What is all this Stuff about Adverse Childhood Experiences?

Mar 31, 2021, 12:48 PM by Dr. Patricia Beach


April is Child Abuse Prevention Month #preventchildabuse  #BeAConnection

No one has the “perfect” family. Far too often, families live situations which are less than ideal. Sometimes the lives of children are marred by violence, abuse, neglect or underlying struggles with drug use, mental illness or constant turmoil.  Our UTMB Patient Safety and Protection Team is committed to helping families avoid the consequences of these childhood experiences.  We feel that every child who is a victim of abuse or neglect should and could have had a different experience.  We want to help families avoid the situations that lead to these unfortunate circumstances. 

April is Child Abuse Prevention Month.  This April we want to share with you some facts about adverse childhood experiences.  Now is not the time to wring our hands and give up! Instead, we should identify the strengths in our families and communities that can avoid the negative long-term effects of adverse experiences so they do not limit our children’s futures.  Our goal is prevention!

Where did this concept of “Adverse Childhood Experiences” come from?  In 1995 physicians and administrators of the Kaiser Permanete Group in California noticed a trend suggesting that adults had more health problems if their childhood was marred by abuse or family dysfunction.  They surveyed over 13,000 adults in their Health Maintenance Organization and discovered there was a strong relationship showing that children who experienced several different categories of adversity were more likely to develop chronic disease and die prematurely than those whose childhoods were less traumatized.

Adverse Childhood Experiences are defined as traumatic events that occur in childhood and are divided into the categories of emotional abuse, physical abuse, sexual abuse, or household challenges.  While parents and professionals continue to debate the threshold for each for each of these conditions, it is clear that the more pervasive the adverse experiences, the greater the potential for an adverse health (broadly defined) outcomes.  Children who feel constantly threatened or belittled by trusted adults or who live in fear of physical or sexual violence are at greatest risk.

The information generated by the Adverse Childhood Experiences studies provide valuable clues to parents about rearing their children.  Over half of the respondents of the original study had experienced at least one category of concern.  There was a graded response, meaning that the more categories of abuse or dysfunction a child experienced the greater the frequency of chronic, life-threatening conditions or events later in life, and the greater the risk of an early death. 

Each week in April we plan to discuss different aspects of adverse childhood experiences and explore the strengths in families and communities that can change the lives of children by promoting a more nurturing environment. There are many ways parents can be consistent in setting limits, yet maintain loving and satisfying relationships with their children.  When confronted with adverse experiences there are ways to mitigate the negative impact.  We hope this series will be helpful to you and to your friends and family who value the quality of life for children and the adults they will become!

By Patricia S. Beach, MD
Co-Director, Division of General Academic Pediatrics
Director UTMB ABC Child Safety and Protection Team
Emeritus Scholar, John P. McGovern Academy of Oslerian Medicine
University of Texas Medical Branch (UTMB)

 Published 4/01/2021

Also see:
More about Child Abuse Prevention Month -  
UTMB Health Primary Care Pediatrics
AAP Schedule of Well-Child Care Visits & Benefits