What are Adverse Childhood Experiences (ACEs)?

ACEs was a collaborative effort between Kaiser Permanente (San Diego, CA) and the Centres for Disease Control and Prevention (Atlanta, GA) designed to examine the long-term relationship between adverse childhood experiences (ACEs) and a variety of health behaviours and health outcomes in adulthood. An underlying thesis of the ACE Study is that stressful or traumatic childhood experiences have negative neurodevelopment. and a significant impact on health and decisions that influence health in adult life.

Although we recognise the ACEs study contribution to childhood trauma, there is no evidence to suggest it as an accurate measure of individual outcomes and therefore we do not use the ACEs questionnaire in therapies.

We have provided the ACEs information for the purpose of interest only.

The ten widely recognised ACEs are:

Physical Abuse
Verbal Abuse
Sexual Abuse
Physical neglect
Emotional Neglect.
Living in a household where:
There are adults with alcohol and drug misuse problems
There are adults with mental health problems
There is domestic abuse
There are adults who have spent time in prison or Parents have separated.

As well as these ACEs, there are a range of other types of childhood adversity that can have similar negative long term effects. These include bereavement, bullying, poverty and community adversities such as living in a deprived area, neighbourhood violence etc. which can lead to toxic stress.

Toxic stress can occur when a child experiences strong, frequent, and/or prolonged adversity — such as physical or emotional abuse, neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship- without adequate support. This kind of prolonged activation of the stress response systems can disrupt the development of brain and other organ systems. It can also increase the risk for stress-related disease and cognitive impairment continuing well into adult years.

 

The impact of ACEs

Reports suggest childhood adversity can create harmful levels of stress which impact healthy brain development. This can result in long-term effects on learning, behaviour and health. ACE surveys in the US and UK are said to demonstrate that ACEs can exert a significant influence throughout people’s life.

ACEs have been found to be associated with a range of poorer health and social outcomes in adulthood and that these risks increase as the number of ACEs increase.

Research has found that people who have experienced 4 or more ACEs are:

Two times more likely to binge drink or have a poor diet
Three times more likely to currently smoke
Four times more likely to have underage sex
Four times more likely to have had or caused an unintended teenage pregnancy
Four times more likely to have smoked cannabis
Eight times more likely to have been a victim of violence in the last year
Ten time more likely to have been a perpetrator of violence in the last year
Each of these is likely to have a knock on effect on other parts of health and wellbeing, for example, having a poor diet put an individual at higher risk of some long term health conditions or being a victim of violence can impact a person’s mental health.

Download ACE’s Questionnaire Here