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Focusing on Adverse Childhood Experiences and Positive Childhood Experiences for Future Outcomes

June 21, 2023

There is a clear association between adverse childhood experiences (ACEs) and poorer physical and mental health outcomes in adulthood. What role do positive childhood experiences (PCEs) play on adult health outcomes? In a new study being early released this month in Pediatrics, Huang et al (10.1542/peds.2022-060951) used nationally representative survey data obtained in 2017 and 2014 to look at PCEs, ACEs, and adult health outcomes. The results are impressive. Adults with at least 5 PCEs had reduced risk of poorer health and fewer mental health diagnoses compared to individuals with two or fewer PCEs. If you need a refresher on the types of PCEs associated with better health, the authors provide plenty of detail in the results and discussion section of their study.

What are the implications of these findings? To answer that question, we invited pediatrician and child advocate Dr. Barbara Frankowski (10.1542/peds.2023-061264) from the University of Vermont to share her thoughts in an accompanying commentary. She notes the importance of the findings in the study by Huang et al and provides ways for pediatricians and other child health professionals to focus on building strengths in their pediatric and adolescent patients. She calls upon all of us to never ask about ACEs without also identifying PCEs or family strengths at the same time. She cites different strength-based frameworks but focuses on a simple one, the Circle of Courage, which calls out four strengths, belonging, mastery, independence, and generosity, and how to cultivate these. If you need tips on how to identify and highlight PCEs in your patients, even those with a high number of ACEs, then you positively should link to both this study and commentary.

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