Early Adverse Childhood Experiences Research Articles

Association of adverse childhood experiences with poor health condition among middle-aged and elderly adults in the United States: A nationally retrospective cohort study

BackgroundThe specific effects of adverse childhood experiences (ACEs) in adulthood and senectitude were less known. We aim to examine the relationship between early ACEs and overall health condition as well as specific dimensions in the middle-aged and elderly population. MethodsIn the 2019-2021 Behavioral Risk Factor Surveillance System Study, robust Poisson regression models were used to estimate the relationship between ACE exposure and current health status among adults aged 45 ≥ years. ResultsOf the 195,472 participants, 53.8% were female and the mean age was 65.0 years. Compared to populations without ACE, ACE exposures were more significantly associated with depression (PR: 2.03, 95%CI: 1.94-2.21), frequent mental health (PR: 1.85, 95%CI: 1.74-1.97) and subject cognitive decline (PR: 1.99, 95%CI:1.85-2.14) than with physical health (PR: 1.37, 95%CI: 1.32-1.44), with dose-response patterns. The association with mental disorder was especially significant among the elderly population. ConclusionEarly ACEs are associated with adverse health outcomes that persist into later life, particularly mental disorders and cognitive decline. Poor mental health may indirectly influence associations with ACEs and cognitive decline as well as physical health. Our findings emphasize the importance of lifelong psychological screening and support for the ACE-exposed middle-aged and elderly population.

Adverse childhood experiences and insecure attachment: The indirect effects of dissociation and emotion regulation difficulties.

Difficulties with dissociation and emotion regulation are well-documented reactions to early adverse childhood experiences (ACEs). Although findings identify dissociation and emotion dysregulation as explaining the relationship between various forms of ACEs and adult psychopathology, less is known about their combined effect in the relationship between ACEs and insecure attachment in adulthood. This study examined the indirect effects of dissociation and emotion regulation difficulties in the relationship between early adverse experiences and insecure attachment traits. Participants (N = 260) completed an online questionnaire measuring ACEs, dissociation, emotion regulation difficulties, and anxious and avoidant attachment. Results indicated that, after controlling for mental health treatment, dissociation and emotion regulation difficulties explained the relationship between ACEs and insecure (anxious and avoidant) attachment. Emotion regulation difficulties were not a significant predictor of avoidant attachment. Findings provide support for greater research on mediating factors in the maintenance of insecure attachment across development and potential implications of dissociation and emotion regulation in clinical and nonclinical populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Exploring stress response's role in executive function impairments among adults with early adverse childhood experiences.

Adverse childhood experiences (ACEs) are recognised as precursors to numerous physical and mental health challenges. However, research on their impact on inhibitory control and working memory, particularly among healthy young adults, remains limited. The role played by the stress response as a moderator in these effects is likewise underexplored. Our study addresses this gap by examining cognitive impairments in non-clinical adults with early childhood trauma, specifically trauma before the age of 13 years, and by assessing the influence of the stress response on these effects. A total of 15 participants with early ACEs were compared with a control group (n = 18) using the Corsi Block Tapping Test (CBTT) and Stroop Word Colour Test (SCWT). Results showed that participants with early ACEs exhibited lower scores on the SCWT but not the CBTT. The stress response emerged as a potential factor in the relationship between early ACEs and cognitive performance. The implications of these findings are then discussed in relation to the existing literature.

Prevalence of Adverse Childhood Experiences in Adolescents with Special Educational and Care Needs in the Netherlands: A Case-File Study of Three Special Educational and Care Settings

AbstractTo date, Adverse Childhood Experiences (ACEs) in adolescents with special educational and care needs have received little attention as an important risk factor for their behavioral, emotional, and learning problems. This study provides insight into ACE prevalence and family risk factors in three Dutch special educational and care settings for vulnerable school-aged youth. 268 adolescents (10–18 years old) with severe and persistent problems at individual and family level, from a special educational setting (setting 1; n = 59), a residential care setting (setting 2; n = 86) and an alternative educational setting (setting 3; n = 123) were included. A retrospective cross-sectional study design was used. Data were collected between 2016 and 2019 through structured case-file analysis. A substantial proportion of the adolescents in all settings experienced at least one ACE, with 69.5% in setting 1, 84.9% in setting 2 and 95.1% in setting 3. Family risk factors were relatively common, among which a limited social network in all settings (20–50%) and debts in setting 2 and 3 (25–40%). The substantial ACE prevalence underlines the need for early ACE awareness. Trauma-informed care and education are needed to adequately understand trauma-related behaviors, prevent retraumatization, and enhance learning and healthy development. Given that ACEs regarding household dysfunction and family risk factors seem to be common in adolescents with special educational and care needs, family centered approaches should be implemented as well in the interest of lifelong health and well-being for both adolescents and their families.

Adverse Childhood Experiences and Developmental Delay in Young US Children.

Adverse childhood experiences (ACEs) are common and have been associated with poor developmental outcomes. We aimed to investigate the relationship between early ACE exposure, subsequent diagnosis of developmental delay, and receipt of developmental delay services by young children. In addition, we aimed to assess the impact of health-promoting behaviors such as breastfeeding and daily reading on these relationships. In this cross-sectional analysis of nationally-representative data from the 2017-2018 National Survey of Children's Health, we examined the relationship between ACEs, prior breastfeeding, daily reading, and developmental delay diagnosis among 7837 children aged 3-5 years, using multivariate logistic regression to adjust for family, personal, and sociodemographic characteristics. We found a dose-dependent relationship between ACEs and developmental delay diagnosis; compared to those without ACEs, developmental delay was more common among those with either one ACE (aOR = 2.03, 95% CI 1.17-3.52) or two or more ACEs (aOR = 2.34, 95% CI 1.25-4.37). Neither breastfeeding (exclusively breastfed for 6 months vs. never breastfed aOR = 0.70, 95% CI 0.33-1.46) nor daily reading (no reading versus daily reading aOR = 1.15, CI 0.57-2.33) were associated with incidence of developmental delay among study participants. There was no significant difference in receipt of services intended to meet developmental needs between children with and without ACEs. Children with very early ACE exposure are at increased risk for diagnosis of developmental delay. Early screening for ACEs and developmental delay may mitigate the early developmental manifestations of ACE exposure in vulnerable children.

Early adverse childhood experiences and adolescent sleep outcomes

BackgroundSleep is critical for physical, mental, and emotional health. This may be particularly true for adolescents experiencing rapid physiological changes. Relatively little is known about how adverse childhood experiences (ACEs) are implicated in adolescent experiences with sleep. ObjectiveWe use data (from the Future of Families and Child Wellbeing Study (FFCWS, n = 3444) to assess the relationship between early ACE exposure (by age 5) and various adolescent sleep outcomes. We anticipate that early ACEs will be associated with poor adolescent sleep outcomes. Methods: FFCWS data includes survey responses from parents and/or primary caregivers and children at birth and approximately one, three, five, nine, and 15 years later. The FFCWS oversampled unmarried parents with low educational attainment, income, and from marginalized racial-ethnic groups. Models of sleep outcomes included ordinary least squares, Poisson, negative binomial, logistic, and order logistic regression, as appropriate. ResultsDespite a high number of ACEs, adolescent hours of sleep were consistent with published recommendations. Other measures of sleep indicated adolescents in the sample experience worse sleep on most other measures. ACE exposure was associated with difficulty falling asleep and staying asleep. More ACEs was also related with problematic sleep environments (i.e., place slept) and increased snoring. There was some evidence that ACEs were related to less sleep on weekends and increased social jet lag (different patterns of sleep between weekdays and weekends). ConclusionsOur findings suggest that ACEs could be important diagnostic data for clinicians in primary care and behavioral sleep medicine practice.

The Association between Adverse Childhood Experiences and Mental Health Wellbeing during the Adulthood: The Cross-Sectional Study of the 2020 United States Behavioral Risk Factor Surveillance System (BRFSS)

To understand the frequency of retrospectively self-reported adverse childhood experiences (ACEs) and evaluate whether early ACEs are independently associated with mental health wellbeing during adulthood.

Early Adverse Childhood Experiences and Later Delinquency: Considering the Role of Middle Childhood Risk Factors

ABSTRACT Evidence suggests that adverse childhood experiences (ACEs) are associated with adolescent and adult delinquency. Simultaneously, studies have identified an association between middle childhood risk factors and subsequent delinquency. However, the research on how the relationship between early ACEs and adolescent delinquency is affected by middle childhood risk factors for delinquency is sparse. The current study addresses this, and other important gaps in existing ACE literature by using data from the Future of Families and Child Wellbeing Study (FFCWS; n = 3,444), a national urban birth cohort, to analyze how different levels of exposure to early ACEs (by age five) are associated with delinquency and to explore how multiple middle childhood risk factors (low self-control, prior delinquency, material hardship, experiences with bullying, and more recent ACE exposure) might mediate these processes. Findings suggest that two or more ACEs is significantly associated with increased rates of adolescent delinquency and that the association grows stronger as ACEs accumulate. Further, later ACEs, low self-control and prior delinquency mediate some of this relationship.

Unpacking the Impact of Early Adverse Childhood Experiences on Early Onset of Sexual Intercourse Among an Urban Birth Cohort of Early Adolescents

PurposeEarly adverse childhood experiences (ACEs) predict early onset of sexual intercourse. However, patterns of ACEs identified using latent class analysis (LCA) and their links to early sexual intercourse have been less examined. In this study, we apply LCA to identify ACEs profiles at age five and to examine whether these profiles differentially predict adolescents' sexual initiation. MethodsWe analyzed data obtained from the Future of Families and Child Wellbeing Study for 3,185 participants (male = 1,638; female = 1,547). This included parental/caregivers' reports of 10 types of ACEs when participants were on average at age five and youth self-report data on sexual intercourse before or at age 15. We used LCA to classify the participants into subgroups and multinomial logistic regressions to examine differences in early sexual initiation among the ACEs subgroups. ResultsLCA showed evidence of four classes for both genders: low adversity (51.8%), socioeconomic adversity (32.0%), family dysfunction (12.0%), and abuse (4.2%). We found class membership differences in early sexual intercourse in all three adversity classes compared to the low adversity group. Pairwise comparison tests further revealed that adolescents in the family dysfunction class had lesser odds of engaging in early sexual intercourse than their counterparts in the socioeconomic adversity and abuse classes. DiscussionOur findings suggest that LCA could help identify meaningful and distinctive child adversity patterns while accounting for the co-occurrence of ACEs. This is particularly helpful in evaluating who might be at greatest health risk which can further inform more effective and targeted interventions.

Evaluation of Midlife Educational Attainment Among Attendees of a Comprehensive Early Childhood Education Program in the Context of Early Adverse Childhood Experiences

Educational attainment is a key social determinant of health and can be particularly consequential for racial and ethnic minority populations. Although the consequences of adverse childhood experiences (ACEs) are well established, there is little research on protective factors and policy-relevant strategies to mitigate ACE-related inequities. To examine associations between early ACEs, comprehensive early intervention, and midlife educational attainment in a cohort of predominantly Black participants. The Chicago Longitudinal Study is a prospective cohort study of Black and Latinx children from Chicago, Illinois. The intervention group included 989 children entering the Child-Parent Center (CPC) preschool Early Childhood Education (ECE) program in the 1980s. The comparison group comprised 550 children participating in usual early childhood services. All participants were followed up for 30 years after the end of the intervention. Analyses were conducted from July 1 to September 1, 2022. Attendance at the CPC preschool ECE program. A standard battery of early childhood ACEs (conventional ACEs), a set of early childhood ACEs more commonly associated with high-poverty contexts (expanded ACEs), and educational attainment at 35 years of age were measured from self-report and administrative records. The original Chicago Longitudinal Study sample comprised 1539 participants (1430 Black participants [92.9%]; 774 female participants [50.3%]). Data on educational attainment and ACEs were available for 1083 of 1467 living participants (73.8%). Participants in the present study (1013 Black participants [93.5%]; 594 female participants [54.9%]) were a mean (SD) age of 35.1 (0.3) years at completion of the midlife survey. For the comparison group but not the CPC intervention group, having 1 or more conventional or expanded ACEs in early childhood was associated with fewer years of education (β = -0.64; 95% CI, -1.02 to -0.26), reduced likelihood of attaining a bachelor's degree or higher (odds ratio, 0.26; 95% CI, 0.09-0.70), and reduced likelihood of attaining an associate's degree or higher (odds ratio, 0.26; 95% CI, 0.11-0.62) after adjusting for covariates. Moderation analyses indicated that CPC participants with either conventional or expanded ACEs in early childhood attained a bachelor's degree or higher and an associate's degree or higher at rates similar to CPC participants without early ACEs (15.4% vs 13.6% for bachelor's degree or higher; 22.4% vs 19.9% for associate's degree or higher). Conversely, comparison group participants with early ACEs had significantly lower rates of educational attainment than their counterparts without ACEs (3.7% vs 12.1% for bachelor's degree or higher; 5.6% vs 17.1% for associate's degree or higher). This cohort study suggests that early ACEs were associated with reduced educational attainment for the comparison group but not for the group participating in the CPC comprehensive early intervention. These results build on research suggesting that youths at higher risk can benefit most from intervention and support ECE as a tool for reducing ACE-related disparities.

Adverse childhood experiences as a risk factor for non-suicidal self-injury and suicide attempts in forensic psychiatric patients

BackgroundExposure to adverse childhood experiences (ACE) have been found to have profound negative consequences on an individuals’ health. Non-suicidal self-injury (NSSI) is a clinically complex and serious global health issue and is closely related to suicide attempts. Previous research has found associations between ACE and NSSI and suicide attempts in clinical samples. However, this association has to our knowledge not been studied to this extent in a sample of forensic psychiatric patients. The aim of this study was therefore to describe the prevalence of adverse childhood experiences (ACE) and their associations with non-suicidal self-injury (NSSI) and/or suicide attempts in forensic psychiatric patients.MethodsThe current study is a cross-sectional study of a consecutive cohort of 98 forensic psychiatric patients (86.7% male) in Sweden. We invited 184 patients with a predicted stay of > 8 weeks who had been cleared for participation by their treating psychiatrist. Of these, 83 declined and 98 eligible patients provided informed consent. Information on ACE, NSSI, and suicide attempts derived from files, self-reports (Childhood Trauma Questionnaire-Short Form; CTQ-SF), and interviews were compared separately among participants with and without NSSI or suicide attempts using t-tests. The dose–response association between ACE and NSSI/suicide attempts was analysed using binary logistic regression.ResultsIn file reviews, 57.2% of participants reported physical abuse, 20% sexual abuse, and 43% repeated bullying by peers during childhood. NSSI and suicide attempts were associated significantly with CTQ-SF total scores, with medium effect sizes (d = .60 to .63, p < .01), and strongly with several CTQ-SF subscales. Parental substance abuse was also associated with NSSI (p = .006, OR = 3.23; 95% confidence interval [CI] = 1.36 to 7.66) and suicide attempts (p = .018, OR = 2.75; 95% CI = 1.18 to 6.42). Each additional ACE factor predicted an increased probability of NSSI (p = .016, OR = 1.29; CI = 1.04 to 1.59) but not of suicide attempts. When anxiety and depressive disorders were included in the model, ACE remained a significant predictor of NSSI.ConclusionsWe report extensive ACE, from both files and self-reports. When comparing groups, correlations were found between ACE and NSSI, and ACE and suicide attempts among forensic psychiatric patients. ACE seem to predict NSSI but not suicide attempts in this group, even when controlling for affective and anxiety disorders. Early ACE among forensic psychiatric patients, especially physical and emotional abuse and parental substance abuse, have important impacts on self-harming behaviours that must be acknowledged both by the institutions that meet them as children and in their later assessment and treatment.

Family Caregiver Acceptability of Assessing Caregiver Adverse Childhood Experiences (ACEs) and Distress in Pediatric Specialty Care

Providing quality healthcare for children includes assessing and responding to needs of their family caregivers. Three salient domains to consider are caregivers' early adverse childhood experiences (ACEs), their current levels of distress, and their resilience in coping with both prior and current stressors. Determine acceptability of assessing caregiver ACEs, current distress, and resilience in pediatric subspecialty care settings. Caregivers of patients in two pediatric specialty care clinics completed questionnaires about their ACEs, recent emotional distress, and resilience. Importantly, caregivers also rated the acceptability of being asked these questions. Participants included 100 caregivers of youth ages 3-17 across Sickle Cell Disease and Pain clinic settings. The majority of participants were mothers (91.0%) who identified as non-Hispanic (86.0%). Caregiver race was primarily African American/Black (53.0%) and White (41.0%). The Area Deprivation Index (ADI) was used to assess socioeconomic disadvantage. High levels of caregiver acceptability or neutrality with assessing ACEs and distress, as well as high ACEs, distress, and resilience. Associations were found between caregiver ratings of acceptability with caregiver resilience and socioeconomic disadvantage. Caregivers reported openness to being asked about their experiences during childhood and recent emotional distress, although ratings of acceptability varied according to other contextual variables, such as level of socioeconomic disadvantage and caregiver resilience. In general, caregivers perceived themselves to be resilient in the face of adversity. Assessing caregiver ACEs and distress in a trauma-informed way may provide opportunities for better understanding the needs of caregivers and families in order to support them more effectively in the pediatric setting.

Early exposure to adverse childhood experiences and delinquent peer association among youth

AbstractObjectiveThis study examines the relationships between cumulative, timing of, and duration of early adverse childhood experiences (ACEs) and delinquent peer association among youth.BackgroundNegative life outcomes associated with delinquent peer affiliation among youth are well established; however, less research has considered how or whether ACEs influence these processes.MethodsData were from the longitudinal Fragile Families and Child Wellbeing Study (n = 3,060). Negative binomial regression models were to assess the relationship between early ACEs (i.e., accumulation, timing/duration) and delinquent peer association.ResultsOur results indicate that as the number of ACEs (by age 5) incrementally increase, the likelihood of reported involvement with delinquent peers increases. Moreover, when it comes to timing and duration of ACE exposure, ACEs that are high but late, intermittent, or chronically high significantly increase the risk of delinquent peer association.Conclusion and implicationsOverall, early ACEs play an important role in delinquent peer association during adolescence. Interventions and preventions strategies, such as psychological first aid and trauma‐informed health care, can help reduce the negative consequences of early ACE exposure, including the risk of associating with delinquent peers.

Adverse Childhood Experiences, Resilience, and Emotional Problems in Young Chinese Children.

Resilience plays an important role in the relationship between adverse childhood experiences (ACEs) and children's health. Young children are often neglected in ACEs research and suffer from the negative consequences of ACEs. However, few studies have focused on the relationship between ACEs and emotional problems in young Chinese children and the moderating and mediating effect of resilience on this relationship. This study included young children at the beginning of their kindergarten year (n = 874, 42.80 ± 4.09 months) from Wuhu City, China, to examine the mediation and moderation effects of resilience on early-life ACEs and emotional problems. Our results show a positive direct effect of ACEs on emotional problems. Furthermore, a positive indirect effect of ACEs and emotional problems on resilience was found. A moderating effect of resilience was not observed in this study. Our findings (a) highlight the significance of paying more attention to early ACEs and revealing a better understanding of the effect of resilience on ACEs at an early age and (b) indicate that age-specific interventions should be provided to enhance young children's resilience when exposed to adversity.

Early Adverse Childhood Experiences and Exclusionary Discipline Practices in Middle Childhood

Previous articleNext article No AccessEarly Adverse Childhood Experiences and Exclusionary Discipline Practices in Middle ChildhoodHyunji Lee, Lisa Schelbe, and Mary Elizabeth RauktisHyunji Lee Search for more articles by this author , Lisa Schelbe Search for more articles by this author , and Mary Elizabeth Rauktis Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Journal of the Society for Social Work and Research Just Accepted Published for the Society for Social Work and Research Article DOIhttps://doi.org/10.1086/724553 Views: 23Total views on this site HistoryAccepted February 01, 2023 © 2023 Society for Social Work and Research. All Rights reserved.PDF download Crossref reports no articles citing this article.

Early Adverse Childhood Experiences and Positive Functioning during Adolescence.

Adverse childhood experiences (ACEs) have been shown to have consequences for adolescent development, yet little is known about the association between ACEs and positive functioning. Positive functioning evaluates engagement, perseverance, optimism, connectedness, and happiness, which are intimately related to pro-social behavior. As skills associated with sociability in adolescence often carry on into adulthood, understanding the developmental origins in inequalities in pro-social behavior, as measured by positive functioning, is key to ensuring equitable life chances across the life course. Subsequently, the Fragile Families and Child Wellbeing Study (FFCWS; n = 3444) was used to examine how early exposure to cumulative ACEs, plus the timing and duration of those ACEs may be associated with positive functioning development in adolescence. The sample consisted of urban-born youth (49% female) with the mean age of 15. Racial/ethnic breakdown of the sample is 18% non-Hispanic White, 49% non-Hispanic Black, 25% Hispanic, and 8% "Other". Overall, estimates suggest that roughly 88% of these youth experienced at least one ACE by age five. The findings indicate that cumulation, timing, and duration of early ACEs are related to overall adolescent positive functioning and four out of the five domains (perseverance, optimism, connectedness, and happiness), even after controlling for more recent ACEs. This study highlights the critical impact of very early ACEs on youth positive functioning, which may confer further physical, mental, and social disadvantages into adulthood. Positive functioning can serve as a protective factor against some of the negative consequences of adversity, and ensuring that all families receive proper supports may limit the lifelong effects of adversity, and most importantly, prevent ACEs from occurring in the first place.

Adverse childhood experiences: Pathways to internalising and externalising problems in young adulthood

AbstractAlthough adverse childhood experiences have been closely linked to a variety of adjustment difficulties in adulthood, less is known about which specific adverse experience or combinations of experiences are differentially predictive of internalising and externalising problems. This would undoubtedly enhance early adverse childhood experiences prevention and intervention programmes. Therefore, this research aims to explore the impact of adverse childhood experiences (abuse and neglect) on deviant behaviour, as well as depressive, anxious and stress symptoms in a community sample of Spanish young adults aged 18–20 years old (N = 270). All participants were recruited using convenience and snowball sampling methods as part of the International Study SOCIALDEVIANCE1820. All answered self‐report questionnaires about sociodemographic issues, adverse childhood experiences as well as current deviant behaviour and current internalising symptoms. Regression and fuzzy‐set qualitative comparative analysis showed that experiencing either physical abuse or a combination of emotional abuse and emotional neglect may lead to externalising problems in men. Internalising problems, however, were linked to the cumulative effect of multiple adverse experiences and were more frequent in women. These pathways to both externalising and internalising problems suggest a differential impact of adverse experiences.

Gender Differences in Adverse Childhood Experiences, Self-Control, and Delinquency

Considerable research has shown that adverse childhood experiences (ACEs) are associated with the development of self-control and delinquent behaviors. Still, no studies have explicitly examined ACEs, low self-control, and delinquency to determine if they are jointly associated, including whether this relationship varies by gender. The current study examines this important gap in existing literature. Using data from the Fragile Families and Childhood Wellbeing Study (FFCW; n = 3,232), we uncover that low self-control mediates the relationship between early ACEs and delinquency and that this relationship exists for both girls and boys.

Racial differences in the effects of early adverse childhood experiences on adolescent delinquency: The role of middle childhood mechanisms

PurposeCertain strains, called adverse childhood experiences (ACE), have continually been found to influence delinquency, but how these ACEs affect delinquency during adolescence and whether middle childhood experiences mediate this relationship remain unclear. Further, racial/ethnic differences in the ACEs to delinquency link remain understudied. The purposes of this study are threefold: (1) to understand the association of different levels of ACEs experienced by age five with adolescent delinquency, (2) explore potential middle childhood mechanisms that may mediate this association, and (3) examine whether the effects vary by race/ethnicity. MethodsNegative binomial regression models were used to examine the relationship between early cumulative ACEs and adolescent delinquency by race/ethnicity. Karlson-Holm-Breen (KHB) method was used examine the extent to which middle childhood mechanisms mediated the relationship between early ACEs and adolescent delinquency by race/ethnicity. ResultsOur findings support the established relationship between early childhood ACEs and youth delinquency but show that different middle childhood mechanisms – such as prior delinquency, low self-control, and cumulative ACEs – mediate the relationship differently across racial/ethnic groups. ConclusionsThis study highlights the importance of early ACEs as an explanation for adolescent delinquency as well as the importance of considering middle childhood mechanisms and race/ethnicity in these relationships.

“My Story Started When I was Younger. . .”: A Qualitative Analysis of Youth’s Differential Journeys Away From School

Adverse childhood experiences (ACEs) increase youths’ risk for leaving high school before graduating. However, to our knowledge, no one has examined how youth themselves conceptualize the role of ACEs in their journeys away from school. In this exploratory qualitative study, we used narrative analysis to examine (1) whether youth (n = 27) described ACEs leading them away from school, (2) how early these trajectories began, from youth’s own perspectives, and (3) if this varied by elements of identity and social position. Focus groups were conducted with youth ages 18-25 from 13 communities across the U.S. We found that youth described their journeys away from school as starting with early ACEs. We also found that youths’ narratives reflected intersectional gender differences in the pathways away from school that youth described. Girls articulated how ACEs influenced subsequent non-academic priorities; they eventually left or were kicked out due to a lack of credits. Boys expressed that early ACEs were followed by risk behaviors, punishment, and dropout. Implications for healing-centered engagement across settings and targeted dropout prevention are discussed.