What Are Adverse Childhood Experiences?

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Children need to feel safe and stable in their home environment in order to thrive in their growth and development. Trauma experienced during childhood can have a lasting impact on health and well-being.

Adverse childhood experiences, also known as ACEs, are adverse (negative and impactful) experiences that occur during formative childhood years. These include single traumatic events and ongoing traumatic experiences like abuse.

This article will help you understand what are adverse childhood experiences, their impact on physical and mental health development, and what recovering from childhood trauma looks like.

A young child in shadow sitting alone in a hallway.

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What Are ACEs?

Each adverse experience a child goes through counts as one trauma. The more trauma someone experiences before 18 years old, the more likely they are to experience adverse adulthood experiences, including substance use disorders and mental health disorders. 

Common ACEs include:

You can tally your ACEs up to see your overall risk of associated future health consequences. 

These 10 ACEs are not the only possible traumas experienced in childhood. Other factors such as racism; bullying; major loss such as a death of a parent, sibling, or caregiver; being involved in an accident; and community violence also can play a part in how the child comes to see and understand the world as either a safe and nurturing environment or somewhere to be cautious and reserved due to fear of what’s to come next.

ACEs and Toxic Stress

ACEs are said to create toxic stress for children during the developmental years. Toxic stress is unhealthy stress because it excessively activates the stress response system. This is said to have a “wear-and-tear” effect on the person’s body and brain.

Health Consequences of ACEs

The health consequences of ACEs are associated with prolonged stress. Prolonged stress changes the developing brain and how it learns to cope with stress.

Physical Health

Physical health conditions associated with ACEs include:

ACEs are associated with at least five of the leading causes of death, including suicide and overdose.

Mental Health

Mental well-being is said to decline as the number of ACEs goes up. The following are all associated with ACEs.

Recovering From Adverse Childhood Experiences

Research has found that play and creative expression (which can be done through different forms of art) can be helpful for people trying to process trauma and recover from ACEs. A 2021 study suggested that play creates the space for self-expression, self-care, and healing from childhood trauma.

Therapies that use a "trauma-informed approach" are targeted toward understanding how trauma, adversity, and toxic stress can affect child development. It is possible for ACEs to be prevented, reduced (in terms of impact on the future), and recovered from with this approach. A trauma-informed approach avoids retraumatization (reliving stressful feelings from an earlier trauma) and empowers the person to change their negative coping strategies to healthier behaviors.


Adverse childhood experiences are experiences that create toxic stress, leading to poorer or negative outcomes in adulthood. ACEs are associated with poorer health outcomes later in life including increased risk of substance use disorder, heart disease, and obesity, as well as mental health challenges. 

A Word From Verywell 

ACEs help us understand how certain past events that occur during formative years can change the way we cope with stress and how this impacts our future. ACEs are not certainties, though. Many people with ACEs also experience positive life events that help reduce stress levels and show them how to cope with stress in healthy ways. If you need more support, a licensed therapist can help.

Frequently Asked Questions

  • How prevalent are adverse childhood experiences?

    Adverse childhood experiences are prevalent across cultures. Reports suggest most children experience at least one ACE in their lifetime. This is the case for:

    • Over 60% of Black children (non-Hispanic)
    • Over 50% of Hispanic children
    • 40% of White children (non-Hispanic)
    • 23% of Asian children (non-Hispanic)

    Some adults (around 16%) have experienced four or more ACEs, with this being particularly true for women and several racial and ethnic groups who are at greater risk.

  • What are the most commonly reported adverse childhood experiences?

    The most commonly reported ACE in the United States is economic hardship, followed by the separation or divorce of a parent or guardian.

  • How does childhood trauma affect the brain?

    Childhood trauma affects the brain by creating toxic stress that eventually changes the person’s stress response system and leads to poor mental health and physical health outcomes.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Adverse childhood experiences.

  2. Aces Too High. What ACEs/PCEs do you have?  

  3. Center on the Developing Child by Harvard University. What are ACEs and how do they relate to toxic stress?.

  4. Centers for Disease Control and Prevention. Adverse childhood experiences, overdose, and suicide.

  5. Sheffler JL, Stanley I, Sachs-Ericsson N. Chapter 4 - ACEs and mental health outcomes in adverse childhood experiences. Academic Press. 2020(47-69). doi:10.1016/B978-0-12-816065-7.00004-5

  6. Chang X, Jiang X, Mkandarwire T, Shen M. Associations between adverse childhood experiences and health outcomes in adults aged 18-59 years. PLoS One. 2019;14(2):e0211850. doi:10.1371/journal.pone.0211850

  7. Pliske MM, Stauffer SD, Werner-Lin A. Healing from adverse childhood experiences through therapeutic powers of play: “I can do it with my hands”International Journal of Play Therapy. 2021;30(4):244–258. doi:10.1037/pla0000166

  8. SAMHSA. SAMHSA’s concept of trauma and guidance for a trauma-informed approach.

  9. National Conference of State Legislature. Adverse childhood experiences.

  10. Child Trends. Adverse childhood experiences: National and state-level prevalence.

By Michelle Pugle
Michelle Pugle, BA, MA, is an expert health writer with nearly a decade of contributing accurate and accessible health news and information to authority websites and print magazines. Her work focuses on lifestyle management, chronic illness, and mental health. Michelle is the author of Ana, Mia & Me: A Memoir From an Anorexic Teen Mind.