Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Association of Adverse Childhood Experiences with Co-occurring Health Conditions in Early Childhood

Bright, Melissa A. PhD*; Thompson, Lindsay A. MD, MS*,†

Journal of Developmental & Behavioral Pediatrics: January 2018 - Volume 39 - Issue 1 - p 37–45
doi: 10.1097/DBP.0000000000000514
Original Articles
Watch video abstract

Objective: To understand how adverse childhood experiences (ACEs) are associated with co-occurring physical, mental and developmental problems during early childhood.

Method: A subsample of 19,957 children aged 2–5 years were selected from the 2011–2012 National Survey for Child Health. Outcomes included 18 health conditions organized in singular condition domains (physical, mental, and developmental), and combinations of condition domains (e.g., physical plus mental, mental plus developmental, etc.). Predictors included 8 ACEs (divorce of a parent, death of a parent, exposure to domestic violence, living with someone with a drug or alcohol abuse problem, household member with a mental illness, parent incarceration, neighborhood violence, discrimination). Multivariable logistic regression was performed controlling for demographic characteristics, having a personal doctor, health insurance coverage, and seeing a health care professional in the previous year.

Results: Experiencing 3 or more ACEs before the age of 5 years was associated with increased likelihood of nearly every co-occurring condition combination across 3 domains of health. Most notably, experiencing 3 or more ACEs was also associated with a 2-fold increase in likelihood of having ≥1 physical condition and ≥1 developmental condition, a 9-fold increase in likelihood of having ≥1 mental and ≥1 developmental condition, and a 7-fold increase in likelihood of having ≥1 physical, ≥1 mental, and ≥1 developmental condition.

Conclusion: This study demonstrates that we can identify the health effects of adversity quite early in development and that management should include communication between both health care and early childhood education providers.

*Anita Zucker Center for Excellence in Early Childhood Studies, University of Florida, Gainesville, FL;

Department of Pediatrics, University of Florida, Gainesville, FL.

Address for reprints: Melissa A. Bright, PhD, Anitza Zucker Center for Excellence in Early Childhood Studies, University of Florida, PO Box 100177, Gainesville, FL 32610-0177; e-mail:

Disclosure: The authors declare no conflict of interest.

See video abstract at

Received May 25, 2017

Accepted August 23, 2017

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.