Adverse Childhood Experiences (ACEs) are possible traumatic events that occur from birth through adolescence (zero to seventeen years of age.) ACEs came to fruition through a study by Dr. Vincent Felitti and Dr. Robert Anda to identify negative critical conditions a child may experience and their lasting impacts. Dr. Felitti, the head of Kaiser Permanente’s Department of Preventive Medicine in San Diego, along with Dr. Anda, a researcher for the Centers for Disease Control and Prevention, set out to conduct a study between 1995-1997 with the hypothesis that childhood trauma is relational to poor physical and mental health in adults. Felitti and Anda collected survey data from 17,000 patients (gathered during their physical exams.) The adverse childhood experience survey included ten questions to identify traumas and neglect. The ACEs were identified as neglect, abuse (sexual, emotional, and physical), and household dysfunctions (including aspects such as parental divorce or separation due to incarceration, substance abuse and addiction, mental health problems, and witnessing violence.)

The results of the study were shocking: there was a direct connection between a child experiencing ACEs and poor mental and physical well-being as an adult. The Centers for Disease Control and Prevention (CDC) reports that the ACE study confirmed that 64% of adults had experienced at least one ACE before age eighteen. What is more alarming, is that almost one in six adults has an ACE score of four or more. It was the first time there was hard evidence that trauma may be directly linked to negative adult circumstances.

The National Institute for Children’s Health Quality (NICHQ) reports that 34.8 million children are subjected to adverse childhood experiences. Research has shown that the higher the ACE score, the higher the risk of chronic medical disorders, mental health disorders, substance use, as well as engagement in risky behavior. What exactly are we talking about here? Carrying an ACE score of four or more puts you at a higher risk for long-lasting health concerns like diabetes, heart disease, cancer, drug abuse, suicidality, risky sexual behaviors, and struggles with finances, job security, and maintaining relationships (just to name a few). The saddest piece of information: the effects can be passed down to our children, which only continues the cycle. For those with an ACE score of six or more, research has shown these individuals may live twenty years less than those with a lesser ACE score.

There are two criteria used to define complex childhood trauma. The first is when a child has experienced multiple ACEs before the age of 18. The second criterion is when the child’s trauma comes directly from their caregiver, or they are in a position where their caregiver does not protect them. Individuals who endure childhood complex trauma may be diagnosed with Complex Post-Traumatic Stress Disorder (C-PTSD) by a trained trauma-informed professional. The Georgetown University Center for Child and Human Development explains that complex trauma is chronic, begins in childhood, and occurs within the primary caregiving environment. Typically, complex trauma includes an occurrence of trauma one after the other or a cluster of events co-occurring within the realm of sexual, emotional, and physical abuse, witnessing violence, and neglect.