The Deepest Well: Healing the Long-Term Effects of Childhood Trauma and Adversity—A Transformative Guide to Understanding Childhood Trauma and Health

by Nadine Burke Harris

With Trinity’s complaint of learning and behavior problems, if her ACE score had been zero, a standard ADHD workup would have been warranted. But now I knew that if a patient had four or more ACEs, she was thirty-two times as likely to have learning or behavior problems, which suggested that the underlying issue was probably not ordinary ADHD. In those cases, I was convinced that the problem was chronic dysregulation of the stress-response system, which inhibited the prefrontal cortex, overstimulated the amygdala, and short-circuited the stress thermostat—in other words, toxic stress. When I flipped through Trinity’s chart, I saw that she had an ACE score of six.