Should ACEs be used as a measure of childhood trauma? Not really.

Often professionals in schools and the mental health field consider the ACEs (Adverse Childhood Experiences) questionnaire as a place to start measuring whether a client has experienced complex trauma. I have heard people in the community — including both clients and professionals — sharing their ACE scores as a shorthand way to communicate the extent of their trauma.

I place no judgment on this occurrence because complex trauma is… well, complex!

It can be helpful to have a way of expressing the degree to which you might understand someone else’s experience with someone you don’t know yet in the context of therapy. But there are also problematic aspects of centering the assessment of childhood trauma in ACEs.

Why is it problematic to measure childhood trauma through ACEs?

For starters, the ACEs questionnaire was never intended to measure trauma — the authors of the study specifically chose not to use that term because adverse experiences do not necessarily equate to or have a causal effect on trauma.

Other researchers have identified skills and factors that indicate a person’s resilience inventory, which has been correlated to whether an adverse experience develops into chronic post-traumatic stress.

The questionnaire was developed to look specifically at interfamilial adverse experiences at a macro level in order to inform public policy and further research. It did not explore the traumatic impact of some of the following sources of complex trauma: race-based oppression and violence, colonization, gender- and sexuality-based oppression, poverty, the stigma of health and mental health diagnoses, the stigma of neurodiversity, bullying, and so much more.

In my opinion, the scope of the questionnaire is far too narrow and inadequate to be used as an assessment tool for complex childhood trauma. And yet, the idea of creating a common language for communicating about trauma is so important to hold in our minds. An expanded scope of adverse experiences underlies many, if not all, forms of health and mental health challenges.

Finally, the concept of applying an ACE score to a human being as opposed to being an indicator of familial, societal, and institutional malaise simply serves to continue to locate the problem within the individual as our society is wont to do.

What’s a healthier way of addressing childhood trauma?

In my practice with clients, I use the Liberation Health Framework to gain a more thorough and unique perspective of the context for a client’s present challenges across personal, institutional, and cultural factors. The Liberation Health Framework centers the client in a position of individual strength and empowerment; a critique of the systems and factors contributing to their problems is essential.

Exploring the client’s problems in this holistic and critical way helps a client develop a new perspective on the importance of self-care and self-discovery — one where they can stop looking for the problem within themselves and learn to curate a life that is in sync with their truth.

This is where you will find the center of you. Get in touch.