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What are ACEs?


Adverse childhood experiences (ACEs) are traumatic events occurring before age 18.  ACEs include all types of abuse and neglect as well as parental mental illness, substance use, divorce, incarceration, and domestic violence.  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 abuse, 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, in comparison to 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 urgency of 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.


Pair of ACEs Tree


The "Building Community Resources (BCR)" Pair of ACEs tree image grew out of the need to illustrate the relationship between adversity within a family and adversity within a community. The leaves on the tree represent the ‘symptoms’ of ACEs that are easily recognized in clinical, educational and social service settings, such as a well child visit or a pre-school classroom. Adverse childhood experiences can increase a person’s risk for chronic stress and adverse coping mechanisms, and result in lifelong chronic illness such as depression, heart disease, obesity and substance abuse. Physical or sexual violence, and abuse or neglect are often less obvious but can exist as chronic stressors.




The tree is planted in poor soil that is steeped in systemic inequities, robbing it of nutrients necessary to support a thriving community. Adverse community environments such as a lack of affordable and safe housing, community violence, systemic discrimination, and limited access to social and economic mobility compound one another, creating a negative cycle of ever worsening soil that results in withering leaves on the tree.


About Adverse Childhood Experiences
Centers for Disease Control and Prevention
Provides an overview of adverse childhood experiences.

Adverse Childhood Experiences: Looking at How ACEs Affect Our Lives & Society [Infographic]
Centers for Disease Control and Prevention
Discusses the types of ACEs, their prevalence, their effects on physical and mental health and society, and strategies to address them.

Essentials for Childhood Framework: Steps to Create Safe, Stable, Nurturing Relationships and Environments for All Children
Centers for Disease Control and Prevention
Explains a strategic approach to building strong communities that support positive child and family development. The goals of the approach include raising awareness, making data-driven decisions, promoting positive norms, and assessing policies that impact families.

Preventing Adverse Childhood Experiences
Center for Disease Control and Prevention
Provides two learning modules to help participants understand, recognize, and prevent adverse childhood experiences (ACES). This training is available to anyone interested in learning more about ACES regardless of profession or educational attainment.


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.

1Centers for Disease Control and Prevention. (2016). About the CDC-Kaiser ACE study: Major findings. Retrieved from

2ACEs in young children involved in the child welfare system. Retrieved from in new window); Centers for Disease Control and Prevention. (2016). About the CDC-Kaiser ACE study: Data and statistics. Retrieved from

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