The study identified the following as ACES: 

• Abuse: Physical abuse, sexual abuse, and emotional abuse 

• Neglect: Physical and emotional neglect 

• Household Dysfunction: Caregiver who has a mental illness, mother treated violently (e.g., Domestic Violence), incarcerated relative, and parental substance abuse in the home 
   

The study did not include traumatic loss, separation, bereavement, sexual and physical assault, community violence, serious medical trauma, accidents, fires, natural disasters, war, terrorism, school violence, racial trauma, bullying, etc. 

It is just important to note that the ACES study taught a lot about the health consequences associated with exposure to early adversity, however, it did not look at every type of trauma exposure. Being clear about what we mean when we talk about ACES is important, which is why there are often other terms such as child traumatic stress or child trauma that are used.  

Other limitations include data collected over 25 years ago and the subjects were generally white with health insurance.  The study did not include a culturally and socio-economic diverse population.  

• For another presentation that helps illustrate these points, go to http://www.canarratives.org