Adverse Childhood Experiences (ACEs) describe some of the most frequently occurring and intense sources of stress that children may experience early in life, which they unknowingly carry forward into adulthood. These experiences may include multiple forms of abuse, violence between parents or caregivers, neglect, other types of severe household dysfunction, like alcohol addiction or substance abuse, and peer, collective and community violence.
Research has found that prolonged and considerable stress during childhood can affect a person’s health and well-being for life. It can interrupt early brain development as well as compromise the way the nervous and immune systems function. Additionally, an individual who has suffered from ACEs’ ability to cope with stress can lead to serious issues including:
- Alcohol addiction and alcoholism
- Drug addiction
- Early initiation of smoking/smoking
- Early initiation of sexual activity
- Multiple sexual partners
- STDs (Sexually Transmitted Diseases)/HIV
- Depression
- Suicide attempts
- Liver disease
What is the ACEs questionnaire?
The ACEs questionnaire is a ten-item self-report measure created for the ACEs study to identify childhood experiences before one’s 18th birthday that involve neglect and abuse. The study speculates that childhood trauma and stress indicates a higher risk of developing mental health problems later on in life, as well as potentially impairs cognitive, emotional and social development.
Find out your ACEs score
Answer the following questionnaire to find out your ACEs score.
While you were growing up, during your first 18 years of life:
- Did a parent or other adult in the household often …
Swear at you, insult you, put you down, or humiliate you? - Act in a way that made you afraid that you might be physically hurt?
Yes No If YES enter 1 ____
- Did a parent or other adult in the household often …
- Push, grab, slap, or throw something at you?
- Hit you so hard that you had marks or were injured?
Yes No If YES enter 1 ____
- Did an adult or person at least 5 years older than you ever…
- Touch or fondle you or have you touch their body in a sexual way?
- Try to or actually have oral, anal, or vaginal sex with you?
Yes No If YES enter 1 ____
4.Did you often feel that .
- No one in your family loved you or thought you were important or special?
- Your family didn’t look out for each other, feel close to each other, or support each other?
Yes No If YES enter 1 ____
- Did you often feel that …
- You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
- Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
Yes No If YES enter 1 ____
6.Were your parents ever separated or divorced?
Yes No If YES enter 1 ____
7.Was your mother or stepmother:
- Often pushed, grabbed, slapped, or had something thrown at her?
- Sometimes or often kicked, bitten, hit with a fist, or hit with something hard?
- Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
Yes No If yes enter 1 ____
8.Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?
Yes No If yes enter 1 ____
9.Was a household member depressed or mentally ill or did a household member attempt suicide?
Yes No If yes enter 1 ____
10.Did a household member go to prison?
Yes No If yes enter 1 ____
Once you are finished, add up all your ‘Yes’ answers to find out your ACEs Score.
TOTAL ____
How do you use the ACE questionnaire?
The ACE questionnaire comes with ten questions. The ten types of stressful events in childhood include five personal events and five that are related to other family members.
The five personal events include:
- Emotional abuse
- Physical abuse
- Sexual abuse
- Emotional neglect
- Physical neglect
The five that are related to other family members include:
- Absence of a parent through divorce, abandonment or death
- A mother or stepmother who was treated violently
- A household member who abused drugs or alcohol
- A household member who went to prison
- A household member who was diagnosed with a mental illness
One point is given for each affirmative answer. Once the questionnaire is complete, the points are tallied for a score out of ten, which is called the ACEs score. Some questions include:
- Was a household member depressed or mentally ill or did a household member attempt suicide?
- Did a parent or other adult in the household often push, grab, slap or throw something at you? Or ever hit you so hard that you have marks or were injured?
- Did you often feel that you did not have enough to eat, had to wear dirty clothes and had no one to protect you? Or your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
The ACE questionnaire has several different applications. It may be administered by healthcare professionals to better understand the childhood trauma of individuals who are experiencing:
- Alcohol and drug issues
- Mental health conditions and suicidal thoughts
- Domestic violence
- Chronic health conditions
- Incarceration
How does the ACEs questionnaire relate to mental and physical health?
The ACEs test identifies major risk factors that may result in the development of social and health issues. Aside from suggesting that a person has a higher probability of experiencing health issues in adulthood, the test also indicates how childhood trauma affects the mortality rate. In fact, a person with an ACEs score of six or higher has a life expectancy that may be reduced by up to 20 years.
Since the ACEs study proposes that there is a significant connection between childhood trauma and chronic diseases later on in life, such as heart disease, diabetes, lung cancer and autoimmune diseases, the test may be able to help individuals with high ACEs scores become more knowledgeable about their increased risk factor for mental health issues. It could also encourage them to seek trauma therapy if they have yet to do so.
In addition, the ACEs study emphasises how certain childhood experiences affect the potential development of mental health conditions in adulthood and may assist mental health professionals when it comes to understanding certain psychological health concerns.
The connection between childhood trauma, social issues and mental and physical health in adulthood may also be used to help inform programmes and health policies that support prevention of and recovery from these issues.
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