Overview

Adverse childhood experiences (ACEs) are things that happen before adulthood that can cause trauma. Or they're things that make a child feel like their home isn't safe or stable. Some examples of ACEs include violence, neglect, abuse, and family mental health or substance use problems.

What are some examples of ACEs?

Here are some of the most common types of ACEs.

• Emotional abuse. An adult insults, puts down, or swears at a child. Or an adult acts in a way that makes the child afraid they will be hurt.
• Physical abuse. An adult hits, kicks, or physically hurts a child.
• Sexual abuse. An adult (or older child) touches a child in a sexual way, makes a child touch them in a sexual way, or has sex (or tries to have sex) with a child.
• Violence in the home. A child sees adults in the home physically harming each other.
• Substance use problems in the home. A household member has problems with drinking, drug use, or misusing prescription medicines.
• Mental health problems in the home. A household member is depressed, has mental health issues, or has attempted or died by suicide.
• Emotional neglect. An adult in the home doesn't make a child feel safe, protected, and cared for.
• Physical neglect. An adult in the home doesn't make sure that a child's basic needs are met.
• Divorce or separation of parents.
• Having a household member go to prison.

There are other childhood experiences that can cause trauma as well. For example, things like discrimination, being bullied, and being in foster care can also cause stress that can have long-term effects.

What happens when a child has had ACEs?

ACEs are common. By adulthood, most people have at least one. How a child is affected by ACEs depends on the type of ACE and how much distress it causes.

Children who have multiple ACEs tend to have more physical and mental health problems later in life. This may be because of physical changes that can happen in a child's body when they have ongoing stress. It may also be because of health-harming behaviors (like smoking or risky sexual behavior) that are more common in people with more ACEs.

Having had ACEs doesn't mean that a child will have physical or mental health problems. But it does mean that their risk for those things is higher. There are things you can do to reduce the effects of ACEs on a child. And there are ways that adults in a child's life can help prevent future ACEs.

What can you do to help?

After a child has had ACEs, the best thing you can do is try to prevent future harm while helping the child heal from the experiences they've already had. Sometimes it can be hard to know where to start, or what to do. Remember, it's never too late to make changes, big or small. Here are some tips.

• Find a counselor.

  A counselor can help the child process their experiences and learn skills to cope. Try to find a counselor who has experience helping kids who've had ACEs or trauma.

• Focus on creating a safe, stable home.
  • Make days calm and predictable. Setting up routines can reduce stress by helping a child know what to expect each day.
  • Be a consistent presence. Show the child that you can be counted on to be there for them.
  • Give affection. Show that you care with both your actions and your words.
  • Manage your reactions to stress. If you tend to get angry, yell, or be short-tempered, work on learning skills for how to respond to stress in a healthier way.
• Encourage the child's ongoing relationship with a trusted adult.

  This could be someone like a teacher, coach, family friend, or grandparent.

• Teach younger children that their bodies are their own.

  For example, if they don't want to hug or be hugged by people, respect their decision.

• Teach adolescents and teens about sexual consent.

  Asking for consent means asking someone else for permission to touch them, kiss them, or be sexual with them in some way. Someone gives consent when they know exactly what they are being asked to do, and they agree clearly without being pressured.

• Ask for help when you need it.
  • Make a list of people who could help you right away, at any time of day. Think of others who could help you now and then, or if you ask them ahead of time. It might help to make a list of names so you know who to call and when.
  • Get connected with housing or food services if you need them. You can find local resources online. Or you can ask a doctor, counselor, or social worker about resources.
• Learn about parenting classes in your area.

  Being a parent is really hard. Classes can help you learn new tools for how to parent as your child changes and grows. Taking classes doesn't mean that you're a bad parent. In fact, it means that you care about doing a good job.

• Get help working through your own ACEs, if needed.

  When adults don't heal from their own ACEs, they're more likely to create homes where children are exposed to ACEs. But it doesn't have to be that way. You can break the cycle.

  • See a counselor.
  • Get treatment for depression and other mental health conditions.
  • Get help if you have problems with substance use.

  People who need longer-term help with mental health or substance use problems sometimes arrange for someone they trust to care for their child while they get the help they need. That may be a hard decision. But parents who take care of themselves will be better able to take good care of their children.