Adverse Childhood Experiences: Assessment and Long-Term Outcomes

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Global Pediatric Health".

Deadline for manuscript submissions: 30 May 2025 | Viewed by 2885

Special Issue Editors


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Guest Editor
1. Egas Moniz School of Health and Science, Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal
2. CiiEM—Centro de Investigação Interdisciplinar Egas Moniz, IUEM, 2829-511 Caparica, Portugal
Interests: positive and adverse childhood experiences; adulthood victimization; victimization in justice-involved populations; mental health
Special Issues, Collections and Topics in MDPI journals

E-Mail Website1 Website2
Guest Editor
1. Faculty of Human and Social Sciences, University of Fernando Pessoa (UFP), Praça 9 de Abril, 349, 4249-004 Porto, Portugal
2. Observatory Permanent Violence and Crime (OPVC), FP-I3ID, Fernando Pessoa University, 4249-004 Porto, Portugal
3. Research Center on Child Studies (CIEC), University of Minho, 4710-057 Braga, Portugal
Interests: victimization; victimology; interparental violence; intimate partner violence; domestic violence; child abuse and neglect; child rights
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
1. Egas Moniz School of Health and Science, Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal
2. Research Center for Psychological Science (CICPSI—Centro de Investigação em Ciência Psicológica), University of Lisbon, 1649-013 Lisboa, Portugal
Interests: children at risk; children of divorce; child abuse and neglect; juvenile delinquency; trauma and post-traumatic growth
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
1. Egas Moniz School of Health and Science, Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal
2. CiiEM—Centro de Investigação Interdisciplinar Egas Moniz, IUEM, 2829-511 Caparica, Portugal
Interests: Emotion regulation and psychopathology; sexual health; disability studies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Research on adverse childhood experiences (ACEs) has highlighted how early traumatic events (e.g., abuse, neglect, and family dysfunction) are linked to increased risks for physical illness, mental health issues, and social challenges. This makes the assessment and study of ACEs’ impact essential. Therefore, this Special Issue aims to deepen knowledge, expand understanding, and explore advanced methods of assessing ACEs, identifying critical factors influencing individual life paths, resilience, and recovery from traumatic experiences, in addition to examining the diverse effects of ACEs across different populations. This Special Issue seeks to publish innovative research about childhood adversity, considering its short-term and long-term impact on psychological well-being, health, and social outcomes.

We invite all researchers to submit original empirical quantitative or qualitative research, original systematic reviews, and original meta-analysis review papers about the assessment and impact of ACEs throughout life (from childhood to adulthood).

Dr. Telma C. Almeida
Dr. Ana Isabel Sani
Dr. Susana Monteiro
Dr. Jorge Cardoso
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • adverse childhood experiences
  • assessment
  • impact
  • mental health
  • social problems
  • physical illness

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Published Papers (4 papers)

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Research

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17 pages, 4925 KiB  
Article
A National Trauma-Informed Adverse Childhood Experience Screening and Intervention Evaluation Project
by Karissa M. Luckett, Rachel Gilgoff, Molly Peterson, Aldina Hovde, Stephanie Pinney, Ruth S. Gubernick, Lisa M. Schafer, Monika Sanchez and Steven Kairys
Children 2025, 12(4), 453; https://doi.org/10.3390/children12040453 - 31 Mar 2025
Viewed by 378
Abstract
Background/Objectives: Adverse childhood experiences (ACEs) are traumatic childhood events that can disrupt neurologic, endocrine, and immune regulation and increase the risk for poor health outcomes. This Trauma-Informed ACE Screening and Intervention Evaluation (TASIE) Quality Improvement (QI) Project, ECHO, evaluated (1) pediatric provider knowledge [...] Read more.
Background/Objectives: Adverse childhood experiences (ACEs) are traumatic childhood events that can disrupt neurologic, endocrine, and immune regulation and increase the risk for poor health outcomes. This Trauma-Informed ACE Screening and Intervention Evaluation (TASIE) Quality Improvement (QI) Project, ECHO, evaluated (1) pediatric provider knowledge of ACEs, toxic stress, and trauma-informed care principles, (2) implementation of ACE screening and clinical response in practice, and (3) patient and provider perspectives around benefits and challenges of ACE screening. Methods: From November 2021 to May 2024, three cohorts, totaling 46 pediatric practices across the U.S., participated in the TASIE Project, which included 2 h ACE training, eight monthly 75 min ECHO sessions, and monthly QI coaching. A mixed-methods approach was used to evaluate monthly data, while patient and provider surveys and provider focus groups were used to evaluate the program. Results: All 46 participating practices implemented ACE screening by the project’s conclusion. Of the patients eligible for ACE screening, over half were screened for ACEs during the program. Providers increased comfort with discussing ACEs and screening questions. During the first month, the practices were reported to have provided education to 56% of patients, and by the end of the project, this rate increased to 79% of patients. Overall, 97% of caregivers and 92% of adolescents screened agreed or somewhat agreed that it is important for providers to know about ACEs and toxic stress so they can offer better care. By the end of the project, for each cohort, providers reported that they were able to screen effectively and efficiently in routine practice and were more familiar with local resources. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Assessment and Long-Term Outcomes)
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25 pages, 521 KiB  
Article
Mediating Effects of Exposure to Violence in Different Contexts of Child-to-Parent Violence: Validation of the Exposure to Violence Scale
by Luis Burgos-Benavides, M. Carmen Cano-Lozano, Isabel Suevos-Rodríguez, Paola Bustos-Benítez and Francisco Javier Rodríguez-Díaz
Children 2025, 12(4), 409; https://doi.org/10.3390/children12040409 - 24 Mar 2025
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Abstract
Exposure to violence is one of the most common adverse effects. In recent years, there has been a particular interest in understanding the link between exposure to violence and the perpetration of other forms of violence, such as child-to-parent violence, a complex family [...] Read more.
Exposure to violence is one of the most common adverse effects. In recent years, there has been a particular interest in understanding the link between exposure to violence and the perpetration of other forms of violence, such as child-to-parent violence, a complex family problem that severely affects the relationships between family members. Objective: We aimed to examine the mediating role of instrumental and reactive reasons in the relationship between exposure to violence and child-to-parent violence in different contexts. To fulfill this objective, it was necessary to analyze the evidence of validity and psychometric properties of the Violence Exposure Scale with Colombian adolescents. Methods: A total of 981 Colombian adolescents between aged 12 and 18 years participated. The participants responded to two psychometric scales: one on exposure to violence and the other on child-to-parent violence. Results: The Violence Exposure Scale presented an excellent psychometric model and evidence of adequate validity and reliability. Girls reported greater exposure to violence at home and boys reported greater exposure to violence at school and on the street. In general, older adolescents reported greater exposure to domestic violence. Instrumental and reactive reasons were significant predictors in the perpetuation of child-to-parent violence, with victimization in the home being the best predictor and reactive reasons the strongest mediating variables. Conclusions: Exposure to violence in the home is a key predictor; however, the co-occurrence of violence in other settings plays an important role in polyvictimization and predicting future violent behavior. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Assessment and Long-Term Outcomes)
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19 pages, 1464 KiB  
Article
Mediating Role of Moral Disengagement Mechanisms in the Relationship Between Perceived Parental Warmth and Youth Violence
by María J. Navas-Martínez, Lourdes Contreras and M. Carmen Cano-Lozano
Children 2025, 12(2), 246; https://doi.org/10.3390/children12020246 - 18 Feb 2025
Viewed by 715
Abstract
Background/Objectives: Although child-to-parent violence (CPV), peer violence (PV), and dating violence (DV) share risk factors and tend to co-occur, little is known about the common and differential mechanisms involved in the development of these types of youth violence. This study aims to (1) [...] Read more.
Background/Objectives: Although child-to-parent violence (CPV), peer violence (PV), and dating violence (DV) share risk factors and tend to co-occur, little is known about the common and differential mechanisms involved in the development of these types of youth violence. This study aims to (1) analyze the relationship between youth violence (CPV, PV, and DV) and perceived parental warmth and moral disengagement mechanisms and (2) explore the mediating role of moral disengagement mechanisms in the relationship between the lack of perceived parental warmth and youth violence. Methods: A cross-sectional population-based survey study was conducted. The sample consisted of 2124 Spanish adolescents (57.9% girls) aged between 13 and 17 years from educational centers. Results: The lack of perceived parental warmth (parental criticism-rejection in particular) is a common risk factor for all three types of violence and, more relevantly, is related to youth violence through moral disengagement mechanisms, highlighting a differential contribution of these mechanisms according to the type of violence. In particular, advantageous comparison and attribution of blame are specific mediators of CPV, and moral justification and distortion of consequences are specific to PV, whereas euphemistic language seems to be a common mediator of PV and DV. Conclusions: This study suggests that adolescents who perceive a lack of parental warmth are more likely to develop different dysfunctional cognitive mechanisms, which in turn are related to different types of youth violence. It would be important to promote warm parenting practices and address the cognitive mechanisms underlying youth violence. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Assessment and Long-Term Outcomes)
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Review

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16 pages, 1165 KiB  
Review
Assessing the Predictive Validity of Risk Assessment Tools in Child Health and Well-Being: A Meta-Analysis
by Ning Zhu, Xiaoqing Pan and Fang Zhao
Children 2025, 12(4), 478; https://doi.org/10.3390/children12040478 - 7 Apr 2025
Viewed by 560
Abstract
Background/Objectives: Violence and harm to children’s health and well-being remain pressing global concerns, with over one billion children affected annually. Risk assessment tools are widely used to support early identification and intervention, yet their predictive accuracy remains contested. This study aims to systematically [...] Read more.
Background/Objectives: Violence and harm to children’s health and well-being remain pressing global concerns, with over one billion children affected annually. Risk assessment tools are widely used to support early identification and intervention, yet their predictive accuracy remains contested. This study aims to systematically evaluate the predictive validity of internationally used child risk assessment tools and examine whether the tools’ characteristics influence their effectiveness. Methods: A comprehensive meta-analysis was conducted using 28 studies encompassing 27 tools and a total sample of 136,700 participants. A three-level meta-analytic model was employed to calculate pooled effect sizes (AUC), assess heterogeneity, and test moderation effects of tool type, length, publication year, assessor type, and target population. The publication bias was tested using Egger’s regression and funnel plots. Results: Overall, the tools demonstrated moderate predictive validity (AUC = 0.686). Among the tool types, the structured clinical judgment (SCJ) tools outperformed the actuarial (AUC = 0.662) and consensus-based tools (AUC = 0.580), suggesting greater accuracy in complex decision-making contexts. Other tool-related factors did not significantly moderate the predictive validity. Conclusions: SCJ tools offer a promising balance between structure and professional judgment. However, all tools have inherent limitations and require careful contextual application. The findings highlight the need for dynamic tools integrating risk and needs assessments and call for practitioner training to improve tool implementation. This study provides evidence-based guidance to inform the development, adaptation, and use of child risk assessment tools in global child protection systems. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Assessment and Long-Term Outcomes)
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