What the terms mean
Adverse childhood experiences (ACEs) comes from a US study run by the Centers for Disease Control and Prevention (CDC) and the health provider Kaiser Permanente. Between 1995 and 1997, more than 17,000 adults answered questions about their childhood. The CDC groups the 10 ACEs it measured into three types:
- abuse: emotional, physical and sexual
- neglect: emotional and physical
- household challenges: a mother treated violently, substance misuse in the household, mental illness in the household, parental separation or divorce, and a household member in prison
The more ACEs people reported, the more likely they were to have poor health later. The 2015 Welsh ACE study found 47% of adults in Wales had at least one ACE and 14% had four or more.
Trauma-informed practice has no single agreed definition. The Office for Health Improvement and Disparities (OHID) published a working definition in 2022 for the health and care sector. It says trauma-informed practice asks “‘What does this person need?’ rather than ‘What is wrong with this person?’”. It also seeks to avoid re-traumatising people. It sets out six principles:
- safety
- trustworthiness
- choice
- collaboration
- empowerment
- cultural consideration
OHID is clear that the purpose “is not to treat trauma-related difficulties, which is the role of trauma-specialist services”. It also says the evidence base “is still being developed”.
What schools are and aren’t required to do
Being “trauma-informed” is not a statutory requirement for schools in England. Here is what the current guidance says.
- KCSIE 2026 uses the phrase “trauma-informed” once, in Annex A. Staff should understand the need for “tailored, trauma-informed and sensitive support” for children with a family member in prison.
- KCSIE Annex B expects the DSL to understand “the lasting impact that adversity and trauma can have, including on children’s behaviour, mental health and wellbeing, and what is needed in responding to this in promoting educational outcomes”. That is a requirement for the DSL’s knowledge, not for a whole school approach.
- KCSIE also says a child’s “experiences of adversity and trauma can leave them vulnerable to further harm” and educationally disadvantaged (paragraph 217). It says children who display harmful sexual behaviour have often experienced abuse and trauma themselves (paragraph 538), and that they need support that addresses any underlying trauma (paragraph 633).
- The DfE’s Mental health and behaviour in schools (2018) is the DfE document that discusses ACEs most directly (paragraphs 3.17 to 3.21). It says staff should understand how the experiences of children in need and looked-after children can affect behaviour. It says behaviour policies should reflect this, “including through individualised graduated responses, balanced with the needs of the whole school community”.
- The DfE’s Behaviour in schools advice (2024) doesn’t use the word trauma. It says staff should take account of contributing factors such as bereavement, abuse or neglect, mental health needs or bullying, and try to understand the underlying causes of behaviour.
- Ofsted’s school inspection toolkit doesn’t mention trauma-informed practice.
So a school can choose a trauma-informed approach, but it should be clear that this is a choice, and it doesn’t replace the behaviour policy or safeguarding procedures.
What the evidence shows
The research on ACEs is strong on one point: at population level, adversity in childhood is linked to poorer health and wellbeing later in life.
The evidence is weaker on what to do about it. The Early Intervention Foundation, now called Foundations, reviewed the evidence in 2020. It found:
- prevalence estimates for ACEs are “imprecise”
- focusing only on the original 10 ACEs “risks missing people who also need help”
- some ACE screening practices raise “serious concerns” about ethics
- trauma-informed care “is not well defined, current practice is highly varied”, and there is “limited robust UK evidence” that it improves outcomes for children
None of this means trauma doesn’t matter. It means an ACE count can’t tell you what an individual child needs. Training alone isn’t enough, and claims that a programme is “evidence-based” should be checked.
Using the ideas well in school
- Don’t score children. An ACE count describes populations, not individuals. Two children with the same score can be affected very differently, and some of the most harmful experiences aren’t on the list.
- Look for the need behind the behaviour, as the DfE’s behaviour advice already asks. Keep clear routines and expectations. The DfE’s 2018 advice lists “clear, consistent discipline”, “a sense of belonging” and good relationships with staff among the factors that protect children’s mental health (table 1).
- Trusted adults. The same advice says schools matter most for children “who may not have a trusted adult they can talk to” (paragraph 3.10).
- Avoid re-traumatising. Don’t ask a child to retell what happened more than needed. Think about how sanctions, isolation or physical intervention will feel to a child who has been hurt.
- Behaviour can be a sign. A change in behaviour can be the first sign of abuse, neglect or exploitation. Pass it to the DSL. Knowing a child has had a difficult past doesn’t replace reporting a new concern.
- Use what you know about the child. If a child has a social worker, KCSIE expects the DSL to hold and use that information when deciding on pastoral and academic support (paragraphs 218 and 219).