study find about chronic disease?

It found that many chronic diseases in adults are determined decades earlier, by experiences in childhood. The risk factors/behaviors for these diseases are initiated during childhood or adolescence and continue into adult life.

Are there factors that can help prevent the long term consequences of experiencing ACES?

Yes, the following can act as protective factors for children:

  • Loving relationships with caring, and consistent adults
  • Strong cultural identity
  • Social connections
  • Stability and responsiveness of staff and systems that interact with the child

More information on protective factors

How do I become more nurturing as a parent or friend to a child?

  • Observe, attend and listen to children.
  • Provide safe and stable home life.
  • Model caring behavior.
  • Respond to child’s needs.
  • Use positive discipline.
  • Notice and reinforce child’s strengths.
  • Set up activities that promote  bonding and attachment.
  • Acknowledge nurturing behavior.

More on everyday actions that help promote resiliency