The National Child Traumatic Stress Network (NCTSN) defines trauma as “the physical and emotional responses of a child to events that threaten the life or physical or emotional wellness of the child, or of someone critically important to the child (such as a parent or sibling).”

Every child responds to trauma differently, but if traumatic experiences remain unaddressed, they have serious long-term effects on children’s well-being. This is especially true when the trauma occurs during early childhood, when kids are forming trusting bonds of attachment, which set the stage for lifelong relationship problems.

What Are ACEs?
The experiences included in the CDC–Kaiser Permanente Adverse Childhood Experience (ACE) Study, a landmark study on childhood trauma (occurring before the age of 18), include:

  • emotional, physical, or sexual abuse
  • emotional or physical neglect
  • witnessing violence against one’s mother
  • a parent’s addiction to alcohol or other substance, or a family member’s mental illness
  • separation or divorce
  • the incarceration of a parent
  • involvement with the foster care system
  • witnessing community violence
  • living in an unsafe neighborhood
  • bullying
  • experiencing racism

Traumatic experiences may be one-time events or they may be frequent and repeated—part of a child’s environment, resulting in toxic stress that elevates unhealthy stress levels over time. One in four children experience more than one ACE, and ACEs have been proven to negatively impact brain development, learning and memory, social skills, and mental and physical health.

What Helps?
The good news is that our brains are plastic and our bodies are resilient, and there are protective factors that can lessen the impact of trauma:

  • Parent/caregiver resilience and knowledge: parents who can cope and who understand their child’s development, positive parenting strategies, and their own responses to trauma;
  • Nurturing and attachment: supporting the child through loving relationships and being attuned to his or her needs;
  • Social connections: family, friends, neighbors, and community members who help;
  • Basic needs: having food, shelter, clothing, and health care;
  • Social and emotional skills: kids and parents being able to manage emotions and share feelings.

The single most effective protective factor is the consistent presence of one or more caring adults, therefore parents and other close caregivers ultimately hold the greatest power in their hands. As a provider who cares for families, you can remind parents of this powerful ability to buffer trauma’s negative effects and to help them leverage it.

*There are many more types of trauma; this list only includes those that were named in the ACE Study. Go to to learn more and find your own ACEs score.

“What is Child Traumatic Stress?” The National Child Traumatic Stress Network.

Felitti, Vincent J, Robert F Anda, Dale Nordenberg, David F Williamson, Alison M Spitz, Valerie Edwards, Mary P Koss, and James S Marks. “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study.” American Journal of Preventive Medicine 14, no. 4 (1998): 245–58.

“When Things Aren’t Perfect: Caring for Yourself and Your Children.” AAP Trauma Guide. 2014.

“Essentials for Childhood: Steps to Create Safe, Stable, Nurturing Relationships and Environments .” Centers for Disease Control. August 2014.

“Key Concepts: Toxic Stress.” Center for the Developing Child at Harvard University. 2017.