Ask Amanda: How Much Does My ACE Score Matter?

Q: I recently heard about ACE scores and discovered mine was a six. Should I be worried about how that’s going to affect me as I grow up? I’m 18 and worried that my trauma might follow me my whole life.

A: It’s understandable that applying a number to your adverse childhood experiences can seem a little, well, depressing maybe. I get that. But here’s the good news— your ACE score is not a crystal ball revealing your future. It’s also not a life sentence. It is a powerful tool that can help you better understand where you’ve been and what type of support may be most meaningful on your journey.

First off, for those who aren’t familiar, the CDC-Kaiser Permanente Adverse Childhood Experiences Study was conducted from 1995 to 1997 to study the parallels between childhood trauma and its effects on one’s physical and mental health in adulthood. They came up with 10 primary trauma types, though since its release, new surveys have added other types of trauma. These include witnessing violence outside the home, witnessing a sibling being abused, living in an unsafe neighborhood, being bullied by a peer or adult, experiencing racism or being separated from a loved one due to deportation.   

Calculate Your ACE Score

To find out your ACE score, total how many of the 10 questions below you’d answer “yes” to:

Prior to your 18th birthday….

__ 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 did they act in a way that made you afraid that you might be physically hurt? 

__ 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?

__ 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 did they attempt to or actually have oral, anal or vaginal intercourse with you?

__ Did you often or very often feel that no one in your family loved you or thought you were important or special, or that your family didn’t look out for each other, feel close to each other, or support each other?

__ 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 did you feel that your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

__ Were your parents ever separated or divorced?

__ Was your mother or stepmother often or very often pushed, grabbed, slapped or had something thrown at her? Or was she sometimes, often or very often kicked, bitten, hit with a fist or hit with something hard? Or was she ever repeatedly hit over the span of a few minutes or threatened with a gun or knife?

__ Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?

__ Was a household member depressed or mentally ill, or did a household member attempt suicide?                      

__ Did a household member go to prison?

Your total number of “yes” answers is your ACE score. 

How ACEs May Affect You

Granted, your score of six may seem daunting, but you’re not alone. Data from the original study of 17,000 individuals revealed that 87 percent had more than one ACE. In another study that ended in 2020, 17 percent of the over 250,000 participants had four or more ACEs. 

In 2019, the Centers for Disease Control and Prevention (CDC) put out a formal call for earlier and more collaborative intervention in cases of childhood trauma. Preventing ACEs, said the CDC, could reduce the following health problems significantly:

• Up to 21 million cases of depression
• Up to 1.9 million cases of heart disease
• Up to 2.5 million cases of obesity 

So, to answer your question, yes, your ACE score matters in terms of your future health risks. But no, you don’t need to be overly worried. Now that you’re aware that your childhood experiences can affect your physical and mental health, you can better prepare for what that might look like. 

Why Hope Is Important After Trauma

ACE scores measure your past, but hope can define your future. And it’s more than just saying, “Things will get better someday,” although, that’s not a bad thing to remind yourself of in the midst of hardship. Did you know, however, that just like trauma, hope can be measured?

Casey Gwinn is co-author of the best-selling book, Hope Rising: How the Science of Hope Can Change Your Life, along with Chan Hellman, PhD. Gwinn, a former prosecutor, is also the president of Alliance for HOPE International. In the book, the authors look at almost 2,000 independent studies about hope to determine that having hope most accurately predicts your future success. 

You can find your hope score here. Scores over 40 are considered slightly hopeful. Over 56 means you likely have a higher level of hope in your life. If you score below 40, your hope is low, but it shouldn’t discourage you, Gwinn says. After all, you can learn hope. 

How? Consider goal setting as a good starting point. But don’t just hang up your vision board and walk away. After all, says Gwinn, “A goal without a plan is just a wish thrown into the universe.”

Break down your goal into steps—think of this like a path to success. Then, practice agency, which is the relentless belief that you can conquer each one of those steps. It may mean refocusing on the goal and not the problem. Again, look ahead and not back.

For more information, read “The Science of Hope.”

Real Stories of How ACEs Affect Them

I asked some individuals to share their ACE scores and share how they think it has affected them as adults. Perhaps not surprisingly, their paths both led to them working with survivors of domestic violence. I’ve changed their names for privacy reasons.  

Jason told me that his early life was “littered with so many setbacks” and he grew up thinking it was normal to hurt others and lose people close to him. So he wasn’t surprised to learn his ACE score was an eight. 

“My ACE score has deeply influenced my adult life in both challenging and powerful ways,” he told me. “On the negative side, it affected my ability to trust, my emotional response with my children and spouse, and how I view myself in certain situations. Instead of letting my past hold me back, I let it guide me towards purpose.”

Like yours, Addison’s score was also a six which she says mostly stems from family substance abuse issues. She’s had a more difficult road, health-wise, but says it was learning her ACE score that made her better understand why she had the challenges she did.

“I have had many of the health and lifestyle issues predicted with higher ACES, like major depression, an anxiety disorder, insomnia, diabetes and smoking. Depression and anxiety have been literally crippling throughout my life with long stretches of time where I couldn't get out of bed,” she told me. She points out that ACEs aren’t always about the “obvious, big traumas,” but how the small, sustained traumas can impact individuals in much larger ways. 

Jason says that knowing his ACE score helped him “fill the void of an unknown language” for the pain he had experienced as a child. 

“As an adult, ACEs help me connect the dots between my past and certain patterns in my behavior, relationships and mental health. I firmly believe that my ACE score does not define who I am. Knowing my score reminded me that my story matters,” he says. 

Madeline, whose ACE score is a 5, told me that, much like you, she was worried her trauma would follow her for her entire life. “In some ways, it has,” she said. “I realize my trauma made me into who I am today, good and not-so-good. But by understanding it, I’m working to end the generational cycle that got me here.” She said working with a therapist to understand that she has a choice in how her childhood trauma shapes her future as a partner and a mom has been a powerful tool. 

Jason said he hopes others, like you, learn their ACE score. 

“ACE helps people recognize how childhood trauma can impact their physical, mental and relationship health and decision-making as adults. When you know your score, you’re not just learning about your past—you’re gaining insight that can shape a healthier future.”

If you can try to predict and plan for the ways your ACE score may affect you growing up, you can be one step ahead of the challenges to come. For example, Brian Martin, author of Invincible: The 10 Lies You Learn Growing Up With Domestic Violence and the Truths to Set You Free, writes, “Those who experienced ACEs are also more likely to engage in harmful behaviors ranging from smoking to eating disorders, substance abuse and suicide attempts. In addition, high-risk sexual practices, including unprotected sex, more sexual partners and having consensual sex at an earlier age, are also more common.”

The reason for this, he says, is that ACE survivors may believe that they aren't worth protecting, or they may engage in harmful behaviors, such as abusing substances, to cope with their negative feelings about themselves.

Knowing that this could be a possibility may allow you to stop and evaluate your impulses before acting on them. Are your choices truly what’s best for you, or are they a reaction to a trauma you’re still healing from? If it’s the latter, reaching out for support and talking to someone who will listen nonjudgmentally, such as a friend, family member, counselor or advocate at your local domestic violence organization, may be your lifesaver. 

You may have heard about safety planning—a written outline of the steps you can take to stay safe when it’s time to leave an abuser. But there’s also such a thing as an emotional safety plan. In a similar way, you can outline the steps you’ll take should you be triggered in your adult life by your childhood trauma. If “A” happens, your healthy coping strategy can be “B.” Your emotional and mental safety are just as important as your physical safety. 

Knowing your ACE score might also be something you want to inform your primary care doctor of. You are at a higher risk for heart disease, cancer, respiratory disease, diabetes, chronic pain, headaches, fibromyalgia and obesity. Being aware of this might mean you request additional or more frequent testing, or may shape some of your health, diet or fitness choices. 

The earlier there can be intervention to combat ACEs, the better. The CDC recommends intervention for ACE survivors before we become adults, which makes sense. At 18, you still have so much life ahead of you and anything is possible. Your past is one chapter, not the whole book. You now hold the power to change your future, so do just that.