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Understanding ACE Scores

Jun 21, 2024 | Child Therapy

Adverse Childhood Experiences (ACEs) can have a profound impact on an individual’s life, influencing their physical and mental health well into adulthood. Understanding your ACE score can be a crucial step in mitigating long-term effects and getting support for those affected by adverse events.

An ACE score is a measure of the types of trauma one experienced during childhood. By examining this score, psychotherapists can better understand the risks and needs of their patients, leading to more effective and tailored interventions. For individuals who may have been affected by trauma, understanding your score and working with a licensed clinician is the first step to addressing unresolved pain and receiving essential support.

What is ACE in Behavioral Health?

The ACE measure is a tool used in psychology to quantify the types of trauma an individual experienced during their childhood (age 0-17). Specifically, it seeks to measure any adverse childhood experience (ACE) and encompasses a range of traumatic events, including household dysfunction, abuse, and neglect. The ACE score includes a series of questions that assess these experiences, providing a standardized way to evaluate the potential impact of early adversity on long-term health and well-being.

In other words, the ACE score is an objective measure designed to standardize the assessment of trauma, enabling researchers to study its effects consistently and inform clinicians on best practices. However, it is important to note that while the score provides valuable insight, it does not capture the full complexity of an individual’s unique experience with stress or trauma.

For clinicians, the ACE score is a starting point in assessing the severity of adverse childhood experiences. When combined with detailed interviews and possible follow-up sessions, it forms the basis for creating a tailored treatment plan that addresses the individual’s specific needs.

How ACE Scores are Calculated

The ACE score is determined through a straightforward assessment that measures various aspects of adverse childhood events on a binary scale (0 for no, 1 for yes). The original assessment includes ten questions, each evaluating specific types of trauma and stress that a person may have experienced before the age of 18. These ten items are:


    1. Physical Abuse
    2. Emotional Abuse
    3. Sexual Abuse


    1. Physical Neglect
    2. Emotional Neglect

Household Dysfunction

  1. Domestic Violence
  2. Substance Abuse in the Household
  3. Mental Illness in the Household
  4. Parental Separation or Divorce
  5. Incarceration of a Household Member

Additionally, there are variations of the ACE test that account for a wider variety of adverse events. The World Health Organization’s ACE-IQ, for instance, includes instances of bullying, community violence, and collective violence. Some tests also include an additional frequency ACE score, which measures adverse events that occurred multiple times, providing a more nuanced view of the severity of experiences.

Clinicians will use different versions of the test depending on the individual and their circumstances and alternate assessments, such as interviews, to get a more complete picture of one’s early life experiences.

Is the ACE Score Useful and What Can it Tell Us?

High ACE scores indicate the potential severity of adverse childhood events, providing clinicians with a starting point to determine the appropriate treatment and support needed. While the ACE score does not necessarily mean that a person has experienced significant trauma, it does highlight the likelihood of substantial stressors that could impact overall well-being.

For individuals with high ACE scores, there is a strong correlation with various mental health issues. These can include an increased risk of depression, anxiety, and post-traumatic stress disorder (PTSD). High ACE scores are also linked to behavioral issues such as substance abuse, self-harm, and difficulties in maintaining healthy relationships.

Physically, high ACE scores are associated with numerous chronic conditions. Individuals with high ACE scores are at a greater risk for cardiovascular disease, diabetes, and chronic inflammation. Primarily, the prolonged stress from adverse experiences can disrupt the auto-immune system and the production of cortisol, eventually leading to a weakened immune system and higher inflammation levels throughout the body.

Overall, the ACE score provides a strong correlation with long-term negative health effects arising from early childhood trauma that persist well into adulthood. Knowing this, clinicians can determine individualized treatment plans that address early childhood trauma while directly managing the potential long-term effects that arise from those experiences.

How to Use ACE Scores Effectively

The ACE score is one of many factors which can be used to determine possible future problems. The ACE score does not capture factors which may lessen the impact of adverse experiences on a person, such as a strong community of support, adults who showed care and concern to help cope with the adverse event(s), or the personal qualities of the individual.

Nevertheless, knowing your ACE score can help individuals better understand their early experiences and how these may influence their current health and behavior. This awareness is the first step in adopting strategies to mitigate the long-term effects of childhood stress. By acknowledging these experiences and their impact, individuals can begin to work on building resilience and coping mechanisms that address the long-term impact of these experiences.

Individuals will receive the best support through tailored treatment when working with a licensed psychotherapist or clinician. These professionals can provide personalized care that addresses the specific needs highlighted by the ACE score while providing an empathetic and understanding environment so that individuals can enjoy better health outcomes and overall well-being.

Psychological Recommendations for High ACE Scores

If you receive a high ACE score, the best practice is to seek a licensed psychotherapist to interpret the results, perform additional assessments if necessary, and develop a tailored support plan. While a high ACE score indicates a higher risk of potential health issues, it is not a formal diagnosis. Working with a psychotherapist can help you understand the implications of your score and provide the necessary guidance to address the risks effectively.

Licensed psychotherapists can offer a comprehensive understanding of your unique experiences and needs, ensuring that the support you receive is both appropriate and effective. They can help you navigate the complexities of your past traumas, offer strategies and interventions to build emotional resilience, improve coping mechanisms, and promote overall well-being. By engaging in therapy, you can work towards overcoming the adverse effects of your early experiences and achieve better health outcomes in the long run.

Get the Support You Need With Start My Wellness

Understanding your ACE score is crucial in identifying adverse childhood experiences’ impact on your long-term health. While the ACE score provides a valuable framework for assessing potential risks, it’s not a definitive diagnosis but rather a starting point for further exploration and personalized treatment. High ACE scores indicate a greater likelihood of physical and mental health challenges, and addressing these can significantly improve health outcomes.

Start My Wellness is ready to help you navigate the complexities of your ACE score and its implications. Our licensed psychotherapists are experienced in interpreting ACE scores and integrating this understanding into comprehensive treatment plans. We provide a compassionate and empathetic environment, ensuring your unique experiences are acknowledged and addressed with the utmost care and expertise.

If you need support in interpreting your ACE score and determining the next steps, contact Start My Wellness today at (248)-514-4955 and meet our therapists. Let us help you build resilience and find the support you need.


  1. Start My Wellness: Trauma in Children – What is an ACE Score?
  2. Start My Wellness: What is Trauma?
  3. Harvard University Center on the Developing Child: Take the ACE Quiz = And Learn What It Does and Doesn’t Mean
  4. The Sociology Quarterly: Long Term Physical Health Consequences of Adverse Childhood Experiences
  5. Start My Wellness: Trauma Informed Care
Dr. Anton Babushkin

Author: Anton Babushkin, PhD

Looking for a Therapist? Start My Wellness has highly experienced Licensed Therapists that are currently accepting new patients.


Blog Posts Tags: Child Therapy
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