The accrual of parent reported adverse childhood experiences following a child protective services investigation: A prospective approach

INTRODUCTION: Most studies on adverse childhood experiences (ACEs) have largely employed retrospective measures from adults, eschewing prospective measures in child samples. In this paper, we tracked the accrual of ACEs during childhood in a sample of children left in-home following a Child Protection Services investigation.

METHODS: Data from three waves of the 2010 National Survey of Child and Adolescent Well-Being were used (n = 1880). ACEs included 5 forms of child maltreatment and parental domestic violence, mental health problems, substance or alcohol abuse, separation, and arrest. At each wave, parents reported child ACE exposure for the previous year. ACE accrual over three years was traced as mean scores, discrete events, and compounding risk. OLS regression predicted accrual of ACEs over time controlling for important covariates.

RESULTS: At baseline, children experienced an average of 2.2 ACEs, which increased by 3.2 by W3 (5.4 total ACEs). The predicted number of ACEs over time increased by 0.58 with each increase of 1 ACE at baseline (t = 11.74, p < .001). As compound risk, children with 0 ACE at baseline accrued an additional 1.7 by W3, while those experiencing 6 ACEs at baseline accrued 5.9 by W3. Children who experienced emotional neglect and psychological aggression accumulated a greater number of ACEs.

CONCLUSION: The average number of ACEs for in-home children increased precipitously over 3 years, and higher ACE scores at baseline were associated with greater accumulation. This indicates that retrospective measurements may not convey the unremitting nature of ACE accrual.