The experiences we have as children help shape how we see ourselves, how we relate to others, and how we respond to the world around us. Positive experiences can build confidence, connection, and a sense of security. Difficult experiences leave their mark, too, and can affect a person’s health and well-being long after childhood ends.
Adverse Childhood Experiences, commonly known as ACEs, are potentially traumatic events that occur before the age of 18. They can include abuse, neglect, witnessing violence, or growing up in a household affected by substance use, mental health challenges, parental separation, or incarceration. Other circumstances, such as food insecurity, homelessness, and unstable housing, can also undermine a child’s sense of safety. According to the Centers for Disease Control and Prevention (CDC), ACEs can have lasting effects on health, well-being, and opportunities throughout a person’s life.
Understanding ACEs isn’t about blaming families or using someone’s childhood to predict their future. Instead, it helps us see how early experiences shape us, and how supportive relationships and environments can make a real difference.
How Common Are ACEs?
Childhood adversity isn’t limited to a small number of people. A 2026 analysis from Child Trends found that 37.5% of U.S. children from birth through age 17 had experienced at least one ACE in 2023. That figure is slightly lower than the 39.8% reported in 2018, but ACEs still affect a significant share of children and families.
ACEs also don’t happen in isolation from the environments where families live. Economic stress, housing instability, limited access to resources, and community violence can all add to the challenges children and caregivers face. At the same time, strong families, supportive communities, and access to resources can offer important protection.
How Can Childhood Adversity Affect Us?
Our bodies are designed to respond to stress. When we face something difficult, our heart rate rises, we become more alert, and we prepare to deal with what’s in front of us. Once the stress passes, our bodies return to normal. Frequent, prolonged, or intense stress in childhood can be different, particularly when children don’t have the support of caring adults. Researchers continue to study how significant childhood stress affects physical and mental health over time. A 2024 study found an association between ACEs and mental health problems later in life, and other evidence links ACEs to longer-term challenges in physical health, education, employment, and financial stability.
The key word, however, is associated. Experiencing adversity as a child does not mean a person will inevitably face these outcomes as an adult.
Your ACE Score Isn’t Your Destiny
You may have heard of an “ACE score.” A traditional ACE questionnaire asks about several categories of childhood adversity, and the number of categories a person has experienced becomes their score. That number helps researchers understand patterns across large groups, but it doesn’t tell anyone’s complete story. A single number can’t capture how often something happened, how severe it was, when it occurred, or the circumstances around it. Most importantly, it doesn’t reflect the relationships, resources, and positive experiences that may also have been present. Two people with similar adversity can go on to have very different outcomes.
Rather than treating an ACE score as a prediction, it’s more useful to see it as one piece of a much larger picture. It can help assess risk, but it can’t predict the future, because it doesn’t account for all the other influences on a person’s health and well-being.
Positive Experiences Matter Too
Research on childhood adversity increasingly considers another important part of the picture: positive childhood experiences, or PCEs. These are the relationships and experiences that help children feel safe, supported, valued, and connected. Recent research among adolescents found that more positive childhood experiences were associated with better mental health and well-being, both for young people with ACEs and for those without them. Positive experiences also appeared to protect against depression among adolescents who had faced adversity.
Positive experiences don’t erase difficult ones. Instead, they give children relationships, skills, and resources that strengthen their ability to cope.
The CDC identifies several protective factors that support children and families. These include safe and nurturing relationships with caregivers, positive friendships, caring adults outside the family, strong social support networks, access to health and mental health services, safe and stable housing, and opportunities to take part in positive activities. Sometimes something as simple as an adult who consistently listens, shows up, and makes a child feel valued can become a vital source of support.
Support Can Lessen the Impact of ACEs
Adversity in childhood doesn’t have to define what comes next. When children and the adults who care for them have reliable support, difficult experiences become easier to manage and their long-term effects can be reduced. The relationships and environments surrounding a child can make a meaningful difference in how adversity shapes their life.
That support can come from many places. Caregivers who feel supported are better able to support their children. Schools can provide stability and connection, and communities can create places where children feel safe and included. Access to health care, mental health services, safe housing, quality childcare, and other resources help families meet their children’s needs and give children who have faced adversity the care they need to heal.
This is why addressing ACEs can’t fall solely on parents or caregivers. Public health should support collaboration among communities, schools, health care, social services, and other sectors to create safe, stable, and nurturing environments for children and families. When families have support before they reach a crisis, we can do more than respond to adversity, we can lessen its effects and help prevent it in the first place.
Understanding the Adults Around Us
Learning about ACEs can also change how we see the adults in our lives. We rarely know everything another person has been through. Someone’s reactions to stress, conflict, relationships, or uncertainty may be shaped in part by experiences that happened long before we met them.
That doesn’t mean childhood adversity explains every behavior or removes personal responsibility. It does remind us that people’s behavior and life experiences are often more complicated than what we see on the surface. Understanding ACEs gives us the chance to replace assumptions with curiosity and to recognize when someone might benefit from additional support.
We Can Help Shape What Comes Next
We can’t change what happened in someone’s childhood, but childhood experiences aren’t the end of the story. Supportive relationships and environments matter throughout our lives, and research continues to find that positive childhood experiences are associated with better mental and physical health, even when adversity is also present. When it comes to the children who are in your life today, every one of us has the opportunity to contribute to those positive experiences. We can listen and create safe spaces. We can connect families with resources and support parents and caregivers. We can notice when someone is struggling and reach out. And we can build communities where children and families know they don’t have to face difficult experiences alone.
ACEs help us understand how the past can influence us. Positive factors and support show us that what happens next matters too.
Listen to more about ACE’s on the Emotion Well Podcast: Support and Healing for Adverse Childhood Experiences (ACEs)