Adverse Childhood Experiences (ACEs) and Research

The complexity of adverse childhood experiences: 10 forms of adversity with 10 areas of research

Our Challenge

One of the biggest challenges preventing adverse childhood experiences (ACEs) is that they represent ten different adult behaviors impacting children and teens. These include physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect, living with a parent with mental health challenges, living with a parent with substance abuse disorders, living with domestic violence, parents separated or divorced, or a parent or household member incarcerated. Each ACE may have its own root causes, impact and prevention and treatment efforts. In order to design a data-driven strategy to prevent and treat ACEs, we will benefit from taking a deep and long dive into the research.

What we do and don’t know

Some forms of ACEs can be reported to the police and child welfare and perpetrators may be prosecuted criminally. Abuse and neglect can have serious, long-lasting physical and emotional effects and can sometimes cause death. Data on physical, sexual and emotional abuse substantiated by child protective services is collected by child welfare. The data do not represent the magnitude of abuse and neglect flying under the radar of law enforcement and the schools.

References and Reading

The research articles offered here are focused on specific ACEs and are primarily from peer-reviewed journals. They can provide ongoing professional development, research, analysis of best practice, and promotion of community dialogue and attention focused on educating all providers and residents about the emotional and financial costs of ACEs. It is worth noting that while ACEs exist in rural and urban environments and among all socio-economic groups, local public acknowledgement of the magnitude of ACEs may differ based on community norms. Familiarity with research on ACEs-related topics is the most effective way for an organization to develop a countywide prevention and treatment strategy.

Physical Abuse

The term physical abuse, in the context of adverse childhood experiences (ACEs), can be defined as any intentional act by a parent or household member causing injury or trauma to a child or youth in the home by way of bodily harm. Other terms sometimes used include physical assault or physical violence.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing prevention strategies by exploring a host of topics including: long-term consequences1,2, integrated parent-child cognitive-behavioral treatment3, posttraumatic stress disorder in survivors4, gender differences in long-term health consequences of physical abuse5, evaluation of suspected physical abuse6, and racial differences in the evaluation of physical abuse7.


  1. Long-Term Consequences of Childhood Physical Abuse. Robin Malinosky-Rummell and David J. Hansen. 1993.
  2. Long-term physical and mental health consequences of childhood physical abuse: Results from a large population-based sample of men and women. Kristen W. Springera, Jennifer Sheridan, Daphne Kuoc and Molly Carnes. 2007.
  3. An Overview of Child Physical Abuse: Developing an Integrated Parent-Child Cognitive-Behavioral Treatment Approach. Melissa K. Runyon, Esther Deblinger and Erika E. Ryan. 2004.
  4. Posttraumatic Stress Disorder in Survivors of Childhood Sexual and Physical Abuse: A Critical Review of the Empirical Research. Ned Rodriguez, PhD, Hendrika Vande Kemp, PhD and David W. Foy PhD. 2008.
  5. Gender Differences in Long-Term Health Consequences of Physical Abuse of Children: Data From a Nationally Representative Survey. Martie P. Thompson, PhD, J. B. Kingree, PhD, and Sujata Desai, PhD. 2011.
  6. The Evaluation of Suspected Child Physical Abuse. Cindy W. Christian and Committee on Child Abuse and Neglect. 2015.
  7. Racial Differences in the Evaluation of Pediatric Fractures for Physical Abuse. Wendy G. Lane, MD, MPH, David M. Rubin, MD, Ragin Monteith, MD and Cindy W. Christian, MD. 2002.

Emotional Abuse

The ACE study defines emotional abuse as a parent or other adult in the household often insulting, humiliating or swearing at a child. It can also mean an adult household member acting in a way that makes children afraid that they might be physically hurt.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing prevention strategies by exploring a host of topics including: failure of empathy1, contribution of childhood emotional abuse to relationship violence2, linking childhood emotional abuse and depressive symptoms3, the attachment system across the life cycle4, comparing emotional abuse to other forms of abuse5, emotional maltreatment and mental disorders6, coping with emotional abuse7, and emotional abuse predicting late adolescent sexual aggression8.


  1. Hurt Feelings: Emotional Abuse and the Failure of Empathy. Lynn Sorsoli. 2004.
  2. A Developmental Process Analysis of the Contribution of Childhood Emotional Abuse to Relationship Violence, Emotional Abuse and Relationship Violence. Sara. R. Berzenski and Tuppett M. Yates. 2010.
  3. Linking childhood emotional abuse and depressive symptoms: The role of emotion dysregulation and interpersonal problems. Carolien Christ, Marleen M. de Waal, Jack J. M. Dekker, Iris van Kuijk, Digna J. F. van Schaik, Martijn J. Kikkert, Anna E. Goudriaan, Aartjan T. F. Beekman and Terri L. Messman-Moore. 2019.
  4. Childhood Emotional Abuse and the Attachment System Across the Life Cycle: What Theory and Research Tell Us. Shelley A. Rigg. 2010.
  5. Is Emotional Abuse As Harmful as Physical and/or Sexual Abuse? Heather L. Dye. 2019.
  6. Childhood emotional maltreatment and mental disorders: Results from a nationally representative adult sample from the United States. Tamara L. Taillieua, Douglas A. Brownridge, Jitender Sareen and Tracie O. Afifi. 2016.
  7. Surviving and Coping with Emotional Abuse in Childhood. Celia Doyle. 2001.
  8. Childhood Emotional Abuse Predicts Late Adolescent Sexual Aggression Perpetration and Victimization. Eileen L. Zurbriggen, Robyn L. Gobin and Jennifer J. Freyd. 2010.

Sexual Abuse

Child sexual abuse, within the context of ACEs, is a form of abuse in which an adult or older household member uses a child for sexual stimulation or gratification. Forms of child sexual abuse include, but are not limited to, adults engaging in sexual activities with a child (whether by asking or pressuring, or by other means), grooming a child for sexual activity, indecent exposure, or using a child to produce pornography.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing prevention strategies by exploring a host of topics including: impact of sexual abuse on female development1, male survivors of childhood sexual abuse2, demography, impact, and interventions3, effects of childhood sexual abuse on children's psychology and employment4, long-term consequences5, abuse by female perpetrators6, prevention7, treatment of sexual offenders8, and abuse of deaf and hard of hearing children9.


  1. The impact of sexual abuse on female development: Lessons from a multigenerational, longitudinal research study. Penelope K. Trickett, Jennie G. Noll and Frank W. Putnam. 2013.
  2. Relational Challenges and Recovery Processes in Male Survivors of Childhood Sexual Abuse. Frances K Grossman, Maryam Kia-Keating and Lynn Sorsoli. 2009.
  3. Child Sexual Abuse: Demography, Impact, and Interventions. Erna Olafson. 2011.
  4. The effects of childhood sexual abuse on children's psychology and employment. Abdul Wohab and Sanzida Akhter. 2010.
  5. Long-Term Consequences of Childhood Sexual Abuse by Gender of Victim. Shanta R Dube, Robert F Anda, Charles L Whitfield, David W Brown, Vincent J Felitti, Maxia Dong and Wayne H Giles. 2005.
  6. The Long-Term Effects of Child Sexual Abuse by Female Perpetrators: A Qualitative Study of Male and Female Victims. Myriam S. Denov. 2004.
  7. The Prevention of Childhood Sexual Abuse. David Finkelhor. 2009.
  8. Treatment of Sexual Offenders: Research, Best Practices, and Emerging Models. Pamela M. Yakes. 2013.
  9. Preventing Abuse of Deaf and Hard of Hearing Children: What Teachers Can Do. Jennifer A. L. Johnson. 2018.

Physical Neglect

Physical neglect, within the context of ACEs, refers to a situation where a parent or caregiver doesn't provide the basic care that a child needs to survive and thrive. This includes meeting basic physical needs like food, clothing, shelter and access to medical and dental care. While it is not a crime for parents to endure economic downturns, unemployment or underemployment, resulting in lack of access to the services for survival, child protective services can remove a child from a parent’s home if vital care is not provided.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing prevention strategies by exploring a host of topics including: long-term health consequences1,2, neglect in childhood as a predictor of violent behavior3, need for cooperation in prevention efforts4, types of child maltreatment and subsequent delinquency5, assessment and intervention6, breaking the intergenerational link7, and prevention updates8.


  1. The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Systematic Review and Meta-Analysis. Rosana E. Norma, Munkhtsetseg Byambaa, Rumna De, Alexander Butchart, James Scott and Theo Vos. 2012.
  2. Long-Term Consequences of Child Abuse and Neglect on Adult Economic Well-Being. Janet Currie and Cathy Spatz Widom. 2010.
  3. Physical neglect in childhood as a predictor of violent behavior in adolescent males. William M.McGuigan, Jack A. Luchette and Roxanne Atterholt. 2018.
  4. Children: Neglect. B. Marc, I. Hanafy. 2016.
  5. Five Types of Child Maltreatment and Subsequent Delinquency: Physical Neglect as the Most Significant Predictor. Caroline B. R. Evans and David L. Burton. 2013.
  6. Child Neglect: Assessment and Intervention. Gail Hornor, RNC, DNP, CPNP. 2014.
  7. Child Abuse and Neglect: Breaking the Intergenerational Link. Melissa T. Merrick, PhD and Angie S. Guinn, MPH. 2018.
  8. The Prevention of Child Physical Abuse and Neglect: An Update. Geoffrey Nelson and Rachel Caplan. 2014

Emotional Neglect

Childhood emotional neglect, within the context of ACEs, occurs when parents fail to respond to their children’s emotional needs. Emotional neglect is different from emotional abuse in that emotional abuse is a purposeful choice to be harmful. Emotional neglect might be apathy or intentional disregard for a child’s feelings, or failure to notice a child’s emotional needs. Parents and other adult household members who emotionally neglect children may still provide services for surviving.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing prevention strategies by exploring a host of topics including: impact on student functioning1, children's perceptions of parental emotional neglect2, mental health consequences3, evidence for the effects of psychological maltreatment4, long-term cognitive, psychological, and health outcomes5, influence of emotional neglect on development6, and the implications of emotional neglect in childhood for the transition to motherhood7.


  1. Emotional neglect and family structure: impact on student functioning. Mary JoWark, Theresa Kruczek and Amanda Boley. 2003.
  2. Children's perceptions of parental emotional neglect and control and psychopathology. Robert Young, Susan Lennie and Helen Minnis. 2011.
  3. Emotional abuse and neglect: time to focus on prevention and mental health consequences. Veena Kumari. 2020.
  4. Evidence for the Effects of Psychological Maltreatment. Stuart N. Hart, PhD, Nelson J. Binggeli, MS and Maria R. Brassard, PhD. 2018.
  5. Long-term Cognitive, Psychological and Health Outcomes Associated With Child Abuse and Neglect. Lane Strathearn, Michele Giannotti, Ryan Mills, Steve Kisely, Jake Najman and Amanuel Abajobir. 2020.
  6. The influence of emotional neglect on development. Corinne Rees. 2008.
  7. “Neglected moms” — The implications of emotional neglect in childhood for the transition to motherhood. Anat Talmon, Michal Horovitz, Nitzan Shabat, Orna Shechter Haramat and Karni Ginzburg. 2019.

Impact of living with parents with mental health challenges

Growing up with a parent or other adult household member with mental health challenges is considered an ACE. Mental health challenges fall along a continuum. Some may be mild or short-lived problems, often the result of a particular situation that can be resolved with support. There can also be severe and enduring mental illness which might include schizophrenia, personality disorders and bi-polar disorder. It is not uncommon for adults to self-medicate with substances to reduce their distressing feelings associated with untreated mental illness. When a parent becomes mentally unwell, it can be difficult for the child to make sense of their parent's behaviour, resulting in confusion, sadness and fear.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing prevention strategies by exploring a host of topics including: parental suicide attempt and risk for substance use disorders1, risk of depression in the offspring of parents with depression2, how children make sense of their parent’s mental health difficulties3, lifespan risks4, defining quality of life in the children of parents with severe mental illness5, adult children of parents with mental illness6, risk of injuries7, mental health needs of latino children in immigrant families8, and racial disparities and access to care9,10,11.


  1. Childhood Exposure to a Parental Suicide Attempt and Risk for Substance Use Disorders. Kimberly H. McManama O’Brien, Christopher P. Salas-Wright, Michael G. Vaughn and Mary LeCloux. 2015.
  2. Risk of Depression in the Offspring of Parents with Depression: The Role of Emotion Regulation, Cognitive Style, Parenting and Life Events. Johanna Loechner, Anca Sfärlea, Kornelija Starman, Frans Oort, Laura Asperud Thomsen, Gerd Schulte-Körne and Belinda Platt. 2019.
  3. How Do Children Make Sense of their Parent’s Mental Health Difficulties: A Meta-Synthesis. Graham John Simpson-Adkins and Anna Daiches. 2018.
  4. Lifespan risks of growing up in a family with mental illness or substance abuse. Vera Clemens, Oliver Berthold, Andreas Witt, Cedric Sachser, Elmar Brähler, Paul L. Plener, Bernhard Strauß and Jörg M. Fegert. 2020.
  5. Defining Quality of Life in the Children of Parents with Severe Mental Illness: A Preliminary Stakeholder-Led Model. Penny Bee, Kathryn Berzins, Rachel Calam, Steven Pryjmachuk and Kathryn M. Abel. 2013.
  6. Adult children of parents with mental illness: parenting journeys. Gillian Murphy, Kath Peters, Lesley Wilkes and Debra Jackson. 2018.
  7. Children of parents with mental illness have higher risk of injuries. Karolinska Institutet, Sweden. 2020.
  8. Addressing the Mental Health Needs of Latino Children in Immigrant Families. Tania Maria Caballero, MD, Lisa Ross DeCamp, MD, MSPH and Rheanna E. Platt, MD, MPH. 2016.
  9. Mental Health in the Context of Health Disparities. Jeanne Miranda, Ph.D., Thomas G. McGuire, Ph.D., David R. Williams M.P.H., Ph.D. and Philip Wang, M.D., Dr.P.H. 2008.
  10. The Impact of Insurance Coverage in Diminishing Racial and Ethnic Disparities in Behavioral Health Services. Margarita Alegria, Ph.D., Julia Lin, Ph.D., Chih-Nan Chen, Ph.D., Naihua Duan, Ph.D., Benjamin Cook, Ph.D. and Xiao-Li Meng, Ph.D. 2012.
  11. Pandemic Highlights Behavioral Health Disparities. Rita Rubin, MA. 2020.

Impact of living with parents with substance use disorders

A common ACE involves children growing up in a home with a parent or other adult household member with a substance use disorder. Children who come from homes in which parents were addicted to drugs or alcohol are more likely to start using drugs earlier in their lives. Patterns of addiction and self-medication to cope with stresses may be passed from adult to child. With substance use disorders can come behaviors that may frighten a child or teen. There can be long-lasting traumatic effects that occur as a result of a child navigating a home where substance-related behaviors, including injury, violence, illness and fatalities, occur.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing prevention strategies by exploring a host of topics including: impact of substance use disorders1, diverse needs of children2, modifying the impact of parents' substance misuse3, implications of COVID-19 for mental health and substance use4, protective mental health factors5, substance abuse among U.S. Latinos6.


  1. The Impact of Substance Use Disorders on Families and Children: From Theory to Practice. Laura Lander, Janie Howsare, and Marilyn Byrne. 2013.
  2. Understanding the Diverse Needs of Children whose Parents Abuse Substances. Jessica M. Solis, Julia M. Shadur, Alison R. Burns and Andrea M. Hussong. 2012.
  3. Understanding and modifying the impact of parents' substance misuse on children. Richard Velleman and Lorna Templeton. 2018.
  4. The Implications of COVID-19 for Mental Health and Substance Use. Nirmita Panchal, Rabah Kamal, Cynthia Cox and Rachel Garfield. 2021.
  5. Protective mental health factors in children of parents with alcohol and drug use disorders: A systematic review. Olga Wlodarczyk, Mirjam Schwarze, Hans-Jürgen Rumpf, Franka Metzner and Silke Pawils. 2017.
  6. Substance Abuse Among U.S. Latinos: A Review of the Literature. Mario R. De La Rosa, PhD, Lori K. Holleran, PhD and ACSW, Douglas Rugh, PhD and MSW and Samuel A. MacMaster, PhD. 2008.

Impact of living with parents engaged in domestic violence

Living in a household where the parent and partners are engaged in domestic violence is an ACE. In many cases of domestic violence, children will view the abusive behavior firsthand. Children and teens who witness domestic violence may be more likely to be vulnerable to a variety of physical and health challenges as they grow older. Depending on the volatile nature of the altercations between adults, domestic violence can be terrifying and deeply troubling to a child. There are “failure to protect” laws in child welfare programs across the United States and domestic violence can in some cases constitute a form of abuse that allows child welfare to take custody of children. Most domestic violence flies under the radar of government officials, including the school community. Students suffer in silence, thinking more about the dangers that await them at home than focusing on school homework.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing prevention strategies by exploring a host of topics including: a public health perspective1, exposure to domestic violence on adolescent internalizing and externalizing behavior problems2, the potential role of schools3, effects of family violence on child behavior and health4, how children affect the mother/victim's process5, intimate partner violence and co-occurring substance abuse/addiction6, and drug abuse, intimate partner violence and opioid-dependent fathers7.


  1. Domestic Violence and Abuse in Intimate Relationships from a Public Health Perspective. Zlatka Rakovec-Felser. 2014.
  2. The Effects of Child Abuse and Exposure to Domestic Violence on Adolescent Internalizing and Externalizing Behavior Problems. Carrie A. Moylan, Todd I. Herrenkohl, Cindy Sousa, Emiko A. Tajima, Roy C. Herrenkohl and M. Jean Russo. 2010.
  3. Domestic Violence and Education: Examining the Impact of Domestic Violence on Young Children, Children, and Young People and the Potential Role of Schools. Michele Lloyd. 2018.
  4. Effects of Family Violence on Child Behavior and Health During Early Childhood. Diana J. English, David B. Marshall and Angela J. Stewart. 2003.
  5. How Children Affect the Mother/Victim's Process in Intimate Partner Violence. Therese Zink, MD, MPH; Nancy Elder, MD, MPH and Jeff Jacobson, PhD. 2003.
  6. Intimate Partner Violence and Co-Occurring Substance Abuse/Addiction. Richard G. Soper, MD, JD, MS, FASAM, DABAM. 2014.
  7. Drug Abuse and Intimate Partner Violence: A Comparative Study of Opioid-Dependent Fathers. Barbara C. Moore, Caroline J. Easton and Thomas J. McMahon. 2011.

Impact of separation or divorce on children

Divorce and separation are considered an ACE for a variety of reasons. Parents separating can be a pivotal experience for children, with negative emotional and financial consequences. From a child's perspective, divorcing can mean years of fighting and threats between parents. Divorce represents a loss of stability and can, in some situations, move a once well-resourced child into poverty. Divorce, and the behaviors leading up to it, can cause a range of emotional responses that include anger, frustration, anxiety, fear and sadness.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing awareness and strategies by exploring a host of topics including: family structure and effects of divorce1, growing up in the divorced family2, effects of divorce on children's adjustment3, financial impact of divorce4, divorce and diverging poverty rates5, impact of divorce on students' life6, marriage as a public issue7.


  1. The impact of family structure on the health of children: Effects of divorce. Jane Anderson. 2014.
  2. Growing up in the Divorced Family. Judith S. Wallerstein, Ph.D. 2005.
  3. The Effects of Divorce on Children's Adjustment: Review and Implications. Daniel S. Shaw. 1991.
  4. Financial Impact of Divorce on Children and Their Families. Jay D. Teachman and Kathleen M. Paasch. 1994.
  5. Divorce and Diverging Poverty Rates: A Risk‐and‐Vulnerability Approach. Bram Hogendoorn, Thomas Leopold and Thijs Bol. 2019.
  6. Impact of Divorce on Students' Life. Laila Akber Cassum. 2018.
  7. Marriage as a Public Issue. Steven L. Nock. 2005.

Impact on children of household members being incarcerated

A child having a parent or household member incarcerated is considered an ACE for a variety of reasons. Incarceration of a parent can mean loss of household income, impacting the economic stability of the family. There may be emotional consequences due to the disrupted family life. There is also the social stigma that children may feel as a result of having a parent incarcerated. Added to many changes that arrive due to a single parent being incarcerated is that children may find themselves in foster care. Children who view the arrest of a parent, especially if it involves a volatile encounter with law enforcement, may find it traumatizing.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing prevention strategies by exploring a host of topics including: developmental perspectives1, association of parental incarceration with psychiatric and functional outcomes of young adults2, challenges and resiliency3, impact of parental incarceration4, considerations for professional school counselors5,6,7, health consequences8, racial disparities9, implications of incarceration for families10, how incarceration affects the health of communities11, and meta-analysis and cost study12.


  1. A Developmental Perspective on Children With Incarcerated Parents. Julie Poehlmann‐Tynan and Kristin Turney. 2020.
  2. Association of Parental Incarceration With Psychiatric and Functional Outcomes of Young Adults. Elizabeth J. Gifford, PhD, Lindsey Eldred Kozecke, JD, Megan Golonka, PhD, Sherika N. Hill, PhD, E. Jane Costello, PhD, Lilly Shanahan, PhD and William E. Copeland, PhD. 2019.
  3. Children of incarcerated parents: Challenges and resiliency, in their own words. Ande Nesmith and Ebony Ruhland. 2008.
  4. The Impact of Parental Incarceration on the Physical and Mental Health of Young Adults. Rosalyn D. Lee, PhD, MPH, MA, Xiangming Fang, PhD and Feijun Luo, PhD. 2013.
  5. Children of Incarcerated Parents: Considerations for Professional School Counselors. Jeffrey M Warren, Gwendolyn L. Coker and Megan L. Collins. 2019.
  6. Training Counselors to Work with the Families of Incarcerated Persons: A National Survey. Jessica Burkholder, David Burkholder, Stephanie Hall and Victoria Porter. 2020.
  7. Teens of Incarcerated Parents: A Group Counseling Intervention for High School Counselors. Jennifer Gerlach. 2020.
  8. Health Consequences of Family Member Incarceration for Adults in the Household. Christopher Wildeman, PhD, Alyssa W. Goldman, MA and Hedwig Lee, PhD. 2019.
  9. A Wealth of Inequalities: Mass Incarceration, Employment and Racial Disparities in U.S. Household Wealth, 1996 to 2011. Bryan L. Sykes and Michelle Maroto. 2016.
  10. Saturday Morning at the Jail: Implications of Incarceration for Families and Children. Joyce A. Arditti, Jennifer Lambert‐Shute and Karen Joest. 2004.
  11. How Incarceration Affects the Health of Communities and Families. Elizabeth J. Gifford. 2019.
  12. Health effects of family member incarceration in the United States: A meta-analysis and cost study. Ashley Provencher and James M. Conway. 2019.

Child Maltreatment and ACEs (General)

While most incidents of ACEs fly under the radar of child protective services, the child welfare system is currently the only government agency with a mandate and funding to address abuse and neglect that meet state and federal criteria. Most of the ten ACEs would not meet the criteria to begin an investigation, which is not to say the adversity endured in the home away from public view is any less damaging and traumatizing than those incidents of maltreatment that do become officially substantiated as abuse and neglect.

It is important for those working to prevent and treat ACEs to have a basic understanding of the child protective services process, its strengths and challenges. A review of the literature focused on various aspects of child maltreatment can be very helpful.

Turning Research into Real World Solutions

The following research articles and resources can serve as a starting point for developing prevention strategies by exploring a host of topics including: child maltreatment frequency and timing of subsequent delinquent behaviors1, gender differences in the impact of abuse2, long-term health consequences3, maltreatment risk as a function of poverty and race/ethnicity4, experiences among hispanic children in immigrant families5, consequences of neglect in emerging adults6, abuse and children with disabilities7, health risks for adolescents in protective custody8, prevention perspectives9, foster care and justice system inequality10, maltreatment and well-being of students11, the dilemma mandatory reporting poses for teachers12, the economic burden of maltreatment13, lifelong effects14, ACEs and adult depression15, ACEs and mental health in adulthood16, ACEs and juvenile offenders17, ACEs and rurality18, the ACES Study19, and a critical assessment of the ACEs study at 20 years20.


  1. Describing associations between child maltreatment frequency and the frequency and timing of subsequent delinquent or criminal behaviors across development: variation by sex, sexual orientation and race. Hannah Lantos, Andra Wilkinson, Hannah Winslow and Tyler McDaniel. 2019.
  2. Gender Differences in the Impact of Abuse and Neglect Victimization on Adolescent Offending Behavior. Jessica J. Asscher, Claudia E. Van der Put and Geert Jan J. M. Stams. 2015.
  3. The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse and Neglect: A Systematic Review and Meta-Analysis. Rosana E. Norman, Munkhtsetseg Byambaa, Rumna De, Alexander Butchart, James Scott and Theo Vos. 2012.
  4. Child maltreatment risk as a function of poverty and race/ethnicity in the USA. Hyunil Kim and Brett Drake. 2018.
  5. Adverse Childhood Experiences Among Hispanic Children in Immigrant Families Versus US-Native Families. Tania Maria Caballero, Sara B. Johnson, Cara R. Muñoz Buchanan and Lisa Ross DeCamp 2017.
  6. The Distal Consequences of Physical and Emotional Neglect in Emerging Adults: A Person-Centered, Multi-Wave, Longitudinal Study. Joseph R. Cohen, Ph.D., Suvarna V. Menon, M.A., Ryan C. Shorey, Ph.D., Vi D. Le, MPH and Jeff R. Temple, Ph.D. 2017.
  7. Abuse and Young Children with Disabilities: A Review of the Literature. Catherine Coor and Rosa Milagros Santos. 2017.
  8. Understanding Health Risks for Adolescents in Protective Custody. Sarah J. Beal, Katie Nause, Imani Crosby and Mary V. Greiner. 2018.
  9. Progress toward a Prevention Perspective. Matthew W. Stagner and Jiffy Lansing. 2009.
  10. Can Foster Care Interventions Diminish Justice System Inequality? Youngmin Yi and Christopher Wildeman. 2018.
  11. The Impact of Child Maltreatment on the Educational and Psychological Well-Being of Students. Jonathan Chitiyo and Zachary Pietrantoni. 2019.
  12. Heads You Win, Tails I Lose: The Dilemma Mandatory Reporting Poses for Teachers. Meredith Falkiner, Donald Thomson, Belinda Guadagno and Andrew Day. 2017.
  13. The economic burden of child maltreatment in the US and implications for prevention. Fang, et al. 2011.
  14. The Lifelong Effects of Early Childhood Adversity and Toxic Stress. Shonkoff, et al. 2012.
  15. ACEs and the risk of depressive disorders in adulthood. Chapman, et all. 2004
  16. The relationship between ACEs and mental health in adulthood. De Venter, et al. 2013.
  17. The prevalence of adverse childhood experiences (ACE) in the lives of juvenile offenders. Baglivio, et al. 2014.
  18. Rural-Urban Differences in Adverse Childhood Experiences Across a National Sample of Children. Elizabeth Crouch, Elizabeth Radcliff , Janice C Probst, Kevin J Bennett, and Selina Hunt McKinney. 2020.
  19. The Adverse Childhood Experiences (ACE) Study. Vincent Felitti, MD, et al.1998.
  20. A Critical Assessment of the Adverse Childhood Experiences Study at 20 Years. Craig A. McEwen, PhD and Scout F. Gregerson, BA. 2019.

Next Steps

100% New Mexico initiative participants are encouraged to form reading and discussion circles, providing a structure for community stakeholders to read and discuss articles and perspectives on root causes, impact, prevention and treatment. A “lunch and learn” series focused on the complex arena of ACEs will not lack for reading material and research to enlighten and inspire.

These references are useful for developing policy, learning experiences, course development, grant writing and other activities focused on fundraising.