In Depth: Understanding Trauma and Adverse Childhood Experiences

Adverse childhood experiences (ACEs) include physical and emotional abuse, neglect, and exposure to family or community violence that can result in chronic disease and mental illness, and the likelihood of being a victim of violence. Community support and policies can help with repair the effects of these experiences.

The benefits of targeting preventive interventions toward children and young people are numerous. In particular, research has well documented that some of the worst health and social problems in our society can arise as a consequence of adverse childhood experiences, such as childhood abuse, neglect, and exposure to other traumatic stressors. The original study of adverse childhood experiences” (or ACEs) was done by Kaiser Permanente’s Health Appraisal Clinic in San Diego in collaboration with the Centers for Disease Control and Prevention.

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As measured in the original research, adverse childhood experiences include: physical abuse; sexual abuse; verbal abuse; witnessing a mother being abused; a household member was a problem drinker or alcoholic or a household member used street drugs; a household member was depressed or mentally ill or a household member attempted suicide; parental separation or divorce; a household member went to prison; emotional neglect; and physical neglect.The original ACEs research measured only these ten forms of trauma. However, other forms of trauma, such as witnessing a sibling being abused, witnessing violence outside the home, being bullied by a classmate or teacher may have a similar impact. Fortunately, because of the plasticity of the brain, the negative effects of early childhood trauma can be mitigated and/or repaired, but that requires access to protective factors—such as access to health and behavioral health services and positive social supports—which are not equitably distributed in our communities. Investing in protective factors in communities that are currently lacking these supports, could help address the negative outcomes of exposure to ACEs as early as possible.