rREST® Inc. ACE Survey

This assessment is designed to determine the number of Adverse Childhood Experiences (ACE's) you may have experienced in your life. What follows is a series of questions directly taken from (Felitti et all., 1998) which has been used by health professionals across the world.

If the survey does not automatically advance to the next question, click the arrow in the bottom right-hand corner of the survey to go to the next page.

DISCLAIMER: You must be over the age of 18 to complete this assessment. Questions within this survey assess issues related to physical and sexual abuse. Please take care in determining if this content will be disturbing to you in any way.

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"Most individuals experience at least one Adverse Childhood Experience. When compared with individuals with no ACEs, those with more ACEs tend to experience social and emotional challenges later in life. When ACEs are fully processed, it is thought they have fewer negative effects in adults." - Dr. Cindy Sholes

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I am over the age of 18. *

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rREST® Inc. ACE Survey

What is your employment status? *

What is your gender? *

Before your 18th birthday, 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? *

Before your 18th birthday, 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? *

Before your 18th birthday, did an adult or person at least five years older than you ever… touch or fondle you or have you touch their body in a sexual way? OR attempt or actually have oral, anal, or vaginal intercourse with you? *

Before your 18th birthday, 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? *

Before your 18th birthday, 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? *

Before your 18th birthday, was a biological parent ever lost to you through divorce, abandonment, or other reasons? *

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Before your 18th birthday, 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? *

Before your 18th birthday, did you live with anyone who was a problem drinker or alcoholic, or who used street drugs? *

Before your 18th birthday, was a household member depressed or mentally ill, or did a household member attempt suicide? *

Before your 18th birthday, did a household member go to prison? *

Complete the fields below so we know where to send your results.

First Name *

Last Name *

Email *

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Thank you for taking the rREST ACE Survey.

There's one last step.

Please click on the submit button in the lower righthand corner of this page to receive an email with your results. The email will be in your inbox 10 minutes after submission.