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

Trauma, Boundaries, and the Battle for Safety

By Melody Aguayo • March 28, 2025
To Set Appropriate Boundaries, You Must Have an Experience of Safety Children who have experienced developmental trauma (in the womb or in early childhood) have an over-active arousal system. This means that even if they are safe, they don’t feel safe. This lack of understanding what “safe” feels like creates lots of boundary issues as they get older. The Under-Boundaried Kid “I feel like I can’t let my kid out of my sight.” “My kid would follow someone off a cliff.” “My kids would try any substance that was given to them. They literally have no sense of independence or safety.” These are the types of phrases I hear from parents with under-boundaried kids. These kids do generally well in the right environment, but if there are rotten apples in the bunch, they join them quickly in whatever activity they are engaging in. They may stay out of trouble until they get a phone, and then they begin to unravel at that point. The Over-Boundaried Kid “My child is always ready to fight.” “Honestly, I hate to ask anything of her. I would rather do it myself than deal with her attitude for every small request.” “My kiddo bosses everyone around. I am shocked he still has any friends.” “She doesn’t care if she breaks our rules or makes us upset.” “He just does whatever he wants.” These are some phrases I hear from parents of over-boundaried kids. These kiddos often avoid safety and seek danger out. Safety feels unfamiliar to them. Safety feels boring and eerily peaceful. Yes, kids can also move back and forth between being over-boundaried and under- boundaried as well, which is extra complicated.

Trapped in Toxicity: Protecting Children from Harmful Environments

By Melody Aguayo • March 21, 2025
Be a Good Parent-Detective No child will come to you and say, “I have been placed in a toxic environment where my growth is limited, and my feelings of safety are compromised.” They don’t have the ability to keep themselves safe. I’m always very irritated when I hear of Bully campaigns that put the responsibility on the victim for seeking help and telling adults. In an ideal world that would happen, but that is just not possible for most victimized children. It is the adults’ job to structure the environment for safety, not the kids’ job to keep themselves safe. You just have to learn to recognize the signs, and if you are confused, then go to the child’s suspected toxic environment and gather information. Volunteer in their school or Sunday School class and observe how your child is functioning in those settings. Don’t listen to other adults more than you listen to your child’s behaviors. No one will pay attention to your child the way you do. I have had so many parents say different versions of these statements to me over the years: “The teacher said he was well liked, but when I observed him in his classroom, I could tell he irritated everyone.” “The school counselor says he is doing fine, but anytime I show up at a classroom party, he is hiding from the other kids.” “The soccer coach doesn’t see any issues at all, but when I pick him up from soccer, he is so dysregulated that it takes me all evening to settle him down.” I understand there are times you can’t take a child out of a toxic environment. Let’s say the neighborhood kids are all mean to your kid, and moving is just not a financial option for your family. In these situations, we can do our best to build a hedge of protection around our kids with more structure. You can tell your child that they are not allowed to play with the neighborhood kids, and instead you can figure out a couple of play dates a week with someone who is kind to them. This will be more time and trouble for you, but this teaches your child that we say “no” to toxic environments and nurture safe ones.

How to get free childcare in the summer?

By Melody Aguayo • March 7, 2025
Sign up for every VBS within a 20-minute drive from your home. If you plan it out well and start early, you can end up with 6 or 7 weeks of free childcare. Plus, you have the added benefit of having your kids scream, “Hey, that’s our church!” every time you drive past any chapel in any direction. Do not hold me accountable for the annoying songs your children will sing loudly ALL YEAR LONG even if your eyes start twitching. And you know how you “lose” things you no longer want your kids to play with, watch, or listen to? Well, you can only “lose” two of the song CDs before your kids catch on.

The Differences in Sexual Development in Children with Complex Trauma

By Melody Aguayo • February 14, 2025
Sometimes I think organizations hire me just to talk about things like “masturbation”. When is the last time a parent posted on Facebook about their kindergartner, “Noel just showed the neighbor her vagina and asked to see his penis!” Or how about, “I caught Miles looking at pornography for the third time!” Both of these things are about as common as someone winning the cross country meet, but they aren’t discussed. Parents are discreet about sex, and by the time most kids go through puberty, the kids understand this discretion. However, this isn’t true of all kids.

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By Melody Aguayo • February 7, 2025
“You have never had to do anything this hard in your life,” our teen son said to us after being given the job of raking and moving an enormous pile of leaves to the front yard. We burst into laughter. He felt so persecuted, when in reality he could move those leaves a thousand times, and it wouldn’t come close to the amount of time, energy, agony, stress, effort, and money that we have put into raising him. Kids are naturally self-centered. Even the most responsible, hard- working, compassionate kids are naturally self-serving.

When Parents Lose Their Minds over “Flip Sequin” Shirts

By Melody Aguayo • January 30, 2025
There is a new fad called “brush changing sequins”. You can find these appealing, brushing sequins on everything from key chains to bedspreads. I had a little girl come into my office with a flip sequin t-shirt on the other day. It was dark blue with a large, glittery silver heart on the front. I am thirty-seven, almost thirty-eight years old, and let me tell you that I had to restrain myself from reaching out and brushing the sequins up and down on her shirt.

Window of Tolerance

By Melody Aguayo • January 23, 2025
"We all have a window of tolerance. When we are operating outside of that window, we behave badly. This window is widening or shrinking, depending on what happens during the day. When we sleep well, eat well, and get the physical movement that we need, our window is larger. Every choice we make during the day either enlarges the window or shrinks it. Every trauma that a person endures shrinks that window of tolerance.

Life on a Raft; Isolation in Families with Special Needs

By Melody Aguayo • January 16, 2025
We still live on the raft, but we visit the island frequently now.  At some point along the way, we got used to the sweetness of the raft – the way it doesn’t matter what you have there or who you are – the way you focus on all the treasures you have, and they seem so many while you are on the raft – the closeness of the people on the raft and those sweet friends that join us here on occasion.
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By Melody Aguayo • January 9, 2025
Let’s face it. Middle school sucks. There is this food chain in middle school, and everyone is in survival mode trying to stay off the bottom of the food chain at any cost. Kids do things in middle school that they wouldn’t do at any other age. They are all pretty terrified of social rejection, and regardless of their popularity status, they all feel rejected at times.

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Shame: a painful feeling of humiliation or distress caused by the consciousness of wrong or foolish behavior.
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