Parenting with ACEs: How you can support your toddler

Toddler-playing-at-pre-school-by-Monkey-Business-Shutterstock-Images, Parenting with ACEs: How you can support your toddler, Culture Currents
Photo: Monkey Business, Shutterstock Images

by Diana Hembree

“My 2-year-old keeps falling down when he tries to walk.”

“My son is almost 24 months old, but all he can say is ‘mama’ and dada.’”

“She just turned 2, and she still can’t follow the simplest instructions.”

When your toddler misses a developmental milestone, like taking her first steps by age 2, it’s natural to fret. After all, in very rare cases, such delays may be a sign of an underlying condition.

But a recent study suggests that some delays may have a more surprising explanation. Children are more likely to miss developmental milestones by age 2 if their parents suffered traumatic events during their own childhood, according to researchers from the Cincinnati Children’s Hospital Medical Center in Ohio.

Researchers call these traumatic events – which can include abuse, neglect, discrimination, homelessness or parental divorce, incarceration, addiction or mental illness – “Adverse Childhood Experiences” (ACEs).

For each extra ACE experienced by a toddler’s mother, the scientists found an 18 percent increase in the child’s risk of a missed milestone. For fathers, there was a similar trend. But the good news is that you can work with your provider to reduce or eliminate that risk. Here is what the research team recommends:

Realize you are not to blame. “If a parent has a high ACE score, it’s important that they know it’s not their fault – and that healing is possible for them and beneficial for their children,” said study co-author Emily Eismann, MS.

Take care of yourself. If you’re healthy and feeling good, you can better respond to your child in a calm, nurturing way. Eismann recommends getting enough sleep and exercise, eating nutritious food, building a good support network of family and friends, and doing mindfulness techniques like deep breathing when you’re stressed.

Ask for help if you feel overwhelmed. “Reaching out for support – connecting with friends, providers or other people who have your back – is an important first step,” says study co-author RJ Gillespie, MD.

Create daily routines kids can count on. “Parents can also support their child’s development by helping them to feel physically and emotionally safe,” said Eismann. Everyday routines such as family dinners, throwing a ball and a bedtime story help children feel secure and connected. Joining in school and community celebrations also gives children a strong feeling of belonging.

Put away the cell phone. If you’re on your cell a lot – as many of us are – try to turn it off when you’re with your kids. Make eye contact with them, play peek-a-boo, listen to them, give them a hug.

Look into a parenting class. Almost none of us were taught parenting skills in school, but schools, YMCAs and other groups now offer parenting classes for adults. If you’d prefer home visits, ask your health provider about a peer parenting coach. It’s comforting to know, for example, that your 2- or 3-year-old’s seemingly endless chant of “No!” is a natural stage of toddlerhood rather than a desire to rile you up – and that giving your toddler choices will often defuse a mini-power struggle.

Get screened for ACEs. If you don’t know your ACE score, consider taking the ACEs survey at your doctor’s office. An ACE score isn’t a diagnosis, but a high score suggests your child could be at higher risk for developmental delays. If so, “earlier intervention is likely more effective,” said study co-author Robert Shapiro.

Consider professional help if you are depressed. According to study leader Alonzo Folger, PhD, therapy for mothers who are in depression is an intervention that shows considerable promise.


Folger, AT, Eismann EA, Stephenson NB, Shapiro RA, Macaluso M, Brownrigg ME, and Gillespie RJ. Parental Adverse Childhood Experiences and Offspring Development at 2 Years of Age. Pediatrics 2018; 141 (4): e20172826.

Diana Hembree is a science writer for the Center for Youth Wellness. She is an award-winning journalist who has worked at Time Inc., the Center for Investigative Reporting and the Energy Bioscience Institute and has written or edited for Forbes, HealthDay, the Washington Post, PBS Frontline, Vibe and many other places. She can be reached at