Adverse childhood experiences: Screening and health in children from birth to age 5.

McKelvey, Lorraine; Edge, Nicola A. Conners; Fitzgerald, Shalese; Kraleti, Shashank; Whiteside-Mansell, Leanne

doi:10.1037/fsh0000301

Cited by 31 publications

(30 citation statements)

References 28 publications

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“…59,60 Findings are also consistent with studies, which demonstrate that children exposed to ACEs are more likely to have special health care needs and chronic health conditions. 26,32,34 Not surprisingly, this outcome is in keeping with our finding that children with exposure to four or more ACEs were more likely to have parental ratings of less than very good or excellent health, as children who are frequently sick are likely to require regular prescription drugs.…”

Section: Discussionsupporting

confidence: 81%

“…In this study, ACE exposure in infancy and toddlerhood was associated with an increased likelihood that a child would have obesity, respiratory problems, regular prescriptions not associated with attention problems, and a health rating below excellent or very good at age 11. This study adds to the existing literature that demonstrates exposure to ACEs in infancy and toddlerhood are associated with clinically significant behavior problems in middle childhood 34 by demonstrating that poor health outcomes are also seen in children exposed to ACEs very early in development. Our finding is particularly noticeable as multiple ACEs accumulate.…”

Section: Discussionmentioning

confidence: 69%

“…There is some indication from existing studies that children in families with ACEs are living in less optimal environments, including homes with secondhand smoke exposure and greater access to risks for injuries. 34 Our analyses controlled for smoking in the home, but the effects of ACEs on respiratory health were evidenced even at lower levels of ACEs.…”

Section: Discussionmentioning

confidence: 96%

“…26,33 In the period of very early childhood, increasing ACE exposure was associated with increased likelihood of having chronic medical conditions and screening at risk for developmental delay. 34 These studies demonstrate the potential for ACEs to contribute to inflammation and comorbid conditions of obesity. Yet, more research is needed to clarify the specifics of these health outcomes and their timing.…”

mentioning

confidence: 82%

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Adverse Childhood Experiences in Infancy and Toddlerhood Predict Obesity and Health Outcomes in Middle Childhood

2019

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Background: The Adverse Childhood Experiences (ACEs) study articulated the negative effects of childhood trauma on adult weight and health. The purpose of the current study is to examine the associations between ACEs in infancy and toddlerhood and obesity and related health indicators in middle childhood. Methods: We used data collected from a sample of low-income families enrolled in the national evaluation of Early Head Start (EHS). Data come from 1335 demographically diverse families collected at or near children's ages 1, 2, 3, and 11. An EHS-ACE index was created based on interview and observation items from data collected at ages 1, 2, and 3, which were averaged to represent exposure across infancy and toddlerhood. At age 11, children's height and weight were measured and parents were asked about their child's health. Results: Children were exposed at rates of 30%, 28%, 15%, and 8% to one, two, three, and four or more EHS-ACEs, respectively. Logistic regressions revealed significant associations between EHS-ACEs in infancy/toddlerhood and obesity, respiratory problems, taking regular nonattention-related prescriptions, and the parent's global rating of children's health at age 11. Across all outcomes examined, children with four or more ACEs had the poorest health. Compared with children with no ACE exposure, the odds of each of the examined health outcomes were over twice as high for children who experienced four or more ACEs. Conclusions: Findings highlight that ACEs experienced very early in development are associated with children whose health is at risk later in childhood.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 82%

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Adverse Childhood Experiences in Infancy and Toddlerhood Predict Obesity and Health Outcomes in Middle Childhood

2019

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“…The goal of the PedHITSS is to identify pediatric patients who are experiencing child abuse, which is an adverse childhood experience predictive of lifelong problematic health outcomes. 23 Therefore, we prioritize sensitivity of the measure (ability to detect children experiencing abuse) over specificity.…”

Section: Discussionmentioning

confidence: 99%

PedHITSS: A Screening Tool to Detect Childhood Abuse in Clinical Settings

Shakil

Day

Chu

et al. 2018

Fam Med

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Background and Objectives: Though child abuse is prevalent and detrimental, health care providers fail to screen for abuse at sufficient rates to detect or preempt events. Current child abuse screening tools lack brevity and usefulness in clinical settings. To validate the Pediatric Hurt-Insult-Threaten-Scream-Sex (PedHITSS) screening tool, a 5-item questionnaire designed to detect and prompt provider investigation into child abuse in clinical settings, the PedHITSS was compared to the Conflict Tactics Scale: Parent-Child Version (CTSPC) screening measure. Methods: Participants included 422 pediatric patients (n=242 nonabused; n=180 abused subsample) recruited from an ambulatory care setting, a medical center at-risk referral clinic, or homeless shelter clinic. Parents were asked to complete a cross-sectional survey, including PedHITSS and CTSPC questionnaires. Concurrent validity of PedHITSS was tested with 242 participants identified as nonabused. Construct validity was assessed with 180 participants previously identified as victims of child abuse. Results: Concurrent validity between the CTSPC and PedHITSS was strong, rs=.70 (P<.01). Sensitivity and specificity for correctly identifying abuse victims (≤12 years) was optimal at a cutpoint of one or greater. There was no significant difference in sensitivity and specificity of HITSS and CTSPC in correctly identifying victims of child abuse. Conclusions: This study indicates that PedHITSS performs as well as CTSPC in identifying and differentiating victims and nonvictims of child abuse. PedHITSS allows health care providers to confidently screen and report suspected cases of child abuse and serves as a mechanism to confirm abuse status through validated means.

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Adverse Childhood Experiences (ACEs) Screening and Assessment in Health and Human Service Settings

Gabrielli

Bennett

Clement

et al. 2023

Issues in Clinical Child Psychology

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Adverse childhood experiences: Screening and health in children from birth to age 5.

Abstract: Findings highlight the potential use of questionnaires and in-home observations to measure and intervene in potentially developing ACEs. Further, our screening was associated with children whose health was at risk very early in development. (PsycINFO Database Record

Cited by 31 publications

References 28 publications

Adverse Childhood Experiences in Infancy and Toddlerhood Predict Obesity and Health Outcomes in Middle Childhood

Adverse Childhood Experiences in Infancy and Toddlerhood Predict Obesity and Health Outcomes in Middle Childhood

PedHITSS: A Screening Tool to Detect Childhood Abuse in Clinical Settings

Adverse Childhood Experiences (ACEs) Screening and Assessment in Health and Human Service Settings

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