The purpose of this bounded case study (Merriam & Tisdell, 2016) was to add to the existing research literature on early childhood trauma in addition to understanding teacher and administrator perceptions on students' adverse childhood experiences (ACEs) in rural, Northwest Missouri elementary schools from 2009 through 2019. Survey participants (n = 31), consisting of kindergarten through third grade teachers and elementary administrators completed surveys on their perceptions of students' ACEs within their school districts. Interview participants (n = 11), consisting of kindergarten through third-grade teachers and elementary principals, shared their perceptions and lived experiences of students' ACEs. Teachers and administrators noticed the most adverse childhood experiences K-3rd grade children in rural Missouri elementary schools were exposed to include: (a) divorce; (b) substance abuse; (c) mental illness; (d) physical abuse; and (e) emotional neglect. Three themes emerged from the study: (1) the family system included household dysfunction that may include impactful events such as divorce, substance abuse, and mental illness; (2) increase of teachers' and administrators' awareness of trauma; and (3) resources and supports. Teachers and administrators noticed an increase in continued trauma perceived to be because of unstable family conditions systems described by Urie Bronfenbrenner's (1970) human ecological systems theory as the microsystem.Suggested implications for teachers, administrators included: (1) an increase of teacher and administrator awareness of trauma; (2) trauma-informed training opportunities through the Missouri Trauma Informed School Initiative for teachers and administrators; (3) a curriculum focus on children's social emotional development; (4) additional youth mental health resources and support for families and school district personnel; and (5) developing and implementing a mentor program partnering teachers and administrators with families in crisis. Additionally, results from the study could aid in helping the MASA, MAESP, and MSTA consider new evidence related to student trauma in rural public elementary schools. This may lead to an opportunity for these professional organizations to review their structures in order to collaborate to create a more robust and meaningful dialogue about childhood trauma. These educational discussions may lead to compelling evidence suggesting adjustments in legislation to support children impact by adverse childhood experiences. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]