Adverse Childhood Experiences and Mental Health, Chronic Medical Conditions, and Development in Young Children

Acad Pediatr. 2015 Sep-Oct;15(5):510-7. doi: 10.1016/j.acap.2015.05.005. Epub 2015 Jul 14.


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: ACE; adverse childhood experience; child welfare; mental health.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Child Abuse / psychology*
  • Child Development*
  • Child Protective Services
  • Child Welfare / psychology*
  • Child of Impaired Parents / psychology*
  • Child, Preschool
  • Chronic Disease
  • Criminal Behavior
  • Cross-Sectional Studies
  • Exposure to Violence / psychology*
  • Female
  • Humans
  • Infant
  • Male
  • Mental Disorders
  • Mental Health*
  • Odds Ratio
  • Social Change*
  • Substance-Related Disorders*