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Adverse Childhood Experiences (ACEs)

A growing body of research has evidenced that early childhood experiences can have a significant impact on outcomes in later life. In the absence of resilience factors, exposure to adversity and related trauma during childhood can increase the risk of violence victimization and perpetration.

What are ACEs?

Adverse childhood experiences (ACEs) are stressful experiences occurring during childhood that directly harm a child (e.g. sexual or physical abuse) or affect the environment in which they live (e.g. growing up in a house with domestic violence). The resulting trauma can continue to affect people as adults, long after it has happened.

To better understand the impact of early childhood experiences on individuals, multiple research studies have been carried out to measure the prevalence of ACEs in Wales, the impact these early childhood experiences can have on individuals across the life course, and opportunities to mitigate the impact of trauma on negative life outcomes. This research has assessed ACEs in the general population, as well as more vulnerable groups (e.g. the homeless population, the offender population and refugee population). Within the general population of Wales, almost half of the population had experienced at least one ACE (47%), while 14% of the population had experienced multiple ACEs before the age of 18 years (4+ ACEs).

This research measured exposure to multiple forms of adversity, which highlighted the following prevalence in Wales.

ACEs in Wales

ACEs do not define anyone and it is never too late to break the cycle of adversity.

Resilience plays an integral role in mitigating the impact of ACEs, whereby individual and community factors offer protection from the harmful impacts of ACEs on health, well-being and prosperity across the life course. Resilience factors can include having trusted adult relationships, supportive friends, and being engaged in community activities such as sports when growing up

Exposure to ACEs can physically change how a child’s brain develops. As a result, ACEs can lead to poor outcomes across the life course, effecting physical and mental health and leading to the adoption of health harming behaviours (e.g. alcohol and drug use). The research supports a dose-response relationship between ACEs and poor outcomes, with higher exposure to ACEs increasing the risk of negative outcomes in later life.

Key reports on the impact of ACEs and the role of resilience include:

Adverse Childhood Experiences and their impact on health-harming behaviours in the Welsh adult population

Adverse Childhood Experiences and their association with Mental Well-being in the Welsh adult population

Adverse Childhood Experiences and their association with chronic disease and health service use in the Welsh adult population

Sources of resilience and their moderating relationships with harms from adverse childhood experiences: Report 1: Mental Illness

Cycles of violence in England and Wales: the contribution of childhood abuse to risk of violence revictimisation in adulthood

The impact of ACEs on violence in Wales

As well as the research carried out with the general population, research has explored the impact of ACEs in more vulnerable groups (e.g. the homeless population, the offender population and refugee population). This provided a strong evidential link between early childhood experiences, vulnerability and crime; which highlighted that ACEs can increase the risk of individuals being exposed to violence, either as a victim or a perpetrator, or engaging in behaviours associated with violence (e.g. substance misuse). Compared to people with no ACEs, individuals exposed to 4+ ACEs are:

Impact of ACEs explained

In collaboration with Bangor University, Public Health Wales explored the prevalence of ACEs in an offender population, to better understand the association between early childhood experiences and offending behaviour. This research demonstrated a much higher prevalence of ACEs within the offender population, and that multiple ACEs can increase the risk of being charged with a violent offence, serving a sentence in a young offender institute, and becoming a prolific offender.

The publications on ACEs in more vulnerable populations can be found here:

Understanding the prevalence of adverse childhood experiences (ACEs) in a male offender population in Wales: The Prisoner ACE Survey (report)

Adverse childhood experiences (ACEs) in an offender population in Wales (infographic)

Adverse childhood experiences: a retrospective study to understand their associations with lifetime mental health diagnosis, self-harm or suicide attempt, and current low mental wellbeing in a male Welsh prison population

Adverse childhood experiences in child refugee and asylum seeking populations

Voices of those with lived experience of homelessness and adversity in Wales: Informing prevention and response

Responding to ACEs in Wales

Research has been carried out across sectors to understand existing responses to vulnerability and to identify opportunities to further enhance multi-agency collaborative working to be more responsive to the needs of vulnerable individuals.

In Wales, a public health approach has been taken to develop trauma-informed services and enable a whole systems response to individuals affected by trauma. This includes working with police, prison and probation services, local authorities, youth justice services, education and housing.

With funding from the Home Office and Welsh Government, Wales has been given the opportunity to build a national response to ACEs and to drive forward change across sectors. Programmes of work, including the ACE Support Hub Cymru and the Early Action Together Programme, have taken great strides in improving responses to vulnerability and increase access to early intervention and preventative support. This work has provided a strong foundation for the Wales Violence Prevention Unit to continue to build on in collaboration with the ACE support hub and E.A.T. programme.

To learn more about these programmes of work, please visit the following websites:

The Early Action Together Programme

The Early Action Together (E.A.T) programme was established in 2018 with funding from the Home Office. This programme set out to support police transformation across the four police forces in Wales, with the aim to improve police and partner responses to vulnerability. The E.A.T. programme adopted a public health approach to policing, utilising the research to inform the development of an ACE and trauma-informed whole systems response to vulnerability, by enhancing existing systems, processes and practice in Wales.

Click here to visit the Early Action Together ACEs learning network.

The ACE Support Hub Wales

The ACE Support Hub Cymru was set up in 2017 to support professionals, organisations and the community to help create an ACE aware Wales. Their mission is to tackle, mitigate and prevent ACEs by sharing ideas and learning, and to challenge and change ways of working, so together we can break the cycle of ACEs.

The ACE Support Hub is funded by Welsh Government and works closely leaders across public and third sector organisations to develop and deliver the ACEs agenda, including youth justice, housing, local authority, health, education and sporting bodies, as well as the local community.

The ACE Support Hub believes that at the heart of a trauma and ACE (TrACE) informed practice, are kindness and relationships. Take a look at the campaign video they ran in 2019, ‘Time to be Kind’.

Click here to visit the ACE support Hub website for more information on their work.

Wales Violence Prevention Unit publications on ACEs:

The annual costs of adverse childhood experiences (ACEs) in Wales pdf
Interim Report - Understanding the Impact of COVID-19 on Violence and ACEs Experienced by Children and Young People in Wales - Welsh pdf
Interim Report - Understanding the Impact of COVID-19 on Violence and ACEs Experienced by Children and Young People in Wales - English pdf