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Understanding Adverse Childhood Experiences (ACEs)

Overview

Adverse childhood experiences (ACEs) are things that happen before adulthood that can cause trauma. Or they're things that make a child feel like their home isn't safe or stable. Some examples of ACEs include violence, neglect, abuse, and family mental health or substance use problems.

What are some examples of ACEs?

Here are some of the most common types of ACEs.

  • Emotional abuse. An adult insults, puts down, or swears at a child. Or an adult acts in a way that makes the child afraid they will be hurt.
  • Physical abuse. An adult hits, kicks, or physically hurts a child.
  • Sexual abuse. An adult (or older child) touches a child in a sexual way, makes a child touch them in a sexual way, or has sex (or tries to have sex) with a child.
  • Violence in the home. A child sees adults in the home physically harming each other.
  • Substance use problems in the home. A household member has problems with drinking, drug use, or misusing prescription medicines.
  • Mental health problems in the home. A household member is depressed, has mental health issues, or has attempted or died by suicide.
  • Emotional neglect. An adult in the home doesn't make a child feel safe, protected, and cared for.
  • Physical neglect. An adult in the home doesn't make sure that a child's basic needs are met.
  • Divorce or separation of parents.
  • Having a household member go to prison.

There are other childhood experiences that can cause trauma as well. For example, things like discrimination, being bullied, and being in foster care can also cause stress that can have long-term effects.

What happens when you've had ACEs?

ACEs are common. Most people have at least one. How you are affected by an ACE depends on the type of ACE and how much distress it caused.

People who have multiple ACEs tend to have more physical and mental health problems than people with few or no ACEs. This may be because of physical changes that can happen in a child's body when they have ongoing stress. It may also be because of health-harming behaviors (like smoking or risky sexual behavior) that are more common in people with more ACEs.

But having had ACEs doesn't mean that you will have physical or mental health problems. It just means that your risk for those things is higher. There are things you can do to reduce the effects of ACEs and take care of your mental and physical health.

How can you reduce the effects?

The best thing you can do is to take care of your mental, emotional, and physical health. Here are some ways to do that.

  • See a counselor. A counselor can help you:
    • Work through emotions about painful childhood experiences.
    • Learn how those experiences might still be affecting you.
    • Learn skills to help change negative thoughts, habits, or behaviors.
  • Address health-harming behaviors.
    • Quit smoking.
    • Avoid drugs and excessive drinking.
    • Get help if you have signs of a substance use disorder. Signs may include trying to stop using a substance but being unable to, and using a substance even though it harms you or your relationships.
  • Make healthy habits.
    • Eat a balanced diet.
    • Get enough sleep.
    • Get regular physical activity.

Many adults have spent a lifetime learning to live with the effects of ACEs. But it's never too late to get help or to make positive changes.

Related Information

Credits

Current as of: February 9, 2022

Author: Healthwise Staff
Medical Review:
Andrew Littlefield PhD - Psychology, Behavioral Health
Lesley Ryan MD - Family Medicine