Childhood Trauma Test (ACE Score)

The ACE Score (0–10) measures exposure to 10 categories of childhood adversity including abuse, neglect, and household dysfunction. ACE scores ≥4 are associated with significantly elevated risk for depression, PTSD, substance use, and chronic disease. Felitti et al. (1998).

What is a Childhood Trauma Test?

A childhood trauma test screens for adverse childhood experiences (ACEs), traumatic events or chronic stressors occurring before age 18 that are associated with lasting physical and mental health consequences. The landmark ACE Study, conducted by Kaiser Permanente and the CDC (Felitti et al., 1998), enrolled over 17,000 adults and established the dose-response relationship between ACE scores and health outcomes across the lifespan.

The original ACE questionnaire assesses 10 categories across three domains: abuse (emotional, physical, sexual), neglect (emotional, physical), and household dysfunction (domestic violence, substance abuse, mental illness, parental separation/divorce, incarcerated household member). Each endorsed category counts as 1 point, yielding a total ACE Score from 0 to 10.

Adults with an ACE score of 4 or more are significantly more likely to experience depression, anxiety, PTSD, substance use disorders, cardiovascular disease, and reduced life expectancy. However, ACEs do not determine destiny, resilience factors including supportive relationships, community resources, and evidence-based treatment approaches substantially mitigate the impact of childhood adversity. The ACE score is a population-level risk indicator, not a personal prognosis.

ACE Score Screener

ACE Study: Felitti et al. (1998). This screener is for educational awareness only and does not constitute clinical assessment. If childhood trauma is affecting your wellbeing, speak with a trauma-informed therapist. Crisis support: 988 Suicide & Crisis Lifeline.

ACE Score Risk Reference

From the CDC-Kaiser ACE Study (Felitti et al., 1998). ACE scores are a population-level risk indicator, resilience, support systems, and treatment substantially modify individual outcomes.

Score Interpretation

ACE Categories (10 Total)

Health Outcomes by ACE Score

Cumulative risk across domains from the original ACE Study and subsequent research.

Childhood Trauma Assessment tools

ACE scores measure exposure, not destiny. Research consistently shows that trauma-focused therapy (EMDR, CPT, TF-CBT, somatic approaches), stable supportive relationships, and community connection substantially reduce the long-term impact of childhood adversity. Many adults with high ACE scores go on to live healthy, fulfilling lives. If you recognize these experiences in yourself, connecting with a trauma-informed therapist is one of the most effective steps you can take.

Trauma-Informed Outcome Monitoring

PCL-5, PHQ-9, GAD-7, and ACE-informed care pathways, integrated trauma outcome monitoring for community mental health, primary care, and specialty behavioral health programs.