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The Adverse Childhood Experiences (ACE Study): Changing the conversation from “What is wrong with you?” to “What happened to you?”

It’s a common misconception that what happens to you in the past, is just that, in the past. Maybe you experienced trauma in your childhood, but why does that matter? Childhood experiences, both positive and negative, have a tremendous impact on your future as it relates to lifelong health issues. When a child or adult acts out of the norm, often the question becomes, “What is wrong with you?” With the research around Adverse Childhood Experiences, we’re beginning to understand we should rather be asking, “What happened to you?”

According to ACEs Too High, ACEs are adverse childhood experiences that harm a child’s developing brain and lead to changes in how they respond to stress. These changes can damage a child’s immune system so profoundly that the effects show up decades later. ACEs are one of the root causes of chronic disease, mental illness, and most violence.1

Through the ACE study research, conducted by Vincent J. Felitte, MD, Kaiser Permanente Medical Program in San Diego, California and Rob Anda, MD, Center for Disease Control in Atlanta, GA, we have a better understanding of the long-term impact of childhood trauma and the reality that time does not heal all wounds without intervention. Ignoring trauma does not make it go away. ACE research continues today as many states continue to gather data that supports the original study.

There are 10 types of childhood trauma measured in the ACE Study. Five are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. Five are related to other family members: an alcoholic parent, a mother who is a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. So a person who’s been physically abused, with one alcoholic parent, and a mother who was beaten up has an ACE score of three.1 You can take the ACE test here.

Without the support of caring and competent adults, stress can become toxic for children, with profound effects on brain structures and functions that develop later in childhood. The common denominator of these ACEs is that they are all predictable. Our brains become wired by our experience in trying to make sense of the world, leaving children at risk of mental health issues, inability to mediate and regulate emotional responses, social interaction deficiencies, and difficulty with abstract thinking leading to problems in school and later with functioning in the world as adults.

This awareness of the connection between what happens to us as children and how we make sense of the world later as adults launched the Trauma Informed Care movement. This approach focuses on experience first, helping to understand emotional and psychological struggles. This is where the shift to understanding what has happened to you begins. Therapists trained in trauma informed treatment can assist individuals to effectively heal from childhood trauma when mental health intervention is needed or desired.

Watch Pediatrician Nadine Burke Harris’s TedMed Talk which explains that the repeated stress of abuse, neglect, and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain.



This post is post number 1 of 3 in our ‘ACEs’ blog series that will run through April. Check out blog two to learn about the long-term consequences of abuse, and blog three about how to move forward in resilience. 

1. ACES Too High


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