You took the ACE questionnaire and got a number between 0 and 10. That number represents how many categories of adverse childhood experiences you reported. Here's what that actually means—and what it doesn't.
The quick answer
The ACE counts types of childhood adversity you experienced before age 18. Higher scores correlate with increased health risks at the population level:
| Score | What the research shows |
|---|---|
| 0 | Baseline health risk |
| 1-3 | Intermediate risk; common in general population |
| 4+ | Significantly elevated health risks |
| 6+ | Substantially elevated risks, including reduced life expectancy |
About 64% of adults report at least one ACE. About 12% score 4 or higher.
What the ACE measures
The 10 questions cover three domains of childhood adversity:
Abuse (3 items)
- Emotional abuse (being sworn at, insulted, put down)
- Physical abuse (being hit, beaten, kicked)
- Sexual abuse (unwanted sexual contact)
Neglect (2 items)
- Physical neglect (not enough food, dirty clothes, no protection)
- Emotional neglect (not feeling loved or valued)
Household dysfunction (5 items)
- Parental separation or divorce
- Witnessing domestic violence
- Living with someone with substance abuse
- Living with someone with mental illness or who attempted suicide
- Having a household member go to prison
Each "yes" counts as one point. The score tells you how many categories you experienced, not how severe any single experience was.
What your score does NOT mean
This is important: your ACE score is not a diagnosis, a prediction, or your destiny.
It doesn't diagnose anything. A high ACE score doesn't mean you have PTSD, depression, or any other condition. It means you experienced certain childhood adversities that, at the population level, correlate with health risks.
It doesn't predict your individual future. The statistics are about groups, not individuals. Many people with high ACE scores live healthy, fulfilling lives. Many people with low scores struggle with health problems. Your score is one data point, not a crystal ball.
It doesn't account for protective factors. The questionnaire doesn't ask about supportive grandparents, caring teachers, close friends, therapy, or other positive experiences that can buffer the effects of adversity.
It doesn't capture everything. Poverty, racism, bullying, community violence, and many other childhood stressors aren't included in these 10 questions.
It doesn't measure severity or duration. Someone who experienced one incident of physical abuse and someone who experienced years of severe abuse would both check the same box.
The research behind ACE scores
The original CDC-Kaiser study followed over 17,000 adults and found dose-response relationships—meaning as ACE scores increased, so did health risks:
At a score of 4 or higher:
- 4.6x increased risk of depression
- 12.2x increased risk of suicide attempt
- 7x increased risk of alcoholism
- 2-4x increased risk of various chronic diseases
At a score of 6 or higher:
- Life expectancy reduced by approximately 20 years
These statistics are stark. They're also population averages. They describe tendencies across thousands of people, not certainties for any individual.
Why ACE scores don't tell the whole story
"There are people with high ACE scores who do remarkably well," says Jack Shonkoff, a pediatrician and director of Harvard's Center on the Developing Child.
Several factors explain why:
Resilience isn't measured. The ACE study focused on risk, not protective factors. Subsequent research shows that supportive relationships, community connections, and access to resources can significantly mitigate the effects of childhood adversity.
Timing matters. When adversity occurred, how long it lasted, and what support was available all affect outcomes—but the ACE counts only presence/absence.
Healing happens. Trauma isn't a permanent state. Therapy, healthy relationships, and time can change how childhood experiences affect you.
Biology isn't destiny. Even neurobiological changes from early stress can be modified through later experiences and interventions.
What to do with your ACE score
If you scored 0
Your reported childhood didn't include these 10 categories of adversity. This doesn't mean your childhood was perfect or that you can't have mental health challenges now—just that these particular risk factors weren't present.
If you scored 1-3
You're in the majority. Most adults report at least one ACE. This range is associated with some increased health risks compared to 0, but not dramatically elevated.
Consider whether these experiences still affect you today. If they do, talking to a therapist about them could be helpful, but it's not urgent unless you're struggling.
If you scored 4+
This score is associated with significantly elevated health risks at the population level. It doesn't mean you're doomed to poor health—it means being proactive makes sense.
Consider:
- Talking to a mental health provider about your trauma history, especially if you notice patterns (relationship difficulties, emotional regulation challenges, physical health problems)
- Getting regular health screenings since ACE exposure correlates with chronic disease risk
- Learning about trauma-informed care and seeking providers who understand how childhood adversity affects health
- Building protective factors now—supportive relationships, stress management skills, and healthy habits can buffer the effects of early adversity
If you scored 6+
The research shows this range carries the highest health risks. Please don't let this paralyze you—use it as information to prioritize your health.
Strongly consider:
- Professional mental health evaluation, ideally with a trauma-specialized provider
- Regular physical health monitoring
- Building a strong support network
- Being gentle with yourself about where you've been and how hard you've worked to get here
Taking the ACE can be hard
If answering these questions brought up difficult memories or emotions, that's normal. The questionnaire asks about painful experiences, and being reminded of them can be distressing.
If you're struggling after taking the ACE:
- Talk to someone you trust
- Contact a mental health provider
- Call or text 988 (Suicide & Crisis Lifeline) if you need immediate support
- Remember that taking this assessment was an act of courage, not a requirement
Common questions
My score was high but I feel fine. Should I worry?
Not necessarily. Many people with high ACE scores function well. The statistics describe population-level risks, not individual certainties. That said, being aware of your history can help you make informed decisions about your health.
Can my score ever go down?
No—the ACE measures historical experiences, not current symptoms. Your childhood history doesn't change. What can change is how those experiences affect you, which is why treatment focuses on healing, not on the score itself.
Should I tell my doctor my ACE score?
It can be helpful. Your ACE history provides context for understanding your health risks. Trauma-informed providers use this information to provide more appropriate care.
Does a low score mean I can't have trauma?
No. The ACE covers only 10 specific categories. Trauma can result from experiences not on this list, and some people are more affected by adversity than others. If you're struggling, your score doesn't invalidate your experience.
Is it bad for my kids to know my score?
That's a personal decision. Understanding generational patterns can be valuable, but it's up to you what to share. What matters more than any number is breaking cycles through awareness and intentional parenting.
The bottom line
Your ACE score is information, not a verdict. It tells you how many categories of childhood adversity you experienced—categories that research has linked to health outcomes across large populations. It doesn't tell you what will happen to you, what you're capable of, or who you can become.
If your score is high, take it seriously enough to be proactive about your health. If it's low, don't assume that means you have no trauma to address. Whatever your number, what matters most is what you do now: building supportive relationships, addressing problems that arise, and treating yourself with the same compassion you'd offer anyone who survived a difficult childhood.
Related assessments
If you want to understand more about how your past affects you now:
- PCL-5 — Measures current PTSD symptoms (these can change with treatment)
- PHQ-9 — Screens for depression symptoms
- GAD-7 — Screens for anxiety symptoms
- DASS-21 — Measures depression, anxiety, and stress together
Unlike the ACE, these assessments measure current symptoms that can improve with treatment.