Cogent Social Sciences

Adverse Childhood Experience (ACE): Reflections and Analyses about its Conceptualization, Measurement, and Applications

ACEs are childhood traumas that are risk factors for unhealthy physical and behavioral outcomes later in life. ACEs are dichotomously measured responses to from 7 to 12 questions that are typically about neglect, loss, exposure to depressed, suicidal, incarcerated, or drug or alcohol-addicted parental figures, physical, sexual or emotional child abuse, and abandonment. Responses are summed to produce a single ACE score. Scores of four or greater tend to produce the most damaging health and behavioral outcomes. Respondents either answer questions directly, or responses are gleaned from other sources, such as standardized scales (i.e. Positive Achievement Change Tool (PACT) or the Multidimensional Clinical Screening Inventory (MCSI)). Theoretical explanations for association between ACEs and poor outcomes include trauma, strain, learning, toxic stress (which interferes with brain development), attachment, biopsychosocial, allostatic load, ecobiodevelopmental, cognitive behavioral theories of emotions, life-course, and various child-developmental theories.

Early ACE scale development in the mid-1990s relied on social science research and these ideas have come full circle so that social scientists are borrowing the ACE scale as another tool for juvenile behavioral screening. At its inception, ACE creators engaged in what sociologists call public sociology. They simplified complex social processes so that everyone can better understand and make use of them. Nonetheless, are they oversimplified for other purposes? For example, the scale ignores factors that are routinely used as predictive measures in criminology, such as race, ethnicity, immigration, socioeconomic status, household crowding, and residential mobility. These measures are often used unsuccessfully as controls in ACEs research for medical predictions, but their inclusion in the index may be beneficial to behavioral assessments. However, adding additional factors to the ACE scale may be prohibitive to its goal which is simplification. So, questions remain, how useful is the ACE scale outside medical fields for research and application? When is it useful and when is its use redundant?

Questions about ACE scale construction and its use outside of its intended field are inherently multidisciplinary. The focused issue should encourage broad-based discourse from medical fields, psychology, sociology, criminology, criminal justice, and social work. Subtopics should include methodological and theoretical clarity in ACE scale development and the topical and contextual scope of its applications for various purposes and populations.

Dr. Judy A. Van Wyk is Professor of Sociology at the University of Rhode Island. Her research centers on violent delinquency, particularly the effects trauma and polyvictimization on violence against others and suicide. She investigates connections between victimization and offending and tests multi-level cross-disciplinary explanations for troubled behavior. Her research aims to aid programming for troubled youth. She has been awarded state and federal grants that have led to publications in some of the premiere sociological and criminological journals.

Dr. Van Wyk does not have any conflicts of interest to disclose.