ACEs (Adverse Childhood Experiences) Basics
by Pat Shelly
What Is the Adverse Childhood Experiences [ACEs] Study and What Is Its Significance?
The ACEs Study [published in 1998] is important because it found links between childhood trauma and long-term health, behavior and social consequences among adults.
How Were These Links Discovered?
Per the below infographic, the authors – from Permanente Medical Group (Kaiser Permanente), Centers for Disease Control and Prevention (CDC), Emory University and the University of Arizona – asked adult patients about any exposure they had as a child to the following:
- Recurrent physical abuse
- Recurrent emotional abuse
- Contact sexual abuse
- Alcohol and/or drug abuser in the household
- An incarcerated household member
- Someone in the household who is chronically depressed, mentally ill, institutionalized or suicidal
- Mother is treated violently
- Parents are separated or divorced
- Emotional neglect
- Physical neglect
A comparison to the participant’s adult health status was made, and strong links were found between high ACE scores (on a scale of 1 to 4+, having more than 2 or more adverse experiences) and impaired health/mental health.
In addition to the negative impact adverse childhood experiences are likely to have on a person, this graphic also shows the prevalence of ACEs and the three primary types of ACES: abuse, neglect and household dysfunction.
The ACE study has provided social workers and other clinicians with an invaluable tool to assess the types of trauma an individual had as a child. It is a way to begin to discuss, “What happened?” with a person. ACEs help establish a history that de-pathologizes the person and enhances a trauma-informed practice.
Below is a pyramid chart created by the CDC that illustrates the gaps that still exist in our knowledge of the full impact of ACE , emphasizing the need for ongoing research.
Longitudinal studies of the ACE Study participants continue through Kaiser and the CDC.
Find out your ACE score here:
UB School of Social Work curricular module on ACEs
The Truth About ACEs Infographic – Robert Woods Johnson Foundation
ACE Pyramid: Centers for Disease Control and Prevention ACE Study site
Here you will find the pyramid, plus CDC ACE studies and updates.
- The ACE Study
The original (1998) study, published in the American Journal of Preventive Medicine
- ACES Too High
Great site for background, news and information about the ACE study, including
developmental neurobiology — how severe stress and trauma affect a child’s developing brain and nervous system, and epigenetics — how our genes turn off and on in response to our experiences and social environment.
How has the ACE Study affected your practice? Teaching? Please share with us your use of or views on ACE.