The ACEs Test

March 10, 2020

What It Means and What It Doesn’t Mean

        Adverse Childhood Experiences (ACEs) are potentially traumatizing childhood events experienced before age 18. Research shows a link between exposure to ACEs and health and well-being over our lifespans. Having a mentally ill parent qualifies as an ACE.

        ACEs can be triggered by poverty, abuse or neglect, parental substance abuse or mental illness, and exposure to violence—to name just some causes.

        Essentially, the higher your ACE score, the more likely you are to have physical and mental health problems as well as emotional and social difficulties later in life. Researchers caution, however, that your ACE score is meant as a guideline. Many other factors can influence health outcomes. Further, positive experiences early in life and having just one supportive adult in your early life can build resilience and offset effects of adversity.

        Further, researchers note that “a high ACE score can act as a rough first screener to identify people who may benefit from services, but it cannot tell you what specifically you are at risk for, nor what to do about it.”(From https://developingchild.harvard.edu/resources/aces-and-toxic-stress-frequently-asked-questions


What’s Your ACE Score? 


Before your 18th birthday:


1. 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 ___


2. 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 ___


3. 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 ___


4. 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 ___


5. 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 ___


6. Were your parents ever separated or divorced? 


No___ If Yes, enter 1 ___


7. 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 over at least a few minutes or threatened with a gun or knife?


No___ If Yes, enter 1 ___


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


No___ If Yes, enter 1 ___


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


No___ If Yes, enter 1 ___



10. Did a household member go to prison?


No___ If Yes, enter 1 ___


This survey was retrieved from “Take the Ace Quiz—And Learn What It Does and Doesn’t Mean,” Center on the Developing Child, Harvard University, https://developingchild.harvard.edu/media-coverage/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean/. Source: NPR, ACEsTooHigh.com. This ACEs quiz is a variation on the questions asked in the original ACEs study conducted by CDC researchers.  



What Does Your ACE Score Mean?


Harvard researchers report, “There is a powerful, persistent correlation between the more ACEs experienced and the greater the chance of poor outcomes later in life, including dramatically increased risk of heart disease, diabetes, obesity, depression, substance abuse, smoking, poor academic achievement, time out of work, and early death.” 

See: https://developingchild.harvard.edu/resources/aces-and-toxic-stress-frequently-asked-questions)          

   According to ACEsConnection, “The more ACEs you have, the greater the risk for chronic disease, mental illness, violence and being the victim of violence . . . People with an ACE score of 4 are twice as likely to be smokers and seven times more likely to be alcoholic. Having an ACE score of 4 increases the risk of emphysema or chronic bronchitis by nearly 400 percent, and attempted suicide by 1200 percent . . . People with an ACE score of 6 or higher are at risk of their lifespan being shortened by 20 years.” 

(From https://acesconnection.com/blog/aces-101-faqs)

Granted, for those of us with high ACE scores, these research findings may seem overwhelming—even alarming, but remember that resilience can be built at any age. If you are the adult child of a mentally ill mother like me, you can find pathways to resilience that mitigate the impact of early adversity. You can move on to lead a happy, healthier life.


(Note: As reported by ACEsConnection, subsequent to the ACE Study, other ACE surveys have expanded types of ACEs to include racism, gender discrimination, witnessing a sibling being abused, witnessing violence outside the home, witnessing a father being abused by a mother, being bullied by a peer or adult, involvement with the foster care system, living in a war zone, living in an unsafe neighborhood, losing a family member to deportation, and other experiences. From: “ACEs Science 101 (FAQs),” https://www.acesconnection.com/blog/aces-101-faqs 



Additional resource:

https://www.cdc.gov/violenceprevention/acestudy/about.html 


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