Today I’m going to revisit the topic of The ACE Quiz, which I covered a couple years ago, as well as add additional material (PACEs) which I have since learned about.
First we will start with the ACE Quiz. “ACE” stands for Adverse Childhood Experiences and an ACE score is a tally of different types of abuse, neglect, and other characteristics of a potentially difficult childhood. According to the ACE study, which developed the quiz, the more difficult your childhood, the higher your score is likely to be; this can translate into emotional effects in the short and long term, but also a higher risk for later health problems. To better help you understand the ACEs Quiz, here it is:
Prior to your 18th birthday:
1. Did a parent or other adult in the household often or very 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?
No___If Yes, enter 1 __
2. Did a parent or other adult in the household often or very often: Push, grab, slap, or throw something at you? Or, ever hit you so hard that you had marks or were injured?
No___If Yes, enter 1 __
3. 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, attempt or actually have oral, anal, or vaginal intercourse with you?
No___If Yes, enter 1 __
4. Did you often or very often feel that: No one in your family loved you or thought you were important or special? Or, that your family didn’t look out for each other, feel close to each other, or support each other?
No___If Yes, enter 1 __
5. Did you often or very often feel that: You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? Or, that your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
No___If Yes, enter 1 __
6. Were your parents ever separated or divorced?
No___If Yes, enter 1 __
7. Was your mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her? Or, sometimes, often, or very 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?
No___If Yes, enter 1 __
8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
No___If Yes, enter 1 __
9. Was a household member depressed or mentally ill, or did a household member attempt suicide?
No___If Yes, enter 1 __
10. Did a household member go to prison?
No___If Yes, enter 1 __
Now add up your “Yes” answers: ___ This is your ACE Score.
I wanted to talk about this because many children in foster care have high ACE scores. In fact, approximately 50 percent of children in the child welfare system have four or more ACEs; comparatively, only 13 percent of children outside of foster care have four or more ACEs. Additionally, according to a recent study, “Children in foster care are at least five times more likely to have anxiety, depression and/or behavioral problems than children not in foster care.” Long term, individuals with high ACE scores also typically have an increase in physical health ailments as well, some resulting in earlier deaths.
Now what does all this mean for you as a foster parent? Well, it could mean that your child will have many struggles and obstacles to overcome. But my point in this post is not to be all “gloom and doom.” Keep in mind that even though it is an indicator of difficult past circumstances, the ACE quiz is not necessarily prophetic. It does not mean that what *could* happen *will* happen; people with high ACE scores can still be very successful and do well in life, and can even counteract some of the potential pitfalls of early childhood trauma.
Bottom line: all the ACE score does is tell you about one type of risk factor among many. It does not keep in mind a child’s genetics or diet. It does not know if the child (we’re going to assume a teenager with this behavior but unfortunately it is not unheard of for younger children) drinks or smokes excessively, or does illegal drugs, all of which would affect emotional and physical health.
But most importantly remember this also: ACE scores don’t take into consideration the positive experiences in early life that can help build resiliency and safeguard a child from the effects of trauma. This is where the PACEs come into play; PACE stands for Protective and Compensatory Experiences (I have also seen it as PCEs, and stands for Positive Childhood Experiences – it’s the same quiz and has the same effects, it’s simply a different name).
Here is the PACEs Quiz:
Prior to your 18th birthday:
1. Did a parent or other adult in the household love you unconditionally (you did not doubt that they cared about you)?
No___If Yes, enter 1 __
2. Did you have at least one best friend (someone you could trust and have fun with)?
No___If Yes, enter 1 __
3. Did you do anything regularly to help others (e.g., volunteer at a hospital, nursing home, church) or do special projects in the community to help others (food drives, Habit for Humanity, etc)?
No___If Yes, enter 1 __
4. Were you regularly involved in organized sports groups (e.g., soccer, basketball, track) or other physical activity (e.g., competitive cheer, gymnastics, dance, marching band)?
No___If Yes, enter 1 __
5. Were you an active member of at least one civic group or non-sport social group such as scouts, church or youth group?
No___If Yes, enter 1 __
6. Did you have an engaging hobby, or an artistic or intellectual pastime either alone or in a group (e.g., chess club, debate team, musical instrument or vocal group, theater, spelling bee, or did you read a lot)?
No___If Yes, enter 1 __
7. Was there an adult (not your parent) you trusted and could count on when you needed help or advice (e.g., coach, teacher minister, neighbor, relative)
No___If Yes, enter 1 __
8. Was your home typical clean AND safe with enough food to eat?
No___If Yes, enter 1 __
9. Overall, did your schools provide the resources and academic experiences you needed to learn?
No___If Yes, enter 1 __
10. In your home, were there rules that were clear and fairly administered?
No___If Yes, enter 1 __
Now add up your “Yes” answers: ___ This is your PACE Score.
As you can probably tell from the PACEs quiz, by virtue of simply having a parent who loves you, a teacher who understands and believes in you, or a trusted neighbor in whom you can confide in may diminish many of the long-term effects of early childhood trauma; just one caring, safe relationship early in life gives any child a much better shot at growing up healthy.
Additionally, community involvement, hobbies and committed involvement in engaging activities also increase the PACEs score. These positive early interactions have been shown to also help children with later learning and literacy. More importantly, they boost kids’ resilience, by helping them build secure attachments…which is a skill they will take with them and use throughout their lives.
Hopefully these quizzes help you have a better understanding of trauma and how it effects children going forward…and also the benefits of secure attachment relationships.
Aufrichtig,
Kris