Date Presented 03/28/20
Early ACEs have implications relating to mental, behavioral, and developmental disabilities and lifelong health. This secondary data analysis of the NSCH demonstrates the relationship between ACEs and symptom severity for children with pediatric disability in the United States. Our results show that as adverse childhood experiences increase, symptom severity increases, emphasizing the importance of understanding underlying contextual factors in early intervention.
Primary Author and Speaker: Rondalyn Whitney
Contributing Authors: Elliott Theeke
INTRODUCTION: The lifelong health consequences of early adverse childhood experiences have profound implications to mental, behavioral and developmental disabilities and health across the lifespan.
PURPOSE: The present study sought to determine the prevalence of Adverse Childhood Experience (ACE), the prevalence of mental behavioral and developmental disorders (MBDD), and Diagnosis Complexity (DxC) as reported by the National Survey of Children’s Health (NSCH) in the 2011 and 2016. Symptom complexity can be viewed as a measure of health outcomes in pediatric populations.
METHODS: We used a correlative and independent t-test analysis to examine the relationships between Adverse Childhood Experience scores (ACE) and the prevalence of mental behavioral and developmental disorders (MBDD) for the two data sets (NSCH 2011 and NSCH 2016). The differences between the 2011 (N = 94,372) and the 2016 (N = 46,635) data collection was reconciled in order to make an accurate comparison of diagnoses and to reflect a change in data collection methods (from phone survey to online questionnaires).
RESULTS: Over the span of five years, there was a decrease in the prevalence of adverse childhood experiences (ACE scores) in the population measured. However, during this same time span, the prevalence of MBDD not only increased but the number of children having more than one diagnosis increased, suggesting an increase in symptom severity in the pediatric population. As adverse childhood experiences increase, there is a significant correlate increase in symptom severity (2011, M = .45; 2016, M = .47, p < 0.001).
DISCUSSION: This is the first study to show the relationship of ACE to symptom severity in the pediatric population. This finding is critical for occupational therapy practitioners working in pediatric settings and emphasizes the importance of how underlying contextual factors impact health outcomes. Importantly, the change in decreased ACE scores may be attributed to the change in the data collection method for the survey (i.e. exclusively online).
References
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Stevens, J.E. (2012). The Adverse Childhood Experiences Study — the largest, most important public health study you never heard of — began in an obesity clinic. ACEs Too High News. Retrieved December 12, 2018 from https://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/
