ACEs Test: Signs Your Child Should be Given a Childhood Trauma Questionnaire

Signs Your Child Should be Given a Childhood Trauma Questionnaire

Are you wondering if your child needs to be tested for ACEs? Read here for a few signs that your child should be given a childhood trauma questionnaire.

Adverse childhood experiences (ACEs) are potentially traumatizing events that have been linked tochronic health problemsin adulthood. ACEs are preventable, but what can we do when a child has already experienced them?

Early intervention can make a difference. Helping children to process trauma and find safe and healthy ways to navigate life may reduce the mental and physical stress that takes a toll as they get older.

However, children often aren't forthcoming about their adverse experiences. Depending on their age and development, they can't always identify traumatic events.

A childhood trauma questionnaire can provide much-needed answers as a starting place for treatment. Read on to learn the signs that a child may benefit from ACE testing.

What Are ACEs?

We first started to hear about ACEs in 1995 thanks to research conducted by Kaiser Permanente and the CDC. The original ACE framework included three types of potentially traumatic circumstances. These include:

  1. Abuse (physical, emotional, and/or sexual)
  2. Neglect (physical and/or emotional)
  3. Household dysfunction (mental illness, incarceration, interpersonal violence, substance abuse, and/or divorce)

In recent years, researchers haveexpanded the ACE framework. We now recognize additional ACEs including:

  1. Community violence and neighborhood safety
  2. Bullying
  3. Unstable living situations such as foster care
  4. Discrimination including racism

ACE testing evaluates the number of ACEs a child has experienced and allots one point for every adverse experience that applies. A score of four or higher can indicate an increased chance of negative health outcomes in the future. 

Signs That a Childhood Trauma Questionnaire Can Help

While prevention is the best solution, there is still hope for children who have already experienced ACEs.Processing trauma soon after it happens can have positive short-term and long-term results. Here are some of the common signs that children are living with trauma.

Emotional Signs of Trauma

Childhood trauma can impact the way that children feel and express their emotions. This can manifest in a wide variety of ways, such as:

  1. Low self-esteem or feelings of low worth
  2. Intense or unpredictable outbursts of anger 
  3. Frequent expressions of fear, shame, or guilt
  4. Depression or a sense of isolation

In general, you may get the sense that the child is very sensitive or has limited control over their emotions. They may seem more (or less) reactive than their peers.

Behavioral Signs of Trauma

Trauma can slow or alter development. In other words, it can change the brain, negatively impacting things like decision-making. As a result, you may notice behaviors like:

  1. Shutting down or dissociating
  2. Difficulty focusing on tasks or conversations
  3. Frequent or disruptive expressions of emotion (e.g., crying or shouting)
  4. Aversions to authority
  5. Regressive behavior (e.g., thumb-sucking in adolescence)
  6. Impulsive or risky behavior (e.g., early sexual activity or substance abuse)
  7. Disordered eating
  8. Self-harm or suicidal ideation

You may notice signs ofrepetition compulsionin children who experience trauma. This can take on many forms, one of them being the reenactment of a traumatic event. Children (and adults) often engage in repetition compulsion to try to make sense of and resolve the trauma they've experienced.

Physical Signs of Trauma

When we talk about physical signs of trauma, we don't just mean evidence of abuse or harm (although these should never be ignored). Just as trauma can alter the brain, it can also impact the body.

For example, a traumatized child may show signs of body dysregulation. For example, the child may react negatively to loud sounds, touching, or specific scents.

On the flip side, some traumatized children may show desensitization to sensory stimuli. For example, you may notice that they don't always register pain and hurt themselves without realizing it. 

Signs of Trauma in Different Age Groups

We often start to notice signs of childhood trauma when emotional reactions and behaviors aren't "age-appropriate." It's useful to distinguish how different age groups may respond to trauma. 

Signs of Trauma in Preschool-Aged Children

At age three or four, children are still learning how to express and understand their emotions in a safe and useful way. They still have strong emotional outbursts (which we often label tantrums) while also showing a growing sense of empathy and interest in their peers.

Preschool-aged children with adverse experiences may:

  1. Express extreme distress or fear when separated from a parent or caregiver
  2. Have frequent severe nightmares
  3. Eat poorly and/or lose weight
  4. Show disinterest or distrust in their peers and adults

They may also show notable developmental delays compared to children similar in age.

Signs of Trauma Elementary Schoolers

Elementary schoolers tend to prioritize close relationships, develop interests in hobbies, and show increasing emotional complexity. They're more equipped to describe their day and emotions. They can differentiate between what we consider "good" behavior and "bad" behavior.

Elementary schoolers with adverse experiences may:

  1. Exhibit signs of anxiety, fear, or shame
  2. Struggle to concentrate or complete tasks
  3. Have difficulty falling or staying asleep
  4. Have strong emotional outbursts or difficulty with emotional regulation
  5. Get into trouble at school, in the community, or at home

At this age, it is often easier to identify learning disabilities, as well. An ACEs questionnaire can help teachers and parents differentiate between trauma responses and learning disabilities. 

Signs of Trauma in Pre-Teens and Teens

Emotional complexity tends to skyrocket for middle and high schoolers. They're often starting to envision their futures while navigating things like peer pressure and puberty.

This is a tough time for all kids, but especially those with childhood trauma, who may exhibit signs such as:

  1. Risky or impulsive behaviors (e.g., early or unsafe sexual activity and/or substance abuse)
  2. Depression, low self-worth, or isolation
  3. Self-harm and suicidal ideation
  4. Frequent struggles with authority figures
  5. People pleasing or fawning behaviors
  6. Disordered eating

Because teens are so emotionally complex, the way they respond to trauma is equally complex. ACE testing can shed light on their experiences and how they've contributed to a teen's emotional presentation and behavior. 

Learn More About ACE Testing Today

ACEs can contribute to worse mental and physical health outcomes in adults. A childhood trauma questionnaire can give parents and teachers more insight into the support and treatment a child may need for healthy development. 

Choice MD is designed to help families feel empowered to find and work with healthcare providers. We understand how important it is to prevent, test for, and respond to ACEs.Learn moreabout the ACE test today.