Table 4.
Mitigating Shortcomings: A Comparison of Modifications Across Selected Iterations of ACE Measures
| Shortcoming | ACE questionnaires | ||||||
|---|---|---|---|---|---|---|---|
| Original ACE (Felitti et al., 1998) | Revised ACE (Finkelhor et al. 2015) | Center for Youth Wellness ACE-Q (Burke-Harris & Renschler, 2015) | BRFSS ACE (Centers for Disease Control & Prevention, 2008) | BARC Pediatric ACE (Koita et al., 2018) | Philadelphia ACE (Pachter et al., 2017) | ACE-IQ (WHO, 2018) | |
| Severity and duration not assessed | X | X | X | Some questions about frequency | X | Some questions about frequency | Most questions ask about frequency |
| Inclusion of double-and triple-barreled items | X | X | X | Items are separated | X | Items are separated | Items are separated |
| Limited breadth of included experiences | X | Added: - Peer victimization - Peer isolation/rejection - Community violence - Low socioeconomic status |
Added: - Foster care - Peer bullying - Death of parent or caregiver - Separated from caregiver due to deportation or immigration - Child had serious illness - Community violence - Discrimination |
Eliminated: -Questions regarding neglect (original ACE items 4 and 5) |
Added: - Community violence - Discrimination - Housing insecurity - Food insecurity - Separation from caregiver due to foster care/immigration - Parent had physical illness/disability - Death of parent or caregiver |
Added: - Community violence - Peer bullying - Presence of supportive adult - Food insecurity - Discrimination - Foster care - Several questions related to illnesses during childhood |
Added: - Child marriage - Additional neglect items - Death of parent or caregiver - Peer bullying - Involvement in fights - Community violence - Items related to war/collective violence |
| Use of presumptive language | X | X | X | Refers to parents broadly as potential victims of domestic violence rather than mother figure only as potential victim | Presumptive question regarding parental marriage adapted to apply more broadly | Presumptive question regarding parental marriage eliminated Refers to parents broadly as potential victims of domestic violence rather than mother figure only as potential victim |
X |