Free · CDC-Kaiser ACE Questionnaire · 10 Questions

ACE Test: What Is Your Adverse
Childhood Experiences Score?

The ACE questionnaire counts ten categories of childhood adversity. Take it in about three minutes and get your score broken down across abuse, neglect, and household challenges — with a straight answer about what the number does and does not mean.

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CDC-Kaiser ACE Questionnaire · 10 Questions~3 MinutesConfidential

What Is Your ACE Score?

Before you begin. These ten questions ask directly about abuse, neglect, and serious difficulty in your household before you turned 18. They can be hard to read, let alone answer. You can stop at any point, and every question has a "I would rather not answer this one" option. Nothing you enter leaves your browser.

If you are in crisis or these questions bring up more than you expected, call or text 988 (Suicide & Crisis Lifeline) at any time.

The ACE questionnaire comes from the CDC-Kaiser Adverse Childhood Experiences Study — one of the largest investigations ever conducted into how childhood adversity relates to health across a lifetime. It counts ten categories of experience, and your score is simply how many of them applied to you.

It is worth being clear about what this measures before you start. An ACE score counts what happened to you. It does not measure how you are doing now, it is not a diagnosis, and it does not predict your future. It is a starting point for a conversation, not a verdict.

The Ten Categories

Part 1:Abuse — emotional, physical, sexual3 questions
Part 2:Neglect — emotional, physical2 questions
Part 3:Household challenges5 questions

A measure of exposure, not a diagnosis. Adapted from the published CDC-Kaiser questionnaire.

What the ACE Study Actually Found

The Adverse Childhood Experiences Study began in the mid-1990s, run jointly by the CDC and Kaiser Permanente and published by Vincent Felitti, Robert Anda and colleagues in 1998. More than 17,000 adults completed a standard health assessment and answered ten questions about their childhoods. It remains one of the largest investigations ever conducted into the relationship between early adversity and adult health.

Two findings made it famous. The first was how common adversity turned out to be — roughly two-thirds of participants reported at least one ACE, in a largely insured, employed, middle-class population. The second was the dose-response relationship: as the number of categories rose, so did the population rate of depression, substance use, and a long list of physical health conditions. The effect was graded, and it held after adjusting for the obvious confounders.

What gets lost in retellings is the nature of that finding. It is an association measured across a large population. It is not a mechanism that operates on individuals, and the original authors never claimed it was. Treating an ACE score as a personal forecast misreads the study — and does real harm to people who then believe their future is already written.

The Ten ACE Categories

Every question asks about the period before your 18th birthday. Each category counts once, regardless of how often it happened — which is one of the instrument's acknowledged limitations.

GroupCategoryWhat it covers
AbuseEmotional abuseFrequent insults, humiliation, or being made to fear physical harm by an adult in the household.
AbusePhysical abuseBeing pushed, grabbed, slapped, or hit hard enough to leave marks or cause injury.
AbuseSexual abuseSexual contact or attempted contact by an adult or anyone at least five years older.
NeglectEmotional neglectNot feeling loved, important, or supported; a family that was not close.
NeglectPhysical neglectNot enough food, dirty clothes, no one to protect you, or caregivers too impaired to provide care.
HouseholdParental separationParents separated or divorced.
HouseholdDomestic violenceA caregiver frequently subjected to violence in the household.
HouseholdSubstance useLiving with a problem drinker, an alcoholic, or someone using street drugs.
HouseholdMental illnessA household member with depression or mental illness, or who attempted suicide.
HouseholdIncarcerationA household member going to prison.

What the ACE Score Does Not Measure

The ten categories were chosen for a specific 1990s research study, not as a complete inventory of childhood adversity. A low score does not mean an easy childhood. None of the following are counted anywhere in the questionnaire:

Bullying, by peers or by adults
Poverty and food or housing insecurity
Racism and discrimination
Community or neighbourhood violence
Medical trauma or serious childhood illness
The death of a parent or sibling
Foster care and placement instability
War, displacement, or natural disaster

It also counts each category only once. One instance and ten years of the same experience produce the same single point. And crucially, it measures exposure only — it asks what happened, never how you are affected today.

ACE Score or Trauma Test — Which Do You Need?

These answer two different questions, and people often arrive looking for one while searching for the other.

ACE Test (this page)Trauma Test
Question it answersWhat happened to me in childhood?How is it affecting me now?
What it measuresExposure — a count of categoriesSymptoms — current distress and functioning
Time frameBefore your 18th birthdayRecent weeks and months
Based onCDC-Kaiser ACE questionnaireITQ, with exposure categories from the LEC-5
Best used forUnderstanding your history and its contextDeciding whether to seek treatment now

If what you actually want to know is whether to seek help, the trauma test will tell you more than this one will. Many people find it useful to take both: the ACE score for context, the trauma test for what to do about it.

Frequently Asked Questions

What is the ACE test?

The ACE test is a 10-question questionnaire from the CDC-Kaiser Adverse Childhood Experiences Study, published by Felitti, Anda and colleagues in 1998. It asks whether ten specific categories of adversity occurred before your 18th birthday, across three groups: abuse (emotional, physical, sexual), neglect (emotional, physical), and household challenges (parental separation, domestic violence, household substance use, household mental illness, and an incarcerated household member). Your ACE score is simply how many of the ten applied to you.

What is a normal ACE score?

There is no "normal" score, but the distribution is well documented. In the original CDC-Kaiser study, roughly a third of participants scored zero, and the most common result among those reporting any adversity was a score of one to three. Around one in eight adults scores four or more. A score of six or higher is far less common.

Is an ACE score of 4 or more high?

Four is the threshold most often cited, because it is the point at which the original study found meaningful increases in the likelihood of later health and mental health difficulties across the population studied. It is important to read that correctly: the ACE study describes statistical associations across more than 17,000 people. It does not predict what will happen to any individual, and many people with scores of four or higher are doing well. A score of four or more is a reason to take your history seriously, not a forecast.

Does a high ACE score mean I will have health problems?

No. The ACE score measures exposure, not outcome. It is a count of what happened, not a diagnosis and not a prediction. Protective factors that the questionnaire never asks about — a supportive relationship, stable housing, an attentive teacher, access to treatment — measurably change long-term outcomes. Two people with identical ACE scores can have completely different lives.

What does the ACE test not measure?

The ACE questionnaire covers ten categories and nothing else. Bullying, poverty, racism, community violence, medical trauma, natural disasters, the death of a parent, and serious childhood illness are all genuinely adverse and none of them are counted. It also measures only what happened, not how you are affected now. For current symptoms, our trauma test or the PCL-5 PTSD test will be more useful.

Does DMHBH treat adults with childhood trauma?

Yes. DeSoto Memorial Hospital Behavioral Health provides trauma-informed outpatient care for adults in Port Charlotte and Arcadia, FL, including our PTSD Intensive Outpatient Program. Treatment begins with grounding and stabilisation skills before any processing of traumatic memories — that sequence is what makes trauma work safe and effective.

Trauma-Informed Outpatient Care · Port Charlotte & Arcadia, FL

Your Childhood Is Not Your Prognosis

Whatever your score, what happens next is not fixed. Our team works with adults carrying childhood trauma — building grounding skills first, then doing the deeper work, without an inpatient stay.

If you are in crisis, call or text 988 immediately.