Adverse childhood experiences and behavioral problems in middle childhood

Abstract

Children who have been exposed to maltreatment and other adverse childhood experiences (ACEs) are at increased risk for various negative adult health outcomes, including cancer, liver disease, substance abuse, and depression. However, the proximal associations between ACEs and behavioral outcomes during the middle childhood years have been understudied. In addition, many of the ACE studies contain methodological limitations such as reliance on retrospective reports and limited generalizability to populations of lower socioeconomic advantage. The current study uses data from the Fragile Families and Child Well being Study, a national urban birth cohort, to prospectively assess the adverse experiences and subsequent behavior problems of over 3,000 children. Eight ACE categories to which a child was exposed by age 5 were investigated: childhood abuse (emotional and physical), neglect (emotional and physical), and parental domestic violence, anxiety or depression, substance abuse, or incarceration. Results from bivariate analyses indicated that Black children and children with mothers of low education were particularly likely to have been exposed to multiple ACE categories. Regression analyses showed that exposure to ACEs is strongly associated with externalizing and internalizing behaviors and likelihood of ADHD diagnosis in middle childhood. Variation in these associations by racial/ethnic, gender, and maternal education subgroups are examined. This study provides evidence that children as young as 9 begin to show behavioral problems after exposure to early childhood adversities.

Adverse Childhood Experiences and ADHD Diagnosis at Age 9 Years in a National Urban Sample

“…These findings add to the growing literature linking ACEs to poor developmental and behavioral outcomes. 17-19,31 …”

“…8-16 More recent work has linked ACEs to poor academic and behavioral outcomes in kindergarten and poor school engagement and behavior problems in middle childhood. 17-19 Whereas associations between ACEs and parent-reported ADHD has been reported in past work, 18-20 to our knowledge no studies have examined associations between ACEs occurring at different developmental periods in childhood and ADHD. The answer to this question can elucidate underlying pathways connecting ACEs to ADHD and inform interventions.…”

The adverse childhood experiences checklist: Can it serve as a clinical and quality indicator?

“…reported a number of challenges with current measures for assessing exposure to cumulative adversity, inhibiting effective screening of ACE in children and adolescents in clinical practice . There is ample evidence that exposure to early social adversity affects children's developmental and behavioural outcomes . There is also evidence that amelioration of biological effects of adversity is possible: factors such as earlier timing of interventions, high‐quality and nurturing parenting traits and greater intervention engagement contribute to intervention success .…”

Violence exposure, conflict, and health outcomes in inner‐city African American adolescents

“…Traumatic life experiences that occur within the family (eg, physical and sexual abuse as well as neglect) or beyond (eg, community and school) are a major public health concern . Violence in the community can include witnessing shootings, stabbings, or drug deals while in the school can involve seeing other students using drugs or being physically or emotionally bullied .…”