The ACE-Q

The Adverse Childhood Experiences Questionnaire (ACE-Q) is a self-report questionnaire designed to correlate household childhood maltreatment and the association between them and risk behaviours in later life. The test does NOT test for stressors outside the home, such as bullying and discrimination.

Take the test here:

Who the test is designed for

• Teenagers
• Adults
• Parents to describe their child’s experiences

Versions & translations

• English
• Spanish
• French
• German
• Norwegian
• Swedish

Taking the test

The ACE-Q consists of 10 statements, giving you 2 choices for each statement:

1. Yes = 1
2. No = 0

Note: Some of the questions may be triggering for people who experienced trauma. If that is the case, you can answer the ACE-Q collaboratively with your therapist or someone you trust or not take the test.

Scoring

• Scoring range: 0-10
• Most of adults score 1 or higher
• A score of 4 is considered clinically significant
• A minority (5%–10%) of the general population score 4 or more

Compared to those with an ACE-Q score of 0, people with a score of 4 are twice as likely to be smokers and 5 times more likely to experience depression. Further, they are 7 times more likely to become alcoholics, 10 times more likely to participate in illicit drug use, and 12 times more likely to attempt suicide.^[1]Nova Psych ACE-Q

Validity

How reliable, accurate, valid, and up to date is the test?

• Reliability was found to be good.
• Validity was found to be good. ^[2]The reliable, valid and economic assessment of early traumatization: first psychometric characteristics of the German version of the Adverse Childhood Experiences Questionnaire (ACE) (Wingenfeld et al, 2011)
• Validation studies suggest that ACE-Q scoring remains strong as a predictive measure despite potential distortion due to historical self-reporting-memory artifacts.

Discussion

Dr. Natalie Engelbrecht:

The ACE-Q helps a person understand whether or not they had a difficult childhood. The main problem I have with the test is the name which can be confusing to clinicians and test-takers alike. It does not consider stressors outside of the household, such as discrimination, a common experience for autistics. In addition, protective factors such as a loving, supportive parent are not considered. And lastly, individual differences, which make a person more or less sensitive to adversity, are not considered.

Still, it is an important test that has been used repeatedly in research to demonstrate that autistics experience significantly more ACEs^[3]Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study (Felitti et al., 1998) which affects their mental and physical health outcomes.^[4]Brief Report: Examining the Association of Autism and Adverse Childhood Experiences in the National Survey of Children’s Health: The Important Role of Income and Co-occurring Mental Health Conditions (Kerns et al., 2017)

My score of 7 indicates a higher risk for negative life outcomes, and I certainly had a rough childhood. I do think that my autism has been protective in some ways. For example, I have noted that autistics often stop contact with harmful parents more often than non-autistics. I suspect the reasoning behind this is due to our pragmatism. I felt that my parents were incapable of parenting lovingly, so I decided that I needed to step in and parent myself in the way a healthy parent would. Another protective factor is that I find autistics tend to find loving relationships. My clinical experience has been that we will ultimately leave destructive relationships and find people that can love us for who we are.

An ACE study of over 9,500 adults found that persons with higher ACE-Q scores experienced more childhood adversity, increasing their risk of chronic disease, mental illness, violence, becoming a victim of violence, and various other consequences.

Kendall

Even though I scored 0 on the ACE-Q, I have experience with 4.5 out of 5 of its predicted consequences. That’s not to say their conclusions aren’t accurate, but that traumatic events outside the home may also be relevant. Taking the test is very quick, and the statements are clear, direct, and easy to understand.

The ACE-Q

• Because of the questions’ sensitive nature, individuals should take the ACE Questionnaire in a confidential space.
• Please note some of the questions may be triggering for people who experienced trauma. If that is the case, you can answer the ACE-Q collaboratively with your therapist or someone you trust or not take the test.
• Before your 18th birthday, did any of the following things occur to you?

If you are looking for an autism assessment,
have a look at the following post:

Online autism assessments