Adverse Childhood Experiences

Studies have linked ACEs with increased chronic disease and higher costs of care across a person's life course.

The ongoing longitudinal Adverse Childhood Experiences Study of adults has found significant associations between chronic conditions; quality of life and life expectancy in adulthood; and the trauma and stress associated with adverse childhood experiences, including physical or emotional abuse or neglect, deprivation, or exposure to violence. Less is known about the population-based epidemiology of adverse childhood experiences among U.S. children.

Using the 2011–12 National Survey of Children’s Health, the researchers assessed the prevalence of adverse childhood experiences and associations between them and factors affecting children’s development and lifelong health. After they adjusted for confounding factors, they found lower rates of school engagement and higher rates of chronic disease among children with adverse childhood experiences. Their findings suggest that building resilience—defined in the survey as “staying calm and in control when faced with a challenge,” for children ages 6-17—can ameliorate the negative impact of adverse childhood experiences. They found higher rates of school engagement among children with adverse childhood experiences who demonstrated resilience, as well as higher rates of resilience among children with such experiences who received care in a family-centered medical home.

They recommend a coordinated effort to fill knowledge gaps and translate existing knowledge about adverse childhood experiences and resilience into national, state, and local policies, with a focus on addressing childhood trauma in health systems as they evolve during ongoing reform.