PEDIATRICS · 2016 · 315 citations · 34 references
Public HealthChild HealthPediatricsChild DevelopmentEarly Childhood Special EducationPediatric EpidemiologyAdverse Childhood ExperiencesChild Behavioral HealthChild Health EpidemiologyChildhood AdversityMental Health Epidemiology In ChildrenAdverse Childhood Experiences ScoringChild Wellbeing AssessmentEarly Childhood ConditionsLogistic RegressionLongitudinal Outcome MeasurementSecondary Case Analysis
OBJECTIVE: To examine associations between adverse childhood experiences (ACEs) in early childhood and teacher-reported academic and behavioral problems in kindergarten. METHODS: We conducted a secondary analysis of data from the Fragile Families and Child Wellbeing Study, a national urban birth cohort. Subjects with primary caregiver-reported information on ACE exposures ascertained at 5 years and teacher-reported outcomes at the end of the child's kindergarten year were included. Outcomes included teacher ratings of academic skills, emergent literacy skills, and behavior. We included 8 ACE exposures on the basis of the original Centers for Disease Control and Prevention Kaiser study and created an ACE score by summing individual adversities. We examined the associations between teacher-reported academic and behavioral outcomes and ACE scores by using logistic regression. RESULTS: In the study sample, 1007 children were included. Fifty-five percent had experienced 1 ACE and 12% had experienced ≥ 3. Adjusting for potential confounders, experiencing ≥ 3 ACEs was associated with below-average language and literacy skills (adjusted odds ratio [AORs]: 1.8; 95% confidence interval [CI]: 1.1-2.9) and math skills (AOR: 1.8, 95% CI: 1.1-2.9), poor emergent literacy skills, attention problems (AOR: 3.5, 95% CI: 1.8-6.5), social problems (AOR: 2.7, 95% CI: 1.4-5.0), and aggression (AOR: 2.3, 95% CI: 1.2-4.6). CONCLUSIONS: In this study of urban children, experiencing ACEs in early childhood was associated with below-average, teacher-reported academic and literacy skills and behavior problems in kindergarten. These findings underscore the importance of integrated approaches that promote optimal development among vulnerable children.
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The Lifelong Effects of Early Childhood Adversity and Toxic Stress
Jack P. Shonkoff, Andrew S. Garner, Ben Siegel et al. · PEDIATRICS · 2011 · 5K citations
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Darren A. DeWalt, Nancy D Berkman, Stacey Sheridan et al. · Journal of General Internal Medicine · 2004 · 2.3K citations · Full text