Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
Mayo Clinic School of Medicine, Rochester, MN, USA.
J Prim Care Community Health. 2022 Jan-Dec;13:21501319221084165. doi: 10.1177/21501319221084165.
Adverse childhood experiences (ACEs) are potentially traumatic events that can cause lifelong suffering, with 1 out of 2 children in the United States experiencing at least 1 ACEs. The intergenerational effect of ACEs has been described, but there's still paucity of knowledge of its impact on child development and behavior in children enrolled in Early Head Start (EHS) home visiting programs. A retrospective observational study was performed with 71 parents and 92 children participating in the EHS Home Visiting Program in Olmsted County from 2014 to 2019. Parents reported their own ACEs using a 10-item questionnaire. Children's social-emotional status was evaluated with Devereux Early Childhood Assessment Second Edition (DECA) and development was evaluated using the Brigance Early Childhood Screens III. Referrals of children by EHS staff to community agencies were recorded. The association between parental ACEs score, developmental outcomes and referrals was analyzed. Parental ACEs score of 4 or more was associated with failing at least 1 domain on the Brigance screen ( = .02) especially adaptive/cognitive domain ( = .05), and increased risk of referral to community resources ( < .001). However, there was no association between ACEs scores and failing DECA screens. We identified an intergenerational association between parental exposure to ACEs and risk for childhood developmental delay and referrals to community services. Parental adverse childhood experiences (ACEs) have intergenerational effects on offspring. In our study, parental ACEs are associated with offspring developmental delays and referral to community resources. Screening for parental adverse childhood experiences, a key social determinant of health, is imperative and should be incorporated into primary care and early childhood settings to identify children at risk for developmental delay.
不良的童年经历(ACEs)是潜在的创伤性事件,可能会导致终身痛苦,美国有 1/2 的儿童至少经历过 1 次 ACEs。ACEs 的代际效应已经被描述过,但对于其对参加早期开端(EHS)家庭探访项目的儿童的发展和行为的影响,仍然知之甚少。本研究采用回顾性观察研究,2014 年至 2019 年,奥姆斯特德县的 71 名父母和 92 名儿童参加了 EHS 家庭探访项目。父母使用 10 项问卷报告自己的 ACEs。儿童的社会情感状况采用第二代德雷克斯早期儿童评估(DECA)进行评估,发育情况采用 Brigance 早期儿童筛查 III 进行评估。EHS 工作人员记录了儿童转介给社区机构的情况。分析了父母 ACEs 评分、发育结果和转介之间的关系。父母 ACEs 评分≥4 分与 Brigance 筛查至少 1 个领域失败有关( = .02),尤其是适应性/认知领域( = .05),并增加了转介到社区资源的风险( < .001)。然而,ACEs 评分与 DECA 筛查失败之间没有关联。我们发现父母暴露于 ACEs 与儿童发育迟缓风险和转介到社区资源之间存在代际关联。父母的不良童年经历(ACEs)对后代有代际影响。在我们的研究中,父母的 ACEs 与后代的发育迟缓以及向社区资源的转介有关。对父母的不良童年经历进行筛查,这是健康的一个关键社会决定因素,至关重要,应该纳入初级保健和幼儿教育环境,以识别有发育迟缓风险的儿童。