Adverse Childhood Experiences (ACEs) refer to traumatic or stressful events occurring during childhood that can have negative impacts on a person’s physical and mental health later in life. These experiences can include various forms of abuse, neglect, and household dysfunction. The original ACEs study conducted by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente in the 1990s identified ten types of adverse childhood experiences:
- Physical Abuse: Physical abuse involves the intentional use of force that results in injury, pain, or impairment.
- Sexual Abuse: Sexual abuse involves any sexual activity with a child, including molestation, rape, or exploitation.
- Emotional Abuse: Emotional abuse refers to behaviors such as verbal assaults, threats, rejection, and intimidation that undermine a child’s sense of self-worth and emotional well-being.
- Physical Neglect: Physical neglect occurs when a caregiver fails to provide a child’s basic needs, such as food, shelter, clothing, or medical care.
- Emotional Neglect: Emotional neglect involves the failure to meet a child’s emotional needs, such as affection, attention, and nurturance.
- Household Substance Abuse: Exposure to household substance abuse refers to living with a caregiver who abuses alcohol or drugs, which can create an unstable and unsafe environment for a child.
- Household Mental Illness: Living with a caregiver who has untreated mental illness can expose a child to emotional instability, neglect, or abuse.
- Household Domestic Violence: Witnessing domestic violence between caregivers can cause trauma and emotional distress for a child, even if they are not directly abused.
- Parental Separation or Divorce: Separation or divorce can disrupt a child’s sense of security and stability, leading to emotional distress and behavioral problems.
- Incarceration of a Household Member: Having a household member incarcerated can result in loss of support, financial instability, and emotional trauma for a child.
The ACEs study found a strong correlation between exposure to ACEs and negative health outcomes later in life, including chronic physical conditions, mental health disorders, substance abuse, and interpersonal difficulties. Additionally, individuals with a higher number of ACEs are at increased risk for a range of adverse outcomes, highlighting the importance of addressing childhood trauma and providing early intervention and support for affected individuals.
Resources Related to Adverse Childhood Experiences
Websites
Take the ACE Quiz – And Learn What It Does and Doesn’t Mean
The Adverse Childhood Experiences, or “ACEs,” quiz asks a series of 10 questions 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 quiz is intended as an indicator of how likely a person might be to face these challenges.
Centers for Disease Control and Prevention (CDC) Adverse Childhood Experiences (ACEs)
The CDC provides extensive resources and publications on ACEs, including data briefs, research articles, and reports summarizing the prevalence, consequences, and prevention strategies related to ACEs.
Tools & Resources
Community Resiliency Model (CRM) Overview and Skills Guide
This resource introduces the Community Resiliency Model (CRM), a set of simple, body-based skills designed to help individuals recognize and manage the effects of stress and trauma. CRM is used to support emotional regulation and recovery, making it especially relevant for individuals impacted by substance use, as well as the professionals who serve them. The guide also includes practical exercises and information on the free iChill app for continued skill-building.
ACEs, Overdose and Suicide Prevention
Adverse childhood experiences (ACEs), overdose, and suicide are urgent, related, public health challenges. Exposure to ACEs is associated with an increased risk of overdose and suicide later in life. These issues are preventable. The American Public Health Association (APHA) and the Center for Disease Control and Prevention (CDC) have developed this website containing videos, infographics, customizable workshop presentations, and one-pagers that make it easy to get the word out.
ACE Interface: The Adverse Childhood Experiences Study
ACE Interface is a Limited Liability Corporation that provides products and services to people like you, who are committed to do everything necessary to accelerate the intergenerational changes that will improve health and quality of life. As originators of the science and community application of the ACE Study, Dr. Robert Anda and Laura Porter develop and disseminate educational products, provide assistance, consultation and analysis, design high-leverage strategies for improving health and well-being, and facilitate empowerment processes that invite everyone to contribute to ACE-informed innovations.
Adverse Childhood Experiences and the Role of Substance Misuse Prevention
This tool educates prevention professionals about Adverse Childhood Experiences (ACEs), including what ACEs are, their prevalence, their impact on substance use and other behavioral health outcomes, and how to integrate addressing them into existing prevention.
Posters & Infographics
ACEs, Resilience, Toxic Stress Concept Cards
A printable set of educational cards from Resilient Georgia covering ACEs, toxic stress, brain development, resilience, and trauma-informed care, with practical guidance for families and providers.
Download Resource
ACEs, Overdose and Suicide Prevention Infographic
Infographics can be valuable communication tools. Using striking, engaging visuals, this infographic can help you communicate information about the intersections of ACEs, overdose, and suicide quickly and clearly.
Download the Infographic
ACEs and Toxic Stress: Frequently Asked Questions
This infographic includes answers to frequently asked questions about ACEs.
View or Download the Infographic
Publications
CDC Vital Signs Report: Adverse Childhood Experiences (ACEs)
This resource is a CDC Vital Signs report from November 2019. It provides an overview of Adverse Childhood Experiences (ACEs), including what they are, how common they are, and their long-term impact on health. The report also outlines prevention strategies at the individual, community, and policy levels.
Understanding Adverse Childhood Experiences: Building Self-Healing Communities
This handout provides an overview of the Adverse Childhood Experiences (ACE) Study, which shows how early adversity affects brain development and long-term health. It explains the lifelong impact of toxic stress, the importance of resilience, and outlines how communities can build supportive systems to promote healing and prevent ACEs.
Roots of Resilience: Nurturing Mental Wellness through the Lens of Adverse Childhood Experiences
In this podcast episode, Fabricia Prado joins host Heather Haslem to examine the profound impact of Adverse Childhood Experiences (ACEs) and their role as the root cause of both physical and mental illness. They discuss the importance of developing a mindful relationship with our bodies and the need for understanding how healing from trauma requires a holistic approach that involves mind, body, and spirit.
Webinars & Online Learning
Current News & Research
Adolescent Opioid Misuse Attributable to Adverse Childhood Experiences
This paper explores how adverse childhood experiences (ACEs), such as abuse, neglect, or household substance abuse, are linked to opioid misuse among adolescents. A study conducted in Ohio found that adolescents who had experienced multiple ACEs were significantly more likely to misuse opioids, with those reporting five or more ACEs being 15 times more likely to engage in opioid misuse. The research concludes that over 70% of recent adolescent opioid misuse can be attributed to ACEs, highlighting the need for early intervention programs to prevent childhood trauma and reduce the risk of substance abuse.
The Opioid Epidemic’s Toll on Children
This article from the Johns Hopkins Bloomberg School of Public Health discusses the opioid epidemics toll on children.
The American Psychologist: “Implications of Adverse Childhood Experiences Screening on Behavioral Health Services: A Scoping Review and Systems Modeling Analysis”
Significant efforts are being made to screen for and respond to ACEs within primary care settings to help mitigate the individual and public health impact of ACEs. A scoping review and simulation modeling demonstrated the potential impacts of ACEs screening on the supply and demand for behavioral health care services.
CASAT OnDemand: “Adverse Childhood Experiences: A Public Health Crisis That is Treatable and Preventable”
Blog post about Adverse Childhood Experiences.