Adverse Childhood Experiences test – Find our how childhood experiences can impact us

This page provides information on Adverse Childhood Experiences on how to conduct an adverse childhood experiences test

Click here for more on our March 25, 2013, Adverse Childhood Experiences Forum.

Jackie Smith Duggan, a United Way intern in 2012, and Eugenia Vavra, United Way’s Health Manager, talk about Adverse Childhood Experiences and how these impact the community.

“ACEs cover all of our United Way areas of work. It’s something we need to look at. The more we can understand about ACEs and how they impact a person’s health the more we can get ahead of the issue,” Eugenia says.

United Way Discussion Topic Receives Local Media Coverage.

KCRG TV9’s, Beth Malicki talks about Adverse Childhood Experiences and how ACES can carry over into adult life.  United Way hosted and recorded an ACES event in March and the audience learned from presented research that if you have an ACES score of four or more, you are five times more likely to be an alcoholic, four times more likely to be sexually active before age 15, and nine times more likely to attempt suicide.

Click here for the media coverage on the topic, and United Way’s event recording and presentations from the presenters.  To determine your ACES score, click here

ACE podcast

Eugenia’s appearance on 96.5 on June 12, 2012:

United Way 6-12-12 ACE 96.5

(The higher the score – between 0-10 – the higher the chance is for negative consequences.)

To print a version of this click here.

ACES Four-page Brief LETTER


A Philanthropic Perspective from United Way of East Central Iowa on Adverse Childhood Experiences (ACEs)

United Way of East Central Iowa staff has attended two of Dr. Anda’s presentations that have resulted in ongoing conversations with partnering agencies and staff to identify the impact of ACEs within United Way’s six-county service area.  In addition, United Way staff has completed research in the areas of Education, Financial Stability, and Health to understand the potential impacts of the ACEs indicators.

Philanthropic Perspective

  • Based on the ACEs Study, an estimated 32,000 children have at least two or more ACEs within United Way’s six-county service area of Benton, Cedar, Iowa, Jones Linn and Washington counties.
  • A United Way Volunteer Health Solutions Team identified ACEs as a “Breakthrough Area” that crosses all areas of our work within Education, Financial Stability and Health and is considered a root cause for many social conditions that United Way is trying to impact with its community investments;
  • An estimated 30% or $1,811,382 is currently invested in health and human services that directly address ACEs indicators.
  • United Way is beginning to ask, “How do our current investments work together to create a thriving and resilient community?”
  • Have completed an initial Resource Map (modeled from Washington State’s model of “Alignment for a Thriving Community”).
    • Researched best practice models from other communities on how to address ACEs.
    • Conducted 10 presentations reaching over 100 service providers educating them on ACEs and the long-term effects;
    • Recognizes the key connection of Trauma Informed Care (TIC) in understanding and responding to the indicators of ACEs.
    • Starting to change service provider language of, “What’s wrong with you?” to “What happened to you?”


  • Through the ACEs community presentations, more education is needed among schools and physicians about ACEs.
  • Issues related to ACEs are being addressed separately by different community groups, although a lot of the same people attend multiple planning committees.
  • There is a lack of vision on how to impact ACEs collectively.
  • United Way has the ability to pull service providers and community stakeholders across a variety of service areas together to talk about how we can address ACEs collectively.

Next Steps

  • Increase awareness of ACEs and their impact on health and well being using a cross-system integration and community collaborative approach.
  • Hold Community Conversations – with service providers, community coalitions, and local/state government to educate and discuss system and policy strategies needed to address ACEs.
  • Build Cross-System Relationships – with schools, corrections, community health clinics, and public health to assess the issues of ACEs and how we can collectively find solutions.
  • Address ACEs across a lifespan – have conversations on the impact of Children, Adolescence, Families, Adults and Older Adults.
    • Prevention and Early Intervention – younger children who have a high ACE score highlights the need for increased support to vulnerable families to try and correct the path they are headed towards.
    • Treatment and Management – adults and older persons who have experienced trauma need to become more self-aware of how the experiences have shaped their life choices and behaviors.  Increasing people’s knowledge of their ACEs score empowers them to make better choices for their own health and the health of their children.

State of Iowa’s Efforts

  • The Iowa Department of Public Health received funding from the Mid-Iowa Health Foundation to add the Adverse Childhood Experiences (ACEs) Module and Mental Illness and Stigma Module to the 2012 Iowa Behavioral Risk Factor Surveillance Survey. The data from this survey will be available mid-2013 and help us illuminate how pervasive ACEs are within the State of Iowa.

Information Shared in Podcast

By: Jackie Smith Duggan, United Way Intern

During the time as an intern at United Way, Eugenia asked that I spend time learning more about the Adverse Childhood Experience study that began in the 90’s by the principal investigators, Dr. Vincent Fellitti and Dr. Robert Anda.   This study was landmark in the size of the study; 17, 000 participants from middle class background, mostly Caucasian, who were employed and educated.

Adverse Childhood Experiences for the purpose of the study were defined as:

  • Physical abuse by a parent
  • Emotional abuse by a parent
  • Sexual abuse by anyone
  • Growing up with an alcohol and/or drug abuser in the household
  • Experiencing the incarceration of a household member
  • Living with a family member experiencing mental illness
  • Witnessing domestic violence
  • Loss of a parent

The ACE study highlighted the link between adverse childhood experiences with negative adult experiences, including physical health risks, substance abuse, involvement in the criminal justice system, mental health problems, unemployment, and poverty.

According to data collected adverse childhood experiences, though well concealed, are unexpectedly common, have a profound negative effect on adult health and well-being a half century later, and are a prime determinant of adult health status in the United States.

The study identified that the early impact of ACEs/trauma –demonstrated a proportional relationship between childhood adversity and adult problems, meaning that the more adverse childhood experiences a person underwent, the greater the impact on that individual’s adult experiences.

Increased risks for:

  • Smoking
  • Severe obesity
  • Physical inactivity
  • Suicide attempts
  • Alcoholism
  • Drug abuse
  • Sexual promiscuity
  • Repetition of original trauma
  • Self Injury
  • Eating disorders
  • Perpetrate interpersonal violence
  • Heart disease
  • Lung disease
  • Liver disease
  • Multiple types of cancer
  • Impaired job functioning
  • Homelessness
  • Criminal justice involvement

The ACE Study has major implications for the healthcare professions: that all patients should be routinely screened for adverse childhood experiences; that a childhood trauma history may be very relevant to both serious illness and vague somatic complaints; and that appropriate approaches to treatment must include dealing with childhood trauma. Additional data suggest that evaluating patients for ACEs is also cost-effective.

The study is also connected with the most recent research of trauma informed care. As we discuss ACEs we are truly discussing trauma and what has emerged from the Trauma informed care studies is in essence this biological impact. Understanding that the ACEs or traumatic experiences can impact the actually functioning of the brain, the reasoning skills in young children, the intense responses to situations.

These ongoing studies also suggest the need for early intervention and support for families and children.  To begin screening early, because the early intervention can create a change in the biological impact of the trauma, and then the long term impact of adult unhealthy decisions as it were these were merely techniques they were using, these were merely coping mechanisms that had gone into place.

Best Practice Information

Another exciting area of United Way’s research included looking at how other states took this landmark information, and began to apply and change it in their own state.


  • Created Community Networks with the sole purpose of creating this collaborative exchange with many community agencies to work on addressing their identified areas of the ACEs in their community.  This included training for all agencies on ACES and trauma informed care, a daycare provider trained in the area of TIC in order to teach one of the children in daycare how to self-soothe due to that child’s exposure to trauma,  training of hospital medical staff on ACEs to help direct more screenings associated with ACEs.


  • Collaborating with a local pediatricians office to begin screening for ACEs with parents and child to help with their community and agencies to help identify ACEs and respond to ACEs.


  • More staff trainings on infant/child mental health and screenings for ACEs.


  • Identify ACEs and changing the landscape of education with training their educators  on ACEs and understanding the biological impact of trauma.  this in turn creates Compassionate Schools, understanding and knowing the impact of trauma on learning and for school staff/educator a like learn to respond differently to the child’s needs.



Posted in Health, Podcasts, United Way of East Central Iowa, Video

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