ACE Test — Free Adverse Childhood Experiences Quiz: Calculate Your ACE Score
Take the ACE questionnaire — 10 questions about childhood adversity that predict adult mental and physical health. Free explanation and CHILDAFF alternative in the Mindtalk app.
Clinically reviewed by Ms. Suhita Saha, MPhil Clinical Psychology, MA Psychology. Last reviewed 2026-09-25.
Important safety information
The ACE (explained) → CHILDAFF alternative includes a question about thoughts of self-harm (question 9). If you have had any such thoughts recently, please reach out for support before or instead of taking this assessment — you do not need to take a test to deserve help.
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The 10 ACEs
Your ACE score is the count of categories you experienced before age 18:
- Emotional abuse — parent frequently insulted, humiliated, or threatened you
- Physical abuse — parent hit, kicked, or physically harmed you
- Sexual abuse — someone at least 5 years older than you touched sexually or attempted / did sexual acts
- Emotional neglect — no one in family made you feel important or loved
- Physical neglect — not enough food, dirty clothes, no one to protect you
- Mother treated violently — witnessed physical violence toward mother
- Parental separation or divorce
- Household substance abuse — someone in household was a problem drinker or drug user
- Household mental illness — someone in household was depressed, mentally ill, or attempted suicide
- Household incarceration — household member went to prison
What your ACE score means
Count one point for each category above that you experienced before age 18. The CDC-Kaiser ACE Study (Felitti & Anda, 1998) found that risk rises with the number of categories:
| ACE score | Adult risk elevation |
|---|---|
| 0-1 | Lowest risk group in the ACE studies (not zero risk) |
| 2-3 | Moderately elevated risk |
| 4+ | Substantially elevated risk for depression, anxiety, PTSD, substance use, cardiovascular disease |
| 6+ | Very high risk; in a 2009 follow-up of the cohort, people with 6+ ACEs died nearly 20 years earlier on average |
These are population averages. The ACE score is a count of past exposure, not a clinical cut-off, and it does not tell you how you are doing now. For that, the Childhood Trauma Test looks at how early adversity still shows up in adult life, and the ITQ screens for current PTSD and complex PTSD.
Score is not destiny. Population-level correlations don't determine individual outcomes. Many adults with high ACE scores recover well — particularly with therapeutic support, stable adult relationships, meaningful work, and self-compassion practice.
Limitations of the original ACE
The original 10 categories don't capture:
- Community violence
- Racism and discrimination
- Poverty
- Chronic illness in the family
- Migration or refugee experience
- Bullying
- Many other childhood adversities that also elevate adult risk
Expanded tools (Philadelphia ACEs, WHO ACE-International) address some of these. The simple 0-10 score is useful but not exhaustive.
What to do with a high ACE
Book with a trauma-focused clinician. Bring the score to intake — it shortens the assessment. Our trauma disorders page explains how childhood trauma is assessed and treated.
Take related assessments:
- ITQ — current PTSD and Complex PTSD symptoms
- Trauma Self-Insight hub — self-understanding
- PHQ-9 and GAD-7 — current mental health
Consider trauma-focused therapy:
- EMDR — strong RCT evidence for adult PTSD and complex trauma
- TF-CBT — trauma-focused CBT
- Somatic Experiencing — body-focused
- Compassion-Focused Therapy — for shame-driven patterns
- Schema Therapy — for early-maladaptive schemas
Post-traumatic growth
Not all adults with high ACE scores experience only adverse outcomes. Post-traumatic growth — meaning-making, resilience, deep empathy, wisdom — is well-documented. Trauma changes people; sometimes the change includes strength alongside vulnerability.
Validation and evidence
The ACE questionnaire comes from the CDC-Kaiser Permanente ACE Study. The first report (Felitti et al., 1998) surveyed 9,508 adults about seven categories of childhood abuse and household dysfunction and found a graded relationship between the number of categories and adult risk behaviours and disease; people with four or more categories had 4- to 12-fold higher risks for alcoholism, drug misuse, depression and suicide attempts. A 2009 follow-up of 17,337 participants found that people with six or more ACEs died nearly 20 years earlier on average. A 2017 meta-analysis of 37 studies (253,719 adults) confirmed that four or more ACEs raise the risk of every outcome studied, most strongly for problematic drug use, violence and mental ill-health. The ACE checklist is a research and awareness tool: it counts exposure and was not designed as a diagnostic test.
References
- Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245-258. PubMed
- Brown DW, Anda RF, Tiemeier H, et al. Adverse childhood experiences and the risk of premature mortality. Am J Prev Med. 2009;37(5):389-396. PubMed
- Hughes K, Bellis MA, Hardcastle KA, et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health. 2017;2(8):e356-e366. PubMed
Related reading
- ITQ trauma screener — current PTSD / CPTSD symptoms
- Trauma & PTSD hub
- Trauma Self-Insight hub
- Family & Parenting hub
- Attachment Style Test — often shaped by childhood adversity
- Mindtalk's trauma-focused clinicians across India
How to take the ACE (explained) → CHILDAFF alternative
- 1
Take CHILDAFF in the Mindtalk app
Tap "Take the ACE Test" to open CHILDAFF — the Mindtalk-hosted childhood-impact screener.
- 2
Answer 10 questions about childhood experiences
For each category, indicate whether you experienced that type of adversity before age 18.
- 3
Get your ACE-equivalent score and interpretation
Receive a score with interpretation and personalised next-step recommendation.
Related assessment guides
CHILDAFF
How has your childhood affected you? Test the pattern in 3 minutes. Free in the Mindtalk app.
Read the guide →ITQ
The only major screener that distinguishes PTSD from Complex PTSD. ICD-11 aligned, 18 items, 10-15 minutes. Free in the Mindtalk app.
Read the guide →PCL-5 (explained) → ITQ free alternative
The PCL-5 — the standard 20-item DSM-5-anchored PTSD self-report scale. Learn what it is, and take the free ITQ trauma screener in the Mindtalk app.
Read the guide →Frequently Asked Questions
- What are the 10 ACE categories?
- The original 10 ACEs: (1) emotional abuse — parent frequently insulted, humiliated, or threatened you; (2) physical abuse — parent hit, kicked, or physically harmed you; (3) sexual abuse — someone at least 5 years older than you touched sexually or attempted / did sexual acts; (4) emotional neglect — no one in family made you feel important or loved; (5) physical neglect — not enough food, dirty clothes, no one to protect you; (6) mother treated violently — witnessed physical violence toward mother; (7) parental separation or divorce; (8) household substance abuse — someone in household was a problem drinker or drug user; (9) household mental illness — someone in household was depressed or mentally ill or attempted suicide; (10) household incarceration — household member went to prison.
- What was the ACE Study?
- The CDC-Kaiser ACE Study was led by Vincent Felitti and Robert Anda. More than 17,000 Kaiser Permanente members took part in 1995-1997. The first paper, published in 1998 in the American Journal of Preventive Medicine, analysed 9,508 respondents and seven categories of adversity, and found a graded relationship: the more categories, the higher the risk of adult health problems including depression, substance misuse, heart disease and lung disease. Later work in the same cohort linked 6 or more ACEs with earlier death.
- What does my ACE score mean?
- ACE 0-1: below-average risk but not risk-free. ACE 2-3: moderately elevated risk. ACE 4+: substantially elevated risk for adult mental and physical health problems. ACE 6+: in a 2009 follow-up of the ACE Study cohort, people with 6 or more ACEs died nearly 20 years earlier on average than those with none. BUT: score is not destiny. Many adults with high ACE scores recover well, particularly with therapeutic support and stable adult relationships.
- Is ACE score deterministic?
- No. Correlations are strong at population level but any individual with a high ACE score may recover well — protective factors matter substantially. Protective factors include stable trusted adult relationships in childhood or adulthood, therapy, self-compassion practice, meaningful work / community, and post-traumatic growth. The ACE score tells you about elevated risk; therapy and support tell you about actual trajectory.
- Is trauma treatable?
- Yes — well documented. EMDR, TF-CBT, Somatic Experiencing, and Compassion-Focused Therapy all have strong evidence for adult recovery from childhood adversity. Recovery is real and lasting for most people who engage with treatment. The older narrative that "you just have to live with it" is outdated.
- What are the limitations of the ACE score?
- The original 10 ACEs don't capture: community violence, racism, poverty, chronic illness in the family, migration/refugee experience, bullying, or many other childhood adversities that also increase adult risk. Expanded ACE tools exist (Philadelphia ACEs, WHO ACE-International) that add these dimensions. The simple 0-10 score is useful but not exhaustive.
- What should I do with a high ACE score?
- Book with a trauma-focused clinician. Bring the score to the intake — it shortens the assessment. Trauma-focused therapy (EMDR, TF-CBT, Somatic Experiencing) has strong evidence for adult recovery. If you also have PTSD symptoms currently, take the [ITQ](/assessments/itq) alongside.
- How do I calculate my ACE score?
- Go through the 10 ACE categories listed on this page and count one point for each that happened to you before your 18th birthday. It does not matter how often it happened; each category counts once. The total, from 0 to 10, is your ACE score. If counting brings up difficult memories, pause and reach out to someone you trust or a helpline.
- Is the ACE test accurate?
- The ACE questionnaire is a retrospective checklist, so it depends on memory and on what you are comfortable disclosing. It is good at showing population-level risk, but it does not measure how adversity affects you now and does not diagnose anything. For current symptoms, the ITQ screens PTSD and complex PTSD, and the Childhood Trauma Test looks at ongoing adult impact.
Need a clinician's read on your results?
A high score is a signal, not a diagnosis. Mindtalk's psychiatrists and clinical psychologists can interpret your results and recommend next steps — same-day appointments available.