April is National Child Abuse Prevention Month, and while it’s critical to take steps to end child abuse in our communities, it’s also important to understand how abuse will affect children as they grow into adulthood — in other words, it’s all about knowing their ACE score.

What’s an ACE score? In the late 1990s, the Centers for Disease Control and the Kaiser Permanente’s Department of Preventative Medicine coordinated the Adverse Childhood Experiences Study (ACE). The study asked a series of questions that measured stressful experiences in childhood — physical and sexual abuse, of course, but also experiences like divorce, death of a family member, if a family member was mentally ill or an alcoholic, or whether or not a child felt hungry, alone or unsupported while growing up.

Researchers found a link between childhood trauma and adult social and emotional issues — adults who experienced trauma as children were more likely to abuse alcohol and drugs, or engage in risky behavior. But they also found a link between childhood trauma and chronic diseases like heart disease, diabetes, lung cancer, and autoimmune diseases. The initial study, along with nearly 60 other studies that followed, also found that those who experienced more than one type of trauma were at greater risk of developing emotional, as well as chronic health, problems.

“The ACE Score attributes one point for each category of exposure to child abuse and/or neglect included in the Adverse Childhood Experiences study,” says Jill Gay, Director of Treatment Services at the Family Nurturing Center. “Add up the points for a score of 0 – 10.  The higher the score, the greater the exposure, and therefore the greater the risk of negative health consequences.” For example, an ACE score of four increased one’s risk of pulmonary lung disease by 390 percent (which makes sense — a child who experienced trauma is more likely to engage in risky behavior like cigarette smoking). Additional research has found that stressful or traumatic events also affect a child’s brain development — it’s hard to focus on learning fractions when the brain is too busy thinking about when the body might get to eat next or is worried about Mom or Dad at home.

“It’s important to know that the cumulative total of a child’s adverse experiences can cause detrimental negative health consequences,” says Gay. However, she also points out that while adverse experiences are very common — think about how many families you know that have experienced divorce — your child’s ACE score doesn’t have to mean they will struggle as adults. It’s all on how kids perceive and cope with the trauma, according to Gay. That means it’s up to parents to take proactive measures — be aware of the impact of adverse experiences and know the resources available, like school, church, family or your community. Says Gay, “How support systems respond when a child has an adverse childhood experience can be the difference between it being a trauma and it being traumatic for the child.”

What’s Your ACE Score?

Take the 10-question survey here. Add up all your “yes” answers to get your ACE Score.

Finding Your ACE Score
While you were growing up, during your first 18 years of life:

  1. 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?
  2. 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?
  3. 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?
  4. Did you often or very often feel … No one in your family loved you or though you were important or special? — Or — Your family didn’t look out for each other, feel close to each other, or support each other?
  5. 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?
  6. Were your parents ever separated in a divorce?
  7. 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 at least a few minutes or threatened with a gun or knife?
  8. Did you live with anyone who was a problem drinker or alcoholic or use street drugs?
  9. Was a household member depressed or mentally ill, or did a household member attempt suicide?
  10. Did a household member go to prison?

Ways You Can Get Involved

Find out how you can participate during April’s National Child Abuse Prevention Month — turn to “Things to Do” on page 50 for a roundup of opportunities happening locally, courtesy of the Family Nurturing Center. Visit familynurture.org for details on how else you can support child abuse prevention year-round.