What Are Adverse Childhood Experiences?

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Childhood trauma profoundly effects nearly everyone, directly or indirectly.

Childhood trauma is the leading cause of death worldwide.

A comprehensive approach emphasizing prevention and healing can largely eradicate the problem.

Michael Menard’s story is one of extraordinary resilience and success. He grew up in a 900-square-foot home, one of 14 children, with an angelic mother and an abusive father. He eventually rose to worldwide vice president of engineering for Johnson and Johnson, having patented the disposable diaper and 14 other absorbent products. His siblings were largely successful, but he wondered why so many suffered medical and psychological disorders. This spurred him to understand the nature, treatment, and prevention of childhood trauma, as described in his book, Greater Than Gravity: How Childhood Trauma Is Pulling Down Humanity.

Menard argues that adverse childhood experiences (ACEs) are humanity’s biggest threat to well-being, affecting billions globally. ACEs’ aftermath cuts across demographic boundaries, is passed down intergenerationally, and touches nearly everyone.

The Leading Cause of Death

Death certificates record proximate causes of death, such as heart attack and suicide, while ignoring upstream factors. Recent research illuminates actual root causes. For example, nearly 90 percent of suicide attempts among high school students are attributable to ACEs (Swedo and colleagues, 2024), as are 80 percent of adult suicides, which translates to 109 suicides per day attributable to long-term effects of ACEs (Grummitt and colleagues, 2021). Advanced epidemiological calculations for the various causes of death rank ACEs as the number one cause of death in America, killing 1401 Americans each day—more than half a million yearly (Grummitt and colleagues, 2021; Austin and colleagues, 2020; Dube and colleagues, 2003). Menard calculates that ACEs steal more years of American life than heart disease, cancer, stroke, and accidents combined. Yet we spend billions annually fighting the “smoke”—the many diseases resulting from ACEs—while largely ignoring the “flames,” ACEs themselves.

ACEs cost America billions to trillions annually, depending on the factors included in the calculations. Each adult with four or more ACEs will cost society $2.1 million over their lifetime in excess medical care, lost productivity, criminal justice involvement, and social services (Peterson and colleagues, 2019). Menard calculates that a company like Johnson and Johnson loses nearly a billion dollars annually because of ACEs, yet very few companies effectively address this. He calculates that each dollar spent implementing trauma-responsive practices in workplaces yields a 9300 percent return on investment.

Untold Human Suffering

In impressive detail, Menard explains that individuals with ACEs are at greater risk for myriad psychological, medical, and functional problems, all rooted in dysregulated stress arousal resulting from ACEs. These include anxiety disorders, depression, substance abuse, attention-deficit/hyperactivity disorder, posttraumatic stress disorder, abnormal brain development, impaired cellular energy production, and social and spiritual disintegration.

Menard writes that in contrast to other public health crises successfully addressed by the nation, such as polio and smoking, the U.S. remarkably “has never had a unified, concerted effort to understand, reduce, or eliminate the devastation caused by childhood trauma.” He offers a range of fresh and powerful ideas to break the destructive cycle of ACEs.

Menard advances a compelling proclamation for change to ACEs survivors, those who are living with or close to survivors (these two groups include almost everyone), and helping professionals who feel compelled to contribute to a collective solution. His proclamation aims to reach healers, educators, parents, policy-makers, and community and workplace leaders.

Beyond Trauma-Informed

Menard exhorts us to move beyond trauma-informed efforts to comprehensive trauma-responsive solutions. Trauma-informed is linguistically imprecise. The term refers to everything from awareness to screening, recognizing symptoms, symptom containment, stigma reduction, and, infrequently, healing. Trauma-informed places primary focus on avoiding harm and not making things worse, rather than healing and prevention. Thus, a school might create safe places to contain symptoms. Workplaces might inform without healing. Leaders and managers might be trained to recognize signs of trauma, accommodate survivors’ symptoms, and create EAP programs that are often staffed by helpers who lack training in treating trauma.

What Are Adverse Childhood Experiences?

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Anyone with minimal training can claim to be trauma-informed. Any place can claim trauma-informed status without systematic practices to prevent and heal. In trauma-informed places, survivors have no way of knowing if help-seeking leads to skilled, effective help.

Trauma-responsive environments don’t just understand and accommodate the effects of childhood trauma but also implement comprehensive programs to heal and prevent. Menard calls for specific interventions:

Awareness of the profound impact of ACEs. Menard describes an aggressive campaign using globally accessible media platforms, national conferences, panel discussions, and education programs in schools, workplaces, and community organizations.

Better education for helping professionals and the public. Today’s schools undereducate about the nature and treatment of trauma. This applies particularly to graduate programs that prepare mental health professionals and other healthcare providers. For example, 750,000 social workers, representing great untapped potential, have minimal formal education about trauma. Menard recommends elevating trauma competence to a core educational requirement, rather than an optional one. Individuals will learn about overcoming childhood trauma—with rapid, effective, well-tolerated trauma treatments—and preventing it in rising generations. Training programs in schools and communities can teach needed self-regulation, resilience, and couple and parenting skills. Parenting education will include bonding skills for the critical first months of life. Trauma-prepared school-based mental health professionals, educators, community leaders, and student peer counselors will be important resources.

Better education for helping professionals and the public. Today’s schools undereducate about the nature and treatment of trauma. This applies particularly to graduate programs that prepare mental health professionals and other healthcare providers. For example, 750,000 social workers, representing great untapped potential, have minimal formal education about trauma. Menard recommends elevating trauma competence to a core educational requirement, rather than an optional one.

Individuals will learn about overcoming childhood trauma—with rapid, effective, well-tolerated trauma treatments—and preventing it in rising generations. Training programs in schools and communities can teach needed self-regulation, resilience, and couple and parenting skills. Parenting education will include bonding skills for the critical first months of life. Trauma-prepared school-based mental health professionals, educators, community leaders, and student peer counselors will be important resources.

Better measurement. Trauma-responsive organizations will measure healing outcomes, such as reduced trauma symptoms, increased resilience scores, improved life function, and post-traumatic growth—not just staff attending training sessions. To better direct resources to the greatest needs, Menard calls for refinement of the original ACEs assessment tool—expanding the original 10 ACEs to a broader array of childhood traumas, and capturing the frequency and intensity of those adversities.

Improve the workplace. A trauma-responsive workplace will integrate recovery and optimal mental health into its core mission, ideally providing on-site, confidential trauma therapy.

Adopt clear criteria. Menard calls on professional associations, accrediting bodies, funding organizations, and government agencies to adopt standardized trauma classifications that distinguish between knowing and effective doing. He proposes four classification levels: trauma-unaware, trauma-aware, trauma-informed, and trauma-responsive. Clear criteria enable funders and policy-makers to better evaluate grant applications, award contracts, and set organizational policies.

Nurturing environments for children. For example, community centers will offer recreational activities, mentoring, safe places, and coping skills training.

Strengthen welfare systems. Robust welfare systems will prioritize early childhood development, parental support, and accessible mental health services.

Menard writes that the path ahead is challenging but filled with potential. Greater Than Gravity is a clarion call to action.

Menard has established United Against Childhood Trauma to help steer the nation to trauma-responsive solutions, with the ultimate goal of providing free treatment to survivors of childhood trauma.

Menard, M. (2026). Greater Than Gravity: How Childhood Trauma Is Pulling Down Humanity. Nashville, TN: United Against Childhood Trauma (UACT).

Schiraldi, G. R. (2021). The Adverse Childhood Experiences Recovery Workbook. Oakland, CA: New Harbinger.

Swedo, E. A., Pampati, S., Anderson, K. N., et al. (2024). Adverse Childhood Experiences and Health Conditions and Risk Behaviors Among High School Students—Youth Risk Behavior Survey, United States, 2024. MMWR Suppl 2024: 73 (Suppl-4): 39-49.

Grummitt, L.R., Kreski, N. T., Kim, S. G., Platt, J., Keyes, K. M., & McLaughlin, K. A. (2021). Association of Childhood Adversity with Morbidity and Mortality in US Adults: A Systematic Review. JAMA Pediatrics, 175(12):1269-1278.

Dube, S. R., et al. (2003). Childhood Abuse, Household Dysfunction, and the Risk of Illicit Drug Use. Pediatrics 111, no. 3, 564–72.

Peterson, C., et al. (2023). Economic Burden of Health Conditions Associated with Adverse Childhood Experiences. JAMA Netw Open.

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