TAKE THE ACE'S QUIZ 

The Adverse Childhood Experiences, or “ACEs,” quiz asks a series of 10 questions about common traumatic experiences that occur in early life. A higher numbers of ACEs often correlate to challenges later in life, including higher risk of certain health problems, the quiz is intended as an indicator of how likely a person might be to face these challenges. The exact score you receive does not necessarily quantify the adverse effects trouble you today, but helps you assess your overall experience. 

The CDC-Kaiser ACE Study is one of the largest investigations of childhood abuse and neglect and household challenges and later -life health and well being. The ACEs Quiz only starts the conversation about childhood trauma, but it is NOT intended to end the journey of awareness on this topic.

The quiz is a helpful TOOL for raising awareness about the potential impact of ACE's.  However, it's very important to remember there are many things this quiz doesn't take into account, which can have a huge impact, which is why it is so important to know that the quiz can ONLY give insight into who might be at risk--not who is at risk--for certain later-life challenges.
 

THINGS YOU NEED TO CONSIDER BEFORE TAKING THE QUIZ

FIRST

There are many experiences that in my opinion can be traumatic for children that the quiz doesn’t ask about —community violence, racism, other forms of discrimination, natural disasters, housing insecurity, medical trauma. That means answering all the questions on the ACE quiz CAN NOT accurately give a full picture of the adversity a child has faced – and thus would not be a true indicator of possible risk—nor a full picture of the possible solutions communities should consider, which is why I say it is just a TOOL. 

SECOND

Everyone is different, and adverse experiences in childhood affect each child differently. Just because a person has experienced several ACEs does not mean that later social, emotional, or health problems are inevitable.

Some children develop resilience – the ability to overcome serious hardship – while others do not.  And the most common factor among children who show resilience is at least one stable and responsive relationship with a supportive adult. Genetic factors also play a role, in that some children are predisposed to be more sensitive to adversity than others.

  • Stressors outside the household (e.g., violence, poverty, racism, other forms of discrimination, isolation, chaotic environment, lack of services)

  • Protective factors (e.g., supportive relationships, community services, skill-building opportunities)

  • Individual differences (i.e., not all children who experience multiple ACEs will have poor outcomes and not all children who experience no ACEs will avoid poor outcomes—a high ACEs score is simply an indicator of greater risk)

WHAT ISN’T ACCOUNTED FOR:

The most important thing to remember is that the ACE score is meant as a guideline: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences, depending on the positive childhood experiences you had (see below).

Prior to your 18th birthday:

  1. 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?
    No___If Yes, enter 1 __

  2. 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?
    No___If Yes, enter 1 __

  3. 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?
    No___If Yes, enter 1 __

  4. 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?
    No___If Yes, enter 1 __

  5. 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?
    No___If Yes, enter 1 __

  6. Were your parents ever separated or divorced?
    No___If Yes, enter 1 __

  7. 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?
    No___If Yes, enter 1 __

  8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
    No___If Yes, enter 1 __

  9. Was a household member depressed or mentally ill, or did a household member attempt suicide?                         No___If Yes, enter 1 __

  10. Did a household member go to prison?
    No___If Yes, enter 1 __

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

The quiz score is based on ten types of childhood trauma measured in the ACE Study. 

Five are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect.

Five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment.

You get one point for each type of trauma. The higher your ACE score, the higher your risk of health and social problems.

As your ACE score increases, so does the risk of disease, social and emotional problems.

The most important thing to remember is that the ACE score is meant as a GUIDELINE: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences.

Remember this, too: 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 grandparent who loves you, a teacher who understands and believes in you, or a trusted friend you can confide in may mitigate the long-term effects of early trauma, psychologists say.

Fortunately, our brains and lives are somewhat plastic, which means our mental and physical health can improve. The appropriate integration of resilience factors born out of ACE concepts — such as asking for help, developing trusting relationships, forming a positive attitude, listening to feelings — can help people improve their lives.

To learn more, check the CDC’s ACE Study website. You’ll find, among other things, a list of studies that explore the ways adverse childhood experiences have been linked to a variety of adult conditions, ranging from increased headaches to depression to heart disease.

You can find more information and the original NPR feature article here.

References & Sources
  1. CDC & Kaiser Study: Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults-The Adverse Childhood Experiences (ACE) Study (1998); Vincent J. Felitti, MD, FACP, Robert F. Anda, MD, MS, Dale Nordenberg, MD, David F. Williamson, MS, PhD, Alison M. Spitz, MS, MPH, Valerie Edwards, BA, Mary P. Koss, PhD, James S. Marks, MD, MPH CLICK HERE

  2. Child Trends Research Brief: Adverse Childhood Experiences: National and State-Level Prevalence (July 2014); Vanessa Sacks, M.P.P., David Murphey, Ph.D., and Kristin Moore, Ph.D. CLICK HERE

  3. Harvard Center on the Developing Child CLICK HERE

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