Get Your Ace Score


“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___________

What are the Implications of my ACE Score?

The full implications of your score, including the increased risk for developing a range of major chronic diseases correlated to your ACE score can be read here: 

The Impact of Emotional Trauma on Health Across a Lifetime.

Further Considerations

There are additional sources of trauma which should also be considered as you investigate the likelihood that your health may have been affected by adverse experiences from the past. These are covered briefly below.

1/ The ACE scoring is rather superficial

The ACE questions can be too superficial to assess for subtle trauma, emotional neglect and other forms of developmental trauma (also known as complex PTSD).

The world-leading expert on trauma, Dr Bessel van der Kolk addressed this in his book “The Body Keeps the Score.”  He created a Trauma Antecedent Questionnaire. The general outline without scoring can be access here:

Trauma antecedents questionnaire



2/ Intergenerational Trauma

Emotional Trauma has also been found to be inherited epigenetically, so for example third generation children of the survivors of the holocaust have been found to have the same physiological symptoms of trauma as their grandparents.

Also the prenatal period, the time we are in our mother’s womb is a critical time when trauma experienced by our mothers can be passed on to the unborn child.

Consider the below questions in relation to your overall ACE score:

  1. Was there significant trauma experienced by your mother during her pregnancy with you?
  2. What are your parents or key caregivers’ ACE scores (based on the above questions?)
  3. Were your parents or grandparents affected by war, political upheaval or other adverse events listed above during their lifetimes?

3/ “Silent ACEs:” The Hidden Epidemic of Attachment and Developmental Trauma

There is a consensus among leading trauma experts that the ACEs questionnaire is inadequate when it comes to assessing specifically for attachment and developmental trauma disorder. A blockbusting 50% of adults have probably experienced this trauma according to major research.

For a more in-depth analysis and understanding about this type of trauma, ensure you read this article linked below. It may well change your responses to questions one and/or four on the ACE score regarding emotional abuse and neglect.

“Silent ACEs:” The Hidden Epidemic of Attachment and Developmental Trauma

4/ Factors which make us more likely to be impacted by ACEs

There are certain factors that can make it more likely that an adverse childhood experience will traumatize us with lasting effects on our physical and mental well-being. These include:

  1. Being a Highly Sensitive Person –  Some people are naturally more emotionally sensitive and aware. They are often “empaths” who can easily feel other people’s feelings and read emotional energy in a room. Their nervous system is therefore more acutely sensitive, which in turn can result in a deeper impact from ACEs.
  2. Having one ACE  can help  – having a low level of ACEs can actually help you deal better with another one – people with no ACEs at all, or very high ACE’s may have the most adverse reactions to an ACE.
  3. No outside support – If, during childhood there was no outside support, or the ACEs we faced were even a family “secret,” research shows the impact is worse for the child. Research shows just having one reliable adult to speak to about their experience can help a child bounce back from an ACE.
  4. How your store your memories of an event, your ability to reframe the meaning and even your beliefs about emotional stress itself will affect how an ACE impacts your health and well-being.

What are the Next Steps – How do I Address my ACE’s and Heal?

So now that you know that emotional trauma may have affected you both physically and emotionally, what are the steps to address it?

First read the article on Healing Trauma Part 1: How Does Our Childhood Biography Become Our Biology?







 Related Articles 

The Impact of Emotional Trauma on Health Across a Lifetime

Healing Emotional Trauma Part 1: How Does Our Childhood Biography Become our Biology?

How to Deal with Emotional Detoxification Reactions – 7 Pitfalls



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