What is your ACE Score?
There are 10 types of childhood trauma measured in the ACE Study. Five are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. Five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. So a person who’s been physically abused, with one alcoholic parent, and a mother who was beaten up has an ACE score of three.
There are, of course, many other types of childhood trauma — racism, bullying, watching a sibling being abused, losing a caregiver (grandmother, mother, grandfather, etc.), homelessness, surviving and recovering from a severe accident, witnessing a father being abused by a mother, witnessing a grandmother abusing a father, involvement with the foster care system, involvement with the juvenile justice system, etc. The ACE Study included only those 10 childhood traumas because those were mentioned as most common by a group of about 300 Kaiser members; those traumas were also well studied individually in the research literature.
The most important thing to remember is that the ACE score is meant as a guideline: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences.
Prior to your 18th birthday:
- Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt? (Y/N)
- Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured? (Y/N)
- Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you? (Y/N)
- Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other? (Y/N)
- Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it? (Y/N)
- Were your parents ever separated or divorced? (Y/N)
- Was your mother or stepmother:
Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife? (Y/N) - Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs? (Y/N)
- Was a household member depressed or mentally ill, or did a household member attempt suicide? (Y/N)
- Did a household member go to prison? (Y/N)
Now add up your “Yes” answers: This is your ACE Score.
(source: acestoohigh.org)
On the second day of training, we had a child come into the office because he was having some behavioral difficulties. My staff was trying to talk him through things unsuccessfully so I discreetly suggested she have him try to blow up a balloon. She was confused but I had just learned that day about how certain things can trigger the trigeminal nerve which activates the vagus nerve and can reset the nervous system. It totally helped! This child went from being inconsolable to talking about what happened and helping us to problem solve for future situations.
Thank you for taking the time to share with my classes last week! Their response to your visit was overwhelming. UCLA is a university that values empirical scientific evidence above all, our student rarely encounter experts in the field who are actually on the front-lines, so it’s no surprise to me that they were deeply affected by you and your story! Real world experience is just as valuable as what is happening in the lab.
I have seen such huge improvement in these kids and so much of this is due to the help you have given their caregivers. Thank you!
Thank you for teaching how to work with people who regress to a younger age. I see it in children AND adults. Before, I would go into observation mode and try to understand “why” it was happening. But now I know how to help in moments like that, besides only trying to comfort, or whatever was situationally appropriate.
Tif, you have changed my life. You have changed my parenting, and my teaching, and because of you, (me & my husband)… our family is flourishing. The things that I have learned from you are unbelievable and felt like you deserved to know that. Thank you so much!
Tif, your training today was outstanding. Your powerpoint, your delivery, and the content and pace were all spot-on. I felt very moved by many of the stories you shared and the photos that went along with the stories. Thank you for sharing with us.
I attended this RISE training before the return to in person learning in our school district. When the kiddos did arrive, they arrived with over a year of non social interaction so I expected some challenges right off the bat. However, I kept thinking about ‘respond don’t react’ with respect to my own triggers as an educator and I must say, I had to modify my behaviors first before I expect the students to do so as same (lead by example). Having a couple of weeks to reflect, I am a better teacher now and perhaps a better human being with the tools the RISE training gave me. Thank You.
We have a teenager who is on the spectrum. He and I have been in a constant back & forth battle for a few years. The things I learned from you today are going to help me professionally as well as personally. Thank you!