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. 2021 Aug 31;8(9):761.
doi: 10.3390/children8090761.

Adverse Childhood Experiences Predict Common Neurodevelopmental and Behavioral Health Conditions among U.S. Children

Kasra Zarei  1 , Guifeng Xu  2 , Bridget Zimmerman  3 , Michele Giannotti  4 , Lane Strathearn  1   5   6
Affiliations

Adverse Childhood Experiences Predict Common Neurodevelopmental and Behavioral Health Conditions among U.S. Children

Kasra Zarei et al. Children (Basel). .

Abstract

Objective: Adverse childhood experiences (ACEs) can have a significant but variable effect on childhood neurodevelopment. The purpose of this study was to quantify and compare the associations between "household challenge" ACEs and common childhood neurodevelopmental and behavioral health conditions, using nationally representative U.S.

Method: This study used data from the 2016-2019 National Survey of Children's Health, a nationwide, population-based, cross-sectional survey. Seven household challenge ACEs (not including child maltreatment) were reported by parents/guardians: parental death, incarceration, divorce/separation, family violence, mental illness, substance abuse, and poverty. Logistic regression with sample weights was used to estimate the odds ratio (OR) for 15 parent-reported neurodevelopmental and behavioral health conditions, by the number of reported ACEs. A dose-response relationship was examined by applying tests of orthogonal polynomial contrasts to fitted logistic regression models.

Results: Down syndrome, Tourette syndrome and cerebral palsy were not associated with household challenge ACEs, whereas behavior/conduct problems, depression, and substance abuse were strongly associated, with adjusted ORs ranging from 6.36 (95% confidence interval (CI) 5.53, 7.32) to 9.19 (95% CI 7.79, 10.84). Other neurodevelopmental conditions not traditionally associated with childhood adversity showed moderate yet robust associations with ACEs, including autism (adjusted OR 2.15, 95% CI 1.64, 2.81), learning disability (adjusted OR 3.26, 95% CI 2.80, 3.80), and attention deficit hyperactivity disorder (adjusted OR 3.95, 95% CI 3.44, 4.53). The ORs increased with the number of ACEs, showing significant positive linear trends.

Conclusion: We found significant dose-dependent or cumulative associations between ACEs and multiple neurodevelopmental and behavioral conditions.

Keywords: adverse childhood experiences; behavioral health; childhood adversity; neurodevelopment; trauma.

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Conflict of interest statement

The authors have no financial relationships relevant to this article to disclose.

Figures

Figure 1
Figure 1
(A) Rank order of point estimate associations between household challenge ACEs and adjusted odds ratios of physical, developmental and behavioral health conditions surveyed in the National Survey of Child Health. (B) Associations between household challenge ACEs and odds ratios of behavioral and developmental health conditions surveyed in the National Survey of Child Health. (C) Dose-response natures of household challenge ACEs and odds ratio estimates.
Figure 2
Figure 2
Model of how intrinsic and extrinsic factors may contribute to the risk of neurodevelopmental and behavioral health conditions.
See this image and copyright information in PMC

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