Since the questionnaire relies on client's observations, all responses should be verified by the clinician, and a definitive diagnosis is made on clinical grounds taking into account how well the client understood the questionnaire, as well as other relevant information from the client.
The CYW ACE-Q is intended for use in pediatric and family practice settings to identify patients at increased risk for chronic health problems, learning difficulties, mental and behavioral health problems and developmental issues due to changes in brain architecture and developing organ systems brought on by exposure to extreme and prolonged stress.
The instrument is comprised of two sections: Section 1 of the CYW ACE-Q (i.e. items #1-10) consists of the traditional ten ACEs for which we have population-level data for disease risk in adults. Section 2 includes nine (CYW ACE-Q Teen) items assessing for exposure to additional early life stressors identified by experts and community stakeholders. These items are hypothesized to also lead to disruption of the neuro-endocrine-immune axis, but are not yet correlated with population level data about risk of disease. They include involvement in the Foster Care system, bullying, loss of parent or guardian due to death, deportation or migration, medical trauma, exposure to community violence, and discrimination.
If the patient’s CYW ACE-Q score from both Section 1 and Section 2 equals zero to three (0-3) and the patient does not present with additional symptomatology (see Relevant Symptomatology listed below), the Primary Care Provider should provide Anticipatory Guidance. If the patient’s score is one to three (1-3) with symptomatology, or four or higher, an appropriate referral to care should be made.
The CYW ACE-Q is not a validated diagnostic tool, and is not intended to be used in the diagnosis or cure of any disease.