What are ACEs?

Trauma, by definition, is unbearable and filled with emotional landmines. Adverse Childhood Experiences (ACEs) and the symptoms that follow have its greatest impact on children. An ACE history counts experiences of abuse, neglect and household challenges that happened to us as children, before the age of 18. ACEs are stressful or traumatic experiences that “happen” in childhood. The are not controllable events or situations. They can be a single event. Or they can be an ongoing struggle where safety, security, trust, or even our very sense of self is threatened or violated.

The Original 10 ACEs (Adverse Childhood Experiences)


As many of us know, these 10 ACEs are not the only kind of adversities we may face as children. Millions of us have experienced discrimination, poverty, and racism as kids, and these experiences can have similar impacts as ACEs. Other common childhood adversities beyond the ten ACEs in the original study include:

  • Discrimination based on race, ethnicity, gender identity or sexual orientation (such as LGBTQ+), religion, learning differences, or disabilities Poverty
  • Racism: Systematic and institutional
  • Other violence : getting bullied, experiencing violence yourself, or seeing others get hurt in your neighborhood, community or school
  • Intergenerational and cultural trauma, like the displacement and genocide of indigenous people, slavery, and the Holocaust
  • Separation from a parent or caregiver because of immigration or foster care
  • Other big changes in life, like migration or immigration, being a refugee or seeking asylum, moving to a new area where you don’t know anyone, or separation from someone important to you
  • Bereavement and survivorship, like having a relative or caregiver die, or surviving an illness, injury or accident, or natural disaster
  • Adult responsibilities as a child : caring for someone who’s sick or disabled, or being the one responsible for getting food on the table at a young age
  • Poverty : lacking enough resources to provide the necessities of life i.e. food, clean water, shelter, and clothing

ACEs and Toxic Stress

The trauma that started “out there” is now played out on a battle field within the body When you’re in a forest and unexpectedly come across a bear, a mortal threat, our brain’s alarm system is triggered. Our stress response is activated and we experience numerous sensations: fear, heart palpitations, panic, etc.

What happens when that bear comes home every night? When this system is activated over and over and over again? Children are especially sensitive to high doses of adversity because their brains and bodies are just developing. A child’s brain alarm tell them happening. It triggers our fight, flight, or freeze response again and again and overloads the system. When our stress response is activated, it also activates our immune system, because if you are in a forest and there’s a bear, you want your immune system to be primed to bring inflammation to stabilize the wound. This all was designed to protect our lives and protect our health. So adverse childhood experiences are associated with changes in the structure and function of children’s developing brains, in their developing hormonal systems, and even in the way their DNA is read and transcribed.

  • Toxic stress can weaken the architecture of the developing brain, with long-term consequences for learning, behavior, and both physical and mental health.
  • Traumatized children become stuck, stopped in their growth because they can’t integrate new experiences.
  • If trauma is not resolved, the stress hormones the body secretes to protect itself, keeps circulating and the emotional and sensory response — mental images sounds, thoughts physical sensations — keep getting replayed again and again.

Frequently asked questions on raising kids with ACEs

How early can my child be impacted by ACEs?

No child is too young to be affected by ACEs. Babies are more vulnerable than any other age group. Their brains are developing rapidly through every new experience and encounter. ACEs and toxic stress can cause developmental challenges, along with a host of other cascading effects, as babies and toddlers grow, especially if they’re not surrounded by safe, nurturing relationships and environments.

Is it always obvious if my child is affected by ACEs?

ACEs can be impactful even if they don’t appear to cause harm in the moment. When kids don’t have their needs met over a period of time, they may demonstrate a lack of focus and inability to concentrate that’s serious enough to result in an ADHD diagnosis. When kids witness interpersonal violence between adults, they may develop asthma. When a caregiver’s anger boils over frequently, with screaming and a loss of emotional control – even without any contact – the results may be as harmful biologically to children as physical abuse.

I’m wondering if some of my kids’ symptoms, health issues, or behaviors might be connected to their ACEs. What should I do?

We can talk to our doctors. Opening up to our doctors or our kid’s pediatrician about our ACE history, along with any concerns we may have about our kid’s health, may help them provide our families with more effective care.

Our doctors may provide formal screening – for us and/or our children, where appropriate – for ACEs, developmental challenges, behavioral health conditions, interpersonal violence, substance abuse, or other issues or conditions. They can help with (or refer us to help for) many difficulties from our own childhood adversity that we’re concerned may be affecting our kids’ well-being now.

It may also be helpful to talk to our children’s teachers or counselors, or other trusted adults in their lives so that they can help actively address our kids’ needs and provide the best support they can offer.

We may want to keep in mind that in most states and US territories, most people who work with kids are required by law to report to child protective services or law enforcement any known or suspected child abuse or neglect.

Do children and teens use the same tool to assess their ACE histories as adults?

While the original ten ACEs are the same for all ages, there are different tools available to explore the ACE history of our child or teen. These tools include additional risk factors for toxic stress, like bullying and discrimination

As a parent with ACEs, how do I cope during stressful situations - like a big life transition, or an ongoing crisis, like the pandemic?

When situations in the present feel overwhelming and out of our control, they can activate similar feelings from past traumas. As parents with ACEs, we likely felt like things were too much or not in our control when we were growing up. Recognizing and acknowledging these feelings is an important first step. Then we can take some time to focus on the things we can control. Dwelling on uncertainty and lack of control can be where stressful situations turn traumatic. The key is to break things down into simple steps that we can control to reduce our stress hormones. Sometimes what we can control is tiny – maybe even as simple as focusing on our breath. Spend time in nature. A solid sleep routine. Find ways to move every day. Eat nourishing foods. Reach out to a friend. Take time to care for our mental health. Pick one thing to start with, something within our reach today.

I’m trying to break the cycle and do things differently with my kids. What if I’m feeling overwhelmed while parenting?

As parents with ACEs, we’re more likely to be coping with our own lasting physical and mental health consequences. We also may be more likely to lash out verbally, or to have more difficulty controlling our impulses, especially when we’re feeling overwhelmed. When we’re dealing with intense stress – the pandemic, economic stress, job stress, then challenges with kids on top of all that – we may find ourselves pushed near the edge of our coping abilities. Crisis resources are available any time to help us. Asking for help is a sign of strength and resilience.

Emotional Toolkit for Kids & Adults

Traumatized children have their own unique way of understanding, coping, and navigating through their physical and emotional world, often becoming stuck in flight, fright, or chronic shutdown mode.

Discovering a variety of healthy coping strategies NOW will prevent children from developing dangerous “quick fixes” to stress LATER