Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jan;87(2):362-370.
doi: 10.1038/s41390-019-0613-3. Epub 2019 Oct 17.

Identifying adverse childhood experiences in pediatrics to prevent chronic health conditions

Andrew J Barnes  1 , Bruno J Anthony  2 , Canan Karatekin  3 , Katherine A Lingras  4 , Rebeccah Mercado  5 , Lindsay Acheson Thompson  5
Affiliations
Review

Identifying adverse childhood experiences in pediatrics to prevent chronic health conditions

Andrew J Barnes et al. Pediatr Res. 2020 Jan.

Abstract

Despite evidence that over 40% of youth in the United States have one or more adverse childhood experiences (ACEs), and that ACEs have cumulative, pernicious effects on lifelong health, few primary care clinicians routinely ask about ACEs. Lack of standardized and accurate clinical assessments for ACEs, combined with no point-of-care biomarkers of the "toxic stress" caused by ACEs, hampers prevention of the health consequences of ACEs. Thus, there is no consensus regarding how to identify, screen, and track ACEs, and whether early identification of toxic stress can prevent disease. In this review, we aim to clarify why, for whom, when, and how to identify ACEs in pediatric clinical care. To do so, we examine the evidence for such identification; describe the efficacy and accuracy of potential screening instruments; discuss current trends in, and potential barriers to, the identification of ACEs and the prevention of downstream effects; and recommend next steps for research, practice, and policy.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest relevant to this article to disclose

Figures

Figure 1.
Figure 1.
Common Screening Measures in Pediatrics Compared to ACE Identification
See this image and copyright information in PMC

References

    1. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998;14:245–58. - PubMed
    1. Liming KW, Grube WA. Wellbeing Outcomes for Children Exposed to Multiple Adverse Experiences in Early Childhood: A Systematic Review. Child Adolesc Soc Work J 2018;35:317–35.
    1. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998;14:245–58. - PubMed
    1. Anda RF, Butchart A, Felitti VJ, Brown DW. Building a Framework for Global Surveillance of the Public Health Implications of Adverse Childhood Experiences. Am. J. Prev. Med. 2010;39:93–8. - PubMed
    1. Evans GW, Kim P. Childhood Poverty and Health. Psychol Sci 2007;18:953–7. - PubMed

Publication types

MeSH terms