Adverse Childhood Experiences (ACE’s) are stressful or traumatic events, like abuse, neglect and trauma. They may also include family dysfunction such as witnessing domestic violence or growing up with family members who are addicted to drugs or alcohol. ACE’s are strongly related to the development and prevalence of a wide range of health problems throughout a person’s lifespan, including those associated with substance abuse and addiction.

Adverse Childhood Experiences include:

ü  Physical abuse

ü  Sexual abuse

ü  Emotional abuse

ü  Physical neglect

ü  Emotional neglect

ü  Intimate partner violence

ü  Mother treated violently  

ü  Substance misuse within household

ü  Household mental illness

ü  Parental separation, abandonment or divorce

  ü   Incarcerated household member

Recent research has demonstrated a strong relationship between childhood trauma, neglect and other adverse experiences, and substance use disorders and behavioral problems. When children are exposed to chronic stressful experiences, their neurodevelopment can be disrupted as their biological system is exposed to toxic stress during critical stages of their development. As a result, the child’s cognitive functioning or ability to cope with negative or difficult emotions can be impaired. Over time, and especially during adolescence, the child may use negative coping strategies, such as substance use or self-harm, as a way to cope with the intense or overwhelming emotions they are experiencing. Eventually, these unhealthy coping mechanisms can lead to addiction, disease, disability, and social and emotional problems, and a shortened lifespan.

How Childhood Trauma Effects Health Across a Lifetime 

Toxic Stress is bad for our brain!

Brain science has taught us that, in the absence of protective factors, toxic stress damages children’s developing brains. Stress is the body’s normal response to every day events or challenges. Positive stress, like the first day of school, a big game, or a test, is a normal part of growing up, and parents or caregivers can help children learn how to handle positive stress, which is moderate and temporary. These kinds of every day demands for a child will increase their heart rate and the amount of stress hormones in their body, but they will return to normal levels quickly. 

Too much stress, toxic stress, occurs when the child is exposed to overwhelming amounts of fear and distress related to violence, threats of violence, physical or sexual abuse, parental loss or abandonment, foster care, parental addiction and/or mental illness. Then a child’s brain and body will produce an overload of stress hormones, such as cortisol and adrenaline, that harm the function and structure of the brain. This can be particularly devastating in children, whose brains are still developing at a significant rate, especially for the first three years of life. Toxic stress is the kind of stress that occurs when a child lives for months or years with a violent alcoholic parent, a severely depressed and neglectful caregiver, repeated ‘attachment disruptions’ such as those that a child experiences in foster care, or a parent who takes out their frustrations by physically and emotionally hurting their child.

For teenagers, the higher the ACE’s score, the more likely they are to engage in increased high risk or self-injurious behaviors such as; smoking, drinking, illicit drug use, promiscuity/pregnancy, cutting, suicidal ideations and/or attempts. For children and teens, it’s important for us to try and understand these behaviors through a ‘trauma lens’ as a way for the child to cope with overwhelming amounts of toxic stress. They are often impulsive, emotionally reactive and have poor regulation skills. Having at least one trusting, caring adult to help them navigate these emotionally turbulent years is a critical component in helping them build positive self care and emotional resiliency.

Knowing one’s ACE’s score helps us to gain insight into why we may be struggling with feelings of depression, shame, guilt, anxiety or loneliness. To relieve these feelings many of us resort to over-eating, using drugs (nicotine, marijuana, opioids) or alcohol as way to get temporary relief from the toxic stress that lives in both the body and mind.

The past isn’t always the past! Find out your ACE’s score here: 

Hope and Resiliency

Adverse childhood experiences and other traumatic events in childhood do not have to dictate one’s future. Children are both malleable and resilient. Children survive and can even thrive despite the trauma in their lives. For children, adverse events and protective factors experienced together have the potential to strengthen resiliency. The most significant factor that will help a child cope with adverse childhood experiences such as exposure to violence, trauma or abuse is having at least ONE dependable, meaningful, ‘primary attachment relationship’. One adult caregiver who has developed a positive, trusting and committed relationship with the child is the most critical factor in assisting the child in healing from a traumatic history.

For adults, knowing and understanding our ACE’s score gives us the ability to have compassion for our younger selves having survived through a tremendous amount of toxic stress. It can also serve to guide us to our strengths and resiliencies as we learn to replace those negative coping strategies with ones that are building us up, relieving our distress and helping us feel more connected to ourselves and to others.


Allison Davis Maxon, M.S., LMFT is a nationally recognized expert in the fields of child welfare and children’s mental health specializing in Attachment, Developmental Trauma and Permanency/Adoption. She is the Executive Director of the National Center on Adoption and Permanency and was the foster care consultant for the Paramount Pictures movie Instant Family. Allison was honored in 2017 with the Congressional Coalition on Adoption Institute ‘Angels in Adoption’ award and is the co-author of Seven Core Issues in Adoption and Permanency: A Guide to Promoting Understanding and Healing in Adoption, Foster Care, Kinship Families and Third Party Reproduction, Jessica Kingsley Publishers 2019. 





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