Adverse Childhood Experiences
What happened to you as a boy still matters. So does what you do with it now.
Adverse Childhood Experiences, or ACEs, are the potentially traumatic events a child lives through before age 18. Research over the last three decades has shown they shape adult health, relationships, and how a man carries stress. This page explains what ACEs are, where to take the official questionnaire, and where to turn for support.
The basics
What counts as an ACE
The term comes from the CDC–Kaiser Permanente ACE Study, which followed more than 17,000 adults in the mid-1990s. Researchers asked about ten kinds of childhood adversity and then compared the answers against the participants' health records. The pattern was clear and has been repeated many times since: the more categories a person experienced, the higher the likelihood of problems later in life, from heart disease and depression to substance use and difficulty holding relationships together.
The ten categories fall into three groups.
Things done to you
- Physical abuse
- Emotional or verbal abuse
- Sexual abuse
Things you went without
- Physical neglect: food, clean clothes, protection, medical care
- Emotional neglect: feeling unloved, unimportant, or unsupported
Things happening around you
- A parent or caregiver treated violently
- Substance use in the home
- Mental illness or a suicide attempt in the home
- Parents separated or divorced
- A household member in prison
These are common, not rare. In CDC survey data, nearly two in three American adults report at least one ACE, and about one in six report four or more. If you recognize yourself in this list, you are in very large company.
Reading the number
What an ACE score does, and does not, tell you
One point per category, zero to ten
The questionnaire asks ten yes-or-no questions about your life before age 18. Each "yes" is one point. The score counts categories, not events: a single incident and years of the same thing both score one.
Researchers often treat a score of four or more as the point where health risks rise sharply. It is a statistical marker for populations, not a verdict on any one man.
The score is a doorway, not a diagnosis. It does not measure how severe an experience was, how long it lasted, or how old you were. It says nothing about what was also present: a grandfather who showed up, a coach, a faith community, a friend's kitchen table. Those protective experiences are real and they change outcomes. Two men with the same score can be living very different lives.
What the score can do is name something. For many men, seeing a number attached to what they had always treated as "just how it was" is the first time they let themselves take it seriously. That is the point of taking it, and the reason to take it with some care, ideally with someone you can talk to afterward.
The questionnaire
Where to take it
There is no login, no fee, and no one collecting your answers unless you choose to share them. These are the sources we consider most credible. The first is the version California's ACEs Aware initiative uses in clinical settings; it is the closest thing to an "official" adult form in current use.
- ACE Questionnaire for Adults (PDF) ACEs Aware, a program of the California Department of Health Care Services and the Office of the California Surgeon General. De-identified: you count your own "yes" answers. Also available in Spanish and other languages on their screening tools page. Recommended
- Take the ACE Quiz, and learn what it does and doesn't mean NPR. The original ten questions in an interactive form, with a clear-eyed explanation of the score's limits. Nothing is stored. Online quiz
- About Adverse Childhood Experiences Centers for Disease Control and Prevention. The authoritative overview of the research, prevalence, and prevention. Background
- ACEs and Toxic Stress: Frequently Asked Questions Center on the Developing Child, Harvard University. Plain answers on how adversity affects the body and brain, and why resilience is learnable. Background
Support
If the questionnaire stirred something up
That is a normal response, and it is a reason to reach out rather than to shut the laptop. Every service below is free or low-cost, confidential, and used to hearing from men who have never said any of this out loud.
Right now, any hour
- Call or text 988 988 Suicide & Crisis Lifeline. For any emotional crisis, not only thoughts of suicide. Chat at 988lifeline.org.
- Dial 988, press 1, or text 838255 Veterans Crisis Line. For veterans, service members, and their families. No VA enrollment required.
- Text HOME to 741741 Crisis Text Line. A trained counselor by text, in English or Spanish, if talking out loud is not an option yet.
Finding ongoing help
- Call 1-800-662-4357 SAMHSA National Helpline. Treatment referrals for mental health and substance use, 24/7, English and Spanish.
- FindTreatment.gov The federal directory of licensed mental health and substance use providers, searchable by location and payment type, including sliding-scale and no-cost options.
- Call 1-800-950-6264 or text NAMI to 62640 NAMI HelpLine. Information, resources, and someone to talk it through with. Weekdays, 10 a.m. to 10 p.m. Eastern.
- Find a therapist Psychology Today's directory. Filter for "trauma and PTSD" and for therapists who work with men; many list whether they take your insurance.
From Men Harvesting Wisdom
The score is where the work starts, not where it ends
Self-care is one of the ten Heroic Dimensions in Men Harvesting Wisdom, and understanding your own history is part of it. Knowing your ACE score does not lower it. What lowers its grip is what men have always done at their best: telling the truth about it to someone trustworthy, and then doing the daily work. If you want company on that road, start with the Men Harvesting Wisdom chapters, or the resources for veterans and families.