trauma, Uncategorized

What are ACEs? Do I want my Child to ACE it?

What exactly are ACEs?  How does it impact my child?  Is it something I need to be concerned about?  These are questions I hear from parents and sometimes, even other professionals.  Today I will give a simplified explanation.

ACE is the acronym for Adverse Childhood Experiences.  Now let’s talk about what that means.  ACEs are stressful or traumatic events.

Some ACEs include:

  • Experiencing a natural disaster
  • Death of a parent or family member
  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Physical neglect (not enough proper nutrition, lack of medical care, lack of exercise for proper development, insecure shelter, and more…)
  • Emotional neglect (being isolated, lack of nurturing contact, multiple caretakers without consistency)
  • Intimate partner violence
  • Parent or sibling treated violently
  • Substance misuse within household
  • Household mental illness
  • Parental separation or divorce
  • Incarcerated household member

You may hear ACEs Score.  This refers to a study published in 1998 in which a measure was developed ranging from 0-10.  The higher the score, the greater the risk for chronic disease such as diabetes, autoimmune disorders, mental illness, substance abuse, and even suicide.  Higher scores indicate complex traumas that are prolonged and often of an interpersonal nature.

Nadine Burke Harris, MD is a pediatrician leading the way to develop methods to screen and treat children and families suffering from toxic stress.  She states “We’re not talking about failing a test or losing at a sports match. We’re talking about threats that are severe or prolonged — things like abuse or neglect, or growing up with a parent who is mentally ill or substance-dependent. Our biological stress response is designed to save our lives from something threatening, and that’s healthy. The problem is that when the stress response is activated repeatedly it can become overactive and affect our brain development, our immune systems and even how our DNA is read and transcribed. High doses of stress hormones can inhibit the brain’s executive functioning and make it harder for kids or adults to exercise impulse control.  We see on M.R.I.s a shrinking of the hippocampus [a brain area important for memory and emotional regulation] and increased size of the amygdala, which is the brain’s fear center. This can make you hypervigilant — overly sensitive to threats or challenges.”


Do you or your child “overreact” often?  This is because the toxic stress altered the brain.  Fight, flight, or freeze is the immediate response to any stressor.  A healthy person would hear “no candy right now” and experience a moment of frustration, disappointment, or anger and then accept it and move on.  That person would have self-regulated the emotion and processed the information to mean candy will be available later.  A child or adult with multiple ACEs hears “no candy right now” and immediately the brain initiates fight, flight or freeze.  The person is unable to self-regulate and may perseverate on the lack of candy.  The fear response causes the brain only to hear “no candy” and interpret this as there is never going to be candy again.

The thought of my never having access to a lifesaver or chocolate again causes my blood pressure to rise and my heart rate to elevate too.  In fact, the more I think about it right now, the more I would be willing to fight pretty hard for chocolate.  I am using a fairly common scenario but you can substitute any noun or preferred activity in that sentence and you have probably experienced the same reaction.  “No video games right now, no bike riding right now, no snacks right now…”  Regardless of the reason that the answer is no, even if it is a valid reason that is designed for a healthy outcome like dinner will be ready in ten minutes or there is a thunderstorm coming; the executive functioning of the brain has been so altered by the toxic stress (high levels of cortisol washing over the brain) during those ACEs, it cannot process the information in order to self-regulate.

Perhaps you have a 7 year old and are receiving multiple phone calls and emails from the school regarding behavior or unfinished work.

When kids have issues with executive functioning, any task that requires planning, organization, memory, time management and flexible thinking becomes a challenge.  Where are these challenges going to flare up like fireworks on the 4th of July?  You guessed it – school!

Now for the good news.  No, the amazing news!  The impact of ACEs can be reversed!  Left untreated, the damage is permanent resulting in neuro-biological impact with increased health risks and largely chronic diseases and social problems.  Did you catch it?  The key word in that sentence was “untreated.”  My husband prefers unaddressed.  I do too, but I tend to slip into clinical terms.  With implementation of strategic therapeutic models like TBRI, the temporal lobes can function normally.  The hippocampus (memory and emotional regulation) can mature in size and the amygdala (fear center) can shrink down to a healthy size.

Children can have healthy attachments to other people and live wonderfully happy lives!  Is there anything better than seeing a happy, healthy child enjoying life and soaking up all that life has to offer without fear?

I hope that you have a better understanding what ACEs are.  Remember, there is a difference between acute trauma and complex trauma.  If you want more information, check out these resources too!

TBRI: A Systemic Approach to Complex Developmental Trauma

Understanding and Responding to ACEs in School Settings

Book: How Your Biography Can Become Your Biology

Please let me know if this was helpful to you in the comments below.