Adverse childhood experiences and brain injury in younger children: Findings from the 2021-2022 National Survey of Children's Health.

Purpose: The purpose of this study was to extend on previous research finding by investigating adverse childhood experiences (ACEs) and brain injury in children younger than 12 years old.

Methods: A total of 58,601 US children under 12 years old were included in the 2020-2021 National Survey of Children's Health, a self-reported national survey administered to caregivers.

Results: ACEs were significantly associated with increased risk for unconfirmed (χ² (55891, 55904) = 141.84, p < 0.001, R² = .03) and confirmed brain injury, χ² (56481, 56494) = 508.28, p < 0.001, R² = .05 when accounting for demographic characteristics. The association between ACEs and brain injury was not contingent on sports involvement; females not involved in sports had the strongest association between ACEs and brain injury (χ² (10938, 10951) = 99.40, p < 0.001, R² = .03) compared to sports-involved females and males. For children under 12 years old with brain injury, the relations between experiencing at least one ACE and health and educational outcomes were significant for all health and educational outcomes (p < 0.001).

Conclusions: Caregiver education on and screening for brain injury in families experiencing ACEs would likely support more timely identification and management of co-occurring brain injury in this population. Further research is needed to identify prevention, assessment, and management strategies that would be specifically beneficial to children at risk for co-occurring brain injury and ACEs to improve health and educational outcomes.