Associations between adverse childhood experiences, resilience, and health and educational outcomes using data from the 2022 National Survey of Children's Health

Background

Exposure to adverse childhood experiences (ACEs) is associated with poor childhood health. There is increasing interest in understanding the influence of positive childhood experiences (PCEs) because of their potential protective role against ACEs.

Objective

We sought to understand 1) whether PCEs are protective against developing learning disabilities and mental, emotional, developmental, and behavioral conditions (MEDBC); 2) whether this relationship varies by number of ACEs.

Participants and setting

We analyzed the 2022 National Survey of Children's Health (NSCH).

Methods

We constructed a variable for “high ACEs” (4+), and 6 PCEs were considered. Outcomes were MEDBC and learning disability. Logistic regression models were: 1) using high ACEs and each individual PCE as predictors; and 2) Model 1 + an interaction term for high ACEs x each PCE. Models were nationally weighted using survey-provided sampling weights and controlled for covariates with significance at p < 0.05.

Results

The sample consisted of 53,133 children. In Model 1, each PCE except reading together (p = 0.795) and singing together (p = 0.551) was associated with a significantly lower odds of having MEDBC. Each PCE except reading together (p = 0.259), singing together (p = 0.583), and having meals together (p = 0.726) was associated with a significantly lower odds of having learning disabilities.

Conclusions

Regardless of number of ACEs, PCEs were associated with lower odds of having a MEDBC and a learning disability. As the enthusiasm for ACEs screening continues, clinicians should also consider PCE screening.