Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur in childhood and can lead to long-term negative impacts on health, opportunities, and overall well-being.
According to a 1998 study published by the CDC-Kaiser Permanente, ACEs can include physical, emotional, and sexual abuse; physical and emotional neglect; mental illness in the household; having an incarcerated relative; witnessing domestic violence; substance abuse; and divorce. It’s important to note that this list is not exhaustive.
How Common Are Adverse Childhood Experiences?
ACEs are more common than many people realize. About 64% of adults report experiencing at least one ACE before the age of 18. One in six adults report experiencing four or more. Among high school students, the most commonly reported ACEs include emotional abuse, physical abuse, and living with someone struggling with substance use or mental illness.
Certain groups of children are at higher risk of experiencing ACEs. These include girls, racial or ethnic minorities, children facing socioeconomic challenges, those with highly stressed caregivers, and those whose family or close friends struggle with substance use or mental health conditions. These experiences are typically beyond a child’s control, yet they can shape that child’s development in powerful ways.
Children who have experienced ACEs might display behaviors such as fear of others, nightmares, bedwetting, mood swings, or difficulty learning. They may also avoid certain situations related to trauma. Since children’s brains are still developing, these experiences can interfere with emotional regulation and cognitive growth.
Toxic Stress
One of the most damaging outcomes of ACEs is toxic stress. While short bursts of stress are natural and manageable, toxic stress occurs when a child is exposed to intense and prolonged adversity without adequate support. The body’s stress response—which releases hormones like cortisol and adrenaline—becomes stuck in overdrive. This constant activation can harm both brain development and physical health; children who experience toxic stress may struggle to build healthy, stable relationships due to the effects it has on their emotional and physiological well-being.
Stress is generally categorized as positive, tolerable, or toxic. Positive stress, such as starting a new school, is short-term and can help build resilience. Tolerable stress, like grieving a loved one, can still be managed when strong support systems are present. Toxic stress, however, results from ongoing trauma—such as abuse or living in a violent household—and can have lasting health consequences if not properly addressed.
Long-Term Effects of Adverse Childhood Experiences
The long-term impacts of ACEs can be profound. Studies show that preventing ACEs could reduce millions of cases of depression and heart disease. The original CDC-Kaiser Permanente study, which surveyed over 17,000 adults, linked ACEs to a higher risk of mental health conditions like anxiety, depression, PTSD, and substance use disorders, as well as chronic illnesses such as cancer and heart disease. Life expectancy can be shortened by nearly 20 years for individuals who experience multiple ACEs.
Adults with ACEs are also more likely to engage in risky behaviors, such as smoking, prescription drug misuse, and unprotected sex. They may also have a higher risk of self-harm and suicide.
Preventing ACEs Through Support and Awareness
Prevention starts with awareness within families and communities about the long-term effects of ACEs on individuals as they grow. Families and communities play a vital role in recognizing the risks and creating safe, supportive environments for children. Caregivers can help by nurturing strong, positive relationships and meeting children’s emotional and physical needs. It’s equally important that caregivers seek out support for their own well-being. A caring, stable environment helps children build resilience, which can protect them from the impact of ACEs.
Learn more about preventing Child Abuse, how and when to report it, and more in our blog about Child Abuse Prevention Month.
