_id

683a164fc782e11e38d1b338

id

10464

title

Adverse Childhood Experiences (ACE) Score

full_title

Adverse Childhood Experiences (ACE) Score

short_title

ACE Score

med_description

Screens for adverse childhood experiences.

short_description

ACE screening.

slug

adverse-childhood-experiences-ace-score

description

The Adverse Childhood Experiences (ACE) Score screens for adverse childhood experiences.

keywords

Adverse Childhood Experiences (ACE) Score, ace, ace score, adverse experiences, trauma, childhood trauma, abuse, child abuse

complaint

[ "Agitation", "Altered Mental Status", "Anxious", "Cancer", "Depressed", "Fatigue", "Injury/Trauma", "Intoxication/Overdose", "Loss of Appetite", "Preventive Care/Screening", "Suicidal", "Weight Loss/Gain" ]

formula

The ACE Score is calculated by the addition of the selected points:

evidence

measurements

[]

information

A higher ACE Score corresponds with a higher risk of health, social, and emotional problems.

refrences

{ "Clinical Practice Guidelines": [], "Manufacturer Website": [], "Original/Primary Reference": [ { "href": "https://pubmed.ncbi.nlm.nih.gov/9635069/", "text": "Felitti VJ, Anda RF, Nordenberg D, et al. 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;14(4):245-258." } ], "Other References": [ { "href": "https://pubmed.ncbi.nlm.nih.gov/30792599/", "text": "Watson P. How to screen for ACEs in an efficient, sensitive, and effective manner. Paediatr Child Health. 2019;24(1):37-38." }, { "href": "https://www.tandfonline.com/doi/full/10.1080/2331205X.2019.1581447", "text": "Zarse EM, Neff MR, Yoder R, Hulvershorn L, Chambers JE, Chambers RA. The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases. Schumacher U, ed. Cogent Medicine. 2019;6(1):1581447." }, { "href": "https://www.cdc.gov/violenceprevention/aces/index.html", "text": "Centers for Disease Control and Prevention. Adverse Childhood Experiences (ACEs). " } ], "Outcomes": [], "Validation": [ { "href": "https://pubmed.ncbi.nlm.nih.gov/15261471/", "text": "Dong M, Anda RF, Felitti VJ, et al. The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse Negl. 2004;28(7):771-784." } ], "Validations": [] }

pearls

• It is crucial not to overinterpret the score—higher ACE scores indicate a greater risk for adverse health outcomes, but they are not predictive of specific issues.
• Trauma discussions may be distressing for some patients; approach these conversations with sensitivity and create a supportive environment.

usecase

• Use this tool to screen for and monitor adverse childhood experiences (ACEs) in adults and children.
• Can be useful in the pediatric, primary care, and mental health settings.

reasons

This score provides insight into a patient’s exposure to potentially adverse events during childhood, which are linked to increased physical, mental, and social health risks. Identifying ACEs early can help with prevention and early intervention.

next_advice

• Use the results to determine the need for mental health support, counseling, or referral to trauma-informed care specialists or social workers. 
  
• Educate patients on their results, discussing its relevance, associated health risks, and available mental health resources to help mitigate the long-term effects of ACEs.
  

next_actions

If evaluating a minor and there is immediate concern for child abuse or neglect, contact child protective services (CPS) to ensure the child's safety and well-being. Reporting is a legal and ethical obligation in most jurisdictions.

next_management

diseases

[ "Alcoholism", "Anxiety", "Cancer", "COPD", "Depression/Suicidality", "Diabetes Mellitus", "Heart Failure", "Hepatitis", "Obesity", "Stroke/TIA", "Trauma", "Ischemia" ]

input_schema

[ { "inct": null, "option_fhir_rules": null, "subheading": "<b>During your first 18 years of life…</b>", "subheading_instructions": null, "type": "subheading" }, { "conditionality": null, "default": 0, "label_en": "<p>Did a parent or other adult in the household <strong>often or very often</strong>... Swear at you, insult&nbsp;you, put you down, or humiliate you? <span style=\"text-decoration: underline;\"><strong>or</strong></span> Act in a way that made you afraid that you&nbsp;might be physically hurt?</p>", "mdcalc_info_concept": null, "name": "q1", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p><span>Did a parent or other adult in the household&nbsp;</span><strong>often or very often</strong><span>... Push, grab, slap, or&nbsp;</span><span>throw something at you?&nbsp;</span><span style=\"text-decoration: underline;\"><strong>or</strong></span><span>&nbsp;Ever hit you so hard that you had marks or were injured?</span></p>", "mdcalc_info_concept": null, "name": "q2", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p><span>Did an adult or person at least five years older than you&nbsp;</span><strong>ever</strong><span>... Touch or fondle you or&nbsp;</span><span>have you touch their body in a sexual way?&nbsp;</span><span style=\"text-decoration: underline;\"><strong>or</strong></span><span>&nbsp;Attempt or actually have oral, anal, or&nbsp;</span><span>vaginal intercourse with you?</span></p>", "mdcalc_info_concept": null, "name": "q3", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p><span>Did you&nbsp;</span><strong>often or very often</strong><span>&nbsp;feel that... No one in your family loved you or thought you were important or special?&nbsp;</span><span style=\"text-decoration: underline;\"><strong>or</strong></span><span>&nbsp;Your family didn&rsquo;t look out for each other, feel close to each other, or support each other?</span></p>", "mdcalc_info_concept": null, "name": "q4", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p><span>Did you&nbsp;</span><strong>often or very often</strong><span>&nbsp;feel that... You didn&rsquo;t have enough to eat, had to wear dirty clothes, and had no one to protect you?&nbsp;</span><span style=\"text-decoration: underline;\"><strong>or</strong></span><span>&nbsp;Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?</span></p>", "mdcalc_info_concept": null, "name": "q5", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p>Were your parents ever separated or divorced?</p>", "mdcalc_info_concept": null, "name": "q6", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p><span>Was your mother or stepmother:&nbsp;</span><strong>Often or very often</strong><span>&nbsp;pushed, grabbed, slapped, or&nbsp;</span><span>had something thrown at her?&nbsp;</span><span style=\"text-decoration: underline;\"><strong>or</strong></span><span>&nbsp;</span><strong>Sometimes, often, or very often</strong><span>&nbsp;kicked, bitten, hit with a fist, or hit with something hard?&nbsp;</span><span style=\"text-decoration: underline;\"><strong>or</strong></span><span>&nbsp;</span><strong>Ever</strong><span>&nbsp;repeatedly hit at least a few minutes or</span><span>threatened with a gun or knife?</span></p>", "mdcalc_info_concept": null, "name": "q7", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p><span>Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?</span></p>", "mdcalc_info_concept": null, "name": "q8", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p><span>Was a household member depressed or mentally ill, or did a household member&nbsp;</span><span>attempt suicide?</span></p>", "mdcalc_info_concept": null, "name": "q9", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": null, "default": 0, "label_en": "<p><span>Did a household member go to prison?</span></p>", "mdcalc_info_concept": null, "name": "q10", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" } ]

instructions

published

2023-02-22T20:06:28.307Z

purpose

[ "Prognosis" ]

search_terms

[ "Adverse Childhood Experiences (ACE) Score", "ace", "ace score", "adverse experiences", "trauma", "childhood trauma", "abuse", "child abuse" ]

seo

{ "keywords_en": "Adverse Childhood Experiences (ACE) Score, ace, ace score, adverse experiences, trauma, childhood trauma, abuse, child abuse", "meta_description_en": "The Adverse Childhood Experiences (ACE) Score screens for adverse childhood experiences." }

specialty

[ "Emergency Medicine", "Family Practice", "Hospitalist Medicine", "Internal Medicine", "Psychiatry" ]

departments

[ "Cardiac", "Hepatic", "Oncologic", "Psychiatric" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10417, "short_title_en": "HITS", "slug": "hurt-insult-threaten-scream-hits-score" }, { "calcId": 10525, "short_title_en": "BAM", "slug": "brief-addiction-monitor-bam" }, { "calcId": 10526, "short_title_en": "DAST-10", "slug": "drug-abuse-screening-test-10-dast-10" } ]

ismed

false

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "cardiology", "gastroenterology", "oncology", "psychiatry" ]

cleaned_use

[ "Use this tool to screen for and monitor adverse childhood experiences (ACEs) in adults and children.", "Can be useful in the pediatric, primary care, and mental health settings." ]

pub

false