Ever wonder why you, your relatives or friends can’t stop smoking, over-eating, drinking, doing meth or other drugs? Why you’re a workaholic, a rage-aholic or shopaholic? Why you’ve shed marriages like a snake sheds skins? Or why you have trouble keeping a job or making friends?
Maybe it has something to do with your -- or their -- ACE score.
Many people who learn about the CDC’s Adverse Childhood Experiences Study (ACE Study) and take a 10-question survey based on its findings say two things: “Now my life makes sense,” and “Why didn’t someone tell me about this years ago?”
The ACE Study uncovered a stunning link between childhood trauma and the adult onset of chronic disease, social and emotional problems.
The study’s researchers – Drs. Robert Anda and Vincent Felitti -- measured 10 types of childhood trauma: Physical, verbal, and sexual abuse, and physical and emotional neglect. And five family dysfunctions: an alcohol or drug-addicted parent, a mother who's a victim of domestic violence, a family member in jail or diagnosed with a mental illness, and the loss of a parent through divorce or abandonment.
The more types of childhood trauma a person has – i.e., the higher the ACE score -- the higher the risk for heart disease, cancer, diabetes, autoimmune disease, as well as depression, violence, being a victim of violence, and suicide.
In this study of 17,000 mostly white, middle-class, employed, college-educated people living in San Diego, most had an ACE score of at least one. One in five had an ACE score of 3 or more. (Here’s a story about the origins of the ACE Study – the largest public health study you never heard of.)
Since the ACE Study published its first results in 1998, the research is catching on. Twenty-one states – most recently, Iowa -- have done their own ACE surveys and have found similar results. ACE surveys have also been done in Philadelphia, for Crittenton Foundation clients, by the World Health Organization in several European countries, and in elementary schools in Spokane, WA. Pediatricians and public health departments are using the research to screen for adverse childhood experiences in their patients.
Based on the 10 types of adverse childhood experiences they measured, the ACE Study researchers developed an easy 10-question survey for people to calculate their own ACE score.
That questionnaire has long been available on several web sites, and now it’s available in a mobile app called ACE Quiz for Android, and Adverse Childhood Experiences Quiz on the iPhone and iPad (although after you've downloaded it, it shows up as The Ace Test in your app list). This app was produced by the Central East Addiction Technology Transfer Network, a program of the Danya Institute. The program is a nonprofit based in Silver Spring, MD, that provides training and support for people who work in the field of substance abuse.
The first version of ACE Quiz was released for Android phones and tablets, and Kindle Fire this week.
The seed for the app was planted about a year ago, when Simone Fary, the organization’s instructional design and technology specialist, heard about the ACE Study. “It was a light-bulb moment,” she says. “It made so much sense. We’ve always known that people with substance abuse problems often faces many other challenges, but this proved it scientifically.”
So, she decided the best way to spread the word was to develop an app based on the questionnaire. “When you do an app, it gets out in the world,” she says.
Because she had no budget to speak of, except the time she put into it, she looked for help on VolunteerMatch.org. She found app developer Neha Kamra and graphic designer Heather Tate, who put together ACE Quiz 1.0.
The app’s pretty simple – it runs you through the 10 yes-no questions, and pops out your score. After taking the quiz, you can read a brief overview of the ACE Study and check out a list of resources.
“I wanted to be very clear that this really isn’t a diagnostic tool,” says Fary. “History is not destiny. This is only an indicator of risk. Just because you might have a high ACE score, you’re not doomed. It just indicates a higher likelihood of a variety of health issues.”
And, in fact, if you’ve had a lot of resilience factors in your life – such as a caring adult who stuck with you through thick and thin, a good education, and/or solid friends – those can go a long way toward blunting the effects of childhood trauma. Future ACE Quiz versions might include a resilience quiz, as well as the ACE questionnaire in different languages.
One more important point: There are, of course, more than 10 types of childhood adversity, such as living in a war zone, witnessing violence outside the home, watching a sibling being abused, being homeless, and moving often. The point of the ACE Study was to look at the life-altering, and often devastating, impact of childhood adversity. It also clearly demonstrated that trauma, such as sexual abuse, rarely happens alone -- if there’s one type, there’s an 87 percent chance that there’s at least one more.
“I really consider this app a way to spread awareness and educate people about the impact of childhood trauma,” says Fary. “I think everybody should understand this…what the long-term consequences of allowing childhood trauma to go unaddressed can be.”
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