Research shows that exposure to ACEs may lead to issues such as mental health conditions, chronic physical health conditions and/or substance abuse.

Whether an event has a lasting negative impact on an individual depends on many environmental factors. Two children who experience the same traumatic event may have different responses depending on many things. For example, the impacts of the event may differ depending on when the event took place during childhood, their support system, and access to mental health resources.

The following list includes some of the most common traumatic events impacting children from ages 1-17:

• Violence

• Abuse (physical, emotional or sexual)

• Neglect

• Loss of a friend or family member

• Missing parental figures or divorce

Other traumatic experiences that can have long-term effects on a child include:

• A disrupted living situation

• Lack of access to healthcare

• Financial challenges

• Being unhoused or moving frequently

• Discrimination

In summary, it's very important for educators to understand the impact of ACEs in their classrooms. These events shape the behavior and well-being of our students, and can sometimes impact their ability to learn, therefore without studying the impact of ACEs, teachers will not be able to effectively teach their learners. The next slide will outline just how prevalent ACEs are in the United States.

Cleveland Clinic. (2023, March 10). Adverse childhood experiences (ACE). https://my.clevelandclinic.org/health/symptoms/24875-adverse-childhood-experiences-ace

The Compassion Prison Project is a website that includes important statistics around ACEs. Click the image to the right to explore.

The following list should not be used as the only form of assessment, but these behavioral observations can be considered "red flags" or warning signs that your student may have experienced one or more ACES:

• Fear of other people

• Difficulty sleeping or frequent nightmares

• Bedwetting

• Changes to their mood

• Difficulty showing affection towards friends or family

• Avoiding situations or events that relate to a traumatic experience

• Difficulty learning in school

Communication with pediatricians (with parental consent) can also help educators gain a fuller picture of a students' background.

Cleveland Clinic. (2023, March 10). Adverse childhood experiences (ACE). https://my.clevelandclinic.org/health/symptoms/24875-adverse-childhood-experiences-ace

Older Students/Teens Self-Reporting Assessment (w/ parental consent)

For older students, the following assessment can be administered to determine exposure to ACEs:

https://www.traumainformedcare.chcs.org/resource/original-ace-questionnaire/

The THQ (Trauma History Questionairre) can also be used with students to obtain more information than just the original ACE Questionairre questions. For example, there are items that measure exposure to community violence, natural disasters, etc.

https://georgetown.app.box.com/s/tsijlp5br1w87o6ezpzlyeyx3dfxqxn6

Parent Reporting

Pediatric ACEs and Related Life Events Screener (PEARLS)

https://www.acesaware.org/wp-content/uploads/2019/12/PEARLS-Tool-Child-Parent-Caregiver-Report-De-Identified-English.pdf

The following individuals are at a higher risk for experiencing ACEs:

• females

• individuals from minority groups

• children who have experienced financial hardships

• children of parents/caregivers who experience high levels of stress

• children who have family members or caregivers who struggle with substance abuse or a mental health condition

Cleveland Clinic. (2023, March 10). Adverse childhood experiences (ACE). https://my.clevelandclinic.org/health/symptoms/24875-adverse-childhood-experiences-ace

Lasting Impact on Health & Well-being

According to the CDC, exposure to ACEs can lead to many negative life outcomes. These outcomes relate to health outcomes in childhood and overall life opportunities into adulthood.

Impact on children (short-term)-

• Impact on immune system and stress response system

• Toxic stress impacts brain functions that support attention/focus, decision making, and learning.

• Difficulty sustaining healthy relationships

Impact on teens/adults (long-term)-

• Increased risk for injury, sexually transmitted diseases, and involvement in sex-trafficking

• Risk of teen pregnancy, pregnancy complications, and fetal death

• Limited post-secondary educational experience

• Job instability, poor socio-economic status

• Racial discrimination due to lack of educational experiences

• Cancer, depression, diabetes, heart disease, & suicide

Centers for Disease Control and Prevention. (2024, April 3). Preventing adverse childhood experiences. https://www.cdc.gov/aces/prevention/index.html

• families who create a safe and consistent environment

• when both the child and family have friendships and connections with peers

• children who do well in school

• children who have caring adults outside of the family who serve as mentors/role models

• families where caregivers make sure basic needs are met (food, shelter, health services)

• families where caregivers have college degrees and stable employment

• families who enforce rules, and closely monitor and supervise their children

• families who work out their challenges peacefully, and help children to resolve their conflicts

• families who do fun, positive activities together

• families who encourage the importance of school for their children

The following community factors can prevent exposure to ACEs:

• when families have access to economic and financial help

• when families have access to medical care and mental health services

• access to safe, stable housing

• access to nurturing and safe childcare, preschools, and after-school programs

• where families have employment opportunities with family-friendly policies

• when communities have strong partnerships between the community and business, health care, government, and other sectors

• when community members feel connected to each other

• when violence is not tolerated or accepted in the community

Centers for Disease Control and Prevention. (2024, April 3). Preventing adverse childhood experiences. https://www.cdc.gov/aces/prevention/index.html

Trauma has a greater impact on individuals when it occurs during early-childhood as opposed to adolescence and/or adulthood.

"Specifically, ACEs target a child’s memory (hippocampus) and areas of the brain that help them think logically (prefrontal cortex) and process emotions (amygdala). Severe or long-term stress places these parts of a child’s brain into survival mode for too long. This can weaken those parts of their brain and influence the way they react to certain situations as they grow into an adult."

When children are exposed to traumatic events, their brain develops and functions differently. As the brain experiences stress, it releases hormones to adapt to the situation. The fight/flight/freeze response is activated and processes external stimuli.

After a child's stress-response system becomes sensitized, the brain will constantly release these hormones in similar situations, even if it is maladaptive (Cleveland Clinic, 2025).

For example, if a child frequently experiences domestic violence at home, her brain will be stuck in a stress-response state. She will eventually make a connection in her brain between adults and danger. This will generalize to her perceptions of adults at school, too. Therefore, she may be fearful and hypervigilant in the classroom, making it difficult to pay attention.

Here's another example of how a student may respond in the "freeze" or dissociation state in the classroom:

A boy did not finish his work in class, so he is asked to stay after for a few minutes to finish it. After a few minutes, the teacher checks in on him, and he is "zoned-out," and seems unresponsive. The teacher may believe he is being defiant, however the boy has experienced sexual abuse, and being alone with the teacher has activated his stress-response. The boy enters a state of dissociation any time he is alone with a male adult, because that is how he responded, and survived, during the abuse. You can see here how behaviors that were adaptive during traumatic events become maladaptive in the classroom.

Cleveland Clinic. (2023, March 10). Adverse childhood experiences (ACE). https://my.clevelandclinic.org/health/symptoms/24875-adverse-childhood-experiences-ace

• "Dosing" small levels of "stress" each day - Students who have experienced trauma can be stuck in the fight/flight/freeze state, especially in the school-setting. By slowly exposing them to small levels of stress (such as a consistent morning greeting), we will slowly help their brain make new connections. These doses should be predictable and consistent. For example, a teacher may let a student know that they will check in with each other for one minute every morning upon arrival. Over time, the student will be more tolerable of this interaction, and will start to form a connection with the adult that allows them to feel safe in the classroom.

• Let your students determine the "dosing" of therapeutic experiences. I learned in Dr. Perry's The Boy Who Was Raised as a Dog, that connecting with students takes time. They will not feel safe with you if you force them to share information or build a relationship before they are ready. When I implemented the 2x10 intervention with one of my students this year, we spent a few days just doing a puzzle together. Over time, we started to have some small talk during our puzzle time. By the end of the intervention, he was fully opening up to me. Teachers need to earn their students trust through micro-interactions each day.

• Rhythmic Exercises - Often times, students who have experienced trauma during childhood have disorganized brainstems and diencephalons. Research shows that activities that mimic heartbeat and breathing can help regulate these lower-brain regions. Some examples include walking, rocking, drumming, and passing a ball back-and-forth.

• As the teacher, take care of yourself first! A teacher's mental health and ability to self-regulate is by far the most important way to teacher students impacted by trauma. Emotions are contagious, and our students respond to situations based on our reactions. There's a famous quote by L.R. Knost that states, "When little people are overcome by big emotions, it is our job to share our calm, not join their chaos." By regulating ourselves, even when students are testing us with certain behaviors, we will build their trust and ensure a climate of safety.

  • Ways teachers can ensure they are regulated throughout the school day:

    • Get enough sleep

    • Eat throughout the school day (DON'T. SKIP. LUNCH).

    • Exercise regularly

    • Devote time for social engagement and hobbies

Perry, B. D., & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a child psychiatrist’s notebook (3rd ed.). Basic Books.

Center for Health Care Strategies. (2019, July). Original ACE Questionnaire. Trauma‑Informed Care Implementation Resource Center. https://www.traumainformedcare.chcs.org/resource/original-ace-questionnaire/ cdc.gov

Cleveland Clinic. (2023, March 10). Adverse childhood experiences (ACE). https://my.clevelandclinic.org/health/symptoms/24875-adverse-childhood-experiences-ace

Compassion Prison Project. (2025). Childhood trauma statistics. Retrieved July 14, 2025, from https://compassionprisonproject.org/childhood-trauma-statistics/

Perry, B. D., & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a child psychiatrist’s notebook (3rd ed.). Basic Books.

Sprenger, M. (2021, April 28). Social and emotional learning and the brain [Video]. YouTube. https://www.youtube.com/watch?v=_3is_3XHKKs

Parents can positively impact their child's social-emotional development by praising their child frequently. They also recommend that parents take parenting classes in order to gain more tools for raising a healthy and happy child.

Centers for Disease Control and Prevention. (2024, April 3). Preventing adverse childhood experiences. https://www.cdc.gov/aces/prevention/index.html