ACE Test for Glass Children

ACE Questionnaire for Glass Children who have a sibling with Reactive Attachment Disorder (RAD) currently or previously living in the home.

ACE=Adverse Childhood Experiences
Glass Children=Children who live with a special needs sibling (in this case RAD) and who are unintentionally looked through by parents who are constantly stamping out behavioral, emotional, and sometimes literal, fires.

While living in your family home:

1. Did a sibling or child in the household often or very often...swear at you, insult you, put you down, or humiliate you? Or act in a way that made you afraid that you might be physically hurt?
No___If Yes, enter 1 __

2. Did a sibling or child in the household often or very often...push, grab, slap, or throw something at you? Or ever hit you so hard that you had marks or were injured?
No___If Yes, enter 1 __

3. Did a sibling or child in the household ever...touch or fondle you or have you touch their body in a sexual way?
No___If Yes, enter 1 __

4. Did you often or very often feel that...no one in your family loved you or thought you were important or special? Or your family didn’t look out for each other, feel close to each other, or support each other?
No___If Yes, enter 1 __

5. Did you often or very often feel that...you didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
No___If Yes, enter 1 __

6. Was a biological parent ever lost to you through divorce, abandonment, or other reason?
No___If Yes, enter 1 __

7. Was your mother or stepmother:
Often or very often pushed, grabbed, slapped, or had something thrown at her? Or sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? Or ever repeatedly hit over at least a few minutes or threatened with a gun or knife? Did a sibling or a child in the household swear at her, insult her, put her down, or humiliate her? Or act in a way that made her afraid that she or one of her children might be physically hurt?
No___If Yes, enter 1 __

8. Did you live with a sibling or a child who was a problem drinker or alcoholic, or who used street drugs? Or was anyone in your household a “cutter” (used sharp objects to harm themselves)?
No___If Yes, enter 1 __

9. Was a sibling or a child in the household depressed or mentally ill, or did a sibling or child in the household attempt suicide?
No___If Yes, enter 1 __

10. Did a sibling or a child in the household go to prison, a therapeutic treatment center, a residential treatment center, group home, boarding school, into the foster care system, or was adopted into a different family?
No___If Yes, enter 1 __

Now add up your “Yes” answers: __   This is your ACE Score.


•This is a modified version of the ACEs test. For the original ACE test: https://acestoohigh.com
•Learn more about the CDC/Kaiser Permanente ACE study: https://www.cdc.gov/violenceprevention/acestudy/