KP/CDC's A.C.E. Quiz (Adverse Childhood Experiences)

{thanks @SDD757 for saving this thread after the last server migration in early April!!}

Someone posted this on a different thread and I found it fascinating and definitely a tool and resource for us CSA Survivors.

Source 1:

An ACE score is a tally of different types of abuse, neglect, and other hallmarks of a rough childhood. According to the Adverse Childhood Experiences study, the rougher your childhood, the higher your score is likely to be and the higher your risk for later [social &] health problems.

Source 2:

The Adverse Childhood Experiences Study (ACE Study) is a research study conducted by the American health maintenance organization Kaiser Permanente and the Centers for Disease Control and Prevention.[1] Participants were recruited to the study between 1995 and 1997 and have been in long-term follow up for health outcomes. The study has demonstrated an association of adverse childhood experiences (ACEs) (aka childhood trauma) with health and social problems across the lifespan. The study has produced many scientific articles and conference and workshop presentations that examine ACEs

Source 3: this is AD HEAVY and would freeze up my regular phone browser - best to use a browser with an an ad blocker)

There are, of course, many other types of childhood trauma — racism, bullying, watching a sibling being abused, losing a caregiver (grandmother, mother, grandfather, etc.), homelessness, surviving and recovering from a severe accident, witnessing a father being abused by a mother, witnessing a grandmother abusing a father, involvement with the foster care system, involvement with the juvenile justice system, etc. The ACE Study included only those 10 childhood traumas because those were mentioned as most common by a group of about 300 Kaiser members; those traumas were also well studied individually in the research literature.

The most important thing to remember is that the ACE score is meant as a guideline: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences.

(By the way, lest you think that the ACE Study was yet another involving inner-city poor people of color, take note: The study’s participants were 17,000 mostly white, middle and upper-middle class college-educated San Diegans with good jobs and great health care – they all belonged to the Kaiser Permanente health maintenance organization.)

Here is the quiz.

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, enter 1 __
  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?
    No___If Yes, enter 1 __
  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?
    No___If Yes, enter 1 __
  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?
    No___If Yes, enter 1 __
  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?
    No___If Yes, enter 1 __
  6. Were your parents ever separated or divorced?
    No___If Yes, enter 1 __
  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?
    No___If Yes, enter 1 __
  8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
    No___If Yes, enter 1 __
  9. Was a household member depressed or mentally ill, or did a household member attempt suicide? No___If Yes, enter 1 __
  10. Did a household member go to prison?
    No___If Yes, enter 1 __
Now add up your “Yes” answers: _ This is your ACE Score

in the replies, below I will add info of what Ace Scores of 3 or higher can do to your health and well-being as an adult....
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from Source 3....

What causes this?
At the same time that the ACE Study was being done, parallel research on kids’ brains found that toxic stress damages the structure and function of a child’s developing brain. This was determined by a group of neuroscientists and pediatricians, including neuroscientist Martin Teicher and pediatrician Jack Shonkoff, both at Harvard University, neuroscientist Bruce McEwen at Rockefeller University, and child psychiatrist Bruce Perry at the Child Trauma Academy.

When children are overloaded with stress hormones, they’re in flight, fright or freeze mode. They can’t learn in school. They often have difficulty trusting adults or developing healthy relationships with peers (i.e., they become loners). To relieve their anxiety, depression, guilt, shame, and/or inability to focus, they turn to easily available biochemical solutions — nicotine, alcohol, marijuana, methamphetamine — or activities in which they can escape their problems — high-risk sports, proliferation of sex partners, and work/over-achievement. (e.g. Nicotine reduces anger, increases focus and relieves depression. Alcohol relieves stress.)

Using drugs or overeating or engaging in risky behavior leads to consequences as a direct result of this behavior. For example, smoking can lead to COPD (chronic obstructive pulmonary disease) or lung cancer. Overeating can lead to obesity and diabetes. In addition, there is increasing research that shows that severe and chronic stress leads to bodily systems producing an inflammatory response that leads to disease.
In addition, toxic stress can be passed down from generation to generation. The field of epigenetics shows that we are born with a set of genes that can be turned on and off, depending on what’s happening in our environment. If a child grows up with an overload of toxic stress, their stress-response genes are likely to be activated so that they are easily triggered by stressful situations that don’t affect those who don’t grow up with toxic stress. They can pass that response onto their children.

Fortunately, brains and lives are somewhat plastic. Resilience research shows that the appropriate integration of resilience factors — such as asking for help, developing trusting relationships, forming a positive attitude, listening to feelings — can help people improve their lives.
I found this whole thing very fascinating - I got a score of 5!! It explains a lot of symptoms that I had no idea were related!!!
This material was developed by Kaiser working with its patient base. It is painful AND relieving to know that we come by our struggles honestly. Living in traumatizing environment will do exactly this to a person. And it is not surprising that trauma is passed down from generation to generation. It certainly isn't created from whole cloth each time it appears in a family, though families can fall victim to circumstances that become the incubators of trauma. The loss of a job during a downturn in the economy can lead to loss of a home. A medical emergency can do the same thing. If the primary breadwinner is brought down by illness the whole family will suffer. When money is tight it is easy for tempers to flair. The ACE assessment points to where things go awry. Those of us who are spending time on this website are living proof that bad things can happen along the way, especially when we are young, that can have a lifetime of negative consequences.

Thanks Kal. You've become a very resourceful person whose efforts benefit us all. Thanks for this.

Jacob S

I got a 6 but feel like the questions left a lot of things out. There was no room for same-age sex abuse for instance and since I don't know the exact criteria for "very often" I couldn't honestly say yes.
I got a 6 but feel like the questions left a lot of things out. There was no room for same-age sex abuse for instance and since I don't know the exact criteria for "very often" I couldn't honestly say yes.
The survey was based on the 10 most reported Adverse Experiences - there could be a multitude of others. The study was only based on responses to these "top 10" .... and 6 is VERY HIGH

betrayed boy

Staff member
i took this a few years ago i scored a 10 and have or had most of the issues in the charts listed above ^.
I scored 8.

Risk groups or affects:
  • High Blood Pressure
  • Depression
  • Anxiety/medication
  • Syncope (getting bad the last few weeks)
  • Diabetic
  • Sleeping disorders
  • Kidney disease
  • Suicide
  • Financial problems (doctors bills and lost time at work)
There are lots of affects and risk factors because parts of the brain that regulates things are damage from trauma.
Kal, first thank you for putting this out there!

Due to my line of work, and personal recreation I’m physically strong and healthy - the more I keep moving, the more distracted I am, and yes, I know that is a form of running.

My major issue is that I’ve always battled suicidal thoughts and attempts. Other big issues anxiety, self harm, putting myself in high risk situations follow. Occasionally drinking gets the best of me, then I see it in my performance and weight, so I have to work even harder to get back in fitness routines. Depression and flashbacks have kept me on the couch for a week sometimes. Autoimmune has been my most visible symptom, in my teens stress triggered Alopecia. About 6 years ago my Aplopecia turned into Alopecia Universalis, which totally humiliating, but still finding my confidence in that.

I scored 5 - Here’s what I’ve been doing about that.
In therapy this time around I committed to doing the work purely a possible with mind and body given healthy focus. Not easy by any stretch, because reactions seem more intense. Yes, I’ve drank some, but I feel I have accountability here, and with my therapist. For other personal accountability I use fitness, yoga, meditation apps to keep me going. Sad I know, but they work. One gap that needs attention, a real life human that I can trust, and I’m working on that.

Thank you again for this insight to health.

TJ jeff

Staff member
Being a solid 7 on the scale it is amazing to me that I can hold it all together and act like a normal human being. Perhaps someday it will catch up with me
Being a solid 7 on the scale it is amazing to me that I can hold it all together and act like a normal human being. Perhaps someday it will catch up with me

Another possibility is that despite the bad things that happened to you TJ there is an innate capacity to attend to life's challenges. It is sometimes possible to overlook our capabilities when we're focused on the trauma we've experienced. Granted, we have limitations, blind spots, ways of hiding that can perpetuate pain... but sometimes along with that we have moments of clarity and then take care of business. Despite some crazy acting out behavior in my life, I also was quite successful at my job. I guess I was adept at compartmentalizing my pain. I've survived, for which I'm grateful. And now I'm grateful for the healing I'm doing. I just want to remember that for all the mess in my life, it wasn't ALL a mess...