Adverse Childhood Experiences

Understanding the lasting effects of negative events in a child’s life

What Are ACEs?

Adverse childhood experiences (ACEs) are potentially traumatic events in a child’s life that can have negative and lasting effects on health and well-being. These experiences occur before the age of 18 and are remembered by that child as an adult.

Such traumatic events may include: psychological, emotional, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill, suicidal, criminal or imprisoned. Maltreatment (child abuse, sexual abuse, neglect, bullying, etc.) causes chronic stress that can disrupt early brain development, and the development of the nervous and immune systems.

Understand how your childhood could have an impact on you:

The Negative Effects of a High ACES Score

Early
Death

Risky Health
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Chronic Health
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Your ACEs aren’t the full story. Research shows that Positive Childhood Experiences (PCEs), which stem from safe, stable, nurturing relationships and environments, have the power to prevent or protect children from the negative impacts of Adverse Childhood Experiences (ACEs).

sad kid holding adult hand - sexual abuse

Effects & Life Outcomes From Adverse Childhood Experiences

Adverse Childhood Experiences have a strong and cumulative impact on the health and functioning of adults. Children who are abused or neglected are at higher risk for health and social problems as adults.

The toxic levels of stress or trauma experienced by a child is linked to poor physical and mental health throughout life.

These problems include lower educational achievement, lower economic success, impaired social success in adulthood, alcoholism, depression, drug abuse, eating disorders, obesity, high-risk sexual behaviors, smoking, suicide, and certain chronic diseases.

ACEs Facts

  • Three in four high school students reported experiencing one or more ACEs (Adverse Childhood Experiences), and one in five experienced four or more ACEs.
  • ACEs that were most common among high school students were emotional abuse, physical abuse, and living in a household affected by poor mental health or substance use.
  • Preventing ACEs could reduce suicide attempts among high school students by as much as 89%, prescription pain medication misuse by as much as 84%, and persistent feelings of sadness and hopelessness by as much as 66%.
  • Estimates show that preventing ACEs could reduce cases of heart disease by 22% and depression by 78% for adults.
  • ACEs are highest among females, American Indian or Alaska Native and multicultural youth, and gay, lesbian, bisexual, or questioning youth.
  • ACEs-related health consequences cost an estimated $14.1 trillion dollars annually in the United States in direct medical spending and lost healthy-life years.

How do ACEs relate to toxic stress?

ACEs research shows the correlation between early adversity and poor outcomes later in life. Toxic stress explains how ACEs ”get under the skin” and trigger biological reactions that lead to those outcomes. In the early 2000s, the National Scientific Council on the Developing Child coined the term “toxic stress” to describe extensive, scientific knowledge about the effects of excessive activation of stress response systems on a child’s developing brain, as well as the immune system, metabolic regulatory systems, and cardiovascular system. Experiencing ACEs triggers all of these interacting stress response systems. When a child experiences multiple ACEs over time—especially without supportive relationships with adults to provide buffering protection—the experiences will trigger an excessive and long-lasting stress response, which can have a wear-and-tear effect on the body, like revving a car engine for days or weeks at a time.

Importantly, the Council also expanded its definition of adversity beyond the categories that were the focus of the initial ACE study to include community and systemic causes—such as violence in the child’s community and experiences with racism and chronic poverty—because the body’s stress response does not distinguish between overt threats from inside or outside the home environment, it just recognizes when there is a threat, and goes on high alert.

What can we do to help mitigate the effects of ACEs?

For those who have experienced ACEs, there are a range of possible responses that can help, including therapeutic sessions with mental health professionals, meditation, physical exercise, spending time in nature, and many others.

The ideal approach, however, is to prevent the need for these responses by reducing the sources of stress in people’s lives. This can happen by helping to meet their basic needs or providing other services.

Likewise, fostering strong, responsive relationships between children and their caregivers, and helping children and adults build core life skills, can help to buffer a child from the effects of toxic stress.

Every action shapes the next generation.

Join us in preventing childhood trauma and empowering parents with the tools to raise confident, connected kids.

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References & Sources

1. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-16935-7 (2023 / 25 years newer) “Association between childhood adversities and premature and potentially avoidable mortality in adulthood: a population-based study”
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC9218229/ (2022 / 8 years newer) “Regional prevalence of adverse childhood experiences in the United States using a nationally representative school-based sample”
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC7592151/figure/f2/ (2020 / 9 years newer) Infographic on the biological changes that can occur due to adverse childhood experiences, etc.
4. https://www.cdc.gov/violenceprevention/pdf/ACEs-Prevention-Resource_508.pdf (2019 / 5 years newer) “Adverse Childhood Experiences Prevention Resource for Action”
5. https://developingchild.harvard.edu/resources/infographics/what-we-can-do-about-toxic-stress/ (2019 / 1 year newer) “What We Can Do About Toxic Stress”
6. https://www.cdc.gov/aces/about/index.html Centers for Disease Control and Prevention. (2025). About Adverse Childhood Experiences.