Rural and Minority Health Research Center (E Crouch, E Radcliff, and P Hung), Arnold School of Public Health, University of South Carolina, Columbia, SC.
Rural and Minority Health Research Center (E Crouch, E Radcliff, and P Hung), Arnold School of Public Health, University of South Carolina, Columbia, SC.
Acad Pediatr. 2019 Nov-Dec;19(8):899-907. doi: 10.1016/j.acap.2019.08.006. Epub 2019 Aug 9.
To examine the association between adverse childhood experiences (ACEs), by multiple types and counts of ACEs, and challenges to school success.
A cross-sectional study was conducted using data from the 2016 National Survey of Children's Health using the ACE module and 3 measures of challenges to school success: lack of school engagement, school absenteeism, and repeated grade.
In multivariable analysis adjusting for selected demographic and other characteristics, children with 4 or more ACEs had higher odds of nonengagement in school (adjusted odds ratio [aOR] 2.15; 95% confidence interval [CI], 1.51-3.07), reported school absenteeism (aOR 1.75; 95% CI, 1.12-2.73), and of repeating a grade (aOR 1.71; 95% CI, 1.19-2.47, Table 4) than children with exposure to less than 4 ACEs. Risk factors for all 3 challenges to school success included age of child and special health care needs, with older children and children with special health care needs more likely to have challenges to school success, across all 3 measures.
Our findings confirm that ACEs can have an impact in childhood and adolescence, not just later in adulthood, as demonstrated by the association between ACEs and measures of school success. These findings further illuminate the connection between ACEs and childhood outcomes of education and health. Future research should examine frameworks that effectively support collaboration between educators, social service providers, and pediatricians as they seek to prevent or reduce the impact of ACEs and other childhood trauma.
研究多种类型和数量的不良儿童经历（ACEs）与学校成功挑战之间的关联。
使用 2016 年全国儿童健康调查中 ACE 模块和 3 项学校成功挑战指标（缺乏学校参与度、逃学和留级）的数据，进行了一项横断面研究。
在调整了选定的人口统计学和其他特征后，在多变量分析中，经历 4 种或更多 ACEs 的儿童更有可能不参与学校活动（调整后的优势比 [aOR] 2.15；95%置信区间 [CI]，1.51-3.07）、报告逃学（aOR 1.75；95% CI，1.12-2.73）和留级（aOR 1.71；95% CI，1.19-2.47，表 4）的可能性高于经历少于 4 种 ACEs 的儿童。所有 3 项学校成功挑战的风险因素均包括儿童年龄和特殊保健需求，年龄较大的儿童和有特殊保健需求的儿童更有可能在所有 3 项措施中遇到学校成功挑战的问题。
我们的研究结果证实，ACEs 不仅在成年后期，而且在儿童和青少年时期也会产生影响，这与 ACEs 与学校成功衡量标准之间的关联相一致。这些发现进一步阐明了 ACEs 与教育和健康方面的儿童期结果之间的联系。未来的研究应该研究有效的框架，以支持教育工作者、社会服务提供者和儿科医生之间的合作，以寻求预防或减轻 ACEs 和其他儿童创伤的影响。
