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Adverse childhood experiences, also known as ACEs, are adverse (negative and impactful) experiences that occur during formative childhood years. These include single traumatic events and ongoing traumatic experiences like abuse.

Adverse Childhood Experiences

What Are Adverse Childhood Experiences?

Children need to feel safe and stable in their home environment in order to thrive in their growth and development. Trauma experienced during childhood can have a lasting impact on health and well-being.

Each adverse experience a child goes through counts as one trauma. The more trauma someone experiences before 18 years old, the more likely they are to experience adverse adulthood experiences, including substance use disorders and mental health disorders.

Common ACEs include:

• Physical abuse

• Verbal abuse

• Sexual abuse

• Physical neglect

• Emotional neglect

• Having a parent who has alcohol use disorder

• Having a parent who’s a victim of domestic violence

• Having a family member who is incarcerated

• Having a family member diagnosed with a mental health illness

• Experiencing divorce of parents

These 10 ACEs are not the only possible traumas experienced in childhood. Other factors such as racism; bullying; major loss such as a death of a parent, sibling, or caregiver; being involved in an accident; and community violence also can play a part in how the child comes to see and understand the world as either a safe and nurturing environment or somewhere to be cautious and reserved due to fear of what’s to come next.

ACEs and Toxic Stress

ACEs are said to create toxic stress for children during the developmental years. Toxic stress is unhealthy stress because it excessively activates the stress response system. This is said to have a “wear-and-tear” effect on the person’s body and brain.

Health Consequences of ACEs

The health consequences of ACEs are associated with prolonged stress. Prolonged stress changes the developing brain and how it learns to cope with stress.

Physical Health

Physical health conditions associated with ACEs include:

• Chronic obstructive pulmonary disease (COPD)

• Asthma

• Kidney disease

• Stroke

• Heart disease

• Cancer

• Diabetes

• Obesity

• Substance use disorders, including alcohol use disorder and cigarette smoking

ACEs are associated with at least five of the leading causes of death, including suicide and overdose.

Mental Health

Mental well-being is said to decline as the number of ACEs goes up. The following are all associated with ACEs.

• Behavioral and emotional dysregulation

• Depressive disorder and anxiety disorders

• Personality disorders

• Psychotic disorders

• Post-traumatic stress disorder (PTSD)

Recovering From Adverse Childhood Experiences

Research has found that play and creative expression (which can be done through different forms of art) can be helpful for people trying to process trauma and recover from ACEs. A 2021 study suggested that play creates the space for self-expression, self-care, and healing from childhood trauma.

Therapies that use a "trauma-informed approach" are targeted toward understanding how trauma, adversity, and toxic stress can affect child development.

It is possible for ACEs to be prevented, reduced (in terms of impact on the future), and recovered from with this approach.

A trauma-informed approach avoids retraumatization (reliving stressful feelings from an earlier trauma) and empowers the person to change their negative coping strategies to healthier behaviors.

Adverse childhood experiences are experiences that create toxic stress, leading to poorer or negative outcomes in adulthood. ACEs are associated with poorer health outcomes later in life including increased risk of substance use disorder, heart disease, and obesity, as well as mental health challenges.

ACEs help us understand how certain past events that occur during formative years can change the way we cope with stress and how this impacts our future. ACEs are not certainties, though.

Many people with ACEs also experience positive life events that help reduce stress levels and show them how to cope with stress in healthy ways. If you need more support, a licensed therapist can help.

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