The Adverse Childhood Experiences (ACE) Study

Our future relies on the healthy growth and development of today's children. As adults we are responsible for ensuring all children have the safe, stable, nurturing, and healthy environments they need to thrive. When children have supportive, loving relationships with the adults in their lives their brain architecture is built in a healthy way, forming a foundation for future growth and development. Child abuse and neglect disrupt those environments and cause a toxic stress reaction to occur in the child's brain. In a toxic stress reaction harmful chemicals flood the child's brain and body resulting in long-term social, emotional, and health consequences.

In 1995, Kaiser Permanente began asking their members undergoing comprehensive physical examinations if they would provide detailed information about their childhood experiences of abuse, neglect, and family dysfunction. Over 17,000 members participated.

The ACE Study findings suggest that certain experiences are major risk factors for the leading causes of illness and death as well as poor quality of life in the United States. Progress in preventing and recovering from the nation's worst health and social problems is likely to benefit from understanding that many of these problems arise as a consequence of adverse childhood experiences.

What is the ACE Study?

The Adverse Childhood Experiences (ACE) Study is one of the largest investigations of the link between childhood maltreatment and health and well-being later in life. Using data from 17,000 participants, the study which was conducted by the Centers for Disease Control (CDC) and Kaiser Permanente, demonstrates that trauma and adverse experiences during childhood are major risk factors for the leading causes of illness and death in United States, as well as for poor quality of life.

What are the ACEs?

The study defines “adverse childhood experiences” as exposure to:

• child abuse
• neglect
• domestic violence
• household members abusing alcohol or drugs
• other traumatic stressors

The ACE Study uses the ACE Score, which is a count of the total number of ACEs respondents reported. The ACE Score is used to measure the total amount of stress in childhood.

Major Findings

Almost two-thirds of the participants reported at least one ACE, and more than one in five reported three or more ACEs. The short- and long-term outcomes of these childhood exposures include a multitude of health and social problems. As the number of ACEs increase, the risk for health problems later in life increase. The following health problems have been linked to adverse childhood experiences:

The ACE Pyramid

Adverse experiences in childhood (ACES) disrupt normal child development, negatively impacting children’s social, emotional and cognitive development.

This leaves children vulnerable, causing many of them to adopt risky health and social behaviors such as drinking, overeating, smoking and sexual promiscuity as a means of coping with the traumas they have experienced.

These risky behaviors translate into poor health, disease, disability and early death.

Why Prevention is Important

Our children are our future parents, workers, and leaders, and they need safe, stable, nurturing environments that foster their healthy growth and devevlopment. Adverse experiences in childhood disrupt normal child development, negatively impacting their brain architecture. Such impairment leaves children vulnerable and without a strong foundation for future growth. Many children and adolescents adopt risky health and social behaviors such as drinking, overeating, smoking and sexual promiscuity as a means of coping with the traumas they have experienced. Eventually, these risky behaviors translate into poor health, disease, disability and early death.

For More Information

Visit the Center for Disease Control's Adverse Childhood Experiences Study