Adverse Childhood Experiences: Translating Knowledge into Identification of Children at Risk for Poor Outcomes

Marie-Mitchell, A.,
O'Connor, T. G.
Published: January, 2013
Journal Article
Journal Name: 
Academic Pediatrics
Volume: 13

Issue: 1

These authors pilot tested a new screening tool for adverse childhood experiences (ACE), and evaluated its ability to distinguish early child outcomes among lower- and higher-risk children. The sample consisted of 102 children (ages 4 to 5 years) presenting for well-child visits at an urban federally qualified health center. Logistic regression analyses adjusting for child sex, ethnicity, and birth weight were used to test the associations between child outcomes and risk exposure based on both a 6-item (maltreatment suspected, domestic violence, substance use, mental illness, criminal behavior, single parent) and 7-item (plus maternal education) Child ACE tool. Effect sizes were generally similar for the 6- and 7-item Child ACE tools, with the exception of 2 subscales identifying developmental delay using the 7-item tool. Adjusted odds of behavior problems, developmental delay, and injury visits were higher for children in the higher-risk ACE group, but lower for obesity. The authors recommend further studies to test incorporation of the 7-item Child ACE tool into practice. Modified Author Abstract.

Correspondence to: Ariane Marie-Mitchell, MD, PhD, MPH, Loma Linda University, Preventive Medicine Department, 24785 Stewart Street, Suite 101, Loma Linda, CA 92354; E-mail:, Website:
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