The Burden of Adverse Childhood Experiences in Children and Those of Their Parents in a Burn Population.

Abstract

The aim of this study was to determine the prevalence, type, and associations of parental and child adverse childhood experiences (ACEs) in children presenting with burn injuries. Parents of burned children completed an ACE-18 survey, including questions on parent and child ACEs, needs, and resiliency. Demographics, burn injury, hospital course, and follow-up data were collected. Family needs and burn outcomes of children with and without ACEs' exposure (no ACE vs one to two ACEs vs three or more ACEs) were analyzed. P <.05 was considered significant. Seventy-five children were enrolled-58.7% were male, 69.3% white. The average age was 6.0 ± 5.2 years. The average total burn surface area was 4.4 ± 5.7% (0.1-27%). Parent ACE exposure correlated with child ACE exposure (r = .57; P = .001) and this intensified by increasing child age (P = .004). Child ACE exposure showed a graded response to family needs, including food and housing insecurity and childcare needs. Stress and psychosocial distress of the parents was significantly associated with their children's ACE burden. The ACE burden of parents of burned children can affect the ACE load of their children. Burned children with more ACEs tend to have significantly more needs and more family distress. Awareness of past trauma can help identify a vulnerable population to ensure successful burn recovery.