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 in rural communities of the Mid-Ohio Valley. The purpose of this qualitative descriptive 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 in the Mid-Ohio Valley. Malcolm Knowles' adult learning theory was used as the theoretical framework for this research study. A qualitative descriptive design was selected. Qualitative descriptive studies provide the rich descriptions and robust data needed to support this research. Study participants included 10 K-6 educators providing direct support to students considered "at-risk." Three research questions were identified for this study. Research Question 1 dealt with teacher perception of training of adverse childhood experiences provided during pre-service preparation. Research Question 2 dealt with teacher perception of in-service professional development since entering the field of education. Research Question 3 dealt with teacher perception of the professional development training needed to effectively provide classroom support to students exposed to adverse childhood experiences. Data collection was completed through an open-ended questionnaire and semi-structured interviews. Thematic analysis was utilized to identify codes, categories, and themes. Seven themes emerged from data analysis. Themes centered on the lack of input into in-service training opportunities and the desire for more in-depth training opportunities. Implications of the findings 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. The effectiveness of specific strategies/supports could be the focus of future research. [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://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]