An ACE Study Primer

Adverse Childhood Experiences (ACEs)  can harm a child’s developing brain and the development of their organs so profoundly that the effects show up decades later in adulthood. The ACE Study, a collaboration between the Centers for Disease Control and Kaiser Permanente Hospital in San Diego, determined that they are the origin of many of our nations chronic diseases, most mental illnesses, and are at the root of most violence.

The 10 ACEs the researchers measured are defined as:

— 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.

People have an ACE score of 0 to 10. Each type of trauma counts as one ACE. Each ACE counts as one, no matter how many times it occurs. According to Dr. Robert Anda, one of the Co-Principal Investigators, these 10 ACEs were chosen because there were existing national programs to address them. For example, the death of a parent is an ACE, but wasn’t chosen because there was no national program to address it. Also, all ACE scores are not created equal. The ACE score is an aggregate score, so the severity is not demonstrated. For example, a person with an ACE score of 1 — but it was a horrific adverse experience — could have more significant outcomes than someone with a score of 2 whose adversity was’t as horrific, or at all.

Please understand this — the ACE score is NOT: a diagnostic tool; not a screening tool; not a predictor at the individual level; and not a fun quiz. It is a predictor of public health risk factors. Why is the ACE score a powerful predictor?

  • ACEs are common
  • They are highly interrelated
  • They are cumulative across the lifespan — generating high risk for many problems
  • If left unchecked, they tend to be progressive
  • They are inter-generationally related — the are often passed on from one generation to another
  • Statistically — by research in Washington State — ACE scores will increase generation to generation unless we change something

So, what do we change? We start first by learning about the ACE Study. This simple primer is not the whole story. In fact, please do not draw conclusions about yourself or others from this brief article. You can go here to learn more about the history, the science, the data, and the outcomes of the ACE Study.

The second thing we can do is change the way we think about ourselves and others. Once you understand the origins of social behaviors and physical health issues (childhood adversity), it will change the conversation you have about others in your mind from “What’s wrong with you?” to “I wonder what happened to you?”

Why are ACEs significant?

There are two main reasons:

1. The ACE Study revealed four main discoveries:

  •  ACEs are common…nearly two-thirds (64%) of adults have at least one.
  •  They cause adult onset of chronic disease, such as cancer and heart disease, as well as mental illness, violence and being a victim of violence
  • ACEs don’t occur alone….if you have one, there’s an 87% chance that you have two or more.
  • The more ACEs you have, the greater the risk for chronic disease, mental illness, violence and being a victim of violence. For example, 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 suicide by 1200 percent. People with high ACE scores are more likely to be violent, to have more marriages, more broken bones, more drug prescriptions, more depression, more autoimmune diseases, and more work absences. People with an ACE score of 6 or higher are at risk of their lifespan being shortened by 20 years.

2. The 17,000 ACE Study participants were mostly white, middle- and upper-middle class, college-educated, and all had jobs and great health care (they were all members of Kaiser Permanente).

If you’d like a presentation on the ACE Study for your organization, group or community please click on Request An ACE Study Presentation. You can also call ChildWise at 406-513-1177