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It is estimated that up to 13% of children have been exposed to three or more adverse childhood experiences. The problem addressed by this study was the lack of adequate and appropriate teacher preparation in the support needed to combat the negative effects of adverse childhood experiences which can inadvertently intensify the academic, behavioral, emotional, social, and health challenges faced by children exposed to trauma. The purpose of this study was to explore teacher perceptions of pre-service and in-service professional development training provided to support the needs of elementary students that have been exposed to adverse childhood experiences in “at-risk”, rural communities. Implications of the finding include the need for teacher preparation programs to include training on adverse childhood experiences and strategies to support children exposed to trauma, for school districts to gather input from faculty on in-service topics that are relevant to needs within the classroom, for school districts to provide more in-depth hands-on and proactive training on strategies to support children exposed to adverse childhood experiences, and on self-care to combat compassion fatigue. [ABSTRACT FROM AUTHOR]