Assessing Childhood Developmental Trauma

The ACE Quiz ("ACE" stands for Adverse Childhood Experiences) has become a standardized way for psychologists and those treating trauma to assess some of the major factors that might contribute to childhood developmental trauma. You can take the ACE quiz here.

The simple 10-question quiz gives you score on a scale of 0 to 10, with points being assigned for exposure to a number of commonly recognized sources of childhood trauma, from physical, emotional, or sexual abuse to physical or emotional neglect to various forms of household dysfunction such as parental divorce or having a parent or family member who is mentally ill, incarcerated, or addicted.

Things the ACE Quiz Looks At

If you score high on the ACE quiz, it means you had numerous factors in your upbringing that might contribute to childhood developmental trauma. In turn, childhood developmental trauma is known to contribute to other problems later in life, including increased risks for stress and depression, substance abuse, heart disease, and more.

Effects of Childhood Developmental Trauma

However, it's important to understand what your score on the ACE quiz means and what it doesn't. If you have a high score, it just means that a lot of those commonly recognized adverse childhood experiences were present in your early life. It doesn't take into account other factors that might have helped you build resilience and overcome these adverse childhood conditions, such as the love and support you received from a certain family member or outside figure.

Some people with high ACE scores show few signs of developmental trauma, while others with low ACE scores go on to develop major depression, addiction, and so forth. So your score is not, strictly speaking, predictive of any particular outcome as an adult.

By contrast, the opposite may also be true. The ACE quiz looks at commonly recognized adverse conditions for developmental trauma, but some possibly traumatizing adverse conditions are glaringly absent.

When I took the ACE quiz, I was at first surprised at how high my number was. The quiz helped me to frame and understand some of the root causes of my own childhood developmental trauma. But over time, I came to realize there were other traumatic adversities in my childhood, too, that the quiz didn't even touch upon, such as sexual orientation and religious upbringing.

What about the fact that I was and am gay, and that I struggled throughout childhood and adolescence to suppress the growing evidence of my own sexual orientation in a homophobic culture that harshly forbade me from being who I was? There's no checkbox on the ACE quiz for internalized homophobia. There should be, because it's a widespread and very damaging form of developmental trauma.

What about the fearful hellfire-and-brimstone sermons I was subjected to as a child in the Southern Baptist Church in Oklahoma, the intense atmosphere of homophobia in that church, and the religious delusions and existential terror I suffered as a result of my indoctrination in that religious culture? In retrospect, I consider what I was subjected to by the church to be a form of child abuse. But again, there's no checkbox on the ACE quiz for religious manipulation and brainwashing. And there should be.

What about complex factors like race and socioeconomic status, which can feed into so many other adverse childhood experiences? There are generational traumas, and traumas that you may be born into because the color of your skin isn't the one that's privileged by the society you live in. No ACE checkboxes for those either.

For now, the ACE quiz is a stepping stone that can help you begin to get a handle on some of the Big 10, as it were. Knowing where you come from in relation to these 10 factors can be helpful in assessing the roots of your own childhood developmental trauma. But you also need to put your ACE quiz results in perspective, and look at the larger picture of things the quiz never touches upon.

The causes and effects of childhood developmental trauma are highly complex, and no standardized test can really give you a complete or accurate reading on the origins or effects of your own childhood trauma. We need better ways of assessing a wider variety of adverse childhood experiences, as well as traumatic social conditions that extend both inward, deep into our hearts and psyches, and outward, beyond the walls of the houses we grew up in.

Dennis Hunter