Adverse Childhood Experiences (ACE): Information Counselors Must Know


Adverse Childhood ExperiencesThe Adverse Childhood Experiences (ACE) study has been called “the largest public health study you’ve never heard of”. For those of us in the counseling profession, I would argue it’s also one of the most important. The study analyzed the correlation between specific childhood experiences and adult mental and physical health. The adverse childhood experiences consists of 10 categories, five of which include various types of abuse, while the remaining five focused on family members and the household.

The categories of experiences are as follows:

  • Physical Abuse
  • Emotional Abuse
  • Sexual Abuse
  • Physical Neglect
  • Emotional Neglect
  • Mother Treated Violently
  • Substance Abuse in Household
  • Household Mental Illness
  • Parental Separation or Divorce
  • Incarcerated Household Member

A positive response in a category raises your ACE score by one, for a total possible score of 10. The ACE score influences the amount of stress experienced by the person and has shown strong correlation with health problems in several areas including:

  • Alcoholism and alcohol abuse
  • Chronic obstructive pulmonary disease (COPD)
  • Depression
  • Fetal death
  • Health-related quality of life
  • Illicit drug use
  • Ischemic heart disease (IHD)
  • Liver disease
  • Risk for intimate partner violence
  • Multiple sexual partners
  • Sexually transmitted diseases (STDs)
  • Smoking
  • Suicide attempts
  • Unintended pregnancies
  • Early initiation of smoking
  • Early initiation of sexual activity
  • Adolescent pregnancy

While the correlation between adverse childhood experiences and adult health may not be that surprising, the level of correlation is astounding. For example, those with an ACE score of four or more experience between a 400% to 1200% increase risks for alcoholism, drug abuse, depression and suicide when compared with a score of zero. The effects increase consistently for ACE scores one through five but seem to flatten somewhat beyond that.


What does this information mean for us? Being able to analyze the historical experiences of our clients may help them understand and conceptualize the challenges they face as adults. Also, those with high ACE scores are likely to have children with high ACE scores. Some research indicates social service workers may have elevated ACE scores themselves. Knowing this can help us create more trauma informed practices that benefit both workers and patients. Hopefully, we can begin to reduce the ACE scores of future generations through education and effective intervention.


9 thoughts on “Adverse Childhood Experiences (ACE): Information Counselors Must Know

  1. This is very important project . I hope to establish a center for human development in gulf area . I will be lucky for our common cooperation .

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