Adverse childhood experiences and mental health, chronic medical conditions, and development in young children
Open accessAbstract
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.
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- Authors
- Kerker, B. D., Zhang, J., Nadeem, E., Stein, R. E. K., Hurlburt, M. S., Heneghan, A., Landsverk, J., & McCue Horwitz, S.
- Affiliations
- Nathan Kline Institute for Psychiatric Research (US)
- Rady Children's Hospital-San Diego (US)
- New York University (US)
- Albert Einstein College of Medicine (US)
- University of Southern California (US)
- Palo Alto Medical Foundation (US)
- Oregon Social Learning Center (US)
- Corresponding author
- Kerker, Bonnie D.
- Venue
- Academic Pediatrics
- Publisher
- Elsevier BV
- Published
- 2015-09
- Volume
- 15
- Issue
- 5
- Pages
- 510-517
- ISSN
- 1876-2859 (ISSN-L)
- PMC
- PMC4562867
- OpenAlex
- W1618306604
- Cited by
- 412
- References
- 41
- Citations by year
- 2026: 28 · 2025: 36 · 2024: 45 · 2023: 46 · 2022: 42 · 2021: 45 · 2020: 87 · 2019: 34 · 2018: 22 · 2017: 17 · 2016: 8 · 2015: 2
- FWCI
- 20.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Academic Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- US National Institute of Mental Health (P30MH090322)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Safety Research › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- adverse childhood experiences, child welfare system, early childhood mental health, chronic disease, social development (developmental psychology), young children, child behavior problems, family stressors, early intervention
- MeSH terms
- Criminal Behavior, Child Protective Services, Exposure to Violence, Mental Disorders, Child Abuse, Child Development, Child Welfare, Child, Preschool, Chronic Disease, Cross-Sectional Studies, Female, Humans, Infant, Male, Mental Health, Social Change, Odds Ratio, Child of Impaired Parents, Substance-Related Disorders
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