​​​Childhood is meant to be a time of innocence, wonder and simple joys. For some however, Adverse Childhood Experiences (ACEs) can have lasting effects into adulthood. Here's what parents need to know about ACEs and how to protect children from these potentially harmful experiences.

Nobel Peace Prize recipient Kailash Satyarthi once said, "Childhood means simplicity. Look at the world with the child's eye - it is very beautiful," reminding us of the innocence and simple joys of childhood. For many children, however, this imagery may be disrupted by adversity

​​ACEs are potentially traumatic events that occur before a child turns 18, which can significantly impact their development and have lasting effects that follow them into adulthood, says Nicholas Goh, psychologist with the Department of Developmental Psychiatry.

Findings from the 2016 Singapore Mental Health Study (SMHS) by IMH revealed that two in three adults experienced at least one ACE. For many individuals, the impact from these experiences can continue across their lifespan, increasing the risks of mental health challenges, such as anxiety, depression and difficulty forming healthy relationships.


According to the Singapore Mental Health Study​ (2016) by IMH, the five most common ACEs in Singapore are emotional neglect (46.5%), parental separation, divorce or death of a parent (21.8%), having a battered mother or female guardian (8.2%) or living with household members who are mentally ill or suicidal (6%).

​ACEs encompass various forms of abuse, neglect and household challenges that a child might face. These may involve severe physical punishments or actions that harm a child's self-worth, for instance, verbal insults, humiliation or threats.

ACEs also include exposing a child to inappropriate content or involving them in sexual acts. Neglect is another form, whether it is failing to provide a child with basic physical needs like food, shelter or clothing, or witholding emotional support, love or affection.

Challenging household situations, including physical abuse, substance abuse, mental illness in the household, parental divorce or having an incarcerated family member, also fall under ACEs.

Other traumatic events include car accidents or natural disasters. All of these events can cause long-term or extreme stress and affect a person physically and emotionally.​


​Psychological stress can become "extreme" when it overwhelms a child's capacity and inner resources to cope, especially during critical developmental stages. When this stress is prolonged and intense, it can be compared to a car engine being revved up for long periods, which eventually leads to wear and tear that increases the risk of stress-related health issues.

Without proper support, the effects of ACEs can extend into adulthood and increase the risk of mental health disorders, chronic health issues and substance abuse down the road. Research also shows that adults who experienced significant ACEs may be more likely to participate in high-risk behaviours such as smoking tobacco, experimenting with addictive substances, and have a higher chance to engage in suicidal behaviour and self-harm, shares Mr Goh.

In the short term, children who experience ACEs may exhibit:

  • Emotional distress - feelings of fear, anxiety or sadness
  • Behavioural problems - acting out or withdrawing from social interactions
  • Academic difficulties - trouble with focusing, a drop in grades or loss of interest in school activities
  • Physical symptoms - unexplained headaches, stomach aches or other ailments

Without proper support, these effects can persist into adulthood, increasing the risk of:

  • Mental health conditions - depression, anxiety, Post-Traumatic Stress Disorder (PTSD)
  • Chronic health problems - high blood pressure, heart disease
  • Substance abuse issues - alcohol or illicit drugs
  • Relationship issues - difficulty forming and maintaining healthy relationships

A/Prof Daniel Fung, Senior Consultant at the Department of Developmental Psychiatry at IMH, notes that intergenerational trauma can result in changed behaviour and alter perceptions of normal relationships. For instance, someone who has experienced coercive abuse may believe that relationships must revolve around fulfilling the needs of the more powerful caregiver. "When they become caregivers themselves, they may relive that kind of trauma on the next generation, becoming abusers themselves," Dr Fung adds.


​While some ACEs can be prevented, Mr Goh acknowledges that there is no way to prevent them all. This is because traumatic events may still occur outside one's control, such as with car accidents or when a family member is seriously ill. "Nevertheless, parents can be mindful of and reduce potential emotional neglect by creating a safe and nurturing environment for the child to thrive in; and paying attention to their child's physical and emotional needs," Mr Goh adds.

Here are his tips for building a nurturing environment for your child:

1. Foster secure attachments
Be a reliable source of comfort and security for your child, helping them feel safe and assured. Research shows that one or more consistent and safe attachments with an adult figure can help children overcome potentially traumatic events.

2. Create a stable and positive home environment
Establish daily routines that provide a sense of safety and predictability. Build a household atmosphere of love, respect and stability.

3. Encourage open communication
Talk openly with your child about their emotions and listen without judgement. Normalise seeking help from a trusted adult when they are unable to cope with challenges that arise.

4. Educate yourself
Learn about child development and effect, non-violent parenting strategies to better understand and meet your child's emotional needs.

5. Model healthy coping habits
Learn and teach stress relief techniques such as deep breathing, mindfulness and physical activity. Demonstrate healthy ways to regulate emotions.

6. Get support when needed
Watch for signs of distress or changes in your child. Reach out to the child's school, teachers or professional services when required. Getting support as a caregiver is also important in helping you care for your child in a safe environment.


​If your child shows unexplained changes in behaviour, such as aggression, withdrawal from social activities they once enjoyed, or difficulty focusing in school, they may need additional support. Physical symptoms such as stomach upsets and headaches, changes in sleep and appetite can also be signs of distress. Other signs to watch out for include talk of self-harm or visible self-inflicted injuries.

While not all ACEs can be prevented, being attentive and responsive to your child's physical and emotional needs can make a big difference in reducing the risks of ACEs at home, says Mr Goh.

​Healing and growth are possible, even for those who are struggling with past trauma. The brain has the capacity to change and develop over time, just as negative experiences can affect brain development, corrective therapeutic experiences can have a profoundly positive impact on how a child recovers and develops after trauma.

Learn more about mental health screenings for children and adolescents at BRAVE.sg​.