Adverse Childhood Experiences

Although you have probably never heard of it, the Adverse Childhood Experience’s study is creating a paradigm shift in the medical community’s approach to disease. 

The study, which began in 1995 and included more than 17,000 middle-class Americans, documented that adverse childhood experiences (ACEs) can clearly contribute to poor physical health outcomes and early death. 

Recently, I took the test myself, which calculates a score based on the 10 most common or significant childhood traumas. I was staggered to find that I scored an 8. Usually, a result above 6 indicates early death (though the way I see it, this is what happens when childhood trauma’s go unchecked). 

I attribute my good health to the way I have attended to my trauma over the years: seeking therapy when needed and engaging in self-care and self-love behaviours. This is the good news: the common effect of trauma can be undone.

I wanted to share with you the ACE study and to give you the test to take for yourself. At the end, I’ll offer my thoughts on the way we can undo the harmful effects of trauma and heal our lives.

The accidental beginning

The roots of the ACE study began by accident in San Diego, California, in the mid 1980’s. Dr. Vincent Felitti, the head of Kaiser’s Department of Preventive Medicine, was trying to figure out why 50% of his clients were dropping out of his obesity clinic, despite the fact that they were successfully losing weight. 

During a line of questioning with one of his drop-outs, Feleitti slipped up. Instead of asking, “How old were you when you were first sexually active?”, he asked, “How much did you weigh when you were first sexually active?”  The patient answered that she was forty pounds (18kg). Sobbing, she revealed she was only four years old, and it was with her father.

In 23 years of practice, Felitti had only come across 2 cases of incest. He decided to dig further, to see if he would find similar results in the other drop-outs. Of the 286 people whom Felitti and his colleagues interviewed, most had been sexually abused as children. He was shocked.  

The study is formed 

The ACE study was born from there. The initial surveys were from 1995 to 1997, with the participants being followed for more than fifteen years. The results showed that there was a direct link between childhood trauma and adult onset of chronic disease, mental illness, perpetration of violence, work issues and shortened life span. 

There are 10 types of childhood trauma measured in the ACE Study. Obviously, there are many other types of childhood trauma: racism, bullying, losing a caregiver, homelessness, foster care, witnessing other abuse, and many more.  These 10 were chosen for their commonality and because they are well studied in research literature.

They are:

  • physical abuse
  • verbal abuse
  • sexual abuse
  • physical neglect
  • emotional neglect
  • an alcoholic parent
  • a mother who is a victim of domestic violence
  • a family member in jail
  • a family member diagnosed with a mental illness
  • the disappearance of a parent through divorce, death or abandonment.

It is important to remember that this is not a study of low-socioeconomic, minority, or otherwise underprivileged population. This is predominately middle class families from San Diego. 

It is also important to truly take in the staggering results: Two-thirds of the 17,000 people in the study had an ACE score of at least one; and 87 percent of those had more than one. In other words, childhood trauma is insanely common. 

Take the test 

Prior to 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___If Yes, enter 1 __

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___If Yes, enter 1 __

Did an adult or person at least 5 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___If Yes, enter 1 __

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___If Yes, enter 1 __

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___If Yes, enter 1 __

Were your parents ever separated or divorced? 

No___If Yes, enter 1 __

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 for at least a few minutes or threatened with a gun or knife? 

No___If Yes, enter 1 __

Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?

No___If Yes, enter 1 __

Was a household member depressed or mentally ill, or did a household member attempt suicide?

No___If Yes, enter 1 __

Did a household member go to prison?

No___If Yes, enter 1 __

Now add up your “Yes” answers: _ This is your ACE Score

What does my score mean? 

A score over 3 increases your risk of psychological disorders, like anxiety and depression.  With a score of 4 or more, physical disorders become common. For example, the likelihood of chronic pulmonary lung disease, or COPD, increases by 390 percent; hepatitis, 240 percent; depression 460 percent; attempted suicide, 1220 percent. 

As your score rises, so does the risk of perpetrating domestic violence, being later raped, teen sexual behaviours or early intercourse, and decreased work performance.  

With an ACE score of 6 or more, the risk of a shortened life span or early death sky rockets. 

Why does this happen?

There are many theories as to why childhood trauma greatly increases the risk of mental and physical ailments and early death. First, it is commonly understood that stress can physically damage a child’s developing brain. When children are in fight or flight (and overwhelmed with stress hormones), they can’t learn or relax in school. They may not develop healthy relationships with friends, teachers or other adults. 

When children can’t focus, perform or connect, they may develop anxiety, shame, or isolation. They may use chemicals or high risk activities in a failed attempt to self-soothe their wounds.

These develop into addictions, or repetitive comfort seeking behaviours. It is these very behaviours: overeating, drug use, risky sexual behaviour, violence etc that begin to damage the physical and mental form. Further shame, guilt and isolation are layered on top, and the cycle continues. 

It is important to understand that addiction, or repetitive compulsive comfort seeking, is as natural a response to ACE’s as bleeding is to be cut. In other words, it is to be expected.

So, what do we do now? 

The answer to how we reverse, or salvage, these proven and harmful effects of childhood trauma is vague, at best. But what we do know, is that it IS possible to lead a long and fulfilled life. 

The very fact that I am here now, a fully functioning, healthy adult with an ACE score of 8, is the proof. 

The way I see it, it is the neglect, abuse, and loss of self care that leads to illness and a shortened life. Knowing this, we can see the antidote: attention, affection, self-love and self-care. 

We need to begin by starting to take care of our minds and bodies, or at the very least, to maintain our current standard of health. That may mean we need to get help. We don’t assume that the baseline of discomfort we feel, or the way we think less of ourselves, is standard. It’s not. 

If you’re not relating to yourself with self love, and kindness: you need to look into that. If there is some way you are not taking care of you: this means there is some self-loathing going on. 

As we learn to tend to ourselves: one little piece at a time, we sew the fabric of our life back together. Therapy, coaching, healthy friendships, long baths, good food, and nourishing activities all play a part in how we love and cherish who we are. 

No matter how high your score, just know this: you are not alone. There is so much support out there for you. You can change your life. 

If you’ve taken the test and your score is over one, we’d love to hear from you. We are here for whatever you need to begin your journey of self care, so please, get in touch now.  


Substance Abuse and Mental Health Services:

Centre for Disease Control:


Published by

Jenny Podorozhnaya

I am a Clinical Supervisor and Psychotherapist, Hypnotherapist, Coach and Trainer living on the Eyre Peninsula in South Australia. I have four children and two cats and am married to Dimitry. All of this keeps me reasonably busy.

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