ACEs (Adverse Childhood Experiences): Childhood Trauma Factors, Explained

Adverse childhood experiences, also called ACEs, are events that happen to children that are potentially traumatic and can lead to long-term negative effects on health and well-being.

The more ACEs a child experiences, the more likely they are to have difficulties with health and development down the road. Researchers who study childhood trauma often look at ACEs to assess the level of adversity a child experienced.

ACEs are very common. About 64% of people in the United States report having experienced at least once adverse childhood experience before they were 18.

• What events are considered adverse childhood experiences (ACEs)?: Many different types of events can be potentially traumatic to children and be considered ACEs. Here are some examples: experiencing physical or emotional abuse, having a caregiver die by suicide, witnessing violence, growing up with caregivers who had substance use or mental health issues, not having enough to eat, homelessness, experiencing discrimination.
• Who experiences ACEs?: ACEs tend to happen more to certain people in certain environments. They disproportionately affect women and Indigenous people, as well as people with low incomes exposed to racism and generational trauma.
• Effects on health: Experiencing ACEs increases a person’s risk of suicide and teen pregnancy, as well as diseases including diabetes, cancer, and heart disease. The chronic stress from ACEs can also change children’s brains in ways that lead to problems with learning, attention, and making decisions.
• Effects on life outcomes: ACEs can affect the course of a child’s life, negatively affecting factors including their grades and achievement at school, graduation, college attendance, employment, and drug use.
• Factors that increase the risk of ACEs: Many factors increase children’s risk of experiencing ACEs, including having caregivers who were abused when they were children, or caregivers who use spanking and other physical punishment, have low income, low education, high stress, high conflict, or negative ways of communicating. Other risk factors include if the family has children with special needs, and a child has aggressive friends or none at all.
• Protective factors: It’s possible to lower a child’s risk of experiencing adverse childhood experiences by surrounding them with warm, stable relationships, and safe, nurturing environments. This includes parents, other adults who serve as mentors, and supportive friends. Living in families where people resolve conflicts peacefully helps, as do basics like having stable housing, good quality childcare, and medical and mental health care.
• ACE questionnaire: The ACE questionnaire or ACE test is a short series of questions that assesses how much a person has been exposed to traumatic events and other risk factors in childhood. Exposure to these increases the risk of problems later in life. Research shows that children who have four or more ACEs present in their lives are at 30 times greater risk for learning and behavior issues, and adults who experienced four or more ACEs have a 12% higher risk of health issues like alcoholism, drug use, and depression.

ACEs test for childhood trauma

Here’s one version of the ACEs questionnaire used by researchers to determine the level of adversity or childhood trauma people experienced when they were 18 years old or younger. We’ve modified the wording slightly to make it easier to read while keeping the meaning.

Your score is the number of these ACEs you have experienced.

• Your caregiver(s) had a hard time getting by on their current income.
• Your parents or guardians separated or got divorced.
• Your parent(s) or guardian(s) died.
• Your parent(s) or guardian(s) served time in prison.
• You experienced your parents or guardians being physically violent with each other, including hitting, slapping, kicking, or any other kind of physical violence.
• You experienced physical violence at home or in your neighbourhood. It happened to you or you saw it happen to others.
• You lived with someone who was severely depressed, suicidal, or otherwise seriously mentally unwell.
• Someone you lived with had issues with alcohol or drug use.
• You experienced racism or unfair treatment based on your race or ethnicity.

If you experienced adverse childhood experiences that are affecting your well-being, it’s not your fault. Help is available.

Consider speaking about it with someone you trust, your doctor, or a mental health professional.

Related articles

For a deeper understanding of trauma and related ideas, you might find these articles on Relationship Smart helpful:

• 7 Ways Childhood Trauma Can Affect Your Relationships
• How to Break the Cycle of Generational Trauma: Expert Q&A
• What Is Trauma Dumping? Why It Can Be Harmful