What are ACES?

In the mid 1990s, the CDC conducted a study of 17,000 volunteers in San Diego. The study was made up of mostly white, college educated, gainfully employed people. Fifty percent were women and the average age of the volunteer was 57 years old. Through this study, we learned that 28% of them had endured physical abuse, 21% had been victim to sexual abuse and 40% of those 17,000 people had endured two or more traumatic instances in their youth. These Adverse Childhood Experiences, or ACES, as they’ve come to be known, include physical and sexual abuse, neglect, witnessing violence, mental illness and substance abuse in the home, natural disasters, war and incarceration of a family member. But the study did more than give us data on the number of people who have endured trauma in their childhoods, it also helped the researchers learn about the impact that trauma can have on a person and their health, long after they have grown into adulthood.

Infographic: The Truth About ACEs

The CDC study and others like it since have shown us that the number of ACES a person has experienced correlates with the likelihood of illness and addiction in their lives. A person with four ACES, for example, has a 700% increase in likelihood that they will become an alcoholic. They are two times more likely to be diagnosed with cancer as well. Someone with a score of six ACES is 3000% more likely to attempt suicide. A high ACES score also increases the chances that a person will suffer from heart disease, obesity and emphysema. They are also more susceptible to mental illnesses like anxiety and depression.

Infographic: The Truth About ACEs

With the dire effects ACES seem to have on adults, years after their trauma, we must also take a look at how it affects children as it is happening. Research has shown that children exposed to ACES have high levels of what is called “toxic stress”. According to the Harvard’s National Scientific Council on the Developing Child, toxic stress refers to strong, frequent, prolonged activation of the body’s stress management system. This causes the body to overproduce stress hormones like cortisol and adrenaline, and forces the developing brain to create neural connections involved with anxiety, fear and impulsivity, while reducing the connections associated with reasoning, planning and behavior control. This can make it difficult for a child to focus and learn and increase their impulsive and aggressive behaviors. A child with an ACES score of 3 is three times as likely to fail academically, five times more likely to have attendance issues and six times more likely to have behavioral problems. Additionally, we have see that these children suffer in their social-emotional development, facing difficulties with trusting caregivers and building and maintaining healthy relationships with the peers and adults in their lives.


Unfortunately, the effects that trauma and toxic stress can have on children can cause permanent, lasting damage. But that doesn’t mean that all hope is lost! The presence of a sensitive and responsive caregiver can prevent elevations in cortisol in children. We as a field are moving towards training our teachers to practice what is being called “Trauma Informed Care” in an effort to counter the effects of childhood trauma. Teachers trained in TIC help children with their social-emotional development, coach them on coping strategies and guide families to solutions as well. By avoiding a punishment approach, which can re-traumatize the child and using positive reinforcement and behavior supports, we can help the children in our care as they build resilience and help break the cycle for the next generation.

In the coming weeks we will take a look at what steps you can take in your classroom to foster resilience in children and their caregivers, activities to help boost social-emotional learning and positive behavior support strategies you can use when faced with difficult behaviors.

Until then, take a moment to look over this ACES questionnaire and perhaps find out what your own ACES score is: ACES Questionnaire.


One thought on “What are ACES?

  1. Great article and super important! As an ECE, I try to be super aware of my kids behavior, after all behavior is communication, and if we can understand the why, we can make appropriate plans to help the child reach self-regulation and have a fuller life and learning experience.

    Liked by 1 person

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