Thank you for sharing your valid concern about the potential misuse of ACE scores – and hence the potential for more harm, trauma and stress to vulnerable individuals and communities.
Dr. Nadine Burke Harris’ vision for ACE scores to become part of universal screenings in order to measure, predict, and/or mitigate potential health risks may be part of a Best Practice routine for conscientious and compassionate practitioners, (as well as educators, and policy makers seeking to increase the well being of students and society as a whole) it also holds the potential for misuse or even abuse in the “wrong” hands - increasing stigma and tribal mentality.
After completing the ACE questionnaire, a nurse friend of mine was questioned by the physician she works for about her score. When she confirmed that it was fairly high she was given a look that conveyed a 'know-it-all' response somewhere between “I thought so” and “that explains a lot”. Though she brushed off the judgmental nod, she (we) share your bigger concern for systems that could potentially misuse ACE score information.
Just as high blood pressure or a history of cancer can become a barrier to resources or opportunities - depending on the situation - a high ACE score in isolation can be processed negatively. For the under trained, under educated and/or misinformed about trauma and toxic stress (which is most of us in the general population), a high ACE score could become yet another label – instead of the tool for which it was intended. No matter how significant or important the ACE score or its findings, it is fundamentally a TOOL – one, that without clear guidelines and systems in place (nationwide and worldwide) for its use, holds the potential for misuse and abuse.