Social/Environmental History

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Caregiver (Self Report)

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What it Measures

A checklist of adverse life experiences; total number of checks is the “ACEs Score,” which is known to be correlated with mental and physical health outcomes, and can be used for treatment planning.

Minimum Age

Maximum Age

7 Categories(Original) (10 item includes loss of parent, Phys Neg, and Emot Neg)
-Psychological Abuse
-Physical Abuse
-Sexual Abuse
-Violence Against Mother
Household Dysfunction:
-Living with Household Member who were Substance Abusers
-Living with Household Member who were Mentally Ill/Suicidal
-Living with Household Member who were Imprisoned….

Number of Items
68…10 true false for 10-item ACEs scale

Free or Cost

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Reviewer Notes
The measure linked here is the original tool used in ACE studies on adults self-reporting events from their childhoods. Most agencies working with youth use an in-house adapted checklist that is completed by youth or caregiver.

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