Adverse Childhood Experiences (ACEs) are traumatic events that occur during childhood (from age 0 to 17 years), these events range from experiencing abuse and witnessing violence to growing up in a household with substance and mental health problems. ACEs are strongly linked to risky health behaviours, chronic physical and mental health conditions, low life potential, and early mortality. There is a direct correlation between the number of ACEs and the risk for these negative outcomes.
The first ACE study was started in 1995 by Kaiser Permanente's Department of Preventive Medicine division, after several astute researchers noticed counterintuitive findings in several weight loss programs, where study dropouts were actually successfully losing weight.[1] A link between obesity and abusive childhood experiences was later established by these researchers.
ACEs have been found to have a graded dose-response relationship with more than 40 outcomes.[2] These outcomes include: smoking, alcohol use disorder, chronic health problems, mental health problems, substance misuse, reduced educational achievement, reduced occupational achievement, obesity, heart disease, cancer, respiratory disease, diabetes, and suicide. However, ACEs alone do not mean that an individual must experience poor outcomes. Positive experiences or protective factors can protect against many of the negative outcomes even after an ACE has occurred.
There is a strong, dose-response relationship between the number of ACEs and the probability of lifetime and recent depressive disorders.[3]
ACEs are categorized into 3
groups: abuse, neglect, and household challenges. Each category is further divided into multiple subcategories. These questions all refer to the respondent’s first 18
years of life.
5
years older than you ever touched or fondled your body in a sexual way, made you touch his/her body in a sexual way, attempted to have any type of sexual intercourse with you.Strategy | Approach and Prevention |
---|---|
Strengthen economic supports to families | • Strengthening household financial security • Family-friendly work policies |
Promote social norms that protect against violence and adversity | • Public education campaigns • Legislative approaches to reduce corporal punishment • Bystander approaches • Men and boys as allies in prevention |
Ensure a strong start for children | • Early childhood home visitation • High-quality child care • Preschool enrichment with family engagement |
Teach skills | • Social-emotional learning • Safe dating and healthy relationship skill programs • Parenting skills and family relationship approaches |
Connect youth to caring adults and activities | • Mentoring programs • After-school programs |
Intervene to lessen immediate and long-term harms | • Enhanced primary care • Victim-centered services • Treatment to lessen the harms of ACEs • Treatment to prevent problem behavior and future involvement in violence • Family-centered treatment for substance use disorders |