Adverse Childhood Experiences (ACEs)

ACEs PyramidWhat are ACEs?

ACEs are adverse childhood experiences that harm children’s developing brains so profoundly that the effects show up decades later; they cause much of chronic disease, most mental illness, and are at the root of most violence.

“ACEs” comes from the CDC-Kaiser Adverse Childhood Experiences Study, a groundbreaking public health study that discovered that childhood trauma leads to the adult onset of chronic diseases, depression and other mental illness, violence and being a victim of violence. The ACE Study has published about 70 research papers since 1998. Hundreds of additional research papers based on the ACE Study have also been published.

The 10 ACEs the researchers measured:
— Physical, sexual and verbal abuse.
— Physical and emotional neglect.
— A family member who is:
      • depressed or diagnosed with other mental illness;
      • addicted to alcohol or another substance;
      •  in prison.
— Witnessing a mother being abused.
— Losing a parent to separation, divorce or other reason.

Of course, there are many other types of childhood trauma — such as witnessing a sibling being abused, witnessing violence outside the home, witnessing a father being abused by a mother, being bullied by a classmate or teacher – but only 10 types were measured. They provide a useful marker for the severity of trauma experienced. Other types of trauma may have a similar impact.

Addressing ACES Offers Public Health Opportunities

  • ACES are the most preventable cause of serious mental illness.
  • ACES are the most preventable causes of drug and alcohol abuse in women.
  • ACES are the most preventable causes of HIV high-risk behavior (IV drugs, promiscuity).
  • ACES are a significant contributor to leading causes of death (heart disease, cancer, stroke, diabetes, suicide).

What can we do?
Adopt a Public Health approach to Child Maltreatment and other ACEs by:

  • Screening for ACEs in systems that serve children and families.
  • Building capacity to prevent & treat child trauma.
  • Increasing access to trauma-informed services for children & families.
  • Integrating and enhancing programs to target synergistic ACEs with highest cumulative risks.
  • Integrating trauma services across family-serving systems.


How childhood trauma affects health across a lifetime (16-minute TED Talk by Dr. Nadine Burke Harris)

The Adverse Childhood Experiences Study – the largest public health study you never heard of – started in an obesity clinic

Aces Too High

ACEs Connection

Paper Tigers Documentary

Trauma Informed Oregon

ACEs Resources in Deschutes County

The Truth About ACEs Infographic (pdf)