ACE questionnaire Please add up your "YES" answer to View you ACE Score 1. Did a parent or other adult in the household often or very often: Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt? Yes No 2. Did a parent or other adult in the household often or very often push, grab, slap, or throw something at you? or, Ever hit you so hard that you had marked or were injured? Yes No 3. Did an adult or person at least 5 years older in a sexual way? Yes No 4. Did you often or very often feel that no one in your family loved you or thought you were important or special? Or, your family didn't look out for each other, feel close to each other, or support each other? Yes NO 5. Did you often or very often feel that you didn't have enough to eat, had to wear dirty clothes, and had no one to protect you? Or, your parents were too drunk or high to take care of you or take you to the doctor if you needed it? Yes No 6. Was a biological parent ever lost to you through divorce, abandonment, imprisonment, or other reason? Yes No 7. Was your mother or stepmother ofter or very often pushed, grabbed, slapped, or had something thrown at her? or, Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or, Ever repeatedly was hit over at least a few minutes or threatened with a gun or knife? Yes No 8. Did you live with anyone who was a problem drinking or alcoholic or who used street drugs? Yes No 9. Was a household member depressed or mentally ill or did a household member attempt suicide? Yes No 10. Did a household member go to prison? Yes No Time is Up!