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Children
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Adverse Childhood Experiences: Prevention, Intervention, and Access to Care
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Adverse Childhood Experiences: Prevention, Intervention, and Access to Care

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Global Pediatric Health".

Deadline for manuscript submissions: closed (20 February 2022) | Viewed by 22993

Special Issue Editors

Dr. Kimberly Burkhart

E-Mail Website
Guest Editor
Division of Developmental Behavioral Pediatrics and Psychology, UH Rainbow Babies and Children’s Hospital 10524 Euclid Ave, Cleveland, OH 44106, USA
Interests: clinical child psychology; pediatric psychology; autism spectrum disorder; integrated pediatric primary care; collaborative care; child maltreatment; social determinants of health; emergency preparedness and response
Special Issues, Collections and Topics in MDPI journals
Dr. Alissa Huth-Bocks

E-Mail Website
Guest Editor
Departments of Pediatrics and Psychiatry, UH Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
Interests: adverse childhood experiences; intimate partner violence; child maltreatment infant and early childhood mental health; parenting; trauma; violence prevention and intervention; poverty
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Exposure to adverse childhood experiences has been recognized as a public health crisis in the United States by leading organizations such as the American Academy of Pediatrics (AAP), the National Child Traumatic Stress Network (NCTSN), and the Substance Abuse and Mental Health Services Administration (SAMHSA). Early exposure to stress and trauma have both short- and long-term physical and mental health outcomes across the lifespan. Health care settings are increasingly recognized as key venues to identify, intervene, and ameliorate the impact of adverse childhood experiences and build resilience among at-risk youth and their families.   

The goal of this Special Issue of Children is to highlight the impact adverse childhood experiences have on accessing medical and behavioral health services and the effect empirically-supported prevention and intervention strategies can have on mitigating the negative impact of adverse childhood experiences and in building resiliency. We invite manuscripts focused on children aged from birth through 21-years-old and their families. We welcome reviews and orginal research focused on the impact of adverse childhood experiences and prevention and intervention strategies for both neurotypical and neurodivergent youth. 

Dr. Kimberly Burkhart
Dr. Alissa Huth-Bocks
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Adverse childhood experiences
  • Healthcare utilization
  • Resiliency
  • Trauma
  • Prevention
  • Intervention

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Published Papers (7 papers)

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Research

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19 pages, 354 KiB  
Article
Early Identification of Risk of Child Abuse Fatalities: Possibilities and Limits of Prevention
by Ivana Olecká
Children 2022, 9(5), 594; https://doi.org/10.3390/children9050594 - 22 Apr 2022
Cited by 3 | Viewed by 2621
Abstract
(1) Background: The aim of the study was to analyse the structure of registered fatal violent crimes against children under 5 years of age and to identify the main characteristics and risk factors of fatal violence against children in order to discuss the [...] Read more.
(1) Background: The aim of the study was to analyse the structure of registered fatal violent crimes against children under 5 years of age and to identify the main characteristics and risk factors of fatal violence against children in order to discuss the possibilities and limits of prevention of these crimes. (2) Methods: Mixed-method design: 1. retrospective statistical analysis of data extracted from Czech statistics about crime. 2. qualitative analysis of autopsy reports and construction of serial case study. The data were pooled from two different sources: 1. Statistics about crime against children aged 0 to 5 (n = 512). 2. Autopsy reports (n = 52) of children up to the age of five. (3) Results: The following indicators and risk factors were identified: mental disorder or cognitive deficits in parents, parents’ immaturity, poor parenting skills, inadequate parenting practices, absence of a deep emotional bond with the mother, lack of parents’ interest in catering to the children’s needs, parents’ addiction, an unprotected, hazardous environment and surroundings, household falling apart, incidence of suspected domestic violence, incidence of multiple bruises and untreated injuries, aggressively dominant parents, poverty, absence of adequate health care, medical neglect of a child, poor health of the child and failure to thrive. (4) Conclusions: The task for the state is to make effective use of all accessible mechanisms to improve the situation in families. Particularly in the context of the newly emerging situation of increasing uncontrolled violence in families in the context of the restrictions of the COVID-19 pandemic, this demand is more than urgent. Close attention should be paid to children who are not registered with pediatricians and fail to attend regular medical examinations. It is also vital to follow families in which violence has already been suspected in the past. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Prevention, Intervention, and Access to Care)
11 pages, 498 KiB  
Article
Impact of Social and Relational Adversity on Access to Services among US Children with Autism Spectrum Disorder 2016–2019
by Sarah D. Ronis, Eunice Lee, Carrie Cuffman and Kimberly Burkhart
Children 2021, 8(12), 1099; https://doi.org/10.3390/children8121099 - 29 Nov 2021
Cited by 3 | Viewed by 2236
Abstract
To explore the impact of social and relational adversity on access to key health services among US children with autism spectrum disorders (ASD), cross-sectional analyses of the 2016–2019 National Survey of Children’s Health assessed use of key health services by children with ASD, [...] Read more.
To explore the impact of social and relational adversity on access to key health services among US children with autism spectrum disorders (ASD), cross-sectional analyses of the 2016–2019 National Survey of Children’s Health assessed use of key health services by children with ASD, accounting for differences in demographic characteristics, medical needs, and experience of social and relational adversities. sUS children with ASD were more than twice as likely as peers without ASD to report two or more social adversities and more than three times as likely to report two or more relational adversities. In multivariable models, relational adversities were significantly associated with greater odds of medication use for ASD (OR 1.50, 95%CI:1.02, 2.17). Social adversities were neither associated with receipt of behavioral therapies nor prescription of medication to treat ASD. Screening for various forms of adversity among youth with ASD is of great importance; even one adverse experience may be enough to influence care of a child with ASD, with differences in effect according to the nature of the particular adversity. Further research should evaluate the role that childhood adversity plays in physical and mental health outcomes in ASD. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Prevention, Intervention, and Access to Care)
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13 pages, 278 KiB  
Article
Maternal-Child Health Outcomes from Pre- to Post-Implementation of a Trauma-Informed Care Initiative in the Prenatal Care Setting: A Retrospective Study
by Nicole Racine, Whitney Ereyi-Osas, Teresa Killam, Sheila McDonald and Sheri Madigan
Children 2021, 8(11), 1061; https://doi.org/10.3390/children8111061 - 18 Nov 2021
Cited by 14 | Viewed by 3563
Abstract
Background: There has been an increase in use of trauma-informed care (TIC) approaches, which can include screening for maternal Adverse Childhood Experiences (ACEs) during prenatal care. However, there is a paucity of research showing that TIC approaches are associated with improvements in maternal [...] Read more.
Background: There has been an increase in use of trauma-informed care (TIC) approaches, which can include screening for maternal Adverse Childhood Experiences (ACEs) during prenatal care. However, there is a paucity of research showing that TIC approaches are associated with improvements in maternal or offspring health outcomes. Using retrospective file review, the current study evaluated whether differences in pregnancy health and infant birth outcomes were observed from before to after the implementation of a TIC approach in a low-risk maternity clinic, serving women of low medical risk. Methods: Demographic and health data were extracted from the medical records of 601 women (n = 338 TIC care, n = 263 pre-TIC initiative) who received prenatal care at a low-risk maternity clinic. Cumulative risk scores for maternal pregnancy health and infant birth outcomes were completed by health professionals. Results: Using independent chi-squared tests, the proportion of women without pregnancy health risks did not differ for women from before to after the implementation of TIC, χ2 (2, 601) = 3.75, p = 0.15. Infants of mothers who received TIC were less likely to have a health risk at birth, χ2 (2, 519) = 6.17, p = 0.046. Conclusion: A TIC approach conveyed modest benefits for infant outcomes, but not maternal health in pregnancy. Future research examining other potential benefits of TIC approaches are needed including among women of high socio-demographic and medical risk. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Prevention, Intervention, and Access to Care)
13 pages, 718 KiB  
Article
Improving Early Diagnosis of Child Neglect for a Better Response in Healthcare Settings
by Silvia Herrero-Roldán, Inmaculada León, Juan Andrés Hernández-Cabrera and María José Rodrigo
Children 2021, 8(10), 859; https://doi.org/10.3390/children8100859 - 27 Sep 2021
Cited by 5 | Viewed by 2753
Abstract
Early diagnosis of child neglect is an ongoing challenge with consequences of the child’s safety, health, and effective referral for intervention. This study aims to obtain a selected set of family, maternal, and dyadic variables of the immediate caregiving environment for diagnosis, preventive, [...] Read more.
Early diagnosis of child neglect is an ongoing challenge with consequences of the child’s safety, health, and effective referral for intervention. This study aims to obtain a selected set of family, maternal, and dyadic variables of the immediate caregiving environment for diagnosis, preventive, and intervention responses in healthcare settings. Mothers and their children under five years old: 51 in the neglected group (NG) and 89 in the non-neglected control group (CG), were recruited through pediatric primary care services and social services in Spain. Family demographics, adverse events, childhood maltreatment, maternal psychopathologies, personality variables, and observed mother–child interactions were assessed. Gradient boosting analyses were applied for the contributor’s relative importance (RI), followed by logistic regression and discriminant analyses for those with higher RI. Parametric analyses showed high diagnostic accuracy (80–82% of NG and 92% of CG) for risky factors of child neglect: having a physically neglected and depressed mother, living in families in need of financial assistance, and large families; and for protective factors: having an older mother and showing higher mother–child emotional availability. Identifying a select group of features makes early diagnosis and preventive intervention more effective for mitigating the impact of child neglect and building mother–child resilience. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Prevention, Intervention, and Access to Care)
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13 pages, 1435 KiB  
Article
Adverse Childhood Experiences Predict Common Neurodevelopmental and Behavioral Health Conditions among U.S. Children
by Kasra Zarei, Guifeng Xu, Bridget Zimmerman, Michele Giannotti and Lane Strathearn
Children 2021, 8(9), 761; https://doi.org/10.3390/children8090761 - 31 Aug 2021
Cited by 28 | Viewed by 6838
Abstract
Objective: Adverse childhood experiences (ACEs) can have a significant but variable effect on childhood neurodevelopment. The purpose of this study was to quantify and compare the associations between “household challenge” ACEs and common childhood neurodevelopmental and behavioral health conditions, using nationally representative U.S. [...] Read more.
Objective: Adverse childhood experiences (ACEs) can have a significant but variable effect on childhood neurodevelopment. The purpose of this study was to quantify and compare the associations between “household challenge” ACEs and common childhood neurodevelopmental and behavioral health conditions, using nationally representative U.S. data. Method: This study used data from the 2016–2019 National Survey of Children’s Health, a nationwide, population-based, cross-sectional survey. Seven household challenge ACEs (not including child maltreatment) were reported by parents/guardians: parental death, incarceration, divorce/separation, family violence, mental illness, substance abuse, and poverty. Logistic regression with sample weights was used to estimate the odds ratio (OR) for 15 parent-reported neurodevelopmental and behavioral health conditions, by the number of reported ACEs. A dose-response relationship was examined by applying tests of orthogonal polynomial contrasts to fitted logistic regression models. Results: Down syndrome, Tourette syndrome and cerebral palsy were not associated with household challenge ACEs, whereas behavior/conduct problems, depression, and substance abuse were strongly associated, with adjusted ORs ranging from 6.36 (95% confidence interval (CI) 5.53, 7.32) to 9.19 (95% CI 7.79, 10.84). Other neurodevelopmental conditions not traditionally associated with childhood adversity showed moderate yet robust associations with ACEs, including autism (adjusted OR 2.15, 95% CI 1.64, 2.81), learning disability (adjusted OR 3.26, 95% CI 2.80, 3.80), and attention deficit hyperactivity disorder (adjusted OR 3.95, 95% CI 3.44, 4.53). The ORs increased with the number of ACEs, showing significant positive linear trends. Conclusion: We found significant dose-dependent or cumulative associations between ACEs and multiple neurodevelopmental and behavioral conditions. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Prevention, Intervention, and Access to Care)
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14 pages, 615 KiB  
Article
Intergenerational Associations between Parents’ and Children’s Adverse Childhood Experience Scores
by Adam Schickedanz, José J. Escarce, Neal Halfon, Narayan Sastry and Paul J. Chung
Children 2021, 8(9), 747; https://doi.org/10.3390/children8090747 - 29 Aug 2021
Cited by 20 | Viewed by 4832
Abstract
Background: Adverse childhood experiences (ACEs) are stressful childhood events associated with behavioral, mental, and physical illness. Parent experiences of adversity may indicate a child’s adversity risk, but little evidence exists on intergenerational links between parents’ and children’s ACEs. This study examines these intergenerational [...] Read more.
Background: Adverse childhood experiences (ACEs) are stressful childhood events associated with behavioral, mental, and physical illness. Parent experiences of adversity may indicate a child’s adversity risk, but little evidence exists on intergenerational links between parents’ and children’s ACEs. This study examines these intergenerational ACE associations, as well as parent factors that mediate them. Methods: The Panel Study of Income Dynamics (PSID) 2013 Main Interview and the linked PSID Childhood Retrospective Circumstances Study collected parent and child ACE information. Parent scores on the Aggravation in Parenting Scale, Parent Disagreement Scale, and the Kessler-6 Scale of Emotional Distress were linked through the PSID 1997, 2002, and 2014 PSID Childhood Development Supplements. Multivariate linear and multinomial logistic regression models estimated adjusted associations between parent and child ACE scores. Results: Among 2205 parent-child dyads, children of parents with four or more ACEs had 3.25-fold (23.1% [95% CI 15.9–30.4] versus 7.1% [4.4–9.8], p-value 0.001) higher risk of experiencing four or more ACEs themselves, compared to children of parents without ACEs. Parent aggravation, disagreement, and emotional distress were partial mediators. Conclusions: Parents with higher ACE scores are far more likely to have children with higher ACEs. Addressing parenting stress, aggravation, and discord may interrupt intergenerational adversity cycles. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Prevention, Intervention, and Access to Care)
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Review

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13 pages, 306 KiB  
Review
Charting a Course towards Resilience Following Adverse Childhood Experiences: Addressing Intergenerational Trauma via Strengths-Based Intervention
by Kathryn H. Howell, Laura E. Miller-Graff, Cecilia Martinez-Torteya, Taylor R. Napier and Jessica R. Carney
Children 2021, 8(10), 844; https://doi.org/10.3390/children8100844 - 24 Sep 2021
Cited by 15 | Viewed by 9982
Abstract
Early research on adverse childhood experiences (ACEs) provided staggering evidence of the significant ramifications of ACEs on physical health and functioning. It brought to the forefront the importance of addressing trauma and family dysfunction to enhance public health. Over the past several decades, [...] Read more.
Early research on adverse childhood experiences (ACEs) provided staggering evidence of the significant ramifications of ACEs on physical health and functioning. It brought to the forefront the importance of addressing trauma and family dysfunction to enhance public health. Over the past several decades, the study of childhood adversity has blossomed, with expanded conceptualizations and assessments of ACEs. This review brings together various biological, psychological, and sociological principles that inform our understanding of ACEs and our approach to treatment. Specifically, we document the evolution of ACEs research, focusing on the intergenerational impact of ACEs, the importance of incorporating a resilience framework when examining ACEs, and implementing interventions that address adversity across generations and at multiple levels of the social ecology. Evidence is provided to support the evolving perspective that ACEs have long-lasting effects beyond the ACE(s)-exposed individual, with significant attention to the impact of parental ACEs on child development. An intergenerational and multilevel approach to understanding and addressing ACEs offers specific areas to target in interventions and in public policy. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Prevention, Intervention, and Access to Care)
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