Adverse Childhood Experiences and Adverse Community Experiences (ACEs) are two elements contributing to our nation’s myriad public health and social crises.

The prevalence of ACEs in our society and low resiliency of our population are factors contributing to our epidemic proportions of :

  • Drug overdoses
  • Obesity
  • Suicide
  • Teenage Pregnancy
  • Unintended Pregnancies
  • Substance Use Disorders
  • Alcohol Use Disorders
  • Diabetes
  • Homelessness
  • Depression
  • Lung Cancer
  • Liver Disease
  • Sexual Risk Behavior
  • Ischemic Heart Disease
  • and so much more…


What is your ACE Score? What is your Resiliency Score? Find out by taking both sides of the test below!


Watch these videos to learn more about Toxic Stress, Adverse Childhood Experiences, and their impact on long term health.


The Substance Abuse and Mental Health Services Administration (SAMHSA) developed this conceptual definition after an extensive literature review of decades of research, the current definitions, and consultation with an expert panel.

“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”

SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, p. 7


You have some understanding of the story of trauma and toxic stress and its relation to overall health. There is much to learn and understand, yet now you have been “trauma-informed”… what does that even mean? The Substance Abuse and Mental Health Services Administration provided guidance in SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, published in July 2014. In this publication, they offer a definition, develop the Three “E’s”, the Four “R’s”, and Six Principles of Trauma-Informed Care.

The Three “E’s” of Trauma: Event(s), Experience of Event(s) and Effect

EVENTS and circumstances may include the actual or extreme threat of physical or psychological harm or severe life-threatening neglect for a child that imperils healthy development.

The individual’s EXPERIENCE of the events or circumstances helps determine whether it is a traumatic event.

The long-lasting adverse EFFECTS of the event are critical. These effects may occur immediately or may have a delayed onset. The duration of the effects can be short to long term.

SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, p. 8

The Four “R’s”: Key Assumptions in a Trauma-Informed Approach

Trauma-Informed individuals, organizations, and communities are those that…

REALIZES the widespread impact of Trauma…

understands paths to RECOVERY from trauma…

RECOGNIZES the signs and symptoms of trauma in patients, families, staff, oneself and others and…​​​​​​​

RESPONDS by fully integrating trauma-informed policies, procedures, and practices, and actively seeks to resist re-traumatization…

SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, p. 9

Six Key Principles of a Trauma-Informed Approach


Trustworthiness and Transparency

Peer Support

Collaboration and Mutuality

Empowerment, Voice and Choice

Cultural, Historical, and Gender Issues

SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach, p. 10


All across the US there are various local efforts to combat ACEs in our community. They engage in Trauma-Informed Community Development (TICD). In Crawford County, Pennsylvania, Peace4Crawford was formed to counter this public health crisis.

Peace4Crawford is a trauma-informed initiative, based in the Crawford County System of Care (SOC) Partnership, promoting social change in Crawford County, heading toward a trauma-informed community.

The SOC is a framework involving collaboration across the community for the purpose of creating a seamless, integrated, and coordinated system of supports for children, youth, and families that is family and youth-driven, strength-based, and trauma-informed. The SOC helps children, youth, and families function better at home, in school, in the community, and throughout life. It is comprised of professional agencies involved in the health and well being of the community, family partners, and youth partners.