Children who face early traumatic experiences at home are at risk of a host of emotional, physical, and behavioral problems, but pediatricians can help guide families toward resilience skills that can help.
Christina D. Bethell, PhD, professor and director of the Child and Adolescent Health Measurement Initiative (CAHMI) at the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, says childhood trauma and toxic stress are common factors across many child, adolescent, and young adult health risks and problems.
“Knowing about adverse childhood experiences (ACEs) can help pediatricians address common roots of child well-being,” Bethell says. “Tools to assess ACEs and follow-up with education, supports, and interventions are available.”
Bethell says her research is the first ever to present a national agenda specific to children’s health services and assess the validity of methods to rate ACEs using parent reporting.1 “The work also advances a positive construct of health by placing the focus on ACEs within the broader context of promoting healthy development and child and family health,” she says.
The goal of the research is to advance action supported by the evidence to address childhood adversity and promote positive health and well-being for children and families, says Bethell. The first step is to raise awareness.
More than 38% of children in every state have been affected by at least one ACE, from the loss of a parent to being a victim of violence, according to the report. In 16 states, about 25% of children have experienced 2 or more ACEs.
The report used data from the 2016 National Survey of Children’s Health that was analyzed by the Robert Wood Johnson Foundation in collaboration with the CAHMI at the Johns Hopkins Bloomberg School of Public Health.
According to this report, 33% of children with 2 or more ACEs have a chronic health condition requiring special healthcare needs compared with 13.6% of children who have not experienced ACEs. Researchers note that, nationally, 46% of children aged younger than 18 years have had at least 1 ACE, and 20% have had 2 or more. The prevalence of ACE rises as children age, with 35% of children aged 5 years and younger experiencing at least 1 ACE compared with 55.7% of children aged 12 to 17 years. Difficulty in meeting family needs because of income and parental divorce or separation made up half of all ACEs reported in the study at 25% each. Nine percent of children lived with someone with a drug or alcohol problem; 8.2% had a parent or guardian spend time in jail; and 7.8% lived with someone who was mentally ill, depressed, or suicidal.