By David Murphey and Jessica Dym Bartlett, Child Trends, July 9, 2019.
Exposure to adversity in childhood is widespread and can pose a serious threat to individual health and well-being over the life course. By age 18, nearly half (45 percent) of children in the United States have had at least one adverse experience; among young children and other vulnerable subgroups, the prevalence is much higher. Childhood adversity is defined as one or more stressful events or conditions that can threaten a child’s sense of safety and negatively affect the child’s developing brain, physical and mental health, and behavior. Examples of common childhood adversities include abuse and neglect, living with a parent with mental illness or a substance abuse disorder, or witnessing violence.
Amid increasing public awareness and concern about the harmful consequences of early adversity, policymakers in a number of states are calling for routine screening of individual children—in pediatric care, home visiting programs, early care and education, schools, and other child and family service settings—using the short list of adversities included in the original Adverse Childhood Experiences (ACEs) study. As this movement gains traction, it is essential for policymakers to understand the limitations of this approach, as well as its potential for unintended consequences. These include:
- The potential for re-traumatizing children and families
- Contributing to stigma and a deficits focus
- The lack of age- and culture-sensitive screening tools
- A misleadingly narrow conception of adversity