Wellbeing Outcomes for Children Exposed to Multiple Adverse Experiences in Early Childhood: A Systematic Review
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Wellbeing Outcomes for Children Exposed to Multiple Adverse Experiences in Early Childhood: A Systematic Review Kiley W. Liming1 · Whitney A. Grube1
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract This systematic review sought to examine and synthesize empirical research on the association between early childhood (0–83 months) exposure to multiple adverse childhood experiences (ACEs) and the child’s social, behavioral, emotional, or physical developmental wellbeing. Guided by inclusion criteria and predefined search terms, articles were identified through electronic bibliographic databases, reference mining, hand searching, and gray literature. Two authors simultaneously conducted title and abstract reviews, and subsequently full-text reviews. Included studies examined early childhood exposure to two or more ACEs and the association between social, emotional, behavioral, physical, and/or overall wellbeing outcomes. Five studies met the predetermined inclusion criteria and were descriptive, secondary data analyses that utilized large, high-risk samples. Findings support a dose–response association between cumulative early childhood ACE exposure and behavioral issues and poor physical health outcomes. Results revealed between 12.3 and 70% of the early childhood samples were exposed to three or more ACEs. Among high-risk samples, exposure to multiple adversities is common although literature is scarce. Policy and practice implications include early assessments and interventions tailored to identifying the most vulnerable early childhood children. Keywords Systematic review · Early childhood · Adverse childhood experiences
Introduction In a 2007 report, the World Health Organization reported there is strong empirical evidence that shows “… many of the challenges in adult society—mental health problems, obesity, stunting, heart disease, criminality, competence in literacy and numeracy—have their roots in early childhood” (Irwin et al. 2007, p. 5). Extensive research has revealed that adverse childhood experiences (ACEs) have been associated with a variety of risky behaviors and negative health and wellbeing outcomes, including: early unintended pregnancies (Hillis et al. 2001), learning and behavior disorders (Burke, Hellman, Scott, Weems, & Carrion, 2011), adult homelessness (Herman, Susser, Struening, & Link, 1997), suicidality (Dube, Anda, Felitti, Chapman, Williamson & * Kiley W. Liming [email protected] Whitney A. Grube [email protected] 1
University of Kansas, 1545 Lilac Lane, Twente Hall, Lawrence, KS 66045, USA
Giles, 2001), illicit drug use (Dube et al. 2003), fetal death (Hillis et al. 2001), eating disorders and chronic health conditions(Felitti et al. 1998; Middlebrooks and Audage 2008), and increased morbidity (Brown et al. 2009). Exposures to ACEs are interrelated and typically do not occur independently of other adversities (Dong et al. 2004; Finkelhor et al. 2007). The impact of exposure to ACEs intersects with multiple developmental domains, including social, emotio
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