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Quick Summary

Adverse Childhood Experiences (ACEs) are stressful or traumatic events that happen before age 18
ACEs are common — about 2 out of 3 adults report at least one ACE in their childhood
ACEs can affect long-term health, relationships, education, and opportunity
The good news: ACEs are preventable, and supportive relationships can help children heal and thrive

What Are Adverse Childhood Experiences (ACEs)?

Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur during childhood (ages 0–17). These experiences can be deeply stressful and may disrupt a child's sense of safety, stability, and bonding.

Common Types of ACEs

Category	Examples
Abuse	Physical abuse, emotional abuse, sexual abuse
Neglect	Physical neglect (basic needs not met), emotional neglect (lack of love or support)
Household Challenges	Parent with mental illness, parent with substance use problem, domestic violence, parental separation or divorce, incarcerated family member
Community and Social Factors	Exposure to violence in the community, discrimination, poverty, bullying, homelessness

Important Notes

Not all stressful childhood events are ACEs. ACEs specifically refer to experiences that threaten a child's safety, stability, or bonding with caregivers.
Children can experience multiple ACEs. The more ACEs a child experiences, the greater the risk for negative outcomes — but support and intervention can make a powerful difference.
ACEs happen across all races, ethnicities, incomes, and education levels. No community is immune.

How Do ACEs Affect Health and Life Outcomes?

ACEs can have lasting effects because chronic stress in childhood can change how the brain and body develop. This is sometimes called "toxic stress."

Potential Long-Term Effects

Physical Health

Higher risk of heart disease, diabetes, cancer, and lung disease
Weakened immune system
Chronic pain or fatigue
Earlier death

Mental and Emotional Health

Higher risk of depression, anxiety, and PTSD
Difficulty managing emotions or stress
Increased risk of substance use or addiction
Thoughts of suicide or self-harm

Social and Life Outcomes

Challenges in school or lower educational attainment
Difficulty forming healthy relationships
Higher risk of unemployment or financial instability
Greater likelihood of involvement with the justice system

The Dose-Response Relationship

Research shows a clear pattern: as the number of ACEs increases, so does the risk for health and social problems. This is called a "dose-response" relationship.

Number of ACEs	Increased Risk For
1–2 ACEs	Moderate increase in risk for mental health challenges, substance use
3–4 ACEs	Higher risk for chronic disease, relationship difficulties, academic struggles
5+ ACEs	Significantly higher risk for multiple health, social, and economic challenges

Important: This is not destiny. Many people with ACEs grow up to live healthy, successful lives — especially when they have supportive relationships and access to help.

Risk Factors: What Makes ACEs More Likely?

Certain conditions can increase the chance that a child will experience ACEs.

Family and Household Factors

Parental stress, mental illness, or substance use
Family conflict or domestic violence
Financial hardship or housing instability
Lack of social support for parents

Community and Society Factors

Neighborhood violence or unsafe environments
Limited access to quality healthcare, education, or childcare
Discrimination or systemic inequality
Lack of community resources or social connection

Important Reminder

Risk factors are not excuses. They help us understand where to focus prevention efforts — not to blame families or communities.

Protective Factors: What Helps Children Heal and Thrive?

Protective factors are conditions or strengths that help children cope with stress and build resilience — even after experiencing ACEs.

For Children and Families

Protective Factor	How It Helps
Safe, stable, nurturing relationships	A caring adult can buffer the effects of stress and help a child feel valued and secure
Social connections	Friends, family, faith communities, and mentors provide support and belonging
Concrete support in times of need	Access to food, housing, healthcare, and childcare reduces family stress
Social and emotional competence	Skills like managing emotions, solving problems, and building relationships help children navigate challenges
Parental resilience	When parents have coping skills and support, they can better care for their children

For Communities and Systems

Schools that promote safety, inclusion, and social-emotional learning
Healthcare systems that screen for ACEs and connect families to resources
Policies that support paid leave, affordable childcare, and living wages
Community programs that build connection and reduce isolation

Prevention: How We Can Stop ACEs Before They Start

ACEs are preventable. Public health research shows that preventing ACEs requires action at multiple levels.

What Works: Evidence-Based Strategies

Strengthen Economic Supports for Families

Policies that reduce financial stress (e.g., tax credits, living wages, affordable housing)
Family-friendly workplace policies (e.g., paid leave, flexible schedules)

Change Social Norms to Support Parents and Caregivers

Public messaging that promotes positive parenting and asks for help when needed
Programs that teach nurturing parenting skills and stress management

Provide Quality Care and Education Early in Life

Access to high-quality childcare and early education
Home visiting programs that support new parents
School-based programs that build social-emotional skills

Teach Skills to Handle Stress and Navigate Challenges

Programs that help children and adults build coping skills, emotional regulation, and problem-solving abilities
Mental health support that is accessible and stigma-free

Connect Youth to Caring Adults and Activities

Mentoring programs, after-school activities, and youth leadership opportunities
Safe spaces for young people to build relationships and explore interests

Intervene to Lessen Harms When ACEs Do Occur

Trauma-informed care in healthcare, schools, and social services
Screening for ACEs and connecting families to counseling, support groups, or other resources
Treatment for mental health conditions, substance use, or family violence

How CDC Is Working to Prevent ACEs

The Centers for Disease Control and Prevention (CDC) leads public health efforts to understand and prevent ACEs.

Key CDC Initiatives

Essentials for Childhood Framework

A guide for communities and states to create safe, stable, nurturing relationships and environments for all children. The framework focuses on:
- Raising awareness and commitment to prevent ACEs
- Using data to inform policies and programs
- Creating norms that support healthy child development
- Implementing strategies that prevent ACEs and promote resilience

ACEs Research and Data

Tracking ACEs prevalence through national and state surveys
Studying how ACEs affect health across the lifespan
Evaluating which prevention strategies work best

Tools and Resources for Communities

Free guides, training materials, and communication toolkits
Technical assistance for states and organizations implementing ACEs prevention
Partnerships with healthcare, education, and social service systems

What You Can Do

If You Are a Parent or Caregiver

Build strong, loving connections with your child through daily moments of attention and care
Learn about child development and positive discipline strategies
Take care of your own mental and physical health — you cannot pour from an empty cup
Reach out for help when you need it. Asking for support is a sign of strength.

If You Work with Children or Families

Use trauma-informed approaches: assume that someone may have experienced adversity, and respond with empathy and support
Screen for ACEs when appropriate, and connect families to resources
Create safe, predictable, and welcoming environments
Advocate for policies that support families and reduce stress

If You Are a Community Member

Be a caring adult in a child's life — mentor, coach, neighbor, or friend
Support local programs that strengthen families and prevent violence
Speak up against stigma around mental health, poverty, or asking for help
Vote for policies that invest in children, families, and communities

If You Experienced ACEs

You are not alone, and what happened is not your fault
Healing is possible. Therapy, support groups, and healthy relationships can help
Focus on building your strengths and the life you want
Consider sharing your story if you feel safe doing so — your experience can help others

Where to Find Help and Resources

For Immediate Support

Crisis Text Line: Text HOME to 741741
National Suicide & Crisis Lifeline: Call or text 988
Childhelp National Child Abuse Hotline: Call or text 1-800-4-A-CHILD (422-4453)

For Families and Caregivers

CDC's Essentials for Childhood resources
Positive parenting programs through local health departments or community centers
Family resource centers that offer counseling, support groups, and practical help

For Professionals

CDC's ACEs prevention toolkit and training modules
Trauma-informed care guidelines from SAMHSA and other national organizations
State ACEs coalitions and learning collaboratives

For Everyone

Learn more about ACEs and resilience at cdc.gov/violenceprevention/aces
Share accurate information to reduce stigma and promote prevention
Support policies and programs that create safe, nurturing environments for all children

Frequently Asked Questions

Are ACEs the same as trauma?

ACEs are a specific type of potentially traumatic experience that happens in childhood. Not all trauma is an ACE, and not all ACEs lead to trauma — especially when children have strong support.

Can adults heal from ACEs?

Yes. The brain and body can heal at any age. Therapy, supportive relationships, healthy lifestyles, and meaning-making can all promote recovery and resilience.

How do I talk to a child about ACEs?

Focus on safety, honesty, and hope. Use age-appropriate language, listen more than you speak, and reassure the child that they are loved and not to blame. If you are unsure, consult a mental health professional.

Does having ACEs mean a child will have problems later?

No. ACEs increase risk, but they do not determine destiny. Protective factors — especially stable, caring relationships — can powerfully buffer the effects of adversity.

How can I find ACEs screening or support in my area?

Start with your healthcare provider, local health department, or community mental health center. Many schools, social service agencies, and family resource centers also offer screening and support.

Take the Next Step with Crestwood General

At Crestwood General, we believe that every child deserves a safe, nurturing start in life — and that healing is possible at any age.

We offer:
- Compassionate, trauma-informed care for patients of all ages
- Resources for parents, caregivers, and professionals working with children
- Connections to community supports and mental health services
- Education on building resilience and promoting lifelong health

If you have questions about ACEs, child development, or family wellness, we are here to help.

Visit crestwoodgeneral.com to learn more, schedule a visit, or access free health resources.

Together, we can build healthier futures — one child, one family, one community at a time.