Adverse Childhood Experiences

Ever heard of an “ACE score”? “ACE” in this instance stands for “Adverse Childhood Experiences,” also known as early trauma events that may have happened in your life before you became an adult.

You can find a free printable copy of the ACE questionnaire here. The questions on this tool assess how many different types of childhood trauma you may have experienced during your formative years, before age 18. 

I began using this screening tool regularly in 2018, when The Deepest Well by Dr. Nadine Burke Harris was released and opened a large-scale conversation within health and mental health about the impacts of these early experiences on long-term health. Trauma-informed care had always been part of my own practice as a social worker, but I became fascinated with the book’s case examples and their applications for my clients. 

Mental and physical health outcomes can be affected by early experiences in many ways. Children going through abuse, neglect, or other hardships may lose trust in others to provide safety or care for them, which can affect the foundation for relationships in the future. They may dissociate, or feel detached from their body, in order to survive the day-to-day. They may blame themselves or feel that the adversity was their fault, due to their limited capacity to understand adult issues at a child’s age and stage. They may experience hyperarousal or a constant feeling of scanning the environment for threats. Feeling in a constant “fight or flight” state causes elevated cortisol levels and inflammation in the body, and a reduced ability to rest and recover from adverse events.

It is important to acknowledge a client’s history of adverse childhood experiences, even if “childhood” was a long time ago. These experiences do create a biological and emotional framework that carries an individual through crucial years of development up through the present day. It is never too late to help create a newfound sense of safety, connection with self, and assurance that trauma and hardship aren’t a child’s fault or responsibility. Working through these issues, even later in life, can still bring healing.