Adverse Childhood Experiences (ACEs) (2024)

When a person experiences strong, frequent, or prolonged adversity such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, or the accumulated burdens of family economic hardship, it can have profound negative effects on the mind and body. The stress response to these events has been known to disrupt the development of brain architecture as well as other bodily systems — neuroendocrine, immune, metabolic, and genetic — leading to what is considered toxic levels of stress.

Toxic stress experienced in early childhood (ages 0 – 17 years) — referred to as adverse childhood experiences or ACEs — has been linked to chronic health problems, mental illness, and substance abuse as that child grows to become an adult. ACEs can also negatively impact education and job opportunities. And more recent studies have highlighted how a history of community-level trauma and violence has profound impacts on health in schools.

Health and learning impacts of ACEs

Kaiser Permanente, together with the CDC, conducted the original study on adverse childhood experiences to uncover that:

  • ACEs are common. Approximately two-thirds of Americans have experienced at least one ACE and one in six have experienced four or more ACEs.
  • Experiencing ACEs increases the risk of negative health outcomes later in life, including obesity, diabetes, depression, heart disease, cancer, stroke.
  • ACEs can affect student learning and behavior in the classroom. Children with three or more ACEs are 5x more likely to have attendance issues, 6x times more likely to have behavior problems, and 3x times more likely to experience academic failure.

Toxic stress and ACEs are an under-recognized and under-addressed reason that many individuals are unable to achieve their full potential. This impacts them in the classroom, in the clinic, in their relationships, and beyond.

Trauma-informed care in schools

Given just how common childhood adversity and toxic stress are, it’s important that schools develop universal trauma-informed principles in their educational spaces and structures to reduce overall exposure to adversity and enhance resilience for both children and adults. All school personnel can be trained to understand “disruptive” behaviors and school difficulties as possible symptoms of toxic stress and to respond with compassionate, protective interventions rather than punitive actions. Partnerships between pediatric providers and educators can promote shared goal setting, decision making, more optimal treatment, and closer follow-up of those students who are struggling from the effects of toxic stress. Strategies for regulating toxic stress physiology include promoting optimal sleep hygiene, anti-inflammatory nutrition, physical exercise, mindfulness practices, experiencing nature, and supportive relationships.


VideoAdverse Childhood Experiences (ACEs): Impact on brain, body and behavior (IHDCYH Talks)This short animated video talks about how Adverse Childhood Experiences (ACEs) impact lifelong development.
VideoHow childhood trauma affects health across a lifetime (Nadine Burke Harris)Childhood trauma isn’t something you just get over as you grow up. Pediatrician Nadine Burke Harris explains that the repeated stress of abuse, neglect, and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain.
Research and ReportsPrevalence of Adverse Childhood Experiences From the 2011-2014 Behavioral Risk Factor Surveillance System in 23 StatesThis study examines disparities in exposure to adverse childhood expereinces (ACEs) among demographic groups including race, ethnicity, household income, sexual identity, education, and employment status.
Research and ReportsAbout the CDC-Kaiser ACE StudyThe CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study is one of the largest investigations of childhood abuse, neglect, and household challenges that impact later-life health and well-being.
Research and ReportsAdvancing Comprehensive School Mental Health SystemsThe National Center for School Mental Health authored a report on Advancing Comprehensive School Mental Health Systems: Guidance from the Field.
ToolkitAddressing Race and Trauma in the ClassroomThis resource helps educators understand how they might address the interplay of race and trauma and its effects on students in the classroom. It includes recommendations for educators and offers a list of supplemental resources that they can use within their school and district frameworks.

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Adverse Childhood Experiences (ACEs) (2024)
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