ACEs and Trauma-Informed Care

ACEs are adverse childhood experiences that may have lasting, negative effects on health and well-being both in childhood and in adult life.

While there is currently not a definitive list of ACEs, the original list included exposure to child abuse, substance abuse, mental illness and suicide, incarceration, and violence. Recent additions included in a study of ACEs conducted by Child Trends are parental separation/divorce, death of parent, and economic hardship. The following information summarizes the study and there is a link to the study at the end of this post.

Key findings:

  • Economic hardship and parental separation/divorce are the most common ACEs reported nationally
  • 45% of children in the U.S. have experienced at least one ACE
  • 61% of black children, 51% of Hispanic children, 40% of white children, and 23% of Asian children have experienced at least one ACE
  • One in nine children has experienced three or more ACEs

ACEs can result in toxic levels of stress hormones that alter normal mental and physical development.  This can lead to alcoholism, drug abuse, depression, suicide, poor physical health, lower educational attainment, unemployment, and poverty. Not all children who experience ACEs have negative outcomes but multiple ACEs substantially increase the risk of negative outcomes.

Protective factors can reduce negative outcomes.  The most significant protective factor is a positive, supportive relationship with one or more adults.  Children who experience ACEs but who can manage their emotions have more positive outcomes.  Resilience can be cultivated through self-care routines and through strengthening social and emotional skills such as empathy, self-regulation, and self-efficacy.

An understanding of ACEs has been accompanied by an increase in the development and application of trauma-informed care.  Trauma-informed care includes a variety of approaches that acknowledge the impact of trauma, recognize its systems, respond with appropriate treatment, and prevent further traumatization. It should be noted that screening for ACEs does not replace comprehensive trauma screening and assessment.

All federally-funded programs and many state programs require that programs and services be trauma-informed.  In response to these mandates, the National Family Preservation Network developed one of the first tools for assessing family trauma.  The tool measures symptoms and indicators of trauma in both children and parents.  In the field study one of the most significant findings was the effect of past trauma in parents involved in abuse/neglect of their children or family conflict.  The tool also measures post-trauma well-being following services.  The field study showed dramatic improvement in post-trauma well-being with services primarily consisting of Intensive Family Preservation Services.

For more information on the Trauma/Post-Trauma Well-Being tool visit

To read the field study report on trauma visit

To read the full report on ACEs visit


Posted by Priscilla Martens, NFPN Executive Director


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