Adverse childhood experiences (ACEs) are associated with disparate health and educational outcomes. The objective of this systematic review and meta-analysis is to determine the relationship between ACEs and academic performance among U.S. children and adolescents. A total of 20 articles were included for a descriptive synthesis and 11 articles were included in the quantitative synthesis. Among the 11 studies, we found a weak, negative correlation between ACEs and academic performance. Further research is needed to explore all the potential adverse exposures that could impact academic outcomes and factors that might mediate the effects of ACEs on academic performance.
AlthubaitA. (2016). Information bias in health research: definition, pitfalls, and adjustment methods. Journal of Multidisciplinary Healthcare, 9, 211–217. https://doi.org/10.2147/JMDH.S104807
BethellC. D.NewacheckP.HawesE.HalfonN. (2014). Changing epidemiology of CHILDREN'S health. Adverse childhood experiences: Assessing the impact on health and school engagement and the mitigating role of resilience. Health Affairs, 33(12), 2106–2115. https://doi.org/10.1377/hlthaff.2014.0914
5.
BlodgettC.,LaniganJ. D. (2018). The association between adverse childhood experience (ACE) and school success in elementary school children. School Psychology Quarterly, 33(1), 137–146. https://doi.org/10.1037/spq0000256
6.
BorensteinM.HedgesL. V.HigginsJ. P.RothsteinH. R. (2010). A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods, 1(2), 97–111. https://doi.org/10.1002/jrsm.12
7.
BoutronI.PageM. J.HigginsJ. P. T.AltmanD. G.LundhA.HrobjartssonA. (2023). Chapter 7: Considering Bias and Conflicts of Interest Among the Included Studies. In Cochrane Handbook for Systematic Reviews of Interventions (6.4). Hoboken, NJ, Chichester, West Sussex: Wiley-Blackwell. www.training.cochrane.org/handbook.
8.
BurkeN. J.HellmanJ. L.ScottB. G.WeemsC. F.CarrionV. G. (2011). The impact of adverse childhood experiences on an urban pediatric population. Child Abuse & Neglect, 35(6), 408–413. https://doi.org/10.1016/j.chiabu.2011.02.006
9.
ChesakS.KhalsaT.BhagraA.JenkinsS.BauerB.SoodA. (2019). Stress Management and Resiliency Training for Public School Teachers and Staff: A Novel Intervention to Enhance Resilience and Positively Impact Student Interactions. Complementary Therapies in Clinical Practice, 37, 32–38. https://doi.org/10.1016/j.ctcp.2019.08.001
10.
Child and Adolescent Health Measurement Initiative. (2020). 2018-2019 national survey of Children’s health (NSCH) data query. Data resource center for child and adolescent health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB).
11.
ClaessensA.EngelM.Chris CurranF. (2015). The effects of maternal depression on child outcomes during the first years of formal schooling. Early Childhood Research Quarterly, 32(201533), 80–93. https://doi.org/10.1016/j.ecresq.2015.02.003
12.
CooheyC.RennerL. M.HuaL.ZhangY. J.WhitneyS. D. (2011). Academic achievement despite child maltreatment: A longitudinal study. Child Abuse & Neglect, 35(9), 688–699. https://doi.org/10.1016/j.chiabu.2011.05.009
13.
CrouchE.RadcliffE.HungP.BennettK. (2019). Challenges to school success and the role of adverse childhood experiences. Academic Pediatrics, 19(8), 899–907. https://doi.org/10.1016/j.acap.2019.08.006
14.
CrozierJ. C.,BarthR. P. (2005). Cognitive and academic functioning in maltreated children. Children and Schools, 27(4), 197–206. https://doi.org/10.1093/cs/27.4.197
15.
De BellisM. D.HooperS. R.SprattE. G.WoolleyD. P. (2009). Neuropsychological findings in childhood neglect and their relationships to pediatric PTSD. Journal of the International Neuropsychological Society, 15(6), 868–878. https://doi.org/10.1017/S1355617709990464
16.
DukeN. N. (2020). Adolescent adversity, school attendance and academic achievement: School connection and the potential for mitigating risk. Journal of School Health, 90(8), 618–629. https://doi.org/10.1111/josh.12910
17.
EckenrodeJ.LairdM.DorisJ. (1993). School performance and disciplinary problems among abused and neglected children. Developmental Psychology, 29(1), 53–62. https://doi.org/10.1037/0012-1649.29.1.53
18.
EinbenderA. J.,FriedrichW. N. (1989). Psychological functioning and behavior of sexually abused girls. Journal of Consulting and Clinical Psychology, 57(1), 155–157. https://doi.org/10.1037//0022-006x.57.1.155
19.
EnlowM. B.EgelandB.BloodE. A.WrightR. O.WrightR. J. (2012). Interpersonal trauma exposure and cognitive development in children to age 8 years: A longitudinal study. Journal of Epidemiology & Community Health, 66(11), 1005–1010. https://doi.org/10.1136/jech-2011-200727
20.
FantuzzoJ. W.PerlmanS. M.DobbinsE. K. (2011). Types and timing of child maltreatment and early school success: A population-based investigation. Children and Youth Services Review, 33(8), 1404–1411. https://doi.org/10.1016/j.childyouth.2011.04.010
21.
FelittiV. J.AndaR. F.NordenbergD.WilliamsonD. F.SpitzA.EdwardsV.MarksH. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults the adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/s0749-3797(98)00017-8
22.
ForsterM.GowerA.BorowskyI.McMorrisB. (2017). Associations between adverse childhood experiences, student-teacher relationships, and non-medical use of prescription medications among adolescents. Addictive behaviors, 68, 30–34. https://doi.org/10.1016/j.addbeh.2017.01.004
23.
FosheeV. A.McNaughton ReyesH. L.GottfredsonN. C.Ling-YinC.EnnettS. T. (2013). A longitudinal examination of psychological, behavioral, academic, and relationship consequences of dating abuse victimization among a primarily rural sample of adolescents. Journal of Adolescent Health, 53(6), 723–729. https://doi.org/10.1016/j.jadohealth.2013.06.016
24.
GlinianaiaS. V.McLeanA.MoffatM.ShenfineR.ArmaroliA.RankinJ. (2021). Academic achievement and needs of school-aged children born with selected congenital anomalies: A systematic review and meta-analysis. Birth Defects Res, 113(20), 1431–1462. https://doi.org/10.1002/bdr2.1961
25.
HinojosaM. S.HinojosaR.BrightM.NguyenJ. (2019). Adverse childhood experiences and grade retention in a national sample of US children. Sociological Inquiry, 89(3), 401–426. https://doi.org/10.1111/soin.12272
26.
HolmesM. R.YoonS.BergK. A.CageJ. L.PerzynskiA. T. (2018). Promoting the development of resilient academic functioning in maltreated children. Child Abuse & Neglect, 75, 92–103. https://doi.org/10.1016/j.chiabu.2017.07.018
27.
HuZ.KamingaA. C.YangJ.LiuJ.XuH. (2021). Adverse childhood experiences and risk of cancer during adulthood: A systematic review and meta-analysis. Child Abuse & Neglect, 117, 105088. https://doi.org/10.1016/j.chiabu.2021.105088
28.
InitiativeC. A. A. H. M. (2020). 2018-2019 national survey of Children’s health (NSCH) data query. Data resource center for child and adolescent health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB).
29.
JimenezM. E.WadeR.Jr.LinY.MorrowL. M.ReichmanN. E. (2016). Adverse experiences in early childhood and kindergarten outcomes. Pediatrics, 137(2), 1–9. https://doi.org/10.1542/peds.2015-1839
Kendall-TackettK. (1997). Timing of academic difficulties for neglected and nonmaltreated males and females. Child Abuse & Neglect: International Journal, 21(9), 885–889. https://doi.org/10.1016/S0145-2134(97)00050-1
32.
KernicM. A.HoltV. L.WolfM. E.McKnightB.HuebnerC. E.RivaraF. P. (2002). Academic and school health issues among children exposed to maternal intimate partner abuse. Archives of Pediatrics and Adolescent Medicine, 156(6), 549–555. https://doi.org/10.1001/archpedi.156.6.549
33.
KinardE. M. (1999). Psychosocial resources and academic performance in abused children. Children and Youth Services Review, 21(5), 351–376. https://doi.org/10.1016/S0190-7409(99)00026-2
34.
KinardE. M. (2001). Characteristics of maltreatment experience and academic functioning among maltreated children. Violence & Victims, 16(3), 323–337.
35.
KingL. M.LewisC.RitchieD. M.CarrC.HartM. W. (2021). Implementation of a teacher-led mindfulness program in a low-income pre- and early-elementary school as part of a trauma-responsive, resilience-building community initiative. Journal of Community Psychology, 49(6), 1943–1964. https://doi.org/10.1002/jcop.22557
36.
KingV. L.MrugS. (2018). The relationship between violence exposure and academic achievement in African American adolescents is moderated by emotion regulation. The Journal of Early Adolescence, 38(4), 497–512. https://doi.org/10.1177/0272431616675973
37.
Kortekaas-RijlaarsdamA. F.LumanM.Sonuga-BarkeE.OosterlaanJ. (2019). Does methylphenidate improve academic performance? A systematic review and meta-analysis. European Child & Adolescent Psychiatry, 28(2), 155–164. https://doi.org/10.1007/s00787-018-1106-3
38.
KurtzP. D.GaudinJ. M.WodarskiJ. S.HowingP. T. (1993). Maltreatment and the school-aged child: School performance consequences. Child Abuse & Neglect, 17(5), 581–589. https://doi.org/10.1016/0145-2134(93)90080-o
LeiterJ.,JohnsenM. C. (1997). Child maltreatment and school performance declines: An event-history analysis. American Educational Research Journal, 34(3), 563–589. https://doi.org/10.3102/00028312034003563
41.
LindeK.LehnigF.NaglM.KerstingA. (2020). The association between breastfeeding and attachment: A systematic review. Midwifery, 81, 102592. https://doi.org/10.1016/j.midw.2019.102592
MargolinG.VickermanK. A.OliverP. H.GordisE. B. (2010). Violence exposure in multiple interpersonal domains: Cumulative and differential effects. Journal of Adolescent Health, 47(2), 198–205. https://doi.org/10.1016/j.jadohealth.2010.01.020
44.
McGrathC. E.WatsonA. L.ChassinL. (1997). Academic achievement in adolescent children of alcoholics. Journal of Studies on Alcohol, 60(1), 18–26. https://doi.org/10.15288/jsa.1999.60.18
45.
McGuireA.JacksonY. (2018). Dimensions of maltreatment and academic outcomes for youth in foster care. Child Abuse & Neglect, 84, 82–94. https://doi.org/10.1016/j.chiabu.2018.07.029
46.
MealingsM.DouglasJ.OlverJ. (2017). Beyond academic performance: Practice implications for working with students following traumatic brain injury. International Journal of Speech Language Pathology, 19(5), 441–453. https://doi.org/10.1080/17549507.2016.1221453
47.
MillsR.AlatiR.O'CallaghanM.NajmanJ. M.WilliamsG. M.BorW.StrathearnL. (2011). Child abuse and neglect and cognitive function at 14 Years of age: Findings from a birth cohort. Pediatrics, 127(1), 4–10. https://doi.org/10.1542/peds.2009-3479
48.
MowbrayC. T.BybeeD.OysermanD.Allen-MearesP.MacFarlaneP.Hart-JohnsonT. (2004). Diversity of outcomes among adolescent children of mothers with mental illness. Journal of Emotional and Behavioral Disorders, 12(4), 206–221. https://doi.org/10.1177/10634266040120040201
49.
MusshafenL. A.TyroneR. S.AbdelazizA.Sims-GomilliaC. E.PongettiL. S.TengF.RenekerJ. C. (2021). Associations between sleep and academic performance in US adolescents: A systematic review and meta-analysis. Sleep Medicine, 83, 71–82. https://doi.org/10.1016/j.sleep.2021.04.015
NielsenM. B.HarrisA.PallesenS.EinarsenS. V. (2020). Workplace bullying and sleep - a systematic review and meta-analysis of the research literature. Sleep Medicine Reviews, 51(101289), 101289. https://doi.org/10.1016/j.smrv.2020.101289
53.
OhD. L.JermanP.Silverio MarquesS.KoitaK.Purewal BoparaiS. K.Burke HarrisN.BucciM. (2018). Systematic review of pediatric health outcomes associated with childhood adversity. BMC Pediatrics, 18(1), 83. https://doi.org/10.1186/s12887-018-1037-7
54.
OuzzaniM.HammadyH.FedorowiczZ.ElmagarmidA. (2016). Rayyan-a web and mobile app for systematic reviews. Systematic Reviews, 5(1), 210. https://doi.org/10.1186/s13643-016-0384-4
55.
PageM. J.McKenzieJ. E.BossuytP. M.BoutronI.HoffmannT. C.MulrowC. D.MoherD. (2021). Updating guidance for reporting systematic reviews: Development of the PRISMA 2020 statement. Journal of Clinical Epidemiology, 134, 103–112. https://doi.org/10.1016/j.jclinepi.2021.02.003
56.
PerrettC.LambP.BusseyM. (2020). Is there an association between external workload and lower-back injuries in cricket fast bowlers? A systematic review. Physical Therapy in Sport, 41, 71–79. https://doi.org/10.1016/j.ptsp.2019.11.007
57.
RabyK. L.RoismanG. I.LabellaM. H.MartinJ.FraleyR. C.SimpsonJ. A. (2019). The legacy of early abuse and neglect for social and academic competence from childhood to adulthood. Child Development, 90(5), 1684–1701. https://doi.org/10.1111/cdev.13033
RoblesA.GjelsvikA.HirwayP.VivierP. M.HighP. (2019). Adverse childhood experiences and protective factors with school engagement. Pediatrics, 144(2), 1–8. https://doi.org/10.1542/peds.2018-2945
61.
RuffR. R.SenthiS.SusserS. R.TsutsuiA. (2019). Oral health, academic performance, and school absenteeism in children and adolescents: A systematic review and meta-analysis. The Journal of the American Dental Association, 150(2), 111–121. https://doi.org/10.1016/j.adaj.2018.09.023
62.
SangsawangB.WacharasinC.SangsawangN. (2019). Interventions for the prevention of postpartum depression in adolescent mothers: A systematic review. Arch Womens Ment Health, 22(2), 215–228. https://doi.org/10.1007/s00737-018-0901-7
63.
SchoberP.BoerC.SchwarteL. A. (2018). Correlation coefficients: Appropriate use and interpretation. Anesthesia & Analgesia, 126(5), 1763–1768. https://doi.org/10.1213/ANE.0000000000002864
ShankarP.ChungR.FrankD. A. (2017). Association of food insecurity with children's behavioral, emotional, and academic outcomes: A systematic review. Journal of Developmental and Behavioral Pediatrics, 38(2), 135–150. https://doi.org/10.1097/DBP.0000000000000383
66.
SheppardW. N. (2012). An ecological approach to understanding physical child abuse and the impact on academics: Differences between behaviors in physically abused and nonabused children regarding parental disciplinary practices, family interaction and family events and their effects on social interaction and school success ProQuest Information & Learning. https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2012-99231-022&site=ehost-live
SylvestreA.BussieresE. L.BouchardC. (2016). Language problems among abused and neglected children: A meta-analytic review. Child Maltreatment, 21(1), 47–58. https://doi.org/10.1177/1077559515616703
69.
ThompsonT.Jr.MassatC. R. (2005). Experiences of violence, post-traumatic stress, academic achievement and behavior problems of urban african-American children. Child and Adolescent Social Work Journal, 22(5), 367–393. https://doi.org/10.1007/s10560-005-0018-5
WhitakerR. C.HermanA. N.Dearth-WesleyT.SmithH. G.BurnimS. B.MyersE. L.KainzK. (2019). Effect of a trauma-awareness course on teachers' perceptions of conflict with preschool-aged children from low-income urban households: A cluster randomized clinical trial. JAMA Network Open, 2(4), e193193. https://doi.org/10.1001/jamanetworkopen.2019.3193
72.
WodarskiJ. S.KurtzP. D.GaudinJ. M.HowingP. T. (1990). Maltreatment and the school-age child: Major academic, socioemotional, and adaptive outcomes. Social Work, 35(6), 506–513. https://doi.org/10.1093/sw/35.6.506
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