Cited by 594Child Abuse and TraumaChild Welfare and AdoptionChild Abuse and Related Trauma

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The impact of adverse childhood experiences on an urban pediatric population

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Burke, Nadine J., Hellman, Julia L., Scott, Brandon G., Weems, Carl F., Carrion, Victor G.·2011·Child Abuse & Neglect

DOI 10.1016/j.chiabu.2011.02.006PMC PMC3119733

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Abstract

Objective The goal of this study was to investigate the adverse childhood experiences (ACEs) in youth in a low-income, urban community. Study design Data from a retrospective chart review of 701 subjects from the Bayview Child Health Center in San Francisco are presented. Medical chart documentation of ACEs as defined in previous studies were coded and each ACE criterion endorsed by a traumatic event received a score of 1 (range=0-9). This study reports on the prevalence of various ACE categories in this population, as well as the association between ACE score and two pediatric problems: learning/behavior problems and body mass index (BMI)≥85% (i.e., overweight or obese). Results The majority of subjects (67.2%, N=471) had experienced 1 or more categories of adverse childhood experiences (ACE≥1) and 12.0% (N=84) had experienced 4 or more ACEs (ACE≥4). Increased ACE scores correlated with increased risk of learning/behavior problems and obesity. Conclusions There was a significant prevalence of endorsed ACE categories in this urban population. Exposure to 4 or greater ACE categories was associated with increased risk for learning/behavior problems, as well as obesity. Practice implications Results from this study demonstrate the need both for screening of ACEs among youth in urban areas and for developing effective primary prevention and intervention models.

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Kiesel, L. R., Piescher, K. N., & L.Edleson, J. (2016) · Journal of Public Child Welfare · doi:10.1080/15548732.2016.1209150 · Cited by 108
“However, research has demonstrated that children who experience multiple childhood adversities fare poorly academically, including exhibiting learning problems and lower achievement (Burke et al., 2011; Holt, Finkelhor, & Kantor, 2007).”
Background
Health Promotion and Diabetes Prevention in American Indian and Alaska Native Communities--Traditional Foods Project, 2008-2014.
Satterfield, D., Debruyn, L., Santos, M., Alonso, L., & Frank, M. (2016) · MMWR Supplements · doi:10.15585/mmwr.su6501a3 · Cited by 73
The Racial and Gender Differences in the Impact of Adverse Childhood Experiences on Juvenile Residential Placement
Zettler, H., Wolff, K. T., Baglivio, M. T., Craig, J. M., & Epps, N. (2018) · Youth Violence and Juvenile Justice · doi:10.1177/1541204017698213 · Cited by 71
Child Maltreatment and Suicide Ideation in Rural China: The Roles of Self-compassion and School Belonging
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Beyond Boys’ Bad Behavior: Paternal Incarceration and Cognitive Development in Middle Childhood
Haskins, A. R. (2016) · Social forces; a scientific medium of social study and interpretation · doi:10.1093/sf/sow066 · Cited by 70
“Relatedly, recent work in the areas of public health and epigenetics (e.g., Burke et al. 2011; Shonkoff et al. 2012) has shed light on how exposure to chronic stressors and accumulated adversity (toxic stress), such as homelessness, extended exposure to violence, poverty, and the incarceration of a…”
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Measuring Childhood Adversity in Life Course Cardiovascular Research: A Systematic Review
Appleton, A. A., Holdsworth, E. A., Ryan, M., & Tracy, M. (2016) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000430 · Cited by 84
“Eighteen studies we reviewed adopted this strategy, of which four used the adverse childhood experiences (ACEs) questionnaire (14,15,22,27) and”
Method
Rethinking flourishing: Critical insights and qualitative perspectives from the U.S. Midwest
Willen, S. S., Williamson, A. F., Walsh, C. C., Hyman, M. S., & Tootle, W. (2021) · SSM - Mental Health · doi:10.1016/j.ssmmh.2021.100057 · Cited by 81
The evolving neurobiology of early-life stress
Birnie, M. T., & Baram, T. Z. (2025) · Neuron · doi:10.1016/j.neuron.2025.02.016 · Cited by 76
Inequity in child health: The importance of early childhood development
Woolfenden, S. R., Goldfeld, S. R., Raman, S., Eapen, V., Kemp, L., & Williams, K. J. (2013) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.12171 · Cited by 65
Social vulnerabilities as risk factor of childhood obesity development and their role in prevention programs
Iguacel, I., Gasch‐Gallén, À., Ayala‐Marín, A. M., Miguel‐Etayo, P. D., & Moreno, L. A. (2020) · International Journal of Obesity · doi:10.1038/s41366-020-00697-y · Cited by 67
ATTACHMENT AND BIOBEHAVIORAL CATCH‐UP: A SYSTEMATIC REVIEW
Grube, W. A., & Liming, K. W. (2018) · Infant Mental Health Journal · doi:10.1002/imhj.21745 · Cited by 83
Childhood stress, life history, psychopathy, and sociosexuality
Patch, E. A., & Figueredo, A. J. (2016) · Personality and Individual Differences · doi:10.1016/j.paid.2016.04.023 · Cited by 65
Child Abuse, Resting Blood Pressure, and Blood Pressure Reactivity to Psychosocial Stress
Gooding, H. C., Milliren, C. E., Austin, S. B., Sheridan, M. A., & McLaughlin, K. A. (2015) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsv040 · Cited by 57
Patterns of adversity and pathways to health among White, Black, and Latinx youth.
Liu, S. R., Kia-Keating, M., & Nylund-Gibson, K. (2018) · International Journal of Child Abuse & Neglect · doi:10.1016/j.chiabu.2018.09.007 · Cited by 57
Exposure to violence in childhood is associated with higher body mass index in adolescence
Gooding, H., Milliren, C., Austin, S., Sheridan, M., & McLaughlin, K. (2015) · International Journal of Child Abuse & Neglect · doi:10.1016/j.chiabu.2015.08.005 · Cited by 57
The Relationship Between ACEs, Trauma-Related Psychopathology and Resilience in Vulnerable Youth: Implications for Screening and Treatment
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Adverse Childhood Experiences Predict Common Neurodevelopmental and Behavioral Health Conditions among U.S. Children
Zarei, K., Xu, G., Zimmerman, B., Giannotti, M., & Strathearn, L. (2021) · Children · doi:10.3390/children8090761 · Cited by 55
“Similar associations have been reported previously for developmental delay [25], ID [26], learning problems [6], severe or frequent headaches (including migraines) [27,28], ADHD [29–31], and anxiety [7–10].”
Background
Screening for Toxic Stress Risk Factors at Well-Child Visits: The Addressing Social Key Questions for Health Study
Selvaraj, K., Ruiz, M. J., Aschkenasy, J. R., Chang, J. D., Heard, A., Minier, M., Osta, A. D., Pavelack, M., Samelson, M., Schwartz, A., et al. (2018) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2018.09.004 · Cited by 60
The Interrelation of Adverse Childhood Experiences within an At-Risk Pediatric Sample
Scott, B. G., Burke, N. J., Weems, C. F., Hellman, J. L., & Carrión, V. G. (2013) · Journal of Child & Adolescent Trauma · doi:10.1080/19361521.2013.811459 · Cited by 60
“This study represents secondary data analysis on a subsample of at-risk urban youth reported in Burke et al. (2011) and additional details of the full sample (N = 701; range = 0–20 years) can be found in that report.”
MethodSelf-citation
Adverse Childhood Experiences, Coping Resources, and Mental Health Problems among Court-Involved Youth
Logan‐Greene, P., Tennyson, R. L., Nurius, P. S., & Borja, S. G. (2017) · Child & Youth Care Forum · doi:10.1007/s10566-017-9413-2 · Cited by 109
“8% had experienced no ACEs of any kind (Burke et al. 2011); examining all ACE items included here showed that only 6.”
Background
Adverse childhood experiences, health, and employment: A study of men seeking job services
Topitzes, J., Pate, D. J., Berman, N. D., & Medina-Kirchner, C. (2016) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2016.09.012 · Cited by 54
Medical Students' Perspectives on Trauma-Informed Care Training.
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Neurodisability among Children at the Nexus of the Child Welfare and Youth Justice System
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“disorder, as well as intellectual disability and conduct disorder) are at increased risk of childhood maltreatment and protective services involvement (Maclean et al. 2017; Lange et al. 2013; Hibbard and Desch 2007; Sullivan and Knutson 1998; Clayton et al. 2018; Burke et al. 2011; Jones et al. 2012).”
Background
Adverse Childhood Experiences and Weight Status among Adolescents
Davis, L., Barnes, A. J., Gross, A. C., Ryder, J. R., & Shlafer, R. J. (2018) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2018.08.071 · Cited by 64
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Adverse Childhood Experiences (ACEs): Translation into Action in K12 Education Settings
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Identity Distress Among Youth Exposed to Natural Disasters: Associations with Level of Exposure, Posttraumatic Stress, and Internalizing Problems
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Self-citation
Unmet Needs
Kowalski, M. A., Kowalski, A., Hamilton, Z. K., Stohr, M. K., Pedneault, A., Baglivio, M. T., Hamilton, Z. K., Stohr, M. K., & Cerutti, D. (2019) · A to Z of Classroom Behaviour · doi:10.4135/9781526482990.n21 · Cited by 48
“…are exposed to trauma (Anda et al., 2006; Copeland, Keeler, Angold, & Costello, 2007), certain subsets of children are at a higher risk for experiencing adverse events, including justice-involved youth (Burke et al., 2011; Baglivio et al., 2014; Cronholm et al., 2015; Flaherty et al., 2009).”
Background
Linking systemic arterial stiffness among adolescents to adverse childhood experiences
Klassen, S. A., Chirico, D., O’Leary, D. D., Cairney, J., & Wade, T. J. (2016) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2016.04.002 · Cited by 48
The biopsychosociotechnical model: a systems-based framework for human-centered health improvement
Card, A. J. (2022) · Health Systems · doi:10.1080/20476965.2022.2029584 · Cited by 79
“…determinants of health, helping pave the way for fields of inquiry such as the impact of adverse childhood experiences (ACEs) on health (Boullier & Blair, 2018; Burke et al., 2011; Dube et al., 2002; Felitti, 2009; Felitti et al., 1998; Hughes et al., 2017; Oh et al., 2018; Schilling et al., 2007).”
Background

Authors: Burke, N. J., Hellman, J. L., Scott, B. G., Weems, C. F., & Carrion, V. G.
Affiliations: California Pacific Medical Center (US)
LSU New Orleans (US)
ORCID: Scott, Brandon G.
Weems, Carl F.
Venue: Child Abuse & Neglect
Publisher: Elsevier BV
Published: 2011-06
Volume: 35
Issue: 6
Pages: 408-413
ISSN: 0145-2134 (ISSN-L)
DOI: 10.1016/j.chiabu.2011.02.006
PMC: PMC3119733
OpenAlex: W2079494095
Cited by: 594
References: 26
Citations by year: 2026: 16 · 2025: 34 · 2024: 40 · 2023: 44 · 2022: 71 · 2021: 106 · 2020: 58 · 2019: 57 · 2018: 38 · 2017: 35 · 2016: 36 · 2015: 21 · 2014: 10 · 2013: 17 · 2012: 10
FWCI: 12.78
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Child Abuse & Neglect (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (K23MH063893, MH 63893)
Topics: Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Sociology and Political Science › Child Welfare and Adoption
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child Abuse and Related Trauma
Keywords: adverse childhood experiences, low-income youth, childhood obesity, body mass index, ACE score, ACE screening, primary prevention
MeSH terms: Adolescent, Child, Child Abuse, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Learning Disabilities, Male, Medical Records, Obesity, Parent-Child Relations, Poverty, Retrospective Studies, Risk Factors, San Francisco, Urban Population, Logistic Models, Young Adult

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The impact of adverse childhood experiences on an urban pediatric population

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