I have spent the majority of my career in mental health, working with youth and young adults, so I know that what happens to you as a child plays a significant role in the person you become.
When we’re young, our brain is elastic and ready to adapt to our circumstances. Our surroundings teach us answers to many questions: Do I feel safe? Are my needs being met? Can I trust the people in my world? Who are healthy and safe people?
Therapeutic interventions help us unpack the lessons we learned as children and discover new tools to process our emotions and manage challenges.
When responding to the needs of children, youth, adults and families who have experienced trauma, one tool that we frequently use at CHRIS 180 to assess their experiences is the ACE questionnaire.
What are ACEs?
Adverse Childhood Experiences, or ACEs, are potentially traumatic events in childhood that can negatively affect our sense of safety, stability and social bonds long-term.
According to the first-ever ACE study, launched by the Centers for Disease Control and Kaiser in the mid-1990s, ACEs are common—61% of adults have experienced at least one ACE.
Trauma affects every community, though women and people of color are at greater risk for experiencing a higher number of ACEs.
About 16% of adults have experienced four or more ACEs. Many of the people CHRIS 180 serves fall into this category.
What does my ACE score mean?
As people live through more ACEs, they are more likely to experience chronic health problems, mental health challenges and substance use challenges. ACEs can also negatively affect job opportunities, education and earning potential. A high number of ACEs is even associated with a shorter life span, incurring horrible costs for families and communities.
Long-term exposure to toxic stress damages the structure and function of your brain—and can even be passed down from generation to generation.
An ACE score is a guideline and can illustrate potential risks, but it isn’t your destiny. It doesn’t capture every kind of childhood trauma. It doesn’t account for all your unique experiences, your behaviors or the positive experiences from early life that can help you build resilience and protect you from the long-term effects of stress and trauma. It also does not capture the protective factors that may exist within us as well as in our support networks.
Learn Your ACE Score
Do you want to know your ACE score? Tally up your yes responses to the questions below.
Before your 18th birthday:
- Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
No___Yes ___ - Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
No___Yes ___ - Did an adult or person at least five years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?
No___Yes ___ - Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?
No___Yes ___ - Did you often or very often feel that … You didn’t 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?
No___Yes ___ - Were your parents ever separated or divorced?
No___Yes ___ - Was your mother or stepmother:
Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
No___Yes ___ - Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
No___Yes ___ - Was a household member depressed or mentally ill, or did a household member attempt suicide?
No___Yes ___ - Did a household member go to prison?
No___Yes ___
Now add up your yes answers: ____
This is your ACE score.
What can we do about ACEs?
Good news: all childhood experiences matter in a child’s development!
Positive childhood experiences (PACEs) like having relationships with adults who take a genuine interest in you, feeling able to talk to your family about your feelings or feeling safe and protected by an adult in your home can build resilience and counter the negative effects of ACEs.
The two biggest protective factors for success in overcoming the risks associated with ACEs are a strong personality and at least one person in your world that supports you.
Each of us can play a role helping young people thrive.
More good news: for children and adults, trauma-informed therapy can help.
CHRIS 180 works to prevent and respond to the effects of trauma in children, their families and their communities so that they can heal and grow stronger together.
Become a mental health champion and help stop the stigma of mental health for those who score highest on the ACE quiz by donating to our Stop the Stigma campaign.
To learn more about resources we offer for healing children, strengthening families, and building community visit us at CHRIS180.org
Dr. Anne Cornell, PhD, LPC, is the Chief Clinical Officer of CHRIS 180.
