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1.5: ACEs

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    Adverse Childhood Experiences (ACEs)

    An image of the aces pyramid. From the bottom of the pyramid it starts with adverse childhood experiences, then social, emotional, and cognitive impairment. Next is adoption of health-risk behaviors, then disease, disability, and social problems. The top is early death.
    Figure 1. The ACEs pyramid

    The term Adverse Childhood Experiences (ACEs) is defined as a traumatic experience that happens to someone before the age of 18 years that the person “recalls” as an adult.[1]

    ACEs can include sexual, psychological, or physical abuse. ACEs have been linked to premature death and various health conditions and risks.[2]

    ACEs score

    To determine your own ACEs score, visit this website

    Several studies have shown that ACEs are associated with health-related risk factors such as substance abuse, risky sexual behavior, obesity, cardiovascular disease, cancer, and diabetes.[3] Having multiple ACEs is an important risk factor for several unfavorable health outcomes, including early death. The research suggests that the impact of these adverse experiences in childhood on adult health status is strong and cumulative.[4]

    Best-practice recommendations for preventing ACEs entail reducing child abuse and neglect by:

    • Strengthening economic supports to families,
    • Supporting parents via education about positive parenting techniques,
    • Providing high-quality care and education immediately following a child’s birth,
    • Improving parenting skills to enhance healthy child development and well-being, and
    • Providing early interventions to reduce adverse effects and to prevent future risks. [5]

    Video Example

    Watch Dr. Bruce Perry talk about reducing the effects of trauma.

    Additional video examples can be viewed on the CDC’s YouTube channel.

    Further Reading

    Center for Disease Control and Prevention: Adverse Childhood Experiences Handout [PDF]

    Center for Disease Control and Prevention: Adverse Childhood Experiences website


    1. Centers for Disease Control and Prevention. (2019). About adverse childhood experiences. Retrieved from www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/aboutace.html↵
    2. Center on the Developing Child at Harvard University. (n.d.). What are ACEs? And how do they relate to toxic stress? Retrieved from https://developingchild.harvard.edu/resources/aces-and-toxic-stress-frequently-asked-questions/
    3. Ximenes, R. B. B., Ximenes, J. C. M., Nascimento, S. L., Roddy, S. M., & Leite, A. J. M. (2019). Relationship between maternal adverse childhood experiences and infant development: A systematic review. Medicine, 98(10) doi: 10.1097/MD.0000000000014644 ↵
    4. Ximenes, R. B. B., Ximenes, J. C. M., Nascimento, S. L., Roddy, S. M., & Leite, A. J. M. (2019). Relationship between maternal adverse childhood experiences and infant development: A systematic review. Medicine, 98(10) doi: 10.1097/MD.0000000000014644 ↵
    5. Centers for Disease Control and Prevention. (2020). Prevention Strategies. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau. Retrieved from https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/prevention.html

    This page titled 1.5: ACEs is shared under a CC BY-NC-SA 4.0 license and was authored, remixed, and/or curated by Diana Lang via source content that was edited to the style and standards of the LibreTexts platform; a detailed edit history is available upon request.