What Are Adverse Childhood Experiences (ACEs)?

The Adverse Childhood Experiences Study (ACE study) confirmed the linkage between exposure to adversity in childhood and the risk of chronic disease and poor health outcomes as an adult.

Dr. Vincent Felitti, from Kaiser Permanente's Health Appraisal Clinic in San Diego and Dr. Robert Anda, from the Centers for Disease Control and Prevention (CDC)were the principle investigators in the study. More than 17,000 Health Maintenance Organization (HMO) members were included in the study (CDC).Most of the study participants were well educated, middle class, and white and consisted of a near equal percent of men and women.

Each participant underwent a thorough physical exam and gave a detailed history of any exposure in childhood to stressful or traumatic experiences. The ACE Study specifically looked at ten categories of abuse, neglect, and family dysfunction.

Each category is worth one point. Exposure to any of the ACEs before the age of 18, regardless of how often it occurred, or how long it lasted, counts as one point resulting in a total of ten points possible. This point total is the ACE score. For example: An individual has a childhood history of witnessed domestic violence in the home, was often physically abused by a parent, and had a parent who was mentally ill and suffered a substance abuse problem. Their ACE score would be four.

The evaluation is ongoing as ACE study participants continue to be followed today.