Trauma in Childhood: The ACE Questionnaire

"When you were a child, did a parent often push, slap, grab, or throw something at you?"

Below are the 10 Questions of the Adverse Childhood Experience (ACE) Questionnaire. The Center for Disease Control-Kaiser ACE study is one of the largest investigations ever conducted on childhood abuse and neglect and later-life health and well-being. Study findings show a graded relationship between high ACEs and negative health and well-being outcomes. In other words, as the number of ACEs increases so does the risk for negative outcomes. No surprise.

At M&C Law, we've been administering the ACE Questionnaire to clients in preparation for sentencing hearings and letting judges know the ACE outcome and implications of the high number of positive answers our clients give (typically scoring higher than 6, often 8, 9, and 10). This information is not presented as an excuse for violating the law, but rather to inform the difficult decision-making and presumptions that are involved in determining an appropriate criminal sentence. Research indicates that higher ACE scores pose higher risk of health, social and emotional problems, including depression, anxiety, and addiction. Our clients often present with anxiety and addiction issues, sometimes having smoked marijuana daily since their early teen years, 13 and 14; they come to us in their 20's, having gotten high multiple times daily for more than 15 years straight and frequently using other substances like opioid-based pills or sryups like Lean and Purple Drank. We refer for treatment and counsel the benefits of sobriety, especially when facing prison for selling drugs, and, when things go well, see clients transform to being clean for the first time ever in their adult lives. The transformation can be remarkable. 

Experience tells us that clients who resort to daily drug use at a young age are trying to suppress feeling any emotions at all, typically tied to trauma in their past. Put more simply, chronic daily drug abuse and addiction in a young person is an atypical habit, usually in response to an atypical or traumatic childhood, marked by neglect, abuse, mental health and addiciton issues among adult caregivers. ACE questions focus on identifying that trauma, and we present that information to inform the evidence-based action plan for an appropriate sentence recommendation. On the other side of the aisle, prosecutors typically focus on incarceration and punishment in a rationale-based analytic - "he made the choice to do this, he needs to be punished, and then he'll learn" - without addressing the root cause of the problems and choices many of our clients face after a life marked by trauma. We've had so many clients start the ACS interview at our office in a normal state, and end it sobbing, clearly the first time they've ever had someone ask about these things, let alone get counseling or help. As we reveal these results, experiences, and recommendations to judges, we're connecting more frequently with a thoughtful prcess at our sentencing hearings.  

The societal costs of traumatic experiences on children and young people are untold. 

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Adverse Childhood Experience (ACE) Questionnaire - Finding your ACE Score

While you were growing up, during your first 18 years of life:

1. Did a parent or other adult in the household often … Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?

2. Did a parent or other adult in the household often … Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?

3. 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 Try to or actually have oral, anal, or vaginal sex with you?

4. Did you often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?

5. Did you often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

6. Were your parents ever separated or divorced?

7. Was your mother or stepmother: Often pushed, grabbed, slapped, or had something thrown at her? or Sometimes or often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?

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

9. Was a household member depressed or mentally ill or did a household member attempt suicide?

10. Did a household member go to prison?

More information on the CDC-Kaiser ACE Study at the Center for Disease Control website:

https://www.cdc.gov/…/childabuseandnegl…/acestudy/about.html


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