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My child's ACE history

While the original ten ACEs are used to assess all ages, there are different tools available to explore the ACE history of your child or teen.

A broader look at adversity

While the original ACE study focused on ten specific categories, there are many other ways children can experience adversity that might lead to a toxic stress response. The tools commonly used to screen for ACEs in young people include a set of questions to identify additional potential sources of toxic stress including:

Community, neighborhood, or school violence (like targeted bullying, assault, gun violence, or war or terrorism)
Discrimination which includes being put down, excluded, or mistreated due to race, ethnicity, gender identity, sexual orientation, religion, learning differences, or disabilities
Housing problems (not having a stable place to live, moving frequently)
Food concerns (worries your child may not have enough to eat)
Being separated from a parent due to foster care or immigration
Living with a parent or caregiver with a serious physical illness or disability
Or having lived with a parent or caregiver who died.

For teens, there are two additional factors considered:

Being detained, arrested, or incarcerated
Verbal or physical abuse or threats from romantic partners

While no tool can address every potential stressor our children may face, starting here can help us gain insight into how much their lived experiences may be impacting their well-being.

Review my child's ACE history

Review my teen's ACE history

Outcomes

The more adversity a child experiences without support, the more likely they’ll develop a toxic stress response.

For children and teens, toxic stress could lead to health and other issues, including asthma, allergies, rashes and eczema, aches and pains, depression, self-harm, learning or behavior problems, developmental delay, ADHD, not graduating high school, early use of alcohol or drugs, and early sexual activity.

As parents, this can sound overwhelming. We face incredible odds holding our families together every day, especially those of us coping with barriers like racism, discrimination, low incomes, and communities lacking resources.

The outcomes for children and teens with high ACEs are not predetermined pathways. Our brains and bodies are amazingly resilient and ready to change – especially when we’re young.

Next steps

With our knowledge of ACEs, we can look at the behaviors and symptoms of our kids and teens through a new lens, knowing that their brains and bodies may be responding to their lived experiences.

It may also be helpful to talk with your child’s doctor, teacher, school counselor, or other trusted adults in your child’s life so they can become active members of your child’s support team. We may want to keep in mind that in many states and US territories, most people who work with kids are required by law to report to child protective services or law enforcement any known or suspected child abuse or neglect.

Adverse experiences aren’t the only ones that impact the health and outcomes of children and teens. Positive experiences are vital to helping kids reach their potential.

There’s a lot we can do to help provide antidotes to the adversity our children face. Nurturing, supportive relationships; safe and stable environments for living, learning and playing; engagement in community; and participation in social activities (like art, music, theater, or sports) are key elements to helping our kids thrive. Learn more about the building blocks of HOPE (Healthy Outcomes through Positive Experiences).

We also recognize that those of us who are able need to continue advocating for policies and resources that make every neighborhood and every school a safe place for kids to learn and grow. We need to ensure every community and family is equipped to provide all kids with the time, attention, care, and access they need to flourish and thrive.

Frequently asked questions on raising kids with ACEs

Learning about ACEs can equip us to better care for our kids and their needs. Below are some common questions caregivers have about ACEs, kids, and parenting.

How early can my child be impacted by ACEs?

No child is too young to be affected by ACEs. Babies are more vulnerable than any other age group. Their brains are developing rapidly through every new experience and encounter. ACEs and toxic stress can cause developmental challenges, along with a host of other cascading effects, as babies and toddlers grow, especially if they’re not surrounded by safe, nurturing relationships and environments.

For more on ACEs and the positive parenting of children ages 0 to 5, check out this free, downloadable toolkit, a collaboration with American Society for the Positive Care of Children: We All Have a Number Story: Your Child’s First Chapters

Is it always obvious if my child is affected by ACEs?

ACEs can be impactful even if they don’t appear to cause harm in the moment. When kids don’t have their needs met over a period of time, they may demonstrate a lack of focus and inability to concentrate that’s serious enough to result in an ADHD diagnosis. When kids witness interpersonal violence between adults, they may develop asthma. When a caregiver’s anger boils over frequently, with screaming and a loss of emotional control – even without any contact – the results may be as harmful biologically to children as physical abuse.

I’m wondering if some of my kids’ symptoms, health issues, or behaviors might be connected to their ACEs. What should I do?

We can talk to our doctors. Opening up to our doctors or our kids’ pediatricians about our ACE histories, along with any concerns we may have about our kids’ health, may help them provide our families with more effective care. Our doctors can be our advocates, and important members of our support teams, especially if they know and understand our families’ situations.

Our doctors may provide formal screening – for us and/or our children, where appropriate – for ACEs, developmental challenges, behavioral health conditions, interpersonal violence, substance abuse, or other issues or conditions. They can help with (or refer us to help for) many difficulties from our own childhood adversity that we’re concerned may be affecting our kids’ well-being now.

It may also be helpful to talk to our children’s teachers or counselors, or other trusted adults in their lives so that they can help actively address our kids’ needs and provide the best support they can offer.

We may want to keep in mind that in most states and US territories, most people who work with kids are required by law to report to child protective services or law enforcement any known or suspected child abuse or neglect.

Do children and teens use the same tool to assess their ACE histories as adults?

While the original ten ACEs are the same for all ages, there are different tools available to explore the ACE history of our child or teen. These tools include additional risk factors for toxic stress, like bullying and discrimination. Learn more here.

As a parent with ACEs, how do I cope during stressful situations - like a big life transition, or an ongoing crisis, like the pandemic?

When situations in the present feel overwhelming and out of our control, they can activate similar feelings from past traumas. As parents with ACEs, we likely felt like things were too much or not in our control when we were growing up. Recognizing and acknowledging these feelings is an important first step. Then we can take some time to focus on the things we can control.

Dwelling on uncertainty and lack of control can be where stressful situations turn traumatic. The key is to break things down into simple steps that we can control to reduce our stress hormones. Sometimes what we can control is tiny – maybe even as simple as focusing on our breath. Spend time in nature. A solid sleep routine. Find ways to move every day. Eat nourishing foods. Reach out to a friend. Take time to care for our mental health. Pick one thing to start with, something within our reach today.

I’m trying to break the cycle and do things differently with my kids. What if I’m feeling overwhelmed while parenting?

As parents with ACEs, we’re more likely to be coping with our own lasting physical and mental health consequences. We also may be more likely to lash out verbally, or to have more difficulty controlling our impulses, especially when we’re feeling overwhelmed. When we’re dealing with intense stress – the public health crises, economic stress, job stress, then challenges with kids on top of all that – we may find ourselves pushed near the edge of our coping abilities. Crisis resources are available any time to help us. Asking for help is a sign of strength and resilience.

We can also give ourselves grace while breaking cycles and figuring out new ways to parent. Those aren’t easy tasks, and we may feel like we don’t have a great roadmap to follow. Communities and resources that share positive parenting advice and skills can help, like American SPCC’s Parenting Resource Center.

Where can I learn more about parenting with ACEs?

To learn more about parenting with ACEs and connect to a community for support and information, check out the Parenting with ACEs Community from PACES (Positive & Adverse Childhood Experiences) Connection.

Helping kids manage stress

How can we accept that our children are doing the best they can with the tools they have in the moment? How can we give them tools to help get their needs met?

Co-regulation

Before kids learn to calm themselves, they can learn from us modeling healthy skills and behaviors for them. One of the most important things we can do for our kids is provide a safe environment to process what they’re thinking and feeling, and practice healthy behaviors. This is called co-regulation, and it’s a collaborative effort between us and our children. Key to creating that space is managing our own stress, by modeling some of our own self-care and self-regulation. This co-regulation stage is critical to our child’s ability to self-regulate as they get older.

Stress and ACEs

We can help validate and empower our kids and teens who have been through tough times or are living with ACEs by acknowledging that their body may be making more stress hormones than the average person.

That can look and feel like having trouble sleeping, difficulty focusing on tasks or paying attention and learning, or struggling with self-control or self-regulation. That’s normal because of what they’ve been through. Our bodies have a mechanism designed to protect us from harm. Because they’ve been through some harm, that mechanism is even stronger.

We can assure them that they don’t need to feel shame, or blame themselves for how they’re feeling or reacting. Their experiences – and the fact that their bodies stepped up to take on the challenges in their lives – are not their fault, and we are here to help provide understanding and support as they learn to manage the reactions and challenges that impact their bodies and their lives.

Behavior is communication

It’s helpful to remember that behavior is communication. Rather than needing to “fix” our child’s behavior, we can look for ways to understand their behavior as our child’s attempt at communicating.

When our kids are struggling with big emotions, the first thing we can help them do is regulate. Check out the tools below to help kids deactivate their fight, flight, or freeze response and return to a calmer state.

Next, we can relate to them, validating how they’re feeling. This helps strengthen the attachment bond.

Once they’re able to think more clearly, we can help them put words to their emotions, reason and problem-solve together, and reflect on any new insights.

Tools

breathing activities for kids

cool-down corner

grounding techniques for kids

meditation
for kids

Building Resilience Toolkit

Resilience is the ability to recover from difficult and stressful situations. Even if our kids have already been through some tough stuff, we can help them build resilience.

No matter where we’re at in our parenting journeys, there are steps we can take to help our families grow stronger and closer. We can help our kids navigate tough times in positive ways.

While some of the adversity our kids face is outside of our control, there are opportunities to reduce the challenges they may face, and to help them reduce and manage the stress they experience. This can help lead to healthier, safer, stronger outcomes for their lives now and in the future.

Explore how to prevent and address adversity, and help protect your kids from the effects of toxic stress.

building a stress-busting routine

Early childhood

The first few years of a child’s life are especially important for development. Millions of connections shape the brain and every system in the body. How we pay attention and respond play a big part in how our babies develop.

Babies’ brains develop through interaction. When babies and young children send out signals that don’t get a response or are met with violence, that neglect or abuse can disrupt brain development. If neglect or abuse becomes chronic, the child’s stress response may become elevated, further affecting development.

The good news is, there are things we can do to make our young children feel supported and cared for. We can encourage healthy brain development, a solid sense of self, and a number of other benefits to our children’s health and well-being throughout their lives.

Check out “How Brains Are Built: The Core Story of Brain Development.” These four minutes may change the way we understand our kids and their minds (and maybe even ourselves!).

Brains aren’t just born, they’re built! Learn more through Brain Story!

For more on ACEs, prevention, and the positive parenting and development of children ages 0 to 5, check out this free, downloadable caregiver toolkit, a collaboration with American Society for the Positive Care of Children:

We All Have a Number Story: Your Child’s First Chapters
CAREGIVER TOOLKIT: AGES 0-5 (PDF)

Parenting infants and young children can be especially stressful. Children ages zero to three have the highest rate of neglect and abuse of any age group, and babies in their first year of life are most at risk. If you feel overwhelmed, know that you’re not alone. It’s okay to ask for help. Get immediate support by contacting the Crisis Text Line for free counseling 24/7 by texting the word ACES to 741741. To learn more about parenting with ACEs and connect to a community for support, check out the Parenting with ACEs Community from PACES Connection.

Where would you like to start?

mental health: pregnancy and year one

secure attachment

serve and return

View the Caregiver Toolkit here:

Caregiver Toolkit: Ages 0-5

Communication and connection

From infancy through adolescence, our kids need our help to understand and navigate their thoughts, feelings, and behaviors, and learn how to express themselves in healthy ways. Uncertainty can create anxiety, at any age. As parents and caregivers, it’s important to talk to our kids about stressful situations in age-appropriate language, and to be calm and sensitive to help them cope.

Here are some suggestions for communicating clearly during times of stress:

BUILD EMOTIONAL VOCABULARY

If your child faces a difficult situation, we must ask them how they feel about it, helping them understand, name and communicate their emotions. A good tool for this is The Wheel of Emotions (kids version or teen/adult version).

SHARE THE FACTS

After listening to your child’s take on a stressful situation, calmly correct any misinformation and share age-appropriate, honest facts and feelings. Help them focus on things we can control to stay healthy, express our feelings, and help others.

MODEL SELF-CARE

When you need a break, communicate it and take the break, whenever possible. If you’re having a really hard time, that’s normal — parenting can be really hard, even in the best of times. Modeling good, honest communication around our feelings helps give kids an example to follow.

STAY CONNECTED

Social supports are essential to our kids’ development and the well-being of our whole family. Find ways to keep your kids connected to their friends, family, teachers, coaches, mentors, etc. — their support team. And make sure to stay connected with your support team, too!

FAMILY JOURNALING

Journaling is a time-honored practice of recording our thoughts, feelings, and ideas in a private space. Having a family practice can help us get in touch with our feelings individually and share them in community.

Closed Journaling

Encourage everyone in the family to keep their own journal. This doesn’t have to be just for writing — we can use drawing, collage, doodling, colors, and song lyrics to express ourselves.

Open Journaling

This is journaling shared between us and our child or teen. One of us creates an entry in the journal – writing, drawing, or whatever they’d like, then passes the journal to the other. The other contributor adds responses, creates their own entry to the journal, and then passes it back. You could also decorate a “mailbox” and write letters back and forth to each other. This type of journaling process can make it easier to communicate about things that might be hard to talk about face to face.

Color Journaling

Have your child or teen create a rainbow on the cover or first page of a notebook. Together, assign each color a mood. In the journal, draw a weekly calendar of seven squares. Each day, in addition to any journaling they may do, your child can color in one or two colors to show the major mood they experienced that day. At the end of the week or month, you can look back on the journal pages and see how things are going, and if there were any patterns or changes. This type of journaling can bring about breakthrough insights for kids, teens, and families.

Help My Kids