Abstract
Objective
To determine the relationships between adverse childhood experiences (ACEs) and mental
health, chronic medical conditions, and social development among young children in
the child welfare system.
Methods
This cross-sectional study used a nationally representative sample of children investigated
by child welfare (National Survey of Child and Adolescent Well-Being II) from 2008
to 2009. Our analysis included caregiver interviews and caseworker reports about children
aged 18 to 71 months who were not in out-of-home care (n = 912). We examined the associations
between ACEs and mental health (measured by the Child Behavior Checklist [CBCL]),
reported chronic medical conditions, and social development (measured by the Vineland
Socialization Scale) in bivariate and multivariate analyses.
Results
Nearly all children (98.1%) were reported to have had an ACE in their lifetime; the
average number of ACEs was 3.6. For every additional reported ACE, there was a 32%
increased odds of having a problem score on the CBCL (odds ratio [OR] 1.32, 95% confidence
interval [CI] 1.14, 1.53) and a 21% increased odds of having a chronic medical condition
(OR 1.21, 95% CI 1.05, 1.40). Among children aged 36 to 71 months, for every additional
reported ACE, there was a 77% increased odds of a low Vineland Socialization score
(OR 1.77, 95% CI 1.12, 2.78).
Conclusions
ACEs were associated with poor early childhood mental health and chronic medical conditions,
and, among children aged 3 to 5, social development. Efforts are needed to examine
whether providing early intervention to families with multiple stressors mitigates
the impact of ACEs on children's outcomes.
Keywords
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Article Info
Publication History
Published online: July 13, 2015
Accepted:
May 15,
2015
Received:
October 9,
2014
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
