What are ACEs?

Our early experiences matter. If children are routinely exposed to situations such as domestic violence, mental ill health, problematic alcohol and other substances, this can lead to negative impacts which can last into adulthood. Such chronically stressful situations are called Adverse Childhood Experiences (ACEs) and they are often associated with poorer outcomes across the lifespan in terms of educational attainment, employment, involvement in crime, family breakdown, and a range of health and wellbeing measures.

What is an Adverse Childhood Experience?

Adverse Childhood Experiences (ACEs) are stressful experiences occurring during childhood that directly harm a child or affect the environment in which they live.  (Bellis et al 2016) 

ACEs can include the following:

  1. Verbal abuse
  2. Physical abuse
  3. Sexual abuse
  4. Physical neglect
  5. Emotional neglect
  6. Parental separation
  7. Domestic violence
  8. Mental ill health
  9. Alcohol or drug misuse

Impact of four or more ACEs

  • Image

    2 times more likely to have a chronic disease

  • Image

    3 times more likely to have respiratory disease

  • Image
    Heart disease

    3 times more likely to develop coronary heart disease

  • Image
    Blood test

    4 times more likely to develop type 2 diabetes

  • Image
    Pint of beer

    4 times more likely to be a high risk drinker

  • Image

    6 times more likely to smoke tobacco or E-cigs

  • Image

    11 times more likely to have smoked cannabis

  • Image

    16 times more likely to have used crack cocaine or heroin

  • Image

    20 times more likely to have been incarcerated in their life

The Pair of ACEs Model

The pair of aces

The Pair of ACEs model is based on research that looked at community resilience and what helps or hinders. We know that poverty, poor housing etc. (as shown on the roots of the tree) exacerbate, or compound, the individual or the family response to other ACEs. They can make what was a tolerable situation of stress, toxic. We're going to look at stress shortly.

It is important to think about ACEs in a way that does not simply 'pathologise' individuals but sees that they have a ripple effect upon whole family systems, communities and ultimately, societies. 

ACEs are a societal issue.

Ellis and Dietz (2017) devised this transformative approach in USA, the Building Community Resilience model, to 

''foster collaboration across child health systems, community based agencies and cross sector partners to address the root cause of toxic stress and Childhood adversity, and build community resilience''. 

Emphasis was for clinicians to see beyond the clinical environment to address social determinants that lead to adverse child and community experiences which both impact upon early childhood development.

Community resilience is defined as 

“the capacity to anticipate risk, limit effects and recover rapidly through survival, adaptability, evolution and growth in the face of turbulent change and stress”. 

  • ACEs Trauma Informed Leaflet - Final version

    ACEs Trauma Informed Leaflet - Final version.pdf


Find out more about ACEs

You can find out more about ACEs and the impact on child development through this short animation that has been developed by the Safeguarding Board for Northern Ireland.

We hope that our viewers find the ACE Animation a helpful tool in raising awareness of what ACEs are and how staff, volunteers and organisations can be the change to support children, adults, families and communities to be more resilient. 

This animation forms the basis of raising awareness of adverse childhood experiences in Northern Ireland and how you can be the change to support children, their families or adults impacted by childhood adversity.

Subtitles | Without subtitles

Subtitles | Without subtitles