Research and Links

Childhood Adversity and Resilience (see data for this topic)

Websites with Related Information

• ACEs Connection Network
• Adverse Childhood Experiences (ACEs), Centers for Disease Control and Prevention
• California Campaign to Counter Childhood Adversity (4CA)
• California Dept. of Social Services: Office of Child Abuse Prevention
• California Essentials for Childhood Initiative, California Dept. of Public Health
• Center for Youth Wellness
• Center on the Developing Child, Harvard University
• Changing Minds, Futures Without Violence, et al.
• Child and Adolescent Health Measurement Initiative: Childhood Trauma and Positive Health
• Child Welfare Information Gateway, U.S. Dept. of Health and Human Services, Children’s Bureau
• National Child Traumatic Stress Network
• Robert Wood Johnson Foundation: Adverse Childhood Experiences
• Substance Abuse and Mental Health Services Administration (SAMHSA): Adverse Childhood Experiences, U.S. Dept. of Health and Human Services

Key Reports and Research

• 4 Essential Facts About Lifelong Health, School Success and Adverse Childhood Experiences Among California’s Children, 2014, Child and Adolescent Health Measurement Initiative
• Adverse Childhood Experiences (ACEs): California Update, 2011-2013 Data, 2016, California Dept. of Public Health
• Adverse Childhood Experiences: Assessing the Impact on Health and School Engagement and the Mitigating Role of Resilience, 2014, Health Affairs, Bethell, C. D., et al.
• Adverse Community Experiences and Resilience: A Framework for Addressing and Preventing Community Trauma, 2016, Prevention Institute, Pinderhughes, H., et al.
• Adverse Family Experiences among Children in Nonparental Care, 2011–2012, 2014, National Health Statistics Reports, Bramlett, M. D., & Radel, L. F.
• Barriers to Success: Toward a Deeper Understanding of Adversity’s Effects on Adolescents, 2017, America’s Promise Alliance, Porche, M. V., et al.
• Building Community Resilience Toolkit Series: Volume I, 2018, San Diego State University, Social Policy Institute, Pimental, K., et al.
• Children Can Thrive: A Vision for California’s Response to Adverse Childhood Experiences, 2015, Center for Youth Wellness
• Essentials for Childhood: Creating Safe, Stable, Nurturing Relationships and Environments, 2019, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control
• Evaluating Community-Based Family Support Networks to Reduce Adverse Childhood Experiences, Mathematica Policy Research
• Home Visiting Is a Valuable Investment in California’s Families, 2018, California Budget & Policy Center, Hutchful, E.
• How to Implement Trauma-informed Care to Build Resilience to Childhood Trauma, 2019, Child Trends, Dym Bartlett, J., & Steber, K.
• Neighborhood Adversity, Child Health, and the Role for Community Development, 2015, Pediatrics, Jutte, D. P., et al.
• Preventing Adverse Childhood Experiences: Leveraging the Best Available Evidence, 2019, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control
• Screening Kids from Birth to Age 5 for Trauma, 2019, Children Now, Francis, L.
• The Prevalence of Adverse Childhood Experiences (ACE) in the Lives of Juvenile Offenders, 2014, Journal of Juvenile Justice, Baglivio, M. T., et al.
• The Prevalence of Adverse Childhood Experiences, Nationally, by State, and by Race/Ethnicity, 2018, Child Trends, Sacks, V., & Murphey, D.
• Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity, 2019, National Academies of Sciences, Engineering, and Medicine
• Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017, Morbidity and Mortality Weekly Report, Merrick M. T., et al.

County/Regional Reports

• Connecting the Dots: Snapshots of Child Well-Being in Los Angeles County, Children's Data Network
• Data Briefs on Adverse Childhood Events Among California’s Children, 2014, Child and Adolescent Health Measurement Initiative

More Data Sources For Childhood Adversity and Resilience

• Adverse Childhood Experiences (ACEs), Centers for Disease Control and Prevention
• California Strong Start Index, First 5 Association of California & Children's Data Network
• Child Trends Databank: Adverse Experiences
• Child Trends Databank: Children's Exposure to Violence
• Maternal and Infant Health Assessment (MIHA), California Dept. of Public Health & University of California San Francisco
• National Survey of Children's Health: Adverse Childhood Experiences, Child and Adolescent Health Measurement Initiative

Learn More About This Topic

Why This Topic Is Important

Childhood adversity—such as child abuse, exposure to violence, family alcohol or drug abuse, and poverty—can have negative, long-term impacts on health and well being (1, 2). Nearly half of U.S. children have experienced at least one adverse childhood event (3). Early experiences affect brain structure and function, which provide the foundation for learning, emotional development, behavior, and health (4). The toxic stress associated with traumatic, and often cumulative, early adverse experiences can disrupt healthy development and lead to behavioral, emotional, school, and health problems during childhood and adolescence (2, 3, 5, 6). It also can lead to serious behavioral, emotional, and health issues in adulthood, such as chronic diseases, obesity, alcohol and other substance abuse, and depression (1, 2, 3). The more traumatic and toxic events experienced by a child, the more likely the impact will be substantial and long-lasting (7).

Resilience, an adaptive response to hardship, can mitigate the effects of adverse childhood experiences (6, 8). It is a process of adapting well in the face of adversity, trauma, threats, or other significant sources of stress. Resilience involves a combination of internal and external factors. Internally, it involves behaviors, thoughts, and actions that anyone can learn and develop. Resilience is also strengthened by having safe, stable, nurturing relationships and environments within and outside the family (6, 8, 9).

For more information on childhood adversity and resilience, see kidsdata.org’s Research & Links section.

Sources for this narrative:

1.  Centers for Disease Control and Prevention. (2016). About adverse childhood experiences. Retrieved from: http://www.cdc.gov/violenceprevention/acestudy/about_ace.html

2.  Shonkoff, J. P., et al. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232-e246. Retrieved from: http://pediatrics.aappublications.org/content/129/1/e232

3.  Child and Adolescent Health Measurement Initiative. (2014). 4 essential facts about lifelong health, school success and adverse childhood experiences among California’s children. Retrieved from: http://childhealthdata.org/docs/presentations-/californiadata.pdf?Status=Master

4.  The Center for the Developing Child. (n.d.). Brain architecture. Retrieved from: http://developingchild.harvard.edu/science/key-concepts/brain-architecture

5.  Moore, K., et al. (2014). Adverse childhood experiences and the well-being of adolescents. Child Trends. Retrieved from: http://www.childtrends.org/?publications=fact-sheet-adverse-childhood-experiences-and-the-well-being-of-adolescents

6.  Bethell, C. D., et al. (2015). Adverse childhood experiences: Assessing the impact on health and school engagement and the mitigating role of resilience. Health Affairs, 33(12), 2106-2115. Retrieved from: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2014.0914

7.  Center for Youth Wellness. (2014). A hidden crisis: Findings on adverse childhood experiences in California. Retrieved from: https://app.box.com/s/nf7lw36bjjr5kdfx4ct9

8.  The Center for the Developing Child. (2015). The science of resilience. Retrieved from: http://developingchild.harvard.edu/resources/inbrief-the-science-of-resilience

9.  Pinderhughes, H., et al. (2015). Adverse community experiences and resilience: A framework for addressing and preventing community trauma. Prevention Institute. Retrieved from: https://www.preventioninstitute.org/publications/adverse-community-experiences-and-resilience-framework-addressing-and-preventing

Policy Implications

In recent years, policymakers, researchers, and advocates increasingly have focused on childhood adversity (e.g., physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship), recognizing that such experiences can have harmful, lifelong consequences (1, 2). For example, children exposed to multiple adverse childhood experiences (ACEs) are more likely to develop negative health behaviors and chronic diseases in adulthood (1). Unaddressed ACEs place strain on public systems, including child welfare, education, health care, and juvenile justice (1). Policymakers have a role in helping to prevent ACEs, as well as in ensuring early identification and intervention for parents and children affected by trauma. While California has made strides in these areas, continued efforts are needed to ensure that all families have the opportunity to help their children thrive and reach their full potential (1, 3).

Policy and program options to help prevent, interrupt, and mitigate the effects of childhood adversity include:

• Raising public awareness about ACEs and their negative, lasting effects on children and families (1)
• Ensuring effective prevention services are in place, including strength-based parenting education, family support, and home-visiting services for families in need (4)
• Promoting policies that help reduce family stress and increase stability for children, e.g., policies to improve the social safety net for families in need, support family-friendly business practices, and ensure quality child care is affordable and accessible (4)
• Institutionalizing trauma-informed policies and practices for public and private systems and organizations (designed specifically to address the consequences of trauma and facilitate resilience and healing), including screening and intervention with health reimbursement mechanisms (1, 3)
• Supporting formal workforce education about ACEs and trauma-informed approaches for professionals who work with families and children, such as administrators, doctors, nurses, educators, social workers, and juvenile justice staff (1, 3)
• Promoting increased collaboration across organizations and systems (e.g., local and state government, education, health care, juvenile justice, child welfare, and nonprofits) to address systemic barriers to preventing or treating trauma and toxic stress, including improving service coordination, sharing data, and aligning measures of success (1, 4)
• Supporting ongoing strategies to provide accessible, culturally competent, trauma-informed, and resilience-building systems of mental health, substance abuse treatment, and other community services (1, 3, 5)
• Expanding data collection related to ACEs and resilience to study and advance effective interventions aimed at preventing and reducing the impacts of trauma on children, families, organizations, systems, and communities (1, 3)

For more information related to ACEs, see kidsdata.org’s Research & Links section or visit the Center for Youth Wellness, the ACEs Connection Network, and the Prevention Institute. Also see Policy Implications in kidsdata.org's Child and Youth Safety and Emotional and Behavioral Health topics.

Sources for this narrative:

1.  Center for Youth Wellness. (2015). Children can thrive: A vision for California’s response to adverse childhood experiences. Retrieved from: https://app.box.com/s/fd9gnls5rsswzo2biepbfiz8m23jy1uk

2.  Child and Adolescent Health Measurement Initiative. (2014). 4 essential facts about lifelong health, school success and adverse childhood experiences among California’s children. Retrieved from: http://childhealthdata.org/docs/presentations-/californiadata.pdf?Status=Master

3.  Bradshaw, J. (2015). Helping children heal: Promising community programs and policy recommendations. Children's Defense Fund - California. Retrieved from: http://www.cdfca.org/library/publications/2015/helping-children-heal.pdf

4.  National Center for Injury Prevention and Control. (2017). Essentials for childhood: Steps to create safe, stable, nurturing relationships and environments. Centers for Disease Control and Prevention. Retrieved from: http://www.cdc.gov/violenceprevention/childmaltreatment/essentials.html

5.  California Department of Social Services, & California Department of Health Care Services. (n.d.). Pathways to mental health services: Core practice model guide. Retrieved from: https://humanservices.ucdavis.edu/programs/resource-center-family-focused-practice/pathways-mental-health-services/pathways

How Children Are Faring

Childhood adversity is common among California children, and many children experience multiple traumatic and negative events. The most timely assessment of childhood resilience and adversity comes from the National Survey of Children's Health (NSCH), in which parents report on the current status of their children. NSCH data from 2016 show that 52% of California children were resilient while 16% of children had experienced two or more adverse childhood events. According to the 2013-2014 Maternal and Infant Health Assessment (MIHA), 25% of postpartum women in California experienced two or more childhood hardships before age 14. The California Behavioral Risk Factor Surveillance System Adverse Childhood Experiences (ACEs) Module, combining data from 2008 to 2013, shows that 17% of adults in households with children experienced at least four ACEs before age 18.

The percentage of postpartum women who experience two or more childhood hardships varies by poverty level and maternal age. According to 2013-2014 MIHA data, among poor women (i.e., those with family incomes up through 100% of the federal poverty guideline), 34% experienced two or more hardships as children, compared with 16% of higher-income women (i.e., those with family incomes over 200% of the federal poverty guideline). Furthermore, one-third of young mothers 15-19 years old experienced two or more hardship as children (33%), compared with less than one-fifth of mothers 35 years old and older (19%).