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ACEs policy and adults: The missing role of sexual abuse

Traumatised adults have been rather neglected in policy on adverse childhood experiences (ACEs) in comparison with children. Yet the key message from the original ACE studies was the need to change the way adults with ill health are heard, understood, diagnosed and treated. Within ACEs policy, childhood sexual abuse (CSA) has also had marginal attention. This paper traces how adult survivors of CSA provided the spark for the first and subsequent ACE studies, describing the serious mental and physical health issues this trauma can bring throughout the lifecourse. It raises the possibility that some of the original ten ACEs may be more impactful to health and wellbeing over the lifecourse than others and should receive greater priority in terms of prevention and recovery. A series of questions is asked about how physical and mental health services are responding, and how they may need to be monitored in order to fully integrate the needs of CSA survivors into current Scottish ACEs policy.