What are aces?

The early years of a person’s life are formative for the future. A person’s ability to realize his or her future potential is greatly impacted by relationships throughout childhood. Dr. Bruce Perry, a leading expert in childhood trauma, explains, “[the] very same sensitivity that makes you able to learn language makes you highly vulnerable to chaos, threat, inconsistency, unpredictability, and violence” (Winfrey, 2018). Simply put, a child raised in a nurturing, well-cared for environment, is more likely to have a well-wired brain than a child raised in chaos, uncertainty, violence and neglect. The latter have higher rates of mental health problems, doing poorly in school, and functioning in the world—all problems stemming from Adverse Childhood Experiences (ACEs).

The Problem of ACEs

According to the Child and Adolescent Health Measurement Initiative (CAHMI), “ACEs include a range of experiences that can lead to trauma and toxic stress and impact children’s brain development and physical, social, mental, emotional, and behavioral health and well-being” (Bethell, Davis, Gombojav, Stumbo, Powers, 2017). Research has demonstrated the negative impact of ACEs, especially multiple ACEs, on long-term wellness. The CDC states, “ACE’s have lasting effect on health (obesity, diabetes, depression, suicide attempts, STD’s, heart disease, cancer, stroke, COPD, broken bones), behavior (smoking, alcoholism, drug use), life potential (graduation rates, academic achievement, loss time from work)” (Centers for Disease Control and Prevention, 2010). Although one ACE tends to have a minimal effect on well-being, two or three risks increase the chance of damaging outcomes by four. Four or more risks increase the chance of damaging outcomes by ten (Citizens Committee for Children of New York, 2013).

The Prevalence of ACEs

These experiences are prevalent across the United States with 60% of adults having had at least one ACE and over 35% of adults having had two or more ACEs in their lifetime (Centers for Disease Control and Prevention, 2010). However, these numbers increase greatly for minority children and children in low-income communities. Whereas 40% of white children have one or more ACEs, 51% of Hispanic children and nearly 64% of black children have one or more ACEs. Similarly, only 26% of children from middle-income families have had one or more ACEs as compared to 62% of low-income children having had at least one ACE (Bethell, Davis, Gombojav, Stumbo, Powers, 2017). Not only are ACEs prevalent across race and income, they are geographically pervasive as well. Ranging from 38.1% of youth in Minnesota to 55.9% of youth in Arkansas, over 34 million children under the age of 18 have had at least one ACE (Bethell, Davis, Gombojav, Stumbo, Powers, 2017).

Why are some people able to overcome, and others can’t?

The prevalence of ACEs along with their devastating effect on well-being raises the question, “Why are some people able to overcome, and others can’t?”

Dr. Bruce Perry concludes, “Really it boils down to something pretty simple. And it’s relationships” (Winfrey, 2018)

The CDC states, “Safe, stable, and nurturing relationships and environments can have a positive impact on a broad range of health problems and on the development of skills that will help children reach their full potential” (Centers for Disease Control and Prevention, 2010).


Bethell, C.D., Davis, M.B., Gombojav, N., Stumbo, S., Powers, K. Issue Brief: A national and across state profile on adverse childhood experiences among children and possibilities to heal and thrive. Johns Hopkins Bloomberg School of Public Health, October 2017. http://www.cahmi.org/projects/adverse-childhood-experiences-aces/

Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey ACE Module Data, 2010. Atlanta, Georgia: U.S.

Citizens Committee for Children. Keeping Track of New York City’s Children, 2013. Retrieved from http://www.cccnewyork.org.

Winfrey, Oprah. (2018, March 11). Treating Childhood Trauma. Retrieved from http://www.cbsnews.com