This study was conducted to quantify the association of adverse childhood experiences (ACEs) and the academic performance of children and adolescents. The literature was systematically searched in six electronic databases, and a meta-analysis was conducted. Twenty studies with a total of 1,196,631 children and adolescents from five countries were included. Meta-analysis showed that ACE score was positively associated with poor academic achievement, grade repetition, and special education support. Compared with children and adolescents without any ACE, those with one or more ACE had a significantly higher risk of poor academic achievement (pooled odds ratio [OR]: 1.45, 95% confidence interval [CI] [1.13, 1.85], I2 = 82.6%) and grade repetition (pooled OR: 1.36, 95% CI [1.29, 1.43], I2 = 71.0%). Moreover, all types of ACEs were positively associated with poor academic achievement and grade repetition. In addition, there was a significant dose-response relationship between the ACE score and the risk of poor academic achievement. This study supported that ACE had a significant impact on the academic performance of children and adolescents. Based on these findings, we recommend that early screening of ACEs for children and adolescent is critical and appropriate support and prevention in education should be developed for those with ACEs. Further studies are needed to further explore the long-term effect of ACEs on education and its gender differences.
BathK. G. (2020). Synthesizing views to understand sex differences in response to early life adversity. Trends in Neurosciences, 43(5), 300–310. https://doi.org/10.1016/j.tins.2020.02.004
2.
BellisM. A.HughesK.FordK.Ramos RodriguezG.SethiD.PassmoreJ. (2019). Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: A systematic review and meta-analysis. The Lancet Public Health, 4(10), e517–e528. https://doi.org/10.1016/S2468-2667(19)30145-8
3.
BethellC.JonesJ.GombojavN.LinkenbachJ.SegeR. (2019). Positive childhood experiences and adult mental and relational health in a statewide sample: Associations across adverse childhood experiences levels. JAMA Pediatrics, 173(11), e193007. https://doi.org/10.1001/jamapediatrics.2019.3007
4.
*BethellC. D.NewacheckP.HawesE.HalfonN. (2014). Adverse childhood experiences: Assessing the impact on health and school engagement and the mitigating role of resilience. Health affairs (Millwood), 33(12), 2106–2115. https://doi.org/10.1377/hlthaff.2014.0914
BoginJ. (2006). Enhancing developmental services in primary care: The help me grow experience. Journal of Developmental and Behavioral Pediatrics, 27(1 Suppl), S8–S52. https://doi.org/10.1097/00004703-200602001-00004
7.
BriggsE. C.Amaya-JacksonL.PutnamK. T.PutnamF. W. (2021). All adverse childhood experiences are not equal: The contribution of synergy to adverse childhood experience scores. The American Psychologist, 76(2), 243–252. https://doi.org/10.1037/amp0000768
8.
BrownS. M.RienksS.McCraeJ. S.WatamuraS. E. (2019). The co-occurrence of adverse childhood experiences among children investigated for child maltreatment: A latent class analysis. Child Abuse & Neglect, 87, 18–27. https://doi.org/10.1016/j.chiabu.2017.11.010
9.
CampbellJ. A.WalkerR. J.EgedeL. E. (2016). Associations between adverse childhood experiences, high-risk behaviors, and morbidity in adulthood. American Journal of Preventive Medicine, 50(3), 344–352. https://doi.org/10.1016/j.amepre.2015.07.022
ChafouleasS. M.JohnsonA. H.OverstreetS.SantosN. M. (2016). Toward a blueprint for trauma-informed service delivery in schools. School Mental Health, 8(1), 144–162.
13.
CrouchE.ProbstJ. C.RadcliffE.BennettK. J.McKinneyS. H. (2019). Prevalence of adverse childhood experiences (ACEs) among US children. Child Abuse & Neglect, 92, 209–218. https://doi.org/10.1016/j.chiabu.2019.04.010
14.
*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
15.
*DukeN. N. (2020). Adolescent adversity, school attendance and academic achievement: School connection and the potential for mitigating risk. The Journal of School Health, 90(8), 618–629. https://doi.org/10.1111/josh.12910
16.
*EckenrodeJ.LairdM.DorisJ. (1993). School performance and disciplinary problems among abused and neglected children. Developmental Psychology, 29(1), 53–62.
17.
FadelE.BoekerH.GaertnerM.RichterA.KleimB.SeifritzE.GrimmS.Wade-BohleberL. M. (2021). Differential alterations in resting state functional connectivity associated with depressive symptoms and early life adversity. Brain Sciences, 11(5), 591. https://doi.org/10.3390/brainsci11050591
18.
FelittiV. J.AndaR. F.NordenbergD.WilliamsonD. F.SpitzA. M.EdwardsVKossM. P.MarksJ. 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
19.
FosterK.RocheM.DelgadoC.CuzzilloC.GiandinotoJ. A.FurnessT. (2019). Resilience and mental health nursing: An integrative review of international literature. International Journal of Mental Health Nursing, 28(1), 71–85. https://doi.org/10.1111/inm.12548
20.
FryD.FangX.ElliottS.CaseyT.ZhengX.LiJ.FlorianL.McCluskeyG. (2018). The relationships between violence in childhood and educational outcomes: A global systematic review and meta-analysis. Child Abuse & Neglect, 75, 6–28. https://doi.org/10.1016/j.chiabu.2017.06.021
21.
FujiwaraT. (2022). Impact of adverse childhood experience on physical and mental health: A life-course epidemiology perspective. Psychiatry and Clinical Neurosciences, 76(11), 544–551. https://doi.org/10.1111/pcn.13464
22.
GilgoffR.SinghL.KoitaK.GentileB.MarquesS. S. (2020). Adverse childhood experiences, outcomes, and interventions. Pediatric Clinics of North America, 67(2), 259–273. https://doi.org/10.1016/j.pcl.2019.12.001
23.
HaganJ. F.ShawJ. S.DuncanP. M. (2008). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents (3rd ed.). American Academy of Pediatrics.
24.
HarrellF. E.Jr.LeeK. L.PollockB. G. (1988). Regression models in clinical studies: Determining relationships between predictors and response. Journal of the National Cancer Institute, 80(15), 1198–1202. https://doi.org/10.1093/jnci/80.15.1198
25.
HigginsJ. P.ThompsonS. G.DeeksJ. J.AltmanD. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327(7414), 557–560. https://doi.org/10.1136/bmj.327.7414.557
26.
HodesG. E.EppersonC. N. (2019). Sex differences in vulnerability and resilience to stress across the life span. Biological Psychiatry, 86(6), 421–432. https://doi.org/10.1016/j.biopsych.2019.04.028
27.
HoutepenL. C.HeronJ.SudermanM. J.FraserA.ChittleboroughC. R.HoweL. D. (2020). Associations of adverse childhood experiences with educational attainment and adolescent health and the role of family and socioeconomic factors: A prospective cohort study in the UK. PLoS Medicine, 17(3), e1003031. https://doi.org/10.1371/journal.pmed.1003031
28.
HughesK.BellisM. A.HardcastleK. A.SethiD.ButchartA.MiktonC.JonesL.DunneM. P. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet Public Health, 2(8), e356–e366. https://doi.org/10.1016/S2468-2667(17)30118-4
29.
IobE.LaceyR.SteptoeA. (2020). The long-term association of adverse childhood experiences with C-reactive protein and hair cortisol: Cumulative risk versus dimensions of adversity. Brain, Behavior, and Immunity, 87, 318–328. https://doi.org/10.1016/j.bbi.2019.12.019
30.
IobE.AjnakinaO.SteptoeA. (2023). The interactive association of adverse childhood experiences and polygenic susceptibility with depressive symptoms and chronic inflammation in older adults: A prospective cohort study. Psychological Medicine, 53(4), 1426–1436. https://doi.org/10.1017/S0033291721003007
31.
*JaffeeS. R.AmblerA.MerrickM.Goldman-MellorS.OdgersC. L.FisherH. L.DaneseA.ArseneaultL. (2018). Childhood maltreatment predicts poor economic and educational outcomes in the transition to adulthood. American Journal of Public Health, 108(9), 1142–1147. https://doi.org/10.2105/AJPH.2018.304587
32.
*JimenezM. E.WadeRJr.LinY.MorrowL. M.ReichmanN. E. (2016). Adverse experiences in early childhood and kindergarten outcomes. Pediatrics, 137(2), e20151839. https://doi.org/10.1542/peds.2015-1839
33.
KawachiI.AdlerN. E.DowW. H. (2010). Money, schooling, and health: Mechanisms and causal evidence. Annals of the New York Academy of Sciences, 1186, 56–68. https://doi.org/10.1111/j.1749-6632.2009.05340.x
34.
LarsonS.ChapmanS.SpetzJ.BrindisC. D. (2017). Chronic childhood trauma, mental health, academic achievement, and school-based health center mental health services. The Journal of School Health, 87(9), 675–686. https://doi.org/10.1111/josh.12541
35.
Lê-ScherbanF.Diez RouxA. V.LiY.MorgensternH. (2014). Does academic achievement during childhood and adolescence benefit later health?Annals of Epidemiology, 24(5), 344–355. https://doi.org/10.1016/j.annepidem.2014.02.008
36.
LopezM.RuizM. O.RovnaghiC. R.TamG. K.HiscoxJ.GotlibI. H.BarrD. A.CarrionV. G.AnandK. J. S. (2021). The social ecology of childhood and early life adversity. Pediatric Research, 89(2), 353–367. https://doi.org/10.1038/s41390-020-01264-x
37.
*MacleanM. J.TaylorC. L.O’DonnellM. (2020). Adolescent education outcomes and maltreatment: The role of pre-existing adversity, level of child protection involvement, and school attendance. Child Abuse & Neglect, 109, 104721. https://doi.org/10.1016/j.chiabu.2020.104721
38.
McLaughlinK. A.SheridanM. A.LambertH. K. (2014). Childhood adversity and neural development: Deprivation and threat as distinct dimensions of early experience. Neuroscience and Biobehavioral Reviews, 47, 578–591. https://doi.org/10.1016/j.neubiorev.2014.10.012
39.
MerrickM. T.FordD. C.PortsK. A.GuinnA. S. (2018). Prevalence of adverse childhood experiences from the 2011–2014 behavioral risk factor surveillance system in 23 states. JAMA Pediatrics, 172(11), 1038–1044. https://doi.org/10.1001/jamapediatrics.2018.2537
40.
MoherD.LiberatiA.TetzlaffJ.AltmanD. G., & PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ, 339, b2535. https://doi.org/10.1136/bmj.b2535
41.
NakamotoJ.SchwartzD. (2010). Is peer victimization associated with academic achievement? A meta-analytic review. Social Development, 19, 221–242.
NelsonC. A.ScottR. D.BhuttaZ. A.HarrisN. B.DaneseA.SamaraM. (2020). Adversity in childhood is linked to mental and physical health throughout life. BMJ, 371, m3048. https://doi.org/10.1136/bmj.m3048
45.
PetersJ. L.SuttonA. J.JonesD. R.AbramsK. R.RushtonL. (2006). Comparison of two methods to detect publication bias in meta-analysis. JAMA, 295, 676–680. https://doi.org/10.1001/jama.295.6.676
46.
*QuG.LiuH.HanT.ZhangH.MaS.SunL.QinQ.ChenM.ZhouX.SunY. (2024). Association between adverse childhood experiences and sleep quality, emotional and behavioral problems and academic achievement of children and adolescents. European Child & Adolescent Psychiatry, 33, 527–538. https://doi.org/10.1007/s00787-023-02185-w
47.
*RoblesA.GjelsvikA.HirwayP.VivierP. M.HighP. (2019). Adverse childhood experiences and protective factors with school engagement. Pediatrics, 144(2), e20182945. https://doi.org/10.1542/peds.2018-2945
ShonkoffJ. P.GarnerA. S. & Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, Section on Developmental and Behavioral Pediatrics. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246. https://doi.org/10.1542/peds.2011-2663
50.
SpannM. N.MayesL. C.KalmarJ. H.GuineyJ.WomerF. Y.PittmanB.MazureC. M.SinhaR.BlumbergH. P. (2012). Childhood abuse and neglect and cognitive flexibility in adolescents. Child Neuropsychology: A Journal on Normal and Abnormal Development in Childhood and Adolescence, 18(2), 182–189. https://doi.org/10.1080/09297049.2011.595400
51.
SterneJ. A.EggerM.SmithG. D. (2001). Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis. BMJ, 323(7304), 101–105. https://doi.org/10.1136/bmj.323.7304.101
52.
TufanaruC.MunnZ.StephensonM.AromatarisE. (2015). Fixed or random effects meta-analysis? Common methodological issues in systematic reviews of efectiveness. International Journal of Evidence-Based Healthcare, 13(3), 196–207. https://doi.org/10.1097/XEB.0000000000000065
53.
Vervoort-SchelJ.MerceraG.WissinkI.Van der HelmP.LindauerR.MoonenX. (2021). Prevalence of and relationship between adverse childhood experiences and family context risk factors among children with intellectual disabilities and borderline intellectual functioning. Research in Developmental Disabilities, 113, 103935. https://doi.org/10.1016/j.ridd.2021.103935
54.
WestfallD. R.AnteraperS. A.Chaddock-HeymanL.DrolletteE. S.RaineL. B.Whitfield-GabrieliS.KramerA. F.HillmanC. H. (2020). Resting-state functional connectivity and scholastic performance in preadolescent children: A Data-Driven Multivoxel Pattern Analysis (MVPA). Journal of Clinical Medicine, 9(10), 3198. https://doi.org/10.3390/jcm9103198
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