The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study is one of the largest investigations of childhood abuse and neglect and household challenges and later-life health and well-being.
The original ACE Study was conducted at Kaiser Permanente from 1995 to 1997 with two waves of data collection. Over 17,000 Health Maintenance Organization members from Southern California receiving physical exams completed confidential surveys regarding their childhood experiences and current health status and behaviors.
Dr. Vincent Felitti, Reflections on the ACES Study
Dr. Vincent Felitti, Director of the California Institutes of Preventive Medicine, presents his pioneering research examining Adverse Childhood Experiences (ACE), and the lifelong impacts that those experiences can have on children who endure them.
Current assessments of adverse childhood experiences (ACEs) may not adequately encompass the breadth of adversity to which low-income urban children are exposed. The purpose of this study was to identify and characterize the range of adverse childhood experiences faced by young adults who grew up in a low-income urban area. Focus groups were conducted with young adults who grew up in low-income Philadelphia neighborhoods. Using the nominal group technique, participants generated a list of adverse childhood experiences and then identified the 5 most stressful experiences on the group list. The most stressful experiences identified by participants were grouped into a ranked list of domains and subdomains. Participants identified a range of experiences, grouped into 10 domains: family relationships, community stressors, personal victimization, economic hardship, peer relationships, discrimination, school, health, child welfare/juvenile justice, and media/technology. Included in these domains were many but not all of the experiences from the initial ACEs studies; parental divorce/separation and mental illness were absent. Additional experiences not included in the initial ACEs but endorsed by our participants included single-parent homes; exposure to violence, adult themes, and criminal behavior; personal victimization; bullying; economic hardship; and discrimination.
Development of a Childhood Adversity Questionnaire
Childhood stressors negatively impact the health and well-being of children. Since the original ACEs study, many studies have shown the association between various negative health outcomes and early life stressors. ACE Assessments allow social service and health organizations use evidence-based interventions to decrease exposure to ACEs and mitigate negative health outcomes if they have been already exposed.
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