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Meta-Analysis
. 2022 Feb 1;149(2):e2021051884.
doi: 10.1542/peds.2021-051884.

Screening for Adverse Childhood Experiences in Children: A Systematic Review

Affiliations
Meta-Analysis

Screening for Adverse Childhood Experiences in Children: A Systematic Review

Sarah Loveday et al. Pediatrics. .

Abstract

Context: Adverse childhood experiences (ACEs) are associated with increased risk of poor mental health outcomes. Although there is interest in screening for ACEs for early identification and intervention, it is not known whether screening improves outcomes for children.

Objective: To systematically review whether screening for ACEs in children leads to an increase in (1) identification of ACEs, (2) referrals to services, (3) increased uptake of services, and (4) improved mental health outcomes for children and parents.

Data sources: Ovid Medline, PsycINFO, CINAHL, and Center for Clinical and Translational Research electronic databases were searched between 2009 and 2021.

Study selection: Studies were included if researchers screened for current ACEs in children aged 0 to 12 years and they had a control comparison.

Data extraction: Information was extracted, including study characteristics, sample demographics, screening tool characteristics, referral rates to services, uptake rates, and mental health outcomes.

Results: A total of 5816 articles were screened, with 4 articles meeting inclusion criteria. Screening for ACEs increases identification of adversity and may increase referrals to services. There are limited data about whether this leads to an increase in referral uptake by families. There are no reported data addressing mental health outcomes.

Limitations: There are few published control trials of moderate quality.

Conclusions: There is limited evidence that screening for ACEs improves identification of childhood adversity and may improve referrals. If we are to realize the hypothesized benefits of ACEs screening on child and parent mental health, it is essential to understand the barriers for families taking up referrals.

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Conflict of interest statement

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.

Comment in

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(4):245–258 - PubMed
    1. Hughes K, Bellis MA, Hardcastle KA, et al. . The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health. 2017;2(8): e356–e366 - PubMed
    1. Shonkoff JP, Garner AS; Committee on Psychosocial Aspects of Child and Family Health; Committee on Early Childhood, Adoption, and Dependent Care; Section on Developmental and Behavioral Pediatrics . The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012;129(1). Available at: www.pediatrics.org/cgi/content/full/129/1/e232 - PubMed
    1. Schilling EA, Aseltine RH Jr, Gore S. Adverse childhood experiences and mental health in young adults: a longitudinal survey. BMC Public Health. 2007;7:30. - PMC - PubMed
    1. Flaherty EG, Thompson R, Litrownik AJ, et al. . Effect of early childhood adversity on child health. Arch Pediatr Adolesc Med. 2006;160(12):1232–1238 - PubMed