Adverse Childhood Experiences

The first step in preventing ACEs is understanding what they are.



The ACE study looked at three categories of adverse experience: childhood abuse, which included emotionalphysical, and sexual abuse; neglect, including both physical and emotional neglect; and household challenges, which included growing up in a household where there was substance abusemental illnessviolent treatment of a mother or stepmother, parental separation/divorce or had an incarcerated household member. Respondents were given an ACE score between 0 and 10 based on how many of the 10 types of adverse experiences they reported experiencing.


Adverse Childhood Experience Abuse
Adverse Childhood Experience neglect
Adverse Childhood Experience Abuse household challenges

Do you or your children have ACEs?

Adverse Childhood Experiences (ACEs) prevent us from leading

healthy and happy lives. Are you ready to take the ACE test?

Check your ACE scoreMore about ACEs

How Many of Us Have ACEs?

Almost two-thirds of adults surveyed reported at least one Adverse Childhood Experience – and the majority of respondents who reported had more than one.



Adverse Childhood Experience Abuse ACEs

People with six or more ACEs die nearly twenty years earlier (on average) than those without ACEs

Our childhood experiences have a tremendous, lifelong impact on our health and the quality of our lives. The ACE study showed dramatic links between adverse childhood experiences and risky behavior, psychological issues, serious illness, and the leading cause of death.

Adverse Childhood Experience Abuse ACEs life expectency

What can be done about ACEs?

These wide-ranging health and social consequences underscore the importance of preventing ACEs before the nurturing relationships and environment can have a positive impact on a broad range of health problems and on the development of skills that will help children reach their full potential. Strategies that address the need of children and their families include:

  • Parent support programs for teens and teen pregnancy prevention programs
  • Mental illness and substance abuse treatment
  • High-quality child care
  • Sufficient economic support for families with lower incomes
  • Home visiting to pregnant women and families with newborns
  • Parenting training programs
  • Intimate partner violence prevention
  • Family-friendly work

Economic Toll

The lifetime cost of non-fatal child mistreatment (which covers 5 of 10 ACEs) incurred annually in the United States is $401 billion.

Adverse Childhood Experience ACEs economic cost

What do ACEs cost you?

Take the quiz to learn your ACE score.

Graphic : NPR
Childhood Trauma Affects Your Future Health.
These ten confidential questions provide your warning signs.


Question 1 of 10

Before your 18th birthday, did a parent or other adult in the household often or very often…
swear at you, insult you, put you down, or humiliate you?
Yes No

Question 2 of 10

Before your 18th birthday, did a parent or other adult in the household often or very often…
push, grab, slap, or throw something at you?
ever hit you so hard that you had marks or were injured?
Yes No

Question 3 of 10

Before your 18th birthday, did an adult or person at least five years older than you ever…
touch or fondle you or have you touch their body in a sexual way?
attempt or actually have oral, anal, or vaginal intercourse with you?
Yes No

Question 4 of 10

Before your eighteenth birthday, did you often or very often feel that…
no one in your family loved you or thought you were important or special?
your family didn’t look out for each other, feel close to each other, or support each other?
Yes No

Question 5 of 10

Before your 18th birthday, did you often or very often feel that…
you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
Yes No

Question 6 of 10

Before your 18th birthday, was a biological parent ever lost to you through divorce, abandonment, or other reason?
Yes No

Question 7 of 10

Before your 18th birthday, was your mother or stepmother:
often or very often pushed, grabbed, slapped, or had something thrown at her?
sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard?
ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
Yes No

Question 8 of 10

Before your 18th birthday, did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
Yes No

Question 9 of 10

Before your 18th birthday, was a household member depressed or mentally ill, or did a household member attempt suicide?
Yes No

Question 10 of 10

Before your 18th birthday, did a household member go to prison?
Yes No

Has anything important happened before your 18th birthday that you think we should have covered?


Please answer these additional questions:

Birth Year: