Editor’s Note: Elizabeth Zeichner (she/her) is a former high school teacher and a resident physician in pediatrics at the Children’s Hospital of Philadelphia. -Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics
Recently, there has been significant research reporting adverse childhood experiences (ACEs) and the downstream health outcomes. However, most of this has been retrospective, focusing on self-reported data from adults reflecting on their childhood experiences, or parent-reported prevalence of ACEs.
This week, Pediatrics is early releasing an article, “Prevalence of Adverse Childhood Experiences Among Adolescents,” by Elizabeth A. Swedo, MD, MPH, and colleagues at the CDC National Center for Injury Prevention and Control, which explores self-reported cross-sectional data from over 33,000 US public-high-school students across 16 states in the 2021 Youth Risk Behavior Surveillance System survey (10.1542/peds.2024-066633).
The study focuses on lifetime prevalence of individual and cumulative ACEs. Individual ACEs include:
- Emotional abuse
- Physical abuse
- Sexual abuse
- Physical neglect
- Witnessed intimate partner violence
- Household substance use
- Household poor mental health
- Incarcerated parent or guardian
The authors found that:
- 4 in 5 adolescents experienced at least one ACE, and 1 in 5 experienced 4+ ACEs.
- There were significant reports of all forms of abuse, with emotional abuse being most reported (65.8%).
- Female students had a higher prevalence of all ACEs (except physical neglect) than their male counterparts.
- Students who identified as a sexual minority also reported higher prevalence of individual ACEs.
There are many interesting results—too many to mention in this blog—particularly when the authors separated the findings by demographic groups. I encourage you to read the entire article. Not surprisingly, there was a higher prevalence of ACEs—and of abuse—when adolescents self-reported, compared to previous studies in which ACEs were reported retrospectively by adults or by parents.
This study emphasizes the importance of self-reported, youth-based surveillance to better understand ACEs in adolescents.
Reflecting on clinical practice, it is important to conduct confidential interviews with adolescents in clinic or while in the hospital to better understand each teen’s unique needs.
