What are ACEs and How to prevent them

What happens in childhood, both the good and bad, plays a role in who a child becomes as an adult. Along those lines, the effects of bad situations, including living through trauma, can be profound.

Experts call traumas in youth adverse childhood experiences or ACEs. Abuse, violence, or neglect as a child or teen can lead to severe mental and physical problems as an adult.

Here’s what to know about ACEs and how to work toward stopping them.

What Is an ACE?

An ACE is a childhood trauma. It could be growing up in an alcoholic home, living through a parent’s divorce, or violence near the home.

ACEs are common. About six in 10 adults live through at least one ACE before age 18. Nearly one in six adults have dealt with ACEs of four or more types before age 18.

There is a strong tie between ACEs and poor outcomes later in life. That includes health problems like:

  • Obesity.
  • Diabetes.
  • Heart disease.
  • Substance misuse.
  • Depression.
  • Poor school performance.
  • Trouble holding a job.

ACEs occur in all types of homes at all income levels. Experts break ACEs down into three major categories.


There are different types of abuse. Abuse could come from a parent, stepparent, or any other adult living in the home.

  • Emotional abuse is when an adult in the home threatens the child with their words. That could mean they swore or insulted the child. It could mean they acted in a way that made them afraid they’d be physically hurt.
  • Physical abuse is when an adult in the home hurts a child enough to have marks on the skin or get injured. That could include punching, hitting, pushing, grabbing, or throwing something.
  • Sexual abuse is when an adult relative, family friend, or stranger touches a child sexually or tries to have sex with them. Sexual abuse also includes an adult making a child touch their body sexually.

Household challenges

ACE challenges within the household can range from seeing or hearing violence to dealing with a parent’s mental illness. Household problems create a feeling of instability and cause stress for kids. Some are:

  • Women facing violence at home. When a father, stepfather, or boyfriend threatens or hurts a mother, stepmother, sister, or aunt. That includes hitting, slapping, grabbing, biting, kicking, throwing an object at, or hitting with an object.
  • Substance misuse at home. When a family member is an alcoholic or misuses drugs.
  • Mental illness at home. If a member of the household is depressed, has another mental illness, or has attempted suicide.
  • Parental separation. If parents separated or divorced during childhood.
  • An incarcerated household member. If someone in the family was absent because they were in jail.


While neglect may not seem as bad as outright abuse, the long-term effects can be just as harmful to a child.

  • Emotional neglect is when a child doesn’t feel loved. If the family wasn’t a source of love or support. No one in the family made the child feel important or special or seemed to care how they were doing.
  • Physical neglect is when family members aren’t around to care for and protect a child. Physical neglect might result in a child not having enough to eat or clean clothes to wear. The parents might have been misusing alcohol or drugs or be dealing with a mental illness.

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Risk Factors for ACEs

Although ACEs can happen anywhere, they are more likely to occur in families:

  • That are financially unstable.
  • With young or single parents.
  • Where parents know little of kids’ needs or development.
  • With parents who dealt with abuse as kids.
  • Where spanking is the prime method of discipline.
  • Where kids aren’t supervised.
  • Where people don’t feel connected to relatives, friends, or neighbors.
  • Who accept or justify violence and aggression.
  • With high conflict or negative ways of communicating.
  • Who face the stress of caring for kids with special needs.

Likewise, kids are at higher risk for an ACE if they:

Effects of ACEs

Kids — and later, adults — get many adverse effects from ACEs.

ACEs can affect a child’s brain development, immune system, and stress-response system. Constant stress puts continual wear and tear on the brain and body. Such toxic stress affects a child’s attention span, decision-making, and learning ability.

Years later, ACEs can put you at risk for problems as an adult. You are more likely to have:

  • Chronic health problems, like heart disease and diabetes.
  • Mental illnesses, including depression.
  • Substance misuse problems.
  • A low level of schooling.
  • Fewer job options.
  • Trouble holding a job.
  • Volatile relationships.
  • Money problems.

How to Prevent ACEs

The good news is that ACEs are preventable. But it takes more than one person to change a child’s situation. Neighborhood centers and faith-based and youth groups can help support at-risk families and communities.

Communities can stop ACEs by:

  • Strengthening economic support to families. This may include family-friendly work policies, flexible work schedules, and paid time off to care for a newborn or another loved one.
  • Ensuring a strong start to life with high-quality childcare and preschool enrichment that includes the family.
  • Teaching relationship skills. Programs may include safe dating, healthy relationships, and parenting skills. Parents can learn ways to support their kids and set a good example with their actions.
  • Connecting kids to caring adults and activities through after-school and other mentoring programs.
  • Providing intervention services such as victim-centered services and medical care. That might include family-centered care for substance misuse and to stop violent behavior.

If you believe a child is at risk for ACEs, seek counseling for yourself or the parent involved. Reaching out for help can be the first step to a healthier future for your whole family.

Editor's Note: This article was originally published on , and was last reviewed on .

CDC, Adverse Childhood Experiences (ACEs), Link

CDC, Violence Prevention: Prevention Strategies, Link

CDC, Help Youth at Risk for ACEs, Link

Childwelfare.gov, Adverse Childhood Experiences (ACEs), Link

Preventchildabuse.org, Adverse Childhood Experiences (ACEs) Prevention, Link

National Library of Medicine, Preventing Adverse Childhood Experiences: The Role of Etiological, Evaluation, and Implementation, Link

Center on the Developing Child, Harvard University, ACEs and Toxic Stress: Frequently Asked Questions, Link

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