Skip to main content

Advertisement

SpringerLink
Log in

Wellbeing Outcomes for Children Exposed to Multiple Adverse Experiences in Early Childhood: A Systematic Review

  • Published:
Child and Adolescent Social Work Journal Aims and scope Submit manuscript

Abstract

This systematic review sought to examine and synthesize empirical research on the association between early childhood (0–83 months) exposure to multiple adverse childhood experiences (ACEs) and the child’s social, behavioral, emotional, or physical developmental wellbeing. Guided by inclusion criteria and predefined search terms, articles were identified through electronic bibliographic databases, reference mining, hand searching, and gray literature. Two authors simultaneously conducted title and abstract reviews, and subsequently full-text reviews. Included studies examined early childhood exposure to two or more ACEs and the association between social, emotional, behavioral, physical, and/or overall wellbeing outcomes. Five studies met the predetermined inclusion criteria and were descriptive, secondary data analyses that utilized large, high-risk samples. Findings support a dose–response association between cumulative early childhood ACE exposure and behavioral issues and poor physical health outcomes. Results revealed between 12.3 and 70% of the early childhood samples were exposed to three or more ACEs. Among high-risk samples, exposure to multiple adversities is common although literature is scarce. Policy and practice implications include early assessments and interventions tailored to identifying the most vulnerable early childhood children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Achenbach, T. M., & Edelbrock, C. S. (1983). Manual for the child behavior checklist: And revised child behavior profile. Burlington: University of Vermont, Department of Psychiatry.

    Google Scholar 

  • Bitsko, R. H., Holbrook, J. R., Kaminski, J. W., Ghandour, R., Smith, C., & Peacock, G. (2016). Health care, family, and community factors associated with mental, behavioral, and developmental disorders in early childhood—United States, 2011–2012. MMWR. Morbidity and Mortality Weekly Report. https://doi.org/10.15585/mmwr.mm6509a1.

    Article  PubMed  Google Scholar 

  • Bloom, S. L. (2000). The neglect of neglect part 1. Psychotherapy Review, 2, 208–210.

    Google Scholar 

  • Brown, D. W., Anda, R. F., Tiemeier, H., Felitti, V. J., Edwards, V. J., Croft, J. B., … Giles, W. H. (2009). Adverse childhood experiences and the risk of premature mortality. American Journal of Preventive Medicine, 37, 389–396.

    Article  Google Scholar 

  • Brown, S. M., & Shillington, A. M. (2017). Childhood adversity and the risk of substance use and delinquency: The role of protective adult relationships. Child Abuse & Neglect, 63, 211–221.

    Article  Google Scholar 

  • Burke, N. J., Hellman, J. L., Scott, B. G., Weems, C. F., & Carrion, V. G. (2011). The impact of adverse childhood experiences on an urban pediatric population. Child abuse & neglect, 35, 408–413.

    Article  Google Scholar 

  • Carlson, E. B., Furby, L., Armstrong, J., & Shlaes, J. (1997). A conceptual framework for the long-term psychological effects of traumatic childhood abuse. Child Maltreatment, 2, 272–295.

    Article  Google Scholar 

  • Center on the Developing Child at Harvard University (2007). The impact of early adversity on children’s development (InBreif). Retrieved from https://developingchild.harvard.edu/resources/inbrief-the-impact-of-early-adversity-on-childrens-development/.

  • Center on the Developing Child at Harvard University (2010). The foundations of lifelong health are built in early childhood. Retrieved from http://developingchild.harvard.edu/wp-content/uploads/2010/05/Foundations-of-Lifelong-Health.pdf.

  • Cooper, J. L., Masi, R., & Vick, J. (2009). Social-emotional development in early childhood: What every policymaker should know. National Center for Children in Poverty, Mailman School of Public Health, Columbia University. Retrieved from https://academiccommons.columbia.edu/catalog/ac:126269.

  • Cross, T., & Smith, K. (2010). The national survey of child and adolescent well-being: Tools for using longitudinal national study of children involved in maltreatment investigations. Portsmouth: Presented at the The International Family Violence and Child Victimization Research Conference.

    Google Scholar 

  • D’Andrea, W., Ford, J., Stolbach, B., Spinazzola, J., & van der Kolk, B. A. (2012). Understanding interpersonal trauma in children: Why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry, 82, 187–200.

    Article  Google Scholar 

  • DeWalt, D. A., & Hink, A. (2009). Health literacy and child health outcomes: A systematic review of the literature. Pediatrics, 124(Supplement 3), S265–S274.

    Article  Google Scholar 

  • Dong, M., Anda, R. F., Felitti, V. J., Dube, S. R., Williamson, D. F., Thompson, T. J., … Giles, W. H. (2004). The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse & Neglect, 28, 771–784.

    Article  Google Scholar 

  • Dube, S. R., Anda, R. F., Felitti, V. J., Chapman, D. P., Williamson, D. F., & Giles, W. H. (2001). Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: Findings from the Adverse Childhood Experiences Study. Journal of the American Medical Association, 286, 3089–3096.

    Article  Google Scholar 

  • Dube, S. R., Anda, R. F., Felitti, V. J., Croft, J. B., Edwards, V. J., & Giles, W. H. (2001). Growing up with parental alcohol abuse: Exposure to childhood abuse, neglect, and household dysfunction. Child Abuse & Neglect, 25, 1627–1640. https://doi.org/10.1016/S0145-2134(01)00293-9.

    Article  Google Scholar 

  • Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: The adverse childhood experiences study. Pediatrics, 111, 564–572. https://doi.org/10.1542/peds.111.3.564.

    Article  PubMed  Google Scholar 

  • Dube, S. R., Felitti, V. J., Dong, M., Giles, W. H., & Anda, R. F. (2003). The impact of adverse childhood experiences on health problems: Evidence from four birth cohorts dating back to 1900. Preventive Medicine, 37, 268–277.

    Article  Google Scholar 

  • Edwards, V. J., Holden, G. W., Felitti, V. J., & Anda, R. F. (2003). Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: Results from the adverse childhood experiences study. American Journal of Psychiatry, 160, 1453–1460.

    Article  Google Scholar 

  • Enlow, M. B., Egeland, B., Blood, E. A., Wright, R. O., & Wright, R. J. (2012). Interpersonal trauma exposure and cognitive development in children to age 8 years: A longitudinal study. Journal of Epidemiology & Community Health. https://doi.org/10.1136/jech-2011-200727.

    Article  Google Scholar 

  • Fantuzzo, J. W., Rouse, H. L., McDermott, P. A., & Sekino, Y. (2005). Early childhood experiences and kindergarten success: A population-based study of a large urban setting. School Psychology Review, 34, 571.

    Article  Google Scholar 

  • Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., … Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14, 245–258.

    Article  Google Scholar 

  • Finkelhor, D., Ormrod, R., Turner, H., & Holt, M. (2009). Pathways to poly-victimization. Child Maltreatment, 14, 316–329.

    Article  Google Scholar 

  • Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2007). Poly-victimization: A neglected component in child victimization. Child Abuse & Neglect, 31, 7–26. https://doi.org/10.1016/j.chiabu.2006.06.008.

    Article  Google Scholar 

  • Fiscella, K., & Kitzman, H. (2009). Disparities in academic achievement and health: The intersection of child education and health policy. Pediatrics, 123, 1073–1080.

    Article  Google Scholar 

  • Flaherty, E. G., Thompson, R., Litrownik, A. J., Theodore, A., English, D. J., Black, M. M., … Dubowitz, H. (2006). Effect of early childhood adversity on child health. Archives of Pediatrics & Adolescent Medicine, 160, 1232–1238. https://doi.org/10.1001/archpedi.160.12.1232.

    Article  Google Scholar 

  • Ford, J. D. (2013). Trauma exposure and posttraumatic stress disorder in the lives of adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 52, 780–783. https://doi.org/10.1016/j.jaac.2013.05.012.

    Article  Google Scholar 

  • Freeman, P. A. C. (2014). Prevalence and relationship between adverse childhood experiences and child behavior among young children. Infant Mental Health Journal, 35, 544–554. https://doi.org/10.1002/imhj.21460.

    Article  Google Scholar 

  • Gerhardt, S. (2006). Why love matters: How affection shapes a baby’s brain. Infant Observation, 9, 305–309.

    Article  Google Scholar 

  • Grasso, D. J., Dierkhising, C. B., Branson, C. E., Ford, J. D., & Lee, R. (2016). Developmental patterns of adverse childhood experiences and current symptoms and impairment in youth referred for trauma-specific services. Journal of Abnormal Child Psychology, 44(5), 871–886. https://doi.org/10.1007/s10802-015-0086-8.

    Article  PubMed  Google Scholar 

  • Herman, D. B., Susser, E. S., Struening, E. L., & Link, B. L. (1997). Adverse childhood experiences: Are they risk factors for adult homelessness? American journal of public health, 87, 249–255.

    Article  Google Scholar 

  • Hillis, S. D., Anda, R. F., Felitti, V. J., & Marchbanks, P. A. (2001). Adverse childhood experiences and sexual risk behaviors in women: A retrospective cohort study. Family Planning Perspectives, 206–211.

  • Irwin, L. G., Siddiqi, A., & Hertzman, C. (2007). Early child development: A powerful equalizer. Vancouver, BC: Human Early Learning Partnership (HELP) Retrieved from https://pdfs.semanticscholar.org/1df8/62d6976456b057e8ce78c9e713807e7590d0.pdf.</bib>

  • Jimenez, M. E., Wade, R. Jr., Lin, Y., Morrow, L. M., & Reichman, N. E. (2016). Adverse experiences in early childhood and kindergarten outcomes. Pediatrics, 137, e20151839. https://doi.org/10.1542/peds.2015-1839.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kalmakis, K. A., & Chandler, G. E. (2014). Adverse childhood experiences: Towards a clear conceptual meaning. Journal of Advanced Nursing, 70, 1489–1501.

    Article  Google Scholar 

  • Keiley, M. K., Howe, T. R., Dodge, K. A., Bates, J. E., & Pettit, G. S. (2001). The timing of child physical maltreatment: A cross-domain growth analysis of impact on adolescent externalizing and internalizing problems. Development and Psychopathology, 13, 891–912.

    Article  Google Scholar 

  • Kerker, B. D., Zhang, J., Nadeem, E., Stein, R. E. K., Hurlburt, M. S., Heneghan, A., … Horwitz, S. M. (2015). Adverse childhood experiences and mental health, chronic medical conditions, and development in young children. Academic Pediatrics, 15, 510–517.

    Article  Google Scholar 

  • Kessler, R. C., Andrews, G., Mroczek, D., Ustun, B., & Wittchen, H.-U. (1998). The World Health Organization composite international diagnostic interview short-form (CIDI-SF). International Journal of Methods in Psychiatric Research, 7, 171–185.

    Article  Google Scholar 

  • Larkin, H., Felitti, V. J., & Anda, R. F. (2014). Social work and adverse childhood experiences research: Implications for practice and health policy. Social Work in Public Health, 29, 1–16. https://doi.org/10.1080/19371918.2011.619433.

    Article  PubMed  Google Scholar 

  • Littell, J. H., Corcoran, J., & Pillai, V. (2008). Systematic reviews and meta-analysis. Oxford: Oxford University Press.

    Book  Google Scholar 

  • Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience, 10, 434–445. https://doi.org/10.1038/nrn2639.

    Article  PubMed  Google Scholar 

  • McGee, R. A., Wolfe, D. A., Yuen, S. A., Wilson, S. K., & Carnochan, J. (1995). The measurement of maltreatment: A comparison of approaches. Child Abuse & Neglect, 19, 233–249

    Article  Google Scholar 

  • Middlebrooks, J. S., & Audage, N. C. (2008). The effects of childhood stress on health across the lifespan. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Retrieved from http://health-equity.lib.umd.edu/932/1/Childhood_Stress.pdf.

  • Ney, P. G., Fung, T., & Wickett, A. R. (1994). The worst combinations of child abuse and neglect. Child Abuse & Neglect, 18, 705–714

    Article  Google Scholar 

  • Phillips, D. A., & Shonkoff, J. P. (2000). From neurons to neighborhoods: The science of early childhood development. National Academies Press.

  • Reichman, N. E., Teitler, J. O., Garfinkel, I., & McLanahan, S. S. (2001). Fragile families: Sample and design. Children and Youth Services Review, 23, 303–326.

    Article  Google Scholar 

  • Sabri, B., Hong, J. S., Campbell, J. C., & Cho, H. (2013). Understanding children and adolescents’ victimizations at multiple levels: An ecological review of the literature. Journal of Social Service Research, 39, 322–334.

    Article  Google Scholar 

  • Shonkoff, J. P. (2010). Building a new biodevelopmental framework to guide the future of early childhood policy. Child Development, 81(1), 357–367. https://doi.org/10.1111/j.1467-8624.2009.01399.x.

    Article  PubMed  Google Scholar 

  • Stein, R. E. K., Hurlburt, M. S., Heneghan, A. M., Zhang, J., Rolls-Reutz, J., Silver, E. J., … Horwitz, S. M. (2013). Chronic conditions among children investigated by child welfare: A national sample. Pediatrics, 131, 455–462. https://doi.org/10.1542/peds.2012-1774.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steinberg, A. M., Pynoos, R. S., Briggs, E. C., Gerrity, E. T., Layne, C. M., Vivrette, R. L., … Fairbank, J. A. (2014). The national child traumatic stress network core data set: Emerging findings, future directions, and implications for theory, research, practice, and policy. Psychological Trauma: Theory, Research, Practice, and Policy, 6(S1), S50.

    Article  Google Scholar 

  • Straus, M. A. (1979). Measuring intrafamily conflict and violence: The conflict tactics (CT) scales. Journal of Marriage and the Family, 41, 75–88.

    Article  Google Scholar 

  • Straus, M. A., Hamby, S. L., Boney-McCoy, S., & Sugarman, D. B. (1996). The revised conflict tactics scales (CTS2) development and preliminary psychometric data. Journal of Family Issues, 17, 283–316.

    Article  Google Scholar 

  • Straus, M. A., Hamby, S. L., Finkelhor, D., Moore, D. W., & Runyan, D. (1998). Identification of child maltreatment with the Parent-Child Conflict Tactics Scales: Development and psychometric data for a national sample of American parents. Child Abuse & Neglect, 22, 249–270.

    Article  Google Scholar 

  • U.S. Department of Health and Human Services Administration for Children and Families. (n.d.). National survey of child and adolescent well-being (NSCAW), 1997-2014 and 2015-2022. Retrieved from https://www.acf.hhs.gov/opre/research/project/national-survey-of-child-and-adolescent-well-being-nscaw.

  • Yoshikawa, H. (2010). The foundations of lifelong health are built in early childhood. Cambridge, MA: Harvard Center on the Developing Child. Retrieved from http://developingchild.harvard.edu/wp-content/uploads/2010/05/Foundations-of-Lifelong-Health.pdf.

Download references

Author information

Authors and Affiliations

  1. University of Kansas, 1545 Lilac Lane, Twente Hall, Lawrence, KS, 66045, USA

    Kiley W. Liming & Whitney A. Grube

Authors
  1. Kiley W. Liming
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Whitney A. Grube
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kiley W. Liming.

Ethics declarations

Conflict of interest

Kiley Liming and Whitney Grube declare that they have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liming, K.W., Grube, W.A. Wellbeing Outcomes for Children Exposed to Multiple Adverse Experiences in Early Childhood: A Systematic Review. Child Adolesc Soc Work J 35, 317–335 (2018). https://doi.org/10.1007/s10560-018-0532-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10560-018-0532-x

Keywords

Search

Navigation