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Adverse Childhood Experiences (ACEs) are traumatic events that occur during childhood, which can have a negative impact on brain development and functions such as fear-processing, decision-making, self-regulation, memory and social skills.

These experiences tend to produce high levels of stress, a natural reaction to dangerous situations. Over time, this stress can reach toxic levels and result in survival responses like behavioural and social difficulties and mental and physical health problems.

The term "adverse childhood experienceswas firstly used by John Bowlby in 1981, resulting from his pioneering work on early attachment. The ACEs movement, however, started almost two decades later.  It was ignited by Vincent Felitti and Robert Anda following their 1998's seminal study showing the correlation between early adversity and poor health outcomes later in life. 

The 10 original types of ACEs defined by Felitti and Anda are as follows:








Household Challenges

Mental health problem

Substance misuse

Domestic violence

Parental separation or divorce

Family member in prison


In the past years, there has been a growing interest in the science, outcomes and prevention of ACEs.

Interpersonal, contextual, community and environmental factors have been given greater attention, resulting in an expanded understanding of adversity. The intergenerational and collective levels of trauma and the impact of epigenetics have also been made clearer via recent studies. 


Socio-economic aspects and experiences such as poverty, lack of opportunity and relational and systemic racism have been added to various ACEs graphics and measurements to assess trauma and resilience as a result of these important developments.

The Pair of ACEs and the 3 Realms of ACEs are two of these enhanced tools:

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The Pair of ACEs has also been further expanded to reflect the COVID-19 pandemic reality and highlight how inequities and disparities impact chronic adversity, especially when race and poverty are taken into consideration.

Click at the picture below to learn more details from Wendy Ellis, the Director of the Building Community Resilience Collaborative and Networks.

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In a metropolis like London, the wider and multidimensional recognition of ACEs is pivotal to understand and meet the needs of its diverse and resourceful communities.

ACEs is not a label or a diagnosis; it is an understanding and acknowledgement of what has happened. Awareness, individual and collective, brings choice and the opportunity to make changes, building healthier relationships and breaking harmful cycles.

We invite you to join the ACEs movement to make our great city an ACE-Aware Metropolis.


Would you like to learn more about ACEs? Click: 

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