BackgroundScreening for Adverse Childhood Experiences (ACEs) in pediatric patients has the potential to prevent poor health outcomes associated with ACEs. Only a limited number of tools screen for all ten ACEs in all pediatric age groups, and none of these have demonstrated robust validity to date. ObjectiveIn order to evaluate the validity of the Whole Child Assessment, we examined associations between poor outcomes in pediatric patients and responses to questions about exposure to and risk of ACEs. MethodsThis cross-sectional study used medical record data from 499 children ages 5−11 years old who received care at one of two university-affiliated clinics in California. All Child-ACE measures were included on the Whole Child Assessment, which caregivers completed when they brought their child to a well-child visit. Medical charts were reviewed for current diagnoses and problems, current or past history of any developmental delay, and health care utilization. ResultsCompared to lower risk patients (0−1 reported ACE exposure), patients with 2 or more reported exposures were statistically significantly more likely to experience sadness, anger, sleep problems, bullying, school problems, and enuresis. The directionality of effects and the number of statistically significant associations improved when adding questions about risk of ACEs to the total Child-ACE score. ConclusionWe found strong relationships between Child-ACEs reported on the Whole Child Assessment and odds of poor child health and psychosocial outcomes in pediatric patients age 5−11 years old, which supports the validity of using the Whole Child Assessment at well-child visits.