Childhood Experiences: They Make Us Who We Are

The term ‘Adverse Childhood Experience’ or simply ‘ACEs’ refers to a range of negative situations a child may face or witness throughout their childhood and before the age of 18.

ACEs can impact kids’ health and well-being, and they can have long-term effects on adults’ health and wellness. They can even have consequences that affect entire families, communities, and our whole society.

The term ‘ACE’ comes from a study that was conducted in the United States in the 1980s that found a significant link between a person’s exposure to ACEs and their physical and mental health throughout their lives.

These experiences include all types of abuse and neglect as well as parental mental illness, substance use, divorce, incarceration, and domestic violence.

The study found that the more ACEs a person has experienced, the greater the risk of them experiencing a range of issues such as chronic disease, depression, and anxiety, as well as poor academic achievement and substance abuse later in life.

What Are The Common ACEs?

The ACE test is broken down into 10 out of approximately 300 different traumas because they were the most common in the group.

The most common 10 ACEs recorded are divided into 3 groups and are listed below:

Additional ACEs can also have a significant impact on children and families. They include:

loss of a parent, caregiver, sibling or grandparent due to death, or separation due to deportation or immigration
living out-of-home, such as foster care or homeless
experiencing harassment, bullying, racism, prejudice or other forms of discrimination
having a serious medical procedure or life-threatening illness
community violence
neglect or abuse from someone other than a parent
growing up with a parent or other household member with a serious physical illness
being in a car accident,
being born prematurely
difficult relationships with your parent … and many other types of adversity we frequently dismiss because they are so common

Experiencing many ACEs without supportive adults can lead to toxic stress. This excessive activation of the stress-response system can lead to long-lasting wear-and-tear on the body and brain.

What Is Your ACE Score?

The survey consists of ten questions. Each “yes” answer is assigned one point. At the end of the questionnaire, the points are totalled for a score out of ten, which is known as the ACE score.

Take the test now to see what your ACE score is. Each “YES” answer counts as 1 ACE.

Prior to 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? or Act in a way that made you afraid that you might be physically hurt?
Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?
Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?
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? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
Were your parents ever separated or divorced?
Was your mother or stepmother:
Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
Was a household member depressed or mentally ill, or did a household member attempt suicide?
Did a household member go to prison?

Now add up your “Yes” answers: This is your ACE Score _________

Risk For Chronic Illness Is Affected By Our ACE Scores

As the number of ACEs increases, so does the risk for these outcomes. The presence of ACEs does not mean that a child will experience poor outcomes. However, children’s positive experiences or protective factors can prevent children from experiencing adversity and can protect against many of the negative health and life outcomes even after adversity has occurred.

Studies have found that ACEs increase the risk for autoimmune diseases such as multiple sclerosis, type 1 diabetes, rheumatoid arthritis, lupus, and more; type 2 diabetes, obesity, asthma, chronic obstructive lung disease, heart disease as well as cancer and other chronic physical and mental illnesses.

The risk of developing the 80 or more types of autoimmune diseases increases as ACE scores rise.

For every increase in the ACE score of 1 point, the risk for developing an autoimmune disease such as type 1 diabetes, lupus, rheumatoid arthritis, Hashimoto’s thyroiditis, and many others goes up by 20%.

An ACE score of only 2 – which can happen if your parents divorced and one of your parents had to cope with a common mental illness such as anxiety or depression – increases the chances of being hospitalized for autoimmune disease by 70 to 80%.

Individuals who had faced 4 or more categories of ACEs were twice as likely to be diagnosed with cancer as individuals who hadn’t experienced childhood adversity.

The risk of chronic illness is especially high when a person has experienced 4 or more ACEs.

With a score of 4 or more, the risk for diabetes goes up 1.6 fold, doubles for cancer and heart disease, quadruples for chronic lung disease and depression, and rises 7 times for alcoholism and12 times for suicide.

An ACE score greater than or equal to 6 shortened an individual’s lifespan by almost 20 years.

The most important thing for you to remember is that your ACE score is meant to be a guideline. If you experienced other types of toxic stress, whether over months or even years, then those would most likely increase your risk of health consequences.

Remember this also: ACE scores don’t tally the positive experiences in early life that can help build resilience and protect a child from the effects of trauma. Having a family who loves you, a teacher who understands and believes in you, or even a trusted friend you can confide in may mitigate the long-term effects of early trauma.

Today, neuroscientists are looking into the brain-body connection and breaking down exactly how the stresses we face when we’re young catches up with us when we’re adults, altering our bodies, our cells, and even our DNA.

Symptoms Are Not Just Psychological

In chronic disease states, lowered cortisol is not due to any adrenal or pituitary insufficiency. It comes from a body caught in a state of survival.

Changes in cortisol reflect an early-life adaptation to increase the persistence of active cortisol in the liver (to maximize fuel output) and kidney (to increase salt retention) without elevation of circulating levels, thus avoiding their deleterious effects on brain and muscle

As with cortisol, changes in blood sugar, insulin levels, blood pressure, heart rate, and other physiological functions can get stuck in high or low patterns. This is part of how our body’s states of survival can lead to symptoms and disease.

Trauma affects both physical and emotional health because it alters the nervous system, the immune system, the cell danger response, gene function, and beyond.

Understanding these mechanisms and the science of trauma offers hope for people living with chronic illness. This is because healing the effects of trauma is possible, even if the events happened far in the past. Addressing the effects of trauma also helps heal symptoms of chronic disease.

Absence of Nurturing – A Larger Impact Than The Presence Of ACEs

A 2019 study in Utah, USA found that the absence of positive, nurturing, protective experiences may have a greater impact on health and risk for chronic conditions than the presence of abuse and other ACEs.

This finding has been a shock to many.

It’s a game-changer for others who have known, deep down, that something wasn’t right even if it all “seemed” normal when they were kids. Their difficulties maintaining healthy relationships, liking other humans or trusting people have just not seemed normal. Their challenges in feeling worthy. Their bodies don’t respond to treatments that seem to work for others.

Anti-ACEs / Counter-ACEs Increase Resilience

The research found that positive experiences are protective. So protective, in fact, that they called them “anti-ACEs” or “counter-ACEs” because they reduce the effects of adversity in significant ways.

They found that the kinds of experiences that reduce the risk for chronic conditions, painful beliefs, and difficult emotions later in life can seem small. They can appear inconsequential given their huge influence. And yet the little things turn out to make a big difference in buffering children from the effects of adversity.

The kinds of things that create, support, and increase resilience in children include:

Having good friends & neighbours
Beliefs that provide comfort
Liking school
Teachers who care
A caregiver who you feel safe with
Opportunities to have fun
Feeling comfortable with yourself
A predictable home routine like regular meals and bedtimes

What anti-ACEs also mean is that support for parents can also help, especially if parents have their own challenges and histories of trauma. Finding ways to create predictable home routines, for example, can make a big difference.

What’s Your Resilience Score?

This questionnaire was developed by the early childhood service providers, pediatricians, psychologists, and health advocates in Maine, USA. They came up with 14 statements with a scoring system that was modeled after the ACE study questions.

Its purpose is limited to parenting education. It was not developed for research. The resilience questions are only meant to prompt reflection and conversation on experiences that may help protect most people (about three out of four) with four or more ACEs from developing negative outcomes. A secure early childhood is helpful, but not necessary. A higher number of positive experiences is not necessarily more protective, but it is indeed helpful in limiting the overall effect of ACEs long-term.