Childhood can be a time of wonder, growth, and safety. Yet for millions of people, early years are marked by experiences that leave lasting scars—not just emotional ones, but physiological changes that can affect health and wellbeing for decades to come. These experiences are known as Adverse Childhood Experiences, or ACEs. Understanding them is an important part of healing from them and trying to make sense of our own life story
What Are ACEs?
Adverse Childhood Experiences encompass a range of potentially traumatic events that occur before the age of 18. The concept emerged from groundbreaking research conducted in the mid-1990s by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente, which surveyed over 17,000 adults about their childhood experiences and current health status.
The original ACE study identified ten categories of childhood adversity, grouped into three main types:
- Abuse: Physical abuse, emotional abuse, and sexual abuse form the first category. These involve direct harm inflicted on a child, whether through physical violence, verbal cruelty that damages self-worth, or sexual contact of any kind.
- Neglect: Both physical and emotional neglect represent failures to provide for a child’s basic needs. Physical neglect means inadequate food, clothing, shelter, or supervision, while emotional neglect involves a lack of love, support, or attention that leaves a child feeling invisible or worthless.
- Household Dysfunction: This broad category includes witnessing domestic violence, living with someone who has a substance abuse problem, experiencing parental separation or divorce, having a household member with mental illness, or having a household member who is incarcerated.
The Biology of Toxic Stress
When we understand ACEs through the lens of neuroscience and physiology, their impact becomes clearer. Children’s brains and bodies are designed to respond to stress, but they’re meant to recover in safe, supportive environments. When that recovery doesn’t happen—when stress becomes chronic and predictable—the body’s stress response system gets stuck in overdrive.
This “toxic stress” floods the developing brain with cortisol and other stress hormones, actually changing brain architecture. The amygdala, responsible for fear and emotional responses, becomes hyperactive. The prefrontal cortex, which handles executive function and emotional regulation, may develop more slowly. The hippocampus, crucial for memory and learning, can be measurably smaller in people who experienced childhood trauma.
Beyond the brain, chronic stress affects the entire body. It triggers inflammation, weakens the immune system, and alters how genes are expressed—a process called epigenetics. These changes help explain why someone who experienced childhood adversity might develop diabetes, autoimmune disorders, or cardiovascular disease decades later, even if they’ve lived healthily as adults.
Beyond Individual Experiences: Expanding the ACE Framework
While the original ten ACEs remain foundational, researchers and practitioners now recognize that adversity extends beyond household dysfunction. Children growing up in poverty face daily stressors that affect development. Those experiencing racism, discrimination, or community violence carry additional burdens. Immigration stress, bullying, and losing a parent to death also qualify as significant adverse experiences.
The expanded ACE framework acknowledges these realities while maintaining its focus on the core insight: early adversity matters profoundly and in measurable, predictable ways.
The Good News: Resilience and Healing
Understanding ACEs isn’t about doom and gloom—it’s about hope and intervention. The same research that revealed the impact of childhood adversity also points toward solutions.
Resilience factors can buffer against ACEs. A single stable, caring adult in a child’s life—whether a parent, grandparent, teacher, coach, or mentor—can make an enormous difference. Positive childhood experiences, such as feeling supported by friends, belonging to a community, and having safe places to play and learn, help build resilience.
Trauma-informed care recognizes that many people have experienced ACEs and approaches them with understanding rather than judgment. Instead of asking “What’s wrong with you?” trauma-informed systems ask “What happened to you?” This shift in perspective opens space for healing.
Evidence-based therapies can help rewire trauma responses. Approaches like cognitive-behavioral therapy, EMDR (Eye Movement Desensitization and Reprocessing), and somatic therapies help people process traumatic memories and develop healthier coping mechanisms. Mindfulness practices, exercise, and creative expression also support healing.
Perhaps most importantly, understanding ACEs helps break cycles of trauma. Parents who recognize how their own childhood experiences affect their parenting can seek support and make different choices for their children.
What This Means for All of Us
ACEs research has transformed how we understand human development, health, and behavior. It explains why some people seem to struggle more than others with health, relationships, or emotional regulation—not because they’re weak or flawed, but because their nervous systems learned to survive in threatening environments. The original ACE study found that people who experienced four or more ACEs had significantly higher risks for depression, substance abuse, and chronic health conditions compared to those with no ACEs, demonstrating a clear dose-response relationship. ACE awareness offers a framework for understanding personal struggles without self-blame.
ACEs don’t have to define a person’s story. With awareness, support, and intervention, healing is possible at any age. The brain remains plastic throughout life, capable of forming new connections and patterns. With this knowledge comes power—the power to seek support, to heal, and ultimately, to break cycles that have persisted for generations.
Finding Support for Your Healing Journey
Understanding ACEs is an essential first step, but healing from childhood trauma often requires professional support. At Firefly Therapy Austin, our therapists specialize in trauma-informed approaches that help rewire the patterns ACEs create. Whether you experienced one adverse childhood experience or several, we’re here to help you process what happened and build the life you deserve. You don’t have to carry this alone.