
The strength of this approach, according to the authors, lies in its wide availability, uncomplicated administration and simple understanding of the scores. Moreover, this tool has increased awareness of the link between early adversity and increased risk of a wide range of mental and physical health problems. However, the authors also highlight a number of limitations.
For example, ACE scores are largely reliant on retrospective reports, which are likely to be biased/unreliable, and assume that each subtype of early adversity has the same association with later outcomes. Also, ACE screening measures do not consider the specific patterning of ACEs (e.g. which adversities co-occur) and overall there is an unclear rationale, according to the authors, for why the 10 original ACEs categories were selected.
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