The information presented here has been broadly taken from CDC-Kaiser ACE Study, from the website of Centers for Disease Control and Prevention.

Trigger Warning: This article might trigger some individuals with memories of abuse, neglect or other anxiety causing experiences.

What is ACE?

Adverse Childhood Experiences (ACE), are referred to the traumatic events an individual experiences before age 18. ACE can be seen as a broad umbrella term under which lies all types of abuse and neglect that one may experience. It includes but is not just restricted to domestic violence, parental separation or divorce, physical hitting, harsh punishments, mental illnesses in the family, substance abuse, malnutrition, poor physical and mental health etc. It can impact one’s education, relationships and job opportunities as well.

ACE can fall under three broad categories: abuse, neglect, and household challenges. Each of these categories will have multiple other subcategories as given below:

  • Abuse
    • Sexual abuse: When any adult, relative, friend, stranger or anyone from the family at least 5 years elder to the victim touched or fondled with one’s body with wrong intentions, or forces the victim to touch their body parts in a sexual way, or has indulged in forceful sexual intercourse
    • Physical abuse: A parent, or any family member who pushes, grabs, slaps, throws things, or hits in order to create hurt or injury
    • Emotional abuse: A parent, or any family member swearing, insulting, passing derogatory comments, inducing fear in an individual
  • Household Challenges
    • Violent treatment meted out on mother: When one might witness or experience harsh treatment meted out on their mother or other close family members, like if they are pushed, slapped, hit, kicked, injured, grabbed, threatened etc.
    • Parental separation or divorce: Divorce or separation between parents
    • Incarcerated household member: Any member of the house had to go to the prison
    • Substance abuse in the household: Any member of the house is an alcoholic or abuses drug excessively
    • Mental illness in the household: When any member of the house has a mental illness, or might have attempted suicide
  • Neglect
    • Physical neglect: This occurs when there is no one to take care of an individual or to protect them, take them to the doctor. This also includes situations where one doesn’t have food to eat, clean clothes to wear or stable caregivers.
    • Emotional neglect: This is when no one from the family can provide care, emotional support, and love. There is no one to act as a strength or support

Why do we need to address ACE?

The very nature of ACE is that it is an event that occurs before age 18. Now it is very likely for these events to occur at home or at school. Hence, it is important for parents, teachers and schools to be able to identify ACE, recognize its signs, and prevent the same in order to prevent its dire consequences.

What are its effects?

Experiencing ACE can lead to long-term negative outcomes. It can lead to complex trauma, poor physical and mental health and related psychological problems like depression, headaches and heart diseases. It can also reduce immunity, affecting one’s nervous system functioning.

ACE can lead to mental illnesses, traumatic brain injuries, risky behaviors like substance abuse, unsafe sex, HIV, STDs, cancer and other chronic illnesses like diabetes. It can cause unwanted pregnancies, birth complications, fetal death etc.

The ACE pyramid shows that ACE impacts one throughout their lifespan, since conception till death. During conception there can be intergenerational or historical trauma that can be passed on from the mother to the child. Beyond which social factors, negative childhood events can trigger disrupted neurodevelopment, social and cognitive impairment, leading to risky behaviors, diseases, disabilities, other complexities and finally early death!

Such is the severity of ACE and hence it is important that we know about it, understand it, and take steps to prevent it.

Preventing ACE

It is important for us to identify and be aware of ACE and its consequences. This knowledge can help in early identification of ACE and seeking help at an earlier time to prevent severe consequences. With this awareness, we can aim at reducing stigma towards seeking help, and establishing caring and nurturing environments.

The basic strategies that can be used to prevent ACE includes:

  • Strengthening economic support and ensuring financial security to families in need.
  • Preventing violence and adversity through social norms, awareness campaigns, regulations and other well devised plans
  • Ensuring a good start for children where families are engaged with schools and, there is quality child care provided. Regular home visits can help understand the family environment better.
  • Teaching skills related to ensuring one’s socio-emotional well-being, healthy relationships, parenting skills etc.
  • Mentoring and related school programs can help connect youth to caring adults and other activities
  • Interventions to prevent or lessen harm through enhanced primary care, victim-centered services, treatments that can be individual or group centered.

Know your ACE Score

The questionnaire attached to this link can help you become aware of the adverse childhood experiences you faced and how it is impacting you. With a higher ACE score, you might want to seek professional help.


Centers for Disease Control and Disease Prevention (April 13, 2020). About the CDC-Kaiser Study.

Centers for Disease Control and Disease Prevention (April 3, 2020). Adverse Childhood Experiences.

Centers for Disease Control and Disease Prevention (April 13, 2020). Prevention Strategies.

Published by Metamorphosis 2020

Metamorphosis is an initiative to shape mental health education at schools. We customize need-based and evidence-based modules for schools, teachers, and parents. These modules can be availed for free!

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