Data source: www.acesaware.org[accessed 26 Oct 2020] Impacts that last a lifetime Visualising the impacts of adverse childhood experiences (ACEs) © 2020 BMJ Publishing Group Ltd. Interactive Adversity in the first years of life may deleteriously affect the course of human development. This graphic shows the wide range of possible consequences throughout the lifetime of children suffering adverse experiences in their early years. Use the buttons below to filter and view the evidence supporting these effects Odds ratio (log scale) 100 10 1 0.1 Notknown Split by: Childhoodimpacts Physical Behavioral Adultimpacts Physical Behavioral Impact type Comparator Study type Publication year Childhood impactsPhysical Childhood impactsBehavioral Adult impactsPhysical Adult impactsBehavioral This view shows the physical and behavoural consequences of adverse childhood experiences, which can extend through childhood and into adulthood, often compounding one another. Each circle represents one consequence, and they are coloured according to the life stage and type of impact (physical or behavioural). The vertical position of the circles shows the odds ratio for someone experiencing ACEs, compared with someone not experiencing ACEs Impact type ≥ 1 ACEOr per additional ACE ≥ 2 ACEs ≥ 3 ACEs ≥ 4 ACEs ≥ 5 ACEs Unknown Each column in this view shows the number of ACEs used for comparison. For example, in the third column, people who had experienced 3 or more ACEs were compared with people that had not experienced any ACEs. In the first column to the left, studies which reported an odds ratio for each ACE experienced are included Comparator Systematic review Cohort study Cross-sectional Other Multiple This view shows the evidence types presented. Research in this area is mostly limited to retrospective observational studies, as randomised designs would not be possible. Some large systematic reviews have been conducted. Some impacts have been studied in multiple types of study, which are included in the column to the right Study type 2000 2005 2010 2015 2020 Multiple This view shows the year of publication of the evidence studying these impacts. The column to the right again shows the impacts for which multiple research studies are available Publication year Physical symptom in children Any unexplained somatic symptoms Coronary artery disease, myocardial infarction, or ischemic heart disease Evidence: 37.5 2.8 – Odds ratio for people with ≥ 5 ACEs,compared with people who have 0 ACEs Karlen J, Ludvigsson J, Hedmark M, Faresjo A, Theodo... Theoretical framework 253 719 (in 37 trials) 2015 Karlen J, Ludvigsson J, Hedmark M, Faresjo A, Theodo... Theoretical framework 253 719 (in 37 trials) 2015 Karlen J, Ludvigsson J, Hedmark M, Faresjo A, Theodo... Theoretical framework 253 719 (in 37 trials) 2015 DRAFT