If Adopted Infants Had ACE Scores

Melody Aguayo • February 21, 2025

I find it interesting that we consider infants to have “risk factors”, but there is no ACE (Adverse Childhood Experiences) score for a newborn.  Why is it that infants have “risk factors”, but then as soon as they are born healthy with an Apgar score above 8, everyone breathes a sigh of relief?


I am encouraged that there has been a surge in understanding that childhood trauma affects mental and physical health.  The survey developed to determine risk factors based on Adverse Childhood Experiences is now easily available on the internet. 
  • Anyone can determine what his/her ACE score is, and the higher your score, the more likely you are to experience one or more of the following:
    • Alcoholism & addiction
    • Poor work performance  
    • Early sexual activity  
    • Suicide attempts  
    • Depression  
    • Risk for intimate violence  
    • Early smoking  
    • Poor academic achievement
    • Illicit drug use 
    • STD’s
    • Unwanted pregnancy
    • Chronic health issues

The list goes on and on, but the basic premise is that the higher your ACE score, the greater your risk of struggling in all areas of your life – work, intimacy, finances, and physical health.


If you want to see the ACE questions, click here http://www.aceresponse.org/img/uploads/file/ace_score_questionnaire.pdf


Here are the reasons I believe that even if you adopt a newborn infant straight from the hospital, he/she has already experienced significant trauma that should be considered true experiences. This distress experienced in utero changes the body and the brain.


  • ACE Questions 1, 2, and 7

    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?


    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 marks or were injured?   


    7.  Was your mother or stepmother: Often 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 hit over at least a few minutes or threatened with a gun or knife?

Infants in the womb experience all the same emotions their birth mothers are experiencing. Birth mothers are almost always living in poverty and often marginalized culturally and racially. We know that these women endure a greater rate of physical violence than other women. These are not women with a world of options and a peace-filled environment. These are not pregnancies where the days to the birth are counted out with excitement while the nursery is being painted by a supportive partner. At the very least, we must acknowledge the stress that surrounds a pregnancy where “adoption” has even become an option. Children under the age of 5 experience the physical assault of a mother as though that physical assault was on their own bodies. Why do we assume this is different for an infant in the womb? I believe they experience the terror of that as well.
  • ACE Question 4

    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?

When infants are born, their EEG’s look very similar to their birth mother’s. If there are depression markers on Mom, those markers are also present on the baby’s EEG. Babies in the womb experience true emotions. If a birth mother is making an “adoption” plan for her infant, can’t you imagine that she is also trying to distance herself emotionally from that baby? Would you not have to do that in order to follow through with an adoption? I am not talking about loving their infant. I do believe all parents love their children, but just like divorce is a process, not an event, so is planning for adoption. The disconnection from a child in the womb is a painful process filled with confusing emotions that do not communicate closeness and support to the baby.  
  • ACE Questions 5& 8

    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?


    8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?


I covered poverty in a previous question, but adoption would not exist as we know it without a huge discrepancy in the amount of money a birth parent has versus an adoptive parent. Poverty is, whether or not we choose to admit it, the main reason there are 147 million orphans in the world.  Substance abuse is also much more common in these situations. More often than not, when I am collecting a history of the kids that I work with, substance abuse is a part of that. 
  • ACE Question 6

    6. Was a biological parent ever lost to you through divorce, abandonment, or other reason?

Yes, these children have experienced abandonment. Even if it was through a loving plan and with the best of intentions, the fact is that they lost their biological parents. This is a real loss that is experienced throughout their lives. They recognize their birth mom’s voice, smell, and heartbeat. Newborns know who their people are. These babies have just been pushed into a cold, new world and lost their people all at the same time. We have to stop believing that just because they can’t express memories of their birth mom,they don’t always feel her loss. I believe trauma can also be experienced by not receiving what you needed to receive. The absence of affection,tenderness, presence, and relationship is distressing. This unseen agony is often overlooked. Not getting what you needed can be as traumatic as being mistreated.


There are 10 questions, and so far I have given explanations as to why 6 of them could apply to most adopted infants. 


It is important to remember that risk factors do not equal fate or destiny, and adopted children do fare better than their non-adopted bio siblings left in poverty. However, they do not fare as well as children who don’t have as many risk factors. I believe that a child adopted at birth could have had as many traumatic experiences as a child adopted at age 8. The earlier we recognize this as a society, the earlier we can mitigate some, but not all, of the effects of trauma with very early intervention. 



References:

https://www.cdc.gov/

http://www.aceresponse.org/img/uploads/file/ace_score_questionnaire.pdf

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