Understanding the ACE Score and Its Impact
Adverse Childhood Experiences, or ACEs, include abuse, neglect, and household dysfunction that occur before age 18. The landmark CDC-Kaiser Permanente ACE Study found that these experiences are far more common than most people realize, and their effects ripple into adulthood in measurable ways.
Higher ACE scores are associated with increased risk of chronic disease, mental health disorders, substance use, and even reduced life expectancy. But here is the part that matters most: an ACE score is not a life sentence.
Can the Effects of ACEs Actually Be Reversed?
The short answer is: the experiences themselves cannot be undone, but their biological and psychological effects can be significantly reduced. Decades of research in neuroscience and psychology show that the brain and body have remarkable capacity for healing, even after severe early trauma.
This is not wishful thinking. It is rooted in a well-documented biological process called neuroplasticity.
What Neuroplasticity Means for Trauma Recovery
Neuroplasticity is the brain’s ability to reorganize itself by forming new neural pathways throughout life. Childhood trauma can alter brain structure, particularly in the amygdala (threat detection), prefrontal cortex (decision-making), and hippocampus (memory). But these changes are not permanent.
Studies using brain imaging have shown that effective therapy can physically change brain structure. The prefrontal cortex can strengthen its connections, the amygdala can become less hyperreactive, and the hippocampus can recover volume lost to chronic stress.
This process takes time, but it is real and measurable.
Evidence-Based Therapies for ACE Recovery
Several therapeutic approaches have strong evidence for treating the effects of childhood adversity:
1. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
TF-CBT is one of the most well-studied treatments for childhood trauma. It helps you identify distorted thoughts formed during traumatic experiences and replace them with more accurate beliefs. Research shows significant improvement in PTSD symptoms, depression, and behavioral problems.
2. EMDR (Eye Movement Desensitization and Reprocessing)
EMDR helps the brain reprocess traumatic memories so they no longer trigger intense emotional responses. The World Health Organization recognizes EMDR as an effective treatment for PTSD. Many patients report meaningful relief within 6 to 12 sessions.
3. Somatic Experiencing
This body-focused approach recognizes that trauma is stored not just in the mind but in the nervous system. Somatic Experiencing helps release trapped fight-or-flight energy through guided body awareness. It is particularly useful for people who struggle with talk therapy alone.
4. Internal Family Systems (IFS)
IFS views the mind as made up of different “parts” that took on protective roles during childhood. By understanding and communicating with these parts, people can reduce self-destructive patterns that originated as survival strategies.
Building Resilience: The Counterweight to ACEs
Research has identified specific protective factors that buffer the effects of ACEs. These factors, sometimes called Positive Childhood Experiences (PCEs) or resilience factors, include:
- At least one stable, caring adult relationship (even if outside the family)
- Sense of belonging in school or community
- Ability to talk about feelings with a trusted person
- Social connectedness and supportive friendships
- Living in a safe, clean neighborhood
- Having consistent routines and structure
A 2019 study published in JAMA Pediatrics found that adults who reported higher PCEs had 72% lower odds of depression and 48% lower odds of poor mental health, even after accounting for their ACE scores.
The key insight: it is never too late to build these protective factors, even in adulthood.
The Healing Timeline
Recovery from childhood trauma is not linear. It does not follow a predictable schedule, and progress often comes in waves. That said, here is a general framework for what to expect:
- Months 1-3: Building safety and trust with a therapist. Learning basic nervous system regulation skills like grounding and breathing exercises.
- Months 3-12: Processing specific traumatic memories. This phase can feel harder before it feels better as buried material surfaces.
- Months 12-24: Integration and identity rebuilding. Many people report feeling like a different person by this stage, with reduced reactivity and more emotional freedom.
- Year 2 and beyond: Ongoing growth and maintenance. Most people continue to notice improvements for years after formal therapy ends.
Some people see significant improvement in weeks. Others need years of sustained work. Both timelines are normal.
Practical Steps You Can Start Today
Healing does not happen only in a therapist’s office. Daily habits play a significant role:
- Regular physical exercise reduces cortisol and increases BDNF, a protein that supports new neural growth
- Mindfulness meditation strengthens the prefrontal cortex and reduces amygdala reactivity
- Adequate sleep is essential for emotional regulation and memory processing
- Journaling helps organize traumatic memories and reduces their emotional charge
- Social connection with safe people counteracts the isolation that trauma creates
Check Your ACE Score
Understanding your ACE score is the first step toward targeted healing. Our free assessment takes about 5 minutes and includes guidance on what your score means.
The Science Is Clear: Healing Is Possible
Having a high ACE score does not define your future. It tells you what happened, not what must happen next. The same brain plasticity that allowed trauma to shape your nervous system also allows therapy, relationships, and healthy habits to reshape it.
If you recognize yourself in these descriptions, reach out to a trauma-informed therapist. You can also explore our Depression, Anxiety, and Stress Test or the Rosenberg Self-Esteem Scale to better understand where you stand today.
