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Instructions

Our relationships and experiences—even those in childhood—can affect our health and well-being. Difficult childhood experiences are very common.

Please tell us whether you have had any of the experiences listed below, as they may be affecting your health today or may affect your health in the future.
This information will help you and your provider better understand how to work together to support your health and well-being.

Below is a list of 10 categories of Adverse Childhood Experiences (ACEs).

From the list below, please select "yes" or "no" next to each ACE category that you experienced prior to your 18th birthday.

Abuse & Neglect

Understanding ACEsOffice of the California Surgeon General

From the list below, please select "yes" or "no" next to each ACE category that you experienced prior to your 18th birthday.

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?

About the ACEs Assessment

The ACE-Q stands for the Adverse Childhood Experiences Questionnaire.
It is a 10-item, self-report screening tool designed to retrospectively assess the extent of exposure to potentially traumatic experiences occurring from birth to age 18.

Purpose and Use

The ACE-Q is based on the groundbreaking Adverse Childhood Experiences (ACE) Study conducted by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente, first published in 1998.

Screening Tool: It is used in public health, primary care, and integrative health settings to screen for childhood adversity, providing a rapid, quantifiable measure of a patient's risk profile.
Root Cause Identification: In functional and integrative medicine, the ACE score is considered a critical antecedent (predisposing factor) that can lead to chronic activation of the stress response, contributing to a wide range of adult physical and mental health issues.
Dose-Response Relationship: The central finding of the ACE Study is the "dose-response relationship"—the more types of ACEs a person experiences, the higher their risk for negative health and social outcomes later in life (e.g., chronic disease, mental illness, substance abuse, and violence).

Scoring & Interpretation

The ACE-Q uses a dichotomous (Yes/No) response format. Each “Yes” answer is scored as 1 point. The “Yes” responses are summed to create a total score ranging from 0 to 10. Higher scores indicate exposure to a greater number of adverse childhood experiences, with each point representing a different type of adversity rather than the frequency or severity of any single experience.

The ACE-Q items can be conceptually grouped into two categories:

Abuse / Neglect (Items 1-5): Emotional, physical, and sexual abuse and emotional and physical neglect
Household Dysfunction (Items 6-10): Household substance abuse, mental illness, incarceration, domestic violence, and parental separation/divorce

For clinical interpretation, ACE-Q scores are categorized as follows, with corresponding qualitative descriptors:

0 ACEs (No Reported Adversity): Indicates no exposure to the measured adverse childhood experiences. Individuals in this category typically show the lowest risk for negative health outcomes.
1-3 ACEs (Low to Moderate Adversity): Indicates exposure to one or more types of adversity. Research demonstrates a modest but statistically significant elevation in risk for various health and social problems compared to individuals with no ACEs.
4+ ACEs (High Adversity): Represents a clinically significant threshold where risk for negative outcomes increases substantially. This category is associated with significantly elevated risk across multiple domains of functioning and should prompt thorough clinical attention.
6+ ACEs (Very High Adversity): Although not a formal categorization in all ACE literature, scores of 6 or higher represent exposure to multiple forms of serious adversity and are associated with the highest risk for severe and complex health problems.

Clinical Recommendations

For clients with clinically significant ACE-Q scores (4+), evidence-based trauma-focused interventions may be indicated, such as
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT),
- Eye Movement Desensitization and Reprocessing (EMDR), or
- Sensorimotor Psychotherapy
However, the selection of intervention should be guided by the client’s specific symptoms, needs, and preferences rather than by the ACE score alone.

All questions & possible results

Abuse & Neglect

From the list below, please select "yes" or "no" next to each ACE category that you experienced prior to your 18th birthday.

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?

Select one option:

Did a parent or other adult in the household often push, grab, slap, or throw something at you?

or hit you so hard that had marks or were injured?

Select one option:

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?

Select one option:

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?

Select one option:

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?

Select one option:

Household Dysfunction Dimension

From the list below, please select "yes" or "no" next to each ACE category that you experienced prior to your 18th birthday.

Were your parents ever separated or divorced?

Select one option:

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?

Select one option:

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

Select one option:

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

Select one option:

Did a household member go to prison?

Select one option:

Possible results

Total Adverse Childhood Experience (ACE) Score: Low to Moderate Adversity (1-3 pts)

Please discuss with your health care provider. Further assessment may still be needed depending on your clinical presentation.

Experiences in childhood are just one part of a person’s life story.
There are many ways to heal throughout one’s life.

Why this result appears:

Your answers indicate exposure to one or more types of adversity.
Research demonstrates a modest but statistically significant elevation in risk for various health and social problems compared to individuals with no ACEs.

Medical Disclaimer & Terms of Use

This assessment is for educational and informational purposes only. It is not a diagnostic tool and does not constitute medical advice, a professional diagnosis, an opinion, or a plan of treatment.
Consult Your Doctor: The results of this electronic assessment are intended to be a starting point for a conversation with a qualified healthcare professional. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
No Doctor-Patient Relationship: Use of this electronic tool does not create a doctor-patient relationship between you and the developers of this assessment. If you are experiencing a medical emergency, please stop and call your local emergency services or go to the nearest emergency room immediately.
Accuracy of Data: By using this tool, you acknowledge that self-reported data is subjective. While this assessment utilizes validated scoring logic (such as the FSFI or DSDS), the interpretation of these scores requires clinical context that can only be provided by a licensed medical provider.

Total Adverse Childhood Experience (ACE) Score: Very High Adversity (6-10 pts)

Seek prompt clinical evaluation with your healthcare practitioner. Further assessment may still be needed depending on your clinical presentation.

Experiences in childhood are just one part of a person’s life story.
There are many ways to heal throughout one’s life.

Why this score appears:

Your answers represent a clinically significant threshold where risk for negative outcomes increases substantially.
This category is associated with significantly elevated risk across multiple domains of functioning and should prompt thorough clinical attention.
Although not a formal categorization in all ACE literature, scores of 6 or higher represent exposure to multiple forms of serious adversity and are associated with the highest risk for severe and complex health problems.

Your healthcare provider may consider the following interventions:

For clients with clinically significant ACE-Q scores (4+), evidence-based trauma-focused interventions may be indicated, such as
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT),
- Eye Movement Desensitization and Reprocessing (EMDR), or
- Sensorimotor Psychotherapy
However, the selection of intervention should be guided by the client’s specific symptoms, needs, and preferences rather than by the ACE score alone.

Medical Disclaimer & Terms of Use

This assessment is for educational and informational purposes only. It is not a diagnostic tool and does not constitute medical advice, a professional diagnosis, an opinion, or a plan of treatment.
Consult Your Doctor: The results of this electronic assessment are intended to be a starting point for a conversation with a qualified healthcare professional. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
No Doctor-Patient Relationship: Use of this electronic tool does not create a doctor-patient relationship between you and the developers of this assessment. If you are experiencing a medical emergency, please stop and call your local emergency services or go to the nearest emergency room immediately.
Accuracy of Data: By using this tool, you acknowledge that self-reported data is subjective. While this assessment utilizes validated scoring logic (such as the FSFI or DSDS), the interpretation of these scores requires clinical context that can only be provided by a licensed medical provider.

Total Adverse Childhood Experience (ACE) Score: No Reported Adversity

Please discuss with your health care provider. Further assessment may still be needed depending on your clinical presentation.

Experiences in childhood are just one part of a person’s life story.
There are many ways to heal throughout one’s life.

Why this result appears:

Your answers indicate no exposure to the measured adverse childhood experiences.
Individuals in this category typically show the lowest risk for negative health outcomes

Medical Disclaimer & Terms of Use

This assessment is for educational and informational purposes only. It is not a diagnostic tool and does not constitute medical advice, a professional diagnosis, an opinion, or a plan of treatment.
Consult Your Doctor: The results of this electronic assessment are intended to be a starting point for a conversation with a qualified healthcare professional. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
No Doctor-Patient Relationship: Use of this electronic tool does not create a doctor-patient relationship between you and the developers of this assessment. If you are experiencing a medical emergency, please stop and call your local emergency services or go to the nearest emergency room immediately.
Accuracy of Data: By using this tool, you acknowledge that self-reported data is subjective. While this assessment utilizes validated scoring logic (such as the FSFI or DSDS), the interpretation of these scores requires clinical context that can only be provided by a licensed medical provider.

Household Dysfunction Score

Abuse & Neglect Score

Total Adverse Childhood Experience (ACE) Score: High Adversity (4-5 pts)

Seek prompt clinical evaluation with your healthcare practitioner. Further assessment may still be needed depending on your clinical presentation.

Experiences in childhood are just one part of a person’s life story.
There are many ways to heal throughout one’s life.

Why this result appears:

Your answers represent a clinically significant threshold where risk for negative outcomes increases substantially.
This category is associated with significantly elevated risk across multiple domains of functioning and should prompt thorough clinical attention.

Your healthcare provider may consider the following interventions:

For clients with clinically significant ACE-Q scores (4+), evidence-based trauma-focused interventions may be indicated, such as
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT),
- Eye Movement Desensitization and Reprocessing (EMDR), or
- Sensorimotor Psychotherapy
However, the selection of intervention should be guided by the client’s specific symptoms, needs, and preferences rather than by the ACE score alone.

Medical Disclaimer & Terms of Use

This assessment is for educational and informational purposes only. It is not a diagnostic tool and does not constitute medical advice, a professional diagnosis, an opinion, or a plan of treatment.
Consult Your Doctor: The results of this electronic assessment are intended to be a starting point for a conversation with a qualified healthcare professional. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
No Doctor-Patient Relationship: Use of this electronic tool does not create a doctor-patient relationship between you and the developers of this assessment. If you are experiencing a medical emergency, please stop and call your local emergency services or go to the nearest emergency room immediately.
Accuracy of Data: By using this tool, you acknowledge that self-reported data is subjective. While this assessment utilizes validated scoring logic (such as the FSFI or DSDS), the interpretation of these scores requires clinical context that can only be provided by a licensed medical provider.

Citation

Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998 May;14(4):245-58.

Source: Centers for Disease Control and Prevention and Kaiser Permanente. Adverse Childhood Experiences (ACE) Study.

Literature

Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998 May;14(4):245-58. — Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS.
The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2006 Apr;256(3):174-86. — Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles WH.
Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice. Acad Pediatr. 2017 Sep-Oct;17(7S):S51-S69. — Bethell CD, Carle A, Hudziak J, Gombojav N, Powers K, Wade R, Braveman P.
Adverse childhood experiences and the risk of premature mortality. Am J Prev Med. 2009 Nov;37(5):389-96. — Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, Giles WH.
Adverse childhood experiences and adult health. Acad Pediatr. 2009 May-Jun;9(3):131-2. — Felitti VJ.

Provided by ISSWSH Reviewed January 30, 2026

Abuse & Neglect

All questions & possible results

Citation

Literature

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