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In Search of the Missing ACEs...


I remain forever grateful that my long felt and seeming innate knowledge (actually garnered from personal experience, work with traumatised animals and people) has been evidenced and validated by the amazing work of Vincent Felitti and Robert Anda.  They created the peg I, we, can hang our experience and expertise on and work to best apply our skills to assist others.  

With ACEs I am now able to communicate my knowledge with clients, colleagues and communities with the additional confidence of empirical research to back me up.  

Their research and evidence extended my awareness way beyond what was my original domain in relation to ACEs (of understanding trauma, being aware and informed whilst working to effect change with 'troubled youth' and 'complicated adults').  I was stunned to silence on learning that, unresolved, these childhood traumas can shorten lives in the most common of ways by double figures.

But now I'm stuck.  

Whilst many ACEs are covered in the 10 questions, many are not.  


Colleagues often talk of the ACEs questionnaire being a diagnostic tool, and I understand many of us are currently engaged in conversations and deliberations as to how to apply ACEs knowledge and research to benefit our clients, colleagues and communities - even ourselves, the best (I am).

I admit having a score out of 10 is useful, shorthand, memorable, but in some clients experiences, and in some communities, individuals feel their experiences are invalidated by the limitations of the questionnaire.

Reassuringly, I've read blogs stating that not all ACEs are covered by the initial research.  So what else should be included?  If we were to extend our awareness and understanding of ACEs what would / could / should we include?


As I continue to deliver community education projects with schools and organisations around ACEs for the remainder of 2019, and work with clients who have experienced childhood adversity beyond the scope of the questionnaire, but who are struggling, despite a low score, what do I say, what do I include and reference?  

I aware there's more and want to step up and include more of what affects us.


So I'm curious.  I wonder what would you include?  What have your clients / communities reported that you know to be an ACE, a childhood trauma?

I would really appreciate you sharing what these hidden ACEs are so we can develop a comprehensive list, reflective of more of our experiences.


As I reflect now, is it a peg that Vincent and Robert created, or a rung?  A rung that offers opportunity afresh for each and every one of us to step up and gain vantage from a new perspective, a different perspective from which we can see the landscape and navigate our best, showing others the way.

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Love the question. For years when doing training and consulting on this topic I often remind people that "the 10" aren't the end of trauma and/or adversity but rather just the ones that were studied. We have talked in depth about issues facing LBGTQ+ and sometimes how "coming out" can turn traumatic. We talk about dangerous neighborhoods, bullying, or the immigrant experience as well. Those are ones that often come up. Lately, there has been lots of conversation around food insecurity and childhood hunger, undiagnosed learning disabilities, and natural disasters effect on childhood experiences. 

I'm guessing the list could be quite long. I know that the World Heath Organization also adapted their ACE Quiz to look at those growing up in war torn nations as well. At the end of the day, it isn't about what the trauma was but that an adversity occurred that left a mark!

Hi, Dawn: These are good questions. Drs. Felitti & Anda also understood that there were other types of ACEs, but the 10 in the study were the 10 they looked at.

Since then, people have expanded the definition to include more ACEs. We have included many examples of those in the Resources Center:

It's probably not a bad idea for organizations to ask the population they're asking and surveying what other ACEs they're experiencing in their lives. For example, a pediatric clinic included bullying for ACE surveys they were doing with adolescents. Another pediatric community whose clients were mainly immigrants from  Central America included loss of a parent to deportation.

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