ACE (BRFSS)
ValidatedAdverse Childhood Experiences – CDC BRFSS ACE Module
18+ yearsSelf~5 min13 questions
I'd like to ask you some questions about events that happened during your childhood. This information will allow us to better understand problems that may occur early in life, and may help others in the future. This is a sensitive topic and some people may feel uncomfortable with these questions. Please keep in mind that you can skip any question you do not want to answer. All questions refer to the time period before you were 18 years of age. Now, looking back before you were 18 years of age—
Report details · optional
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About this screener — evidence, source, alternatives
The Adverse Childhood Experiences module of the US CDC Behavioral Risk Factor Surveillance System, which grew out of the CDC-Kaiser Permanente ACE Study. It asks about household mental illness, substance misuse, incarceration, parental separation, intimate partner violence, and physical, emotional and sexual abuse before age 18, plus two neglect items added in 2021. The ACE count is a population risk marker, not a diagnosis.
Evidence · validated
The ACE questions derive from the CDC-Kaiser Permanente ACE Study of over 17,000 HMO members (1995–1997), which linked cumulative childhood adversity to adult health risks (Felitti et al., 1998). The BRFSS module is used for US population surveillance (e.g. Swedo et al., MMWR 2023). It measures exposure, is not a diagnostic screen, and has no validated individual cut-off.
Free alternative to
- Childhood Trauma Questionnaire (CTQ) · Pearson
Paid retrospective measure of childhood abuse and neglect; the ACE module is the free population-surveillance alternative.
Source & licence
Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System (BRFSS) Adverse Childhood Experience (ACE) Module, 2021–current. Based on the CDC-Kaiser Permanente ACE Study (Felitti VJ, Anda RF, et al. Am J Prev Med. 1998;14(4):245–258). Scoring per Swedo EA, et al. MMWR Morb Mortal Wkly Rep. 2023;72(26):707–715.
Licence: Public domain — US federal government (CDC) survey module; CDC states the ACE Study questionnaires are not copyrighted and free to use
CDC ACE Study page: https://www.cdc.gov/violenceprevention/aces/about.html. Interviewer-administered in BRFSS; here self-completed. The interviewer's 'Refused' code is shown as 'Prefer not to answer', and the reference to a referral phone number is omitted from the preamble. Item 6 is shown with 'your' where the CDC fact sheet prints 'you'.
Official source ↗