What Only ACE Trainees Know About Trauma

I took the training course for the largest ACE screening program in the world so you don’t have to. Here’s what I learned: Humans are incredibly fragile.

CATEGORY: GOVERNMENT PROJECTS

Nadine Burke Harris, MD, MPH

Source: Aces Aware Learning Center
Read time: 1.5 minutes
 
This Happened
In July 2025, California’s ACEs Aware campaign proudly announced that its online training for health professionals would remain available—an enduring centerpiece of the state’s grandiose effort to decrease adverse childhood experiences (ACEs). Curious about how they believe an extraordinary social transformation could be engineered through a 10-item paper survey during routine health care appointments, I took the course.
The Only State Doing This
California remains the only state attempting a statewide system in which children are universally screened for ACEs during primary-care visits. The initiative launched in 2020 under the state’s inaugural Surgeon General, pediatrician Nadine Burke Harris, M.D., who served from 2019 to 2022.
The Premise, in Their Own Words
The training opens with 11-minutes showcasing Burke Harris delivering the standard points of the ACE narrative:

• ACEs supposedly cause a sweeping list of lethal diseases.
• The initiative is framed as a crisis in need of action because it promotes “health equity.”
• The goal is to cut ACEs in half in one generation.
• All guidelines are allegedly based in the “science.”
• ACEs are described as the “21st-century version of infectious diseases.”

From there, the training requires one to read five short clinical vignettes—with required test questions—intended to demonstrate how ACEs shape health across the lifespan. The lessons were familiar: a boy’s asthma worsens; a woman is anxious about a medical procedure; a nurse becomes destabilized by the rollout of ACE screening itself; all because their fragile psyches were triggered by memories of past childhood stress. One quiz question directly asserts that trauma “alters the structure and function of the developing limbic system” and causes neuronal loss in the prefrontal cortex.
The Basic Premise Is Implausible.
The entire ACE framework assumes that handing caregivers a screen in a doctor’s office—and maybe giving a few minutes of advice about community resources—can meaningfully prevent the underlying adversities themselves—something a century of social programs has failed to achieve. This is utopian delusions on steroids. If enormous societal problems such as abuse, addiction, mental illness, and domestic violence could be prevented through brief questionnaires, we would have solved them decades ago. But there is a deeper problem.
Correlation Is Not Causation—But ACE Science Pretends It Is
The foundational ACE studies are cross-sectional. They measure adversity from the past and health conditions in the present. Such studies have zero ability to determine what caused what. Yet ACE advocates insist they know causality.
A far more plausible explanation is that the same family environments where ACEs are more common are also environments where poorer physical and mental health are more common—for complex genetic, behavioral, and socioeconomic reasons that cluster within families. In other words, ACEs and health problems co-occur, but one does not necessarily cause the other. The ACE framework largely ignores basic facts of genetics and heritable traits.
Skipping the Science
The ACE movement sounds noble. But a closer look reveals a fabrication built on weak science, untested assumptions, an unwavering belief that correlation equals causation, and a public health experiment that uses children as guinea pigs.