Adverse Childhood Experiences (ACEs) are stressful events occurring in childhood that can negatively influence how individuals live their lives.


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About Adverse Childhood Experiences

ACEs are stressful or traumatic experiences, including abuse, neglect and a range of household dysfunctions such as witnessing domestic violence or growing up with substance abuse, mental illness, parental discord or incarceration.

Living with ACEs results in individuals developing coping and lifestyle strategies that are based on poor parental attachment and the effects of trauma.

This short animated film was developed by Public Health Wales and Blackburn with Darwen Local Authority to raise awareness of ACEs, their potential to damage health across the life course and the roles that different agencies can play in preventing ACEs and supporting those affected by them.

Understanding the impacts of ACEs

As knowledge of ACEs increases, so is the understanding that a person’s behaviour is a reflection of the coping strategies they developed when living with adversity. The impact of a high ACE score affects how a person perceives themselves (self-esteem, self-image), how they interact with others (passively or angrily), how they cope with the emotional pain (depression, anxiety, alcohol or drug use), how they use their parenting skills; it can also leave them with confusion about issues of trust, boundaries and respectful relationships (both with adults and children). Compared with people with no ACEs, those with four or more ACEs are:

  • 4 times more likely to be a high-risk drinker
  • 6 times more likely to have had or caused unintended teenage pregnancy
  • 6 times more likely to smoke e-cigarettes or tobacco
  • 6 times more likely to have had sex under the age of 16
  • 11 times more likely to have smoked cannabis
  • 14 times more likely to have been a victim of violence over the last 12 months
  • 15 times more likely to have committed violence against another person in the last 12 months
  • 16 times more likely to have used crack cocaine or heroin
  • 20 times more likely to have been incarcerated at any point in their lifetime

Source: Public Health Wales 2016 By informing and educating individuals about the physical and emotional impact of ACEs, we enable them to develop understanding and resilience and so empower them to make changes that are health-affirming rather than health-damaging. Below is an example of some of our current work.

Rock Pool’s work with ACEs in Harpurhey

Manchester City Council and Rock Pool are working together on a year long place-based pilot to help staff from all public, voluntary and community sector services, better understand Adverse Childhood Experiences. We have been commissioned to deliver 16 full-day ACE Awareness and Routine Enquiry Training courses, and 8 half-day ACE Awareness and Impact Training courses to about 600 staff who provide operational frontline delivery in Harpurhey. They are being trained, coached and developed to offer a trauma-informed approach to engaging with current and future service users/people with lived experience. The project is undergoing constant evaluation and will test whether having a trauma-informed workforce at place level (not particular organisations) allows the workforce to engage on a deeper level with service users/people with lived experience.

Who we are working with

The organisations involved in this new, integrated model of workforce reform include Integrated Neighbourhood Teams, Police, GPs, Youth Services, Voluntary and Community Sector, Health and Social, Substance Misuse Services, Early Help, Fire and Rescue, Mental Health Services, Domestic Violence and Abuse Services, Early Years Services, Health Visiting, Nurseries, Schools (primary and secondary) and a College.

Next steps – Training the Trainers

Once the training has been completed and is informing practice, Rock Pool will work with Manchester City Council to develop a cohort of Train the Trainers. Their role will be to act as advocates in their organisation and sector, and deliver the training on a wider scale.

“The ACE training in Harpurhey was inspirational – this approach has the ability to really change outcomes for people. The session really brought to life how using a trauma informed approach is possible for everybody.”

Councillor Sue Murphy CBE, Deputy Leader, Manchester City Council

“The knowledge and experiences of the trainers has enabled participants from a range of agencies to gain a greater understanding and knowledge of trauma informed practice. Rock Pool have provided us with a great foundation that will allow staff to work with Harpurhey residents in a more effective way.”

Gareth Nixon, ACEs Project Manager

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