Children thrive in environments where they feel safe, stable, and bonded to their family. Unfortunately, children that are in contact with the child welfare system have experienced negative and often traumatic situations that can have a lasting impact. In order to support the wellbeing of children and families, the Adverse Childhood Experiences (ACEs) framework identifies discouraging conditions that children may experience, so that prevention strategies can work to reduce the likelihood of their recurrence and mitigate their effects.
What Are ACEs?
ACEs are traumatic events that occur before a child reaches the age of 18. ACEs include all types of abuse and neglect, such as parental substance use, incarceration, and domestic violence. ACEs can also include situations that may cause trauma for a child, such as having a parent with a mental illness or being part of a family going through a divorce. A landmark study in the 1990s found a significant relationship between the number of ACEs a person experienced and a variety of negative outcomes in adulthood, including poor physical and mental health, substance use, and risky behaviors.1 The more ACEs experienced, the greater the risk for these outcomes. By definition, children in the child welfare system have suffered at least one ACE. Recent studies have shown that compared with the general population, these children are far more likely to have experienced at least four ACEs (42 percent vs. 12.5 percent).2
How Can This Information Help Children?
Research about the lifelong impact of ACEs underscores the sense of urgency in implementing prevention activities to protect children from these and other early traumas. When children do experience trauma, understanding the impact of ACEs can lead to more trauma-informed interventions that help to mitigate negative outcomes. Many communities are now exploring how a focus on reducing ACEs can help prevent child maltreatment, produce healthier outcomes for children and families, and save costs down the road. The following resources provide an overview of ACEs and how healthy outcomes from positive experiences can be used to help mitigate the impact of ACEs on child development.
ACEs and Toxic Stress: Frequently Asked Questions [Infographic]
Harvard University, Center on the Developing Child (2020)
Presents an infographic that defines adverse childhood experiences (ACEs) and explains how they relate to toxic stress. The website also explores how trauma is connected to ACEs and toxic stress and how to reduce their effects.
Adverse Childhood Experiences
Child Trends (2019)
Presents key facts about adverse childhood experiences (ACEs) and examines trends related to ACEs, focusing on differences by age, race, poverty level, and parental education.
Adverse Childhood Experiences Are Different Than Child Trauma, And It's Critical to Understand Why
Bartlett & Sacks (2019)
Describes how adverse childhood experiences differ from other commonly used terms, including childhood adversity, trauma, and toxic stress. The resource defines each of these terms and provides information on them.
Preventing Child Abuse and Neglect: A Technical Package for Policy, Norm, and Programmatic Activities (PDF - 3,994 KB)
Fortson, Klevens, Merrick, Gilbert, & Alexander (2016)
Centers for Disease Control and Prevention
Presents specific strategies to prevent child abuse from occurring and approaches to reduce the immediate and long-term effects of child abuse and neglect. The package offers information to inform policies at the community and State levels.
Research Review: New Data on ACES
Prevent Child Abuse America (2019)
Explores emerging research on adverse childhood experiences (ACEs), including interventions to address the consequences of ACEs, and examines key areas of limitation associated with the current ACEs framework.
Road to Resilience: Raising Healthy Kids: Adverse Childhood Experiences
Mayo Clinic Health System (2020)
Offers information on adverse childhood experiences (ACEs) through a 6-week virtual training program to help youth combat ACEs. The training materials consist of a game board, a toolkit, and a video. Additional videos are also available.
Essentials for Childhood: Promoting Healthy Outcomes From Positive Experiences (PDF - 633 KB)
Sege & Linkenbach (2014)
Examines how safe, stable relationships in childhood promote positive health outcomes and reduce the risk of maltreatment as well as the ways in which child-serving professionals can support these relationships.
HOPE - Healthy Outcomes From Positive Experiences
Presents a multidisciplinary approach to strengthening positive childhood experiences to mitigate the effects of adverse childhood experiences on child development.
Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels (PDF - 347 KB)
Bethell, Jones, Gombojav, Linkenbach, & Sege (2019)
Examines the relationship between positive childhood experiences and socioemotional support with adult depression and negative mental health outcomes when controlling for adverse childhood experience exposure levels.
1Centers for Disease Control and Prevention. (2016). About the CDC-Kaiser ACE study: Major findings. Retrieved from https://www.cdc.gov/violenceprevention/acestudy/about.html.
2ACEs in young children involved in the child welfare system. Retrieved from https://www.flcourts.org/content/download/215886/1961262/ACEsInYoungChildrenInvolvedInTheChildWelfareSystem.pdf; Centers for Disease Control and Prevention. (2016). About the CDC-Kaiser ACE study: Data and statistics. Retrieved from https://www.cdc.gov/violenceprevention/acestudy/about.html.