Adverse Childhood Experiences, commonly known as ACEs, refer to traumatic childhood events with significant and lasting adverse effects in all aspects of later life.

The term was first coined in 1998 in a study by the Center for Disease Control and Prevention (CDC) and the Kaiser Permanente healthcare organization. The researchers determined that suffering traumatic experiences early in life can lead to chronic health conditions, mental illness, and substance abuse, among other negative experiences. 

However, suffering from ACEs doesn’t mean all hope is lost because there are ways to mitigate their effects. With enough help, anyone who suffers ACEs can live a fulfilling and healthy life. 

Risk Factors for ACEs

Identifying the risk factors for ACEs is a critical step towards preventing these experiences and ensuring a healthy, supportive environment for children. 

Individual Risk Factors

Birth complications: Babies born prematurely or with low birth weight are at higher risk of experiencing ACEs, as they often require additional medical care and support, which may strain their families.

Developmental disabilities: Children with developmental or intellectual disabilities may be at an increased risk for ACEs, as they may face unique challenges, such as communication difficulties, social isolation, and vulnerability to abuse.

Mental health issues: Children who struggle with mental health issues, such as anxiety, depression, or ADHD, may be more likely to experience ACEs, as their symptoms can create added stress on their families and increase the likelihood of interpersonal conflict.

Family Risk Factors

Parental substance abuse: Parents or guardians who abuse alcohol or drugs are likely to create an environment that fosters ACEs, as substance abuse often leads to poor decision-making, impaired caregiving, and increased risk of violence.

Domestic violence: Exposure to domestic violence, whether it is directed at the child or occurs between other family members, is a significant risk factor for ACEs, as it creates a toxic and unstable environment for the child.

Mental health issues in parents: Parents struggling with mental health issues may be more likely to expose their children to ACEs, as they may have difficulty providing a stable, nurturing environment.

Parental separation or divorce: Family instability, such as separation or divorce, can increase the risk of ACEs for children, as it often leads to financial difficulties, emotional turmoil, and potential exposure to new caregivers who may not be as invested in the child’s well-being.

Neglect: Children who experience neglect from their parents or caregivers, whether it is physical or emotional, are at high risk for ACEs, as they lack the essential support, care, and attachment needed for healthy development.

Community Risk Factors

Poverty: Families living in poverty are at higher risk for ACEs, as financial strain can lead to increased stress, inadequate resources, and limited access to support services.

Neighborhood violence: Children living in communities with high rates of crime and violence are at greater risk for ACEs, as they may be exposed to traumatic events and feel a constant sense of insecurity.

Lack of social support: Communities with limited social support networks may increase the risk of ACEs, as families and children are less likely to access necessary resources and emotional support during difficult times.

How Common Are ACEs?

The original study showed that approximately 66% of ‌adults had experienced at least one type of ACE. More recent estimates by the CDC indicate that 1 in 6 adults have experienced four or more types of ACEs.

Additionally, ACEs are more common in certain races than in others. According to the 2017-2018 National Survey of Children’s Health, the percentage of children who’ve suffered at least one ACE is:

  • 61% for non-Hispanic Black children
  • 51% for Hispanic children
  • 40% for non-Hispanic White children
  • 23% for non-Hispanic Asian children

Regardless of race, the most common ACEs are the following:

  • Experiencing psychological, physical, or sexual abuse
  • Financial adversity
  • Parental separation
  • Witnessing violence against a parent
  • Living with household members who abuse substances
  • Living with mentally ill household members
  • Living with suicidal household members
  • Living with household members who have been imprisoned

How do Adverse Childhood Events Impact Us?

ACEs can have long-lasting effects that result in complex clinical profiles in adult life. These are the most common aspects of life where ACEs increase the risk of illness and maladaptive behaviors.

Mental Health

People who suffer ACEs are at a higher risk of experiencing mental illnesses, such as depression, anxiety, and post-traumatic stress disorder (PTSD).

Additionally, according to the original study, people who suffered four or more categories of ACE had 4 to 12 times higher risks of suffering depression and attempting suicide than people who suffered none.

Physical Health

Repeated or prolonged trauma can cause “toxic stress,” defined by the Center on the Developing Child as a prolonged activation of the stress response system. This can severely impact a child’s metabolism, brain architecture, and immune system, making one more likely to develop chronic conditions that might have otherwise been avoided later in life.

A study conducted in the UK even links ACEs with a higher risk of cancer and heart, lung, and liver disease. Sexually transmitted diseases are also associated with ACEs.

According to the original study, people with four or more ACEs were more likely to self-report poor health and be less physically active, leading to severe obesity in some cases.

Social & Familial Environments

Because ACEs warp a child’s view of relationships, many adult survivors face difficulty maintaining a healthy family and social connections. They may repeatedly find themselves in abusive relationships or expose their children to ACEs.

Other social and familial consequences include the following:

  • Higher risk of being incarcerated
  • Higher likelihood of violent tendencies
  • Higher chance of experiencing early unwanted pregnancies
  • Higher unemployment rate
  • More difficulty managing finances

Substance Abuse

Adults who suffer from ACEs are at higher risk of alcoholism, tobacco, and drug use.

According to the original study, people with four or more ACEs had 4 to 12 times higher chances of experiencing health risks for alcoholism and drug abuse.

How to Mitigate the Effects of ACEs?

Realizing you are not alone and worth helping is a powerful first step. While it’s not possible to undo the trauma experienced during childhood, there are several things you can do to mitigate the effects of ACEs:

  • Reach out to friends or family that you feel safe around so they can offer support
  • Look for therapists or social workers in your area who can teach you techniques to cope with your symptoms and get to the root of your problems
  • Speak to your healthcare provider about your mental or physical illness symptoms
  • Perform exercises that relieve stress, like meditation, journaling, and breathing exercises
  • Exercise more. Physical activity fills your brain and the rest of your body with chemicals that improve your mood, boost your immune system and relieve stress
  • Join a support group. Speaking with people who experienced other ACEs can help you feel less isolated and gain coping skills

Remember that healing is a journey, and taking things one step at a time is okay. With time, effort, and support, it is possible to overcome the effects of ACEs and live a fulfilling life.