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“ACE” is the abbreviation for ‘adverse childhood experience.” There are ten types of ACEs as defined by the original and ongoing collaborative research between the Centers for Disease Control and Prevention in Atlanta, GA, and Kaiser Permanente in San Diego, CA. In the first study completed in 1998 of 17,500 adults ACEs included:

  • Parents separating or divorce
  • Physical, sexual, or emotional abuse
  • Physical and emotional neglect
  • Domestic violence
  • Mental illness in the family
  • Substance abuse
  • Incarceration by a related family member

The questions below cover all ten ACEs and were originally designed by the co-principal investigators of the studies, Robert F. Anda, MD, MS, with the CDC; and Vincent J. Felitti, MD, with Kaiser Permanente:

Prior to your 18th birthday:

  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?
    No___If Yes, add 1 point __
  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?
    Yes, add 1 point  __
  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?
    If Yes, add 1 point __
  4. 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?
    If Yes, add 1 point __
  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?
    If Yes, add 1 point __
  6. Were your parents ever separated or divorced?
    If Yes, add 1 point __
  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 over at least a few minutes or threatened with a gun or knife?
    Yes, add 1 point __
  8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
    If Yes, add 1 point __
  9. Was a household member depressed or mentally ill, or did a household member attempt suicide?   If Yes, add 1 point __
  10. Did a household member go to prison?
    If Yes, add 1 point __Now add up your “Yes” answers: _ This is your ACE Score:_____Your total ACE’s are only a guide and the original ten types of ACEs described above are certainly not an exhaustive list, they were simply mentioned the most by a group of 300 people originally interviewed at Kaiser Permanente and were well researched in the published literature.To get your “Extended ACE Score” which covers adverse childhood experiences not included in the original research, consider the the additional questions below and update your score.

    Extended ACE Score

    Below are additional common ACE’s:

    1. Were you bullied, taunted or shunned at school? If Yes, add 1 point___
    2. Did you experience racism or homophobia or similar forms of hate abuse? If Yes, add 1 point____
    3. Did you experience a serious physical trauma, illness or accident in childhood which required hospitalization? If Yes, add 1 point____
    4. Did you experience a difficult or traumatic birth? If Yes, add 1 point___
    5. Did you witness violence or abuse of a sibling, parent or family member? If Yes, add 1 point____
    6. Did an important family member or caregiver die during your childhood? If Yes, add 1 point___
    7. Did you experience homelessness during childhood? If Yes, add 1 point___
    8. Did your family experience significant adverse financial events during your childhood such as loss of job, financial stability or home? If Yes, add 1 point___

    Total additional Points:____

    Grand subtotal___________