Imagine a young child seeing their parent hurt another right before their eyes. This isn’t just a bad moment; it’s a life-altering trauma. These Adverse Childhood Experiences (ACEs) can deeply affect a child’s brain development, leading to severe cognitive and emotional challenges. Research shows these experiences put children at high risk for serious mental, physical, emotional, and social health complications. The more ACEs a child faces, the more profound the impact.

What are ACEs?

ACEs are negative experiences that leave lasting harmful effects on children. These can range from household dysfunction to direct abuse or neglect. Identifying ACEs is crucial, as they profoundly shape children’s development and future health. Without intervention, ACEs can lead to lifelong health issues, risk aversion, passivity, and both perpetration and victimization of violence.

ACE expert Jane Ellen Stevens explained, “They respond to the world as a place of constant danger. With their brains overloaded with stress hormones and unable to function appropriately, they can’t focus on learning. They fall behind in school or fail to develop healthy relationships with peers or create problems with teachers and principals because they are unable to trust adults.”

Categories of ACEs

Researchers have identified three categories of ACEs: Abuse, Neglect, and Household Dysfunction. Within these categories are various experiences such as household substance abuse, parental separation, mental illness in the family, violence, incarceration, emotional and physical abuse, and neglect.

The ACE Test

Dr. Vincent Felitti and Dr. Robert Anda developed a 10-question test to study the impact of ACEs. Each “Yes” response, indicating an ACE, scores one point. The goal was to correlate ACEs with health outcomes. The initial study found that over 66% of participants had at least one ACE, with 22% scoring three or more and 12.5% scoring four or more.

ACE Test Results

The study revealed high prevalence rates for various ACEs:

  • 28% experienced physical abuse
  • 27% witnessed household substance abuse
  • 26% faced economic hardship
  • 21% were sexually abused
  • 15% were emotionally neglected
  • 10% were physically neglected

The study showed strong correlations between ACEs and mental and physical health issues, chronic diseases, and employment status.

Why ACEs Matter

ACEs trigger a “Fight or Flight” response, leading to toxic stress when prolonged. Constant survival mode hinders learning and relationship-building, often resulting in depression, anxiety, and avoidance behaviors.

Children with four or more ACEs are 32 times more likely to have learning or behavior problems in school.

Health Impact of Multiple ACEs

Single ACEs increase the risks of homelessness, violence, and absenteeism. Multiple ACEs lead to Complex PTSD and severe health issues:

  • 3 times more likely to attempt suicide
  • 4 times more likely to be alcoholics
  • Nearly 3 times more likely to use illicit drugs

A score of four or more on the ACE test shows even higher risks:

  • 12 times more likely to attempt suicide
  • 7 times more likely to be alcoholics
  • 390% higher risk of chronic obstructive pulmonary disease (COPD)
  • 10 times more likely to use illicit drugs
  • 2 times more likely to be nicotine-addicted
  • 460% more likely to suffer from depression

People with six or more ACEs die on average 20 years earlier than those with zero ACEs.

Break the Cycle of ACEs and Generational Trauma

Providing care for children and adults means addressing generational challenges. ACEs can be passed from one generation to the next, much like genetic traits. “What you experience in childhood and how you grow up have huge implications for how you are as an adult,” said Dr. Robert A. Chambers.

Breaking generational trauma is complex and requires a deep understanding of the issues, as well as efforts to prevent and treat the root causes. Experts recommend early identification and treatment of trauma.

Knowing one’s ACE score can be like understanding a genetic risk for high blood pressure: being aware of the risk allows for early intervention with healthy habits and treatments.  “The comparison between ACEs and genetics is very interesting because ACEs tend to be passed down as if they were genetic, but it’s a culture that’s passed down from generation to generation within families,” said Dr. Chambers.

Parents who recognize their risk for ACEs can seek help to prevent passing trauma to their children.

Economic Impact of ACEs

ACEs cost the economy $124 billion over the affected individuals’ lifetimes, with $83.5 billion in productivity losses and $25 billion in healthcare costs. Combined with child maltreatment and domestic abuse, the annual cost is roughly $500 billion. Addressing ACEs benefits not only health but also economic stability.

Understanding and addressing ACEs is essential for breaking the cycle of trauma. Providing early intervention and support can help children overcome these adverse experiences and lead healthier, more productive lives.