While the original ten ACEs are used to assess all ages, there are different tools available to explore the ACE history of your child or teen.
The original 10 ACEs
Adverse Childhood Experiences
Abuse
Neglect
Household Challeges
Use
Violence
Illness
A broader look at adversity
While the original ACE study focused on ten specific categories, there are many other ways children can experience adversity that might lead to a toxic stress response. The tools commonly used to screen for ACEs in young people include a set of questions to identify additional potential sources of toxic stress including:
- Community, neighborhood, or school violence (like targeted bullying, assault, gun violence, or war or terrorism)
- Discrimination which includes being put down, excluded, or mistreated due to race, ethnicity, gender identity, sexual orientation, religion, learning differences, or disabilities
- Housing problems (not having a stable place to live, moving frequently)
- Food concerns (worries your child may not have enough to eat)
- Being separated from a parent due to foster care or immigration
- Living with a parent or caregiver with a serious physical illness or disability
- Or having lived with a parent or caregiver who died.
For teens, there are two additional factors considered:
- Being detained, arrested, or incarcerated
- Verbal or physical abuse or threats from romantic partners
While no tool can address every potential stressor our children may face, starting here can help us gain insight into how much their lived experiences may be impacting their well-being.
Outcomes
The more adversity a child experiences without support, the more likely they’ll develop a toxic stress response.
For children and teens, toxic stress could lead to health and other issues, including asthma, allergies, rashes and eczema, aches and pains, depression, self-harm, learning or behavior problems, developmental delay, ADHD, not graduating high school, early use of alcohol or drugs, and early sexual activity.
As parents, this can sound overwhelming. We face incredible odds holding our families together every day, especially those of us coping with barriers like racism, discrimination, low incomes, and communities lacking resources.
The outcomes for children and teens with high ACEs are not predetermined pathways. Our brains and bodies are amazingly resilient and ready to change — especially when we’re young.
Next steps
With our knowledge of ACEs, we can look at the behaviors and symptoms of our kids and teens through a new lens, knowing that their brains and bodies may be responding to their lived experiences.
It may also be helpful to talk with your child’s doctor, teacher, school counselor, or other trusted adults in your child’s life so they can become active members of your child’s support team. We may want to keep in mind that in many 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.
Adverse experiences aren’t the only ones that impact the health and outcomes of children and teens. Positive experiences are vital to helping kids reach their potential.
There’s a lot we can do to help provide antidotes to the adversity our children face. Nurturing, supportive relationships; safe and stable environments for living, learning and playing; engagement in community; and participation in social activities (like art, music, theater, or sports) are key elements to helping our kids thrive. Learn more about the building blocks of HOPE (Healthy Outcomes through Positive Experiences).
We also recognize that those of us who are able need to continue advocating for policies and resources that make every neighborhood and every school a safe place for kids to learn and grow. We need to ensure every community and family is equipped to provide all kids with the time, attention, care, and access they need to flourish and thrive.