Take the ACE Quiz – And Learn What It Does and Doesn’t Mean

March 2, 2015

Publication: NPR

Featured Expert: Jack P. Shonkoff

Link: http://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean

The Adverse Childhood Experiences, or “ACEs,” quiz asks a series of 10 questions (see below) about common traumatic experiences that occur in early life. Since higher numbers of ACEs often correlate to challenges later in life, including higher risk of certain health problems, the quiz is intended as an indicator of how likely a person might be to face these challenges.

The quiz is a helpful tool for raising awareness about the potential impact of ACEs. But it’s important to remember all the things this quiz doesn’t take into account. First, there are many experiences that could be traumatic for children that the quiz doesn’t ask about—community violence, racism, other forms of discrimination, natural disasters, housing insecurity. That means answering all the questions on the ACE quiz will not give a full picture of the adversity a child has faced – and thus would not be a true indicator of possible risk—nor a full picture of the possible solutions communities should consider.

Second, everyone is different, and adverse experiences in childhood affect each child differently. Just because a person has experienced several ACEs does not mean that later social, emotional, or health problems are inevitable. Some children develop resilience – the ability to overcome serious hardship – while others do not. Genetic factors also play a role, in that some children are predisposed to be more sensitive to adversity than others. And the most common factor among children who show resilience is at least one stable and responsive relationship with a supportive adult.

The ACEs quiz gives no insight into whether an individual child might be more or less sensitive to adversity and asks no questions about whether there may have been any protective relationships in place to help buffer the child from stress. So the ACEs quiz can only give insight into who might be at risk—not who is at risk—for certain later-life challenges. In this series of three short videos, you can learn more about what resilience is, the science behind it, and how it’s built.

What’s In the ACEs Quiz?

For each “yes” answer, add 1. The total number at the end is your cumulative number of ACEs.
Before your 18th birthday:

  1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
  2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
  3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?
  4. Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?
  5. Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
  6. Were your parents ever separated or divorced?
  7. Was your mother or stepmother:
    Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
  8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
  9. Was a household member depressed or mentally ill, or did a household member attempt suicide?
  10. Did a household member go to prison?

Source: NPR, ACEsTooHigh.com. This ACEs Quiz is a variation on the questions asked in the original ACEs study conducted by CDC researchers.

What’s Missing?

  • Stressors outside the household (e.g., violence, poverty, racism, other forms of discrimination, isolation, chaotic environment, lack of services)
  • Protective factors (e.g., supportive relationships, community services, skill-building opportunities)
  • Individual differences (i.e., not all children who experience multiple ACEs will have poor outcomes and not all children who experience no ACEs will avoid poor outcomes—a high ACEs score is simply an indicator of greater risk)

For more:

March 2, 2015
Publication: NPR
Featured Expert: Jack P. Shonkoff
Link: http://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean

An ACE score is a tally of different types of abuse, neglect, and other adverse childhood experiences. A higher score indicates a higher risk for health problems later in life. This NPR story helps people evaluate their ACE score, and quotes Center Director Jack P. Shonkoff, who notes that building resilience can help people do well despite high ACE scores. Learn more about what ACEs are and how they relate to toxic stress.

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