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The ACE Questionnaire - A Roadmap to Understanding and Healing

Updated: May 9

What is the ACE Questionnaire?

The ACE questionnaire, developed by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente, is a self-report survey designed to uncover the prevalence of adverse childhood experiences in an individual's life. These experiences encompass various forms of abuse, neglect, and household dysfunction that may have occurred during your childhood and adolescence.

The questionnaire comprises ten questions, grouped into three categories:


a. Emotional abuse

b. Physical abuse

c. Sexual abuse


a. Emotional neglect

b. Physical neglect

Household Dysfunction:

a. Witnessing domestic violence

b. Living with a substance-abusing household member

c. Living with a mentally ill household member

d. Parental separation or divorce

e. Incarcerated household member

Each affirmative response to these questions represents an ACE, and your total ACE score is calculated by adding up these affirmations. A higher ACE score indicates a greater exposure to adverse childhood experiences.

Health Risks due to High Ace Score

Adverse Childhood Experiences (ACEs) have a profound and lasting impact on the health of both children and adults. Mental health, physical health and substance abuse issues can all be affected by a person’s Ace score.

1. Mental Health Issues:

  • Children: ACEs can lead to mental health problems such as depression, anxiety, and post-traumatic stress disorder (PTSD). Children who experience trauma may struggle with emotional regulation, exhibit behavioral problems, and have difficulty forming healthy relationships.

  • Adults: ACEs in childhood are strongly associated with a higher risk of developing mental health disorders in adulthood. Adults with a history of ACEs are more likely to experience chronic stress, which can contribute to conditions like depression, anxiety disorders, and substance abuse.

2. Physical Health Problems:

  • Children: ACEs can have immediate physical health consequences in children, including sleep disturbances, headaches, and gastrointestinal problems. Chronic stress resulting from ACEs can also weaken a child's immune system.

  • Adults: ACEs are linked to a range of chronic health conditions in adulthood. These include heart disease, diabetes, obesity, and autoimmune disorders. The chronic stress and unhealthy coping mechanisms often associated with ACEs can contribute to these physical health issues.

3. Substance Abuse:

  • Children: Adolescents who experience ACEs are more likely to engage in risky behaviors, including substance abuse, as a way to cope with their trauma.

  • Adults: Adults are at a higher risk of developing substance use disorders. The use of substances like alcohol and drugs can become a maladaptive coping mechanism to numb emotional pain.

4. Risky Behaviors:

  • Children: ACEs can lead to engaging in risky behaviors during adolescence, such as early sexual activity, promiscuity, and delinquency.

  • Adults: Adults may continue to engage in risky behaviors, including unprotected sex, which can increase their risk of sexually transmitted infections and unintended pregnancies.

5. Relationship Difficulties:

  • Children: ACEs can affect a child's ability to form secure attachments and maintain healthy relationships, potentially leading to difficulties in forming trusting and stable relationships later in life.

  • Adults: Adults may struggle with intimacy, trust issues, and communication problems in their relationships.

6. Lifespan and Mortality:

  • Children: ACEs can negatively impact a child's overall well-being, potentially affecting their growth and development.

  • Adults: Adults who have a high ACE score often experience a reduced lifespan. The cumulative effects of chronic stress and the associated health problems can lead to premature death.

It's important to note that the effects of ACEs can be mitigated and even prevented with appropriate interventions. Early identification, therapy, and support systems can help children and adults heal from their traumatic experiences and reduce the long-term health consequences of ACEs. Additionally, public awareness and policies that focus on trauma-informed care and prevention are crucial steps in addressing the impact of ACEs on health and well-being.

How the ACE Questionnaire Can Help You:

  • Self-Awareness: Completing the ACE questionnaire can be a profound exercise in self-awareness. It prompts you to reflect on your past experiences and gain a better understanding of your childhood environment.

  • Validation: For many individuals, acknowledging and quantifying their ACEs can be validating. It helps affirm that the challenges they faced were indeed significant and that their feelings and reactions are valid.

  • Connecting the Dots: The questionnaire allows you to connect the dots between your past experiences and current struggles, whether they involve mental health issues, relationship challenges, or unhealthy coping mechanisms.

  • Empowerment: Understanding your ACE score empowers you to take control of your own healing journey. It can motivate you to seek therapy, counseling, or support groups that specialize in trauma recovery.

  • Breaking the Cycle: Recognizing your ACEs can be the first step in breaking the cycle of adversity. By addressing your past and healing from it, you can prevent the perpetuation of ACEs in future generations.

  • Building Resilience: Learning about ACEs can teach you about resilience. Many individuals who have faced adversity in childhood develop remarkable resilience, and recognizing this strength can boost your self-esteem and self-confidence.

  • Treatment Guidance: If you've experienced significant trauma, understanding your ACE score can guide mental health professionals in tailoring treatment approaches that are best suited to your needs.

The ACE questionnaire is a tool that can help you navigate the complex terrain of your past experiences and their impact on your present life. It's a stepping stone towards healing, self-discovery, and personal growth. Remember that you are not defined by your ACE score; rather, it is a starting point for understanding your journey and charting a course towards a healthier and happier future. Embrace the process, seek support, and never underestimate your capacity for resilience and growth. Your healing journey begins with the power of understanding.


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