Toxic Stress Caused by Adverse Childhood Experiences (ACES)



Learning how to cope with difficulty is animportant part of healthy development. When we experience stress or adversity, our brain’s stress response system is activated and goes on alert. When the stress is relieved, the stress response system winds down and the body returns to normal.

For young children, this return to normal depends upon the presence of supportive adult caregivers who can help relieve the stress a child experiences—whether the stress is normal and essential (positive), more severe and longer-lasting (tolerable) or strong, frequent and prolonged (toxic).

When caring adults are not present, stressful situations such as exposure to violence or neglect cause a child’s stress response system to stay activated. Constant activation of the stress response overloads developing systems in the brain, leading to serious lifelong consequences. When the stress response system is set on high alert for prolonged periods, scientists call this toxic stress.

Toxic stress can reduce important neural connections in areas of the brain, just when those connections should be growing. The release of stress hormones causes neurons to die off instead of making vital connections. To prevent toxic stress from harming children, the Council promotes environments that are nurturing, interactive and stable.


The incidence and effects of childhood trauma—also called Adverse Childhood Experience (ACE)—was the subject of a large-scale study from 1995-1997. In this study, 17,000 members of the Kaiser Permanente Health Plan (average age 57) were asked to complete a confidential survey that contained questions about childhood maltreatment and family dysfunction, as well as their current health status and behaviors. The study was a collaboration between the federal Centers for Disease Control and Prevention and Kaiser Permanente. It was perhaps the largest scientific research study of its kind, analyzing the relationship between multiple categories of childhood trauma and health and behavioral outcomes later in life. Co-principal investigators were Robert F. Anda, MD, MS, and Vincent J. Felitti, MD. Dr. Felitti has become a friend to Maine and has helped guide the Council’s work, see Health Accountability Team.

Childhood traumas reviewed by the Study include: recurrent physical and emotional abuse, contact sexual abuse; physical and emotional neglect; and factors such as household members with alcohol and drug abuse, chronic depression, and mental illness; family members who were institutionalized, suicidal, or incarcerated; mother who was violently abused; and parents who were separated, divorced or in some way lost in early childhood.


  1. Adverse Childhood Experiences and, in particular the incidence of more than one ACE, are vastly more common than what was previously known.
  2. ACEs have a powerful correlation to adult health even more than 50 years later. In fact, they are major risk factors for the leading causes of death, illness and poor quality of life.
  3. The more ACEs the person experienced the more likely the incidence of: smoking, alcoholism, chronic obstructive pulmonary disease, obesity, depression, attempted suicide, diabetes, intravenous drug use and heart disease.
  4. Children with a greater number of adverse experiences are far more likely, as adults, to suffer from a variety of health and mental health problems–exposure to violence or neglect, lack of access to health care, hunger or inadequate nutrition, parents with mental health problems or chronic stress from financial insecurity, etc.

Adverse Childhood Experiences can lead to disrupted neurodevelopment and social, emotional and cognitive impairment which lead to the adoption of health risk behaviors and ultimately disease, disability, social problems, and even death as noted in the ACEs pyramid.

ACEs clearly lead to problems that reduce the likelihood of an adult leading a successful, healthy, productive life. Reducing childhood trauma in order to reduce inequalities in opportunity down the line is an economic as well as a moral imperative. Research shows high quality early care and education yield the most significant positive outcomes for children who face a number of adverse early experiences.

Related citation: National Scientific Council on the Developing Child. (2005/2014). Excessive Stress Disrupts the Architecture of the Developing Brain: Working Paper 3. Updated Edition. Retrieved from

Please follow the work of the Maine Children’s Growth Council to find out how you can help lay the foundation for your child and for Maine’s future. Speak out and educate yourself about ACES and toxic stress. Contact us today for more information.

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