Childhood Experiences

Please approach all material with care. This material is not a substitute for usual healthcare. 

Please be aware that if you are a parent yourself, this form may be stressful. If you yourself have had a difficult childhood, it almost certainly could make it more possible that your stress rubbed off on your children. This form is about understanding how trauma is passed over generations. 

These forms don’t take into account ACEs from racism, sexism, ageism. and other forms of prejudice and injuries, for example those suffered by immigrants. Also the long term effects of childhood difficulties differ from person to person, and also whether there was support by another adult.

Your Childhood Experiences affect your life. If you feel in a safe place, complete this form. I would suggest you discuss adverse child events scores with your doctor or health care provider before completing the form, as it could trigger bad memories or even flashbacks. 

The higher the number, the more adverse or difficult childhood experiences in your life, the more likely you are to have Complex PTSD.


Below: Another form you can complete if you prefer more in-depth questions.