Can the Cumulative Adverse Childhood Experiences (ACE) Score Actually Identify the Victims of Intrafamilial Childhood Maltreatment? Findings from a Study in the Child Welfare System.

Beáta Kovács-Tóth,Barnabás Oláh,Ildikó Kuritárné Szabó

doi:10.3390/ijerph18136886

Abstract

Studies show that a significant proportion of children in the Child Welfare System (CWS) have suffered adverse childhood experiences (ACEs), which have led to well documented serious consequences. This study assessed and compared the ACE status of adolescents aged 12 to 17 placed in a family style group care (FGC) setting (n = 240) to the ACE status of adolescents living with their biological parents (n = 516). The ACE Score Calculator was employed. The populational differences in ACE scores and in the prevalence of ACEs were assessed using generalized linear and logistic regression models. Adolescents living in FGC settings reported more than five times as many multiple adverse experiences (≥4 types of ACEs) as those living with their biological parents. Adolescents living in FGC settings seem to be more willing to report family dysfunction rather than their maltreatment history and are less willing to report maltreatment. In the FGC group, a surprisingly high proportion of adolescents reported having experienced no maltreatment, which is probably highly underreported and/or unrecognised in the CWS. In fact, a high ACE score will not identify the children who have experienced direct maltreatment but will highlight the consequences of the unfavourable factors inherent in disadvantaged social situation instead.

Highlights

The children living under child protection care are one of the populations most at risk as they are exposed to a number of risk factors affecting their development starting from the moment of conception, such as intrauterine adversities [2,3], the consequences of inadequate nutrition [4], difficulties arising from the family’s socioeconomic position, poverty [5,6], or massive exposure to different forms of childhood neglect and maltreatment [7,8], which will subsequently lead to a broad spectrum of lifelong negative impacts [3,9,10]
Our study aimed to examine one group of risk factors, namely adverse childhood experiences and their self-reported patterning among children in family-style group care (FGC), as these experiences have been empirically confirmed to be interrelated with a wide range of adverse social, emotional, cognitive, and socioeconomic outcomes
More than five times as many adolescents in this group had experienced four or more adverse childhood experiences, and the cumulative ACE score mean in this group was three times higher compared to the control group, which clearly indicates that exposure to multiple adverse experiences is definitely higher in the FGC group

Summary

Introduction

The children living under child protection care are one of the populations most at risk as they are exposed to a number of risk factors affecting their development starting from the moment of conception, such as intrauterine adversities [2,3], the consequences of inadequate nutrition [4], difficulties arising from the family’s socioeconomic position, poverty [5,6], or massive exposure to different forms of childhood neglect and maltreatment [7,8], which will subsequently lead to a broad spectrum of lifelong negative impacts [3,9,10]. Identifying this population is especially important if we want to protect these children, and prevent them from experiencing further adversities

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Results

Discussion

Conclusion