The latent variable is then regressed on the predictors. The most common of these additional constructs include witnessing neighborhood violence (6 tools), bullying (4 tools), discrimination (4 tools), and parental death (4 tools). Data Resource Center for Child and Adolescent Health. All methods use a numeric, cumulative risk scoring methodology. 2021 Center for Health Care Strategies. Last, class 3 seems to correspond to children who have likely experienced several specific ACEs and are likely as not to have experienced several others. A review of developmental research on resilience in maltreated children. The NSCH-ACEs measure was acceptable to respondents as evidenced by few missing values and no reduction in response rate attributable to asking about childrens ACEs. This questionnaire was used to assess participants in the original Adverse Childhood Experiences study, conducted by CDC and Kaiser Permanente and published in 1998. Brown JD, King MA, Wissow LS. The impact of enhancing students social and emotional learning: a meta-analysis of school-based universal interventions. The authors have no conflicts of interest to disclose. Appendix E in the Technical Appendix (http://www.cahmi.org/wp-content/uploads/2015/01/ACEs-Measurement-paper-Technical-Appendix.pdf) shows prevalence of each outcome across income groups and according to NSCH-ACEs status (no ACEs, 1, 23, or 4 ACEs). We included a reflective approach because of our interest in the covariance among ACEs items and concerns about the state of the art in formative variable assessment methods raised in the literature.40,80,81 Using these different approaches all set within SEM allowed us to compare the results across models (fit as well as parameters), with convergence providing support for the internal validity of a latent ACEs construct from a variety of perspectives. A total of 1,784 adults completed the Philadelphia Urban ACE Survey for a response rate of 67.1 percent, and found a higher prevalence of ACEs than found in previous studies. . Rather, in this article we seek to contribute to efforts to examine methods for assessing ACEs should doing so be found to contribute to mitigating the effects of ACEs, preventing ACEs, and promoting resilience and social and emotional well-being among children and families. (While the questions contained in this form are personal in nature and may elicit memories of difficult childhood experiences, the intent of the questionnaire is to identify treatment and support needs, with the goal of furthering the client's success.) Feasible and valid measurement methods are required to guide and evaluate primary care, public health, acute care, and other community-based models that endeavor to prevent and address the consequences of ACEs and promote healthy development and well-being among children, youth, and families. Adverse Childhood Experiences (ACEs) are events like abuse, neglect, violence, loss of a parent todivorce or incarceration, and trauma that happen between birth and age 18. For children, such encounters might also involve an assessment of current (vs historic/past) exposures. Philadelphias Expanded ACE questionnaire measures problems experienced in the community. Atlanta-based Ace Pickleball Club eyes Philadelphia [Accessed February 17, 2016]; Stambaugh LF, Ringeisen H, Casanueva CC, et al. Acad Pediatr. PDF Childhood Stress and Urban Poverty: The Impact of Adverse Childhood In conjunction with the Public Medical Management Corporation's Household Health Scrutinize, researchers surveyed 1,784 adult participants in Pa about the original Acces and five additional community . They are likely to have experienced: income difficulty (at least some income difficulty odds = 0.82), having a divorced parent (0.77), having seen physical abuse (0.72), and having lived with someone who has a drug or alcohol problem (0.83). All but 2 tools have 14 or fewer constructs. Also essential is establishing the feasibility, validity, and specific implementation approach for ACEs assessment methods, including evaluating the validity and value of methods to score and interpret information resulting from the use of a measure of ACEs with children or adults/parents. Behavioral Risk Factor Surveillance System. None of the tools alter scoring on the basis of the age an individual was when exposed to ACEs. Its the same process when supporting a child with ACES. In 2012 and 2013, members came together to develop the Philadelphia Expanded ACE Study to understand the impact of community-level adversities. Center on the Developing Child. Documentation for 11 of the 14 tools include some type of guidance for introducing and framing ACEs questions with respondents and/or for what to do in response to ACEs disclosed by respondents. Before The difficult to get by on income and treated unfairly due to race/ethnicity items have relatively low (although not necessarily problematically low)79 loadings. The first of the 3 approaches is a formative approach suggested by Bollen83 that constrains the residual variable of the latent adversity variable and items to 0 and is statistically identified through the regression of the latent variable on the predictor variables in the model. A Validation of the Adverse Childhood Experiences Scale in Nigeria - IISTE Bentall RP, Wickham S, Shevlin M, et al. Some reported no documented testing/validation whereas others reported extensive cognitive testing, focus group discussions, pilot testing, and use of statistical modeling and factor analysis to assess scoring and internal validity. Palmer RF, Graham JW, Taylor B, et al. Data management. The aims of the review were:77 1) determine where ACE questionnaires have been implemented 78 globally, 2) determine what versions of ACE questionnaires have been used and how those 79 questionnaires have differed, 3) the types of settings the ACE questionnaires were used (clinical In addition, at least with respect to the ACEs included on the NSCH, our LCA results suggest that, beyond separating children into those who have and have not experienced ACEs, there are not distinct patterns of ACEs experiences that readily separate children into substantively meaningful and easily identifiable types; with the possible exception of the income difficulty NSCH-ACEs topic. In our study we did not identify any consistent patterns to provide evidence for creating categorical subgroups on the basis of types of adverse experiences. Clinical significance of a proposed developmental trauma disorder diagnosis. CDC. Treated unfairly because of race/ethnicity? Reconsidering formative measurement. More information on the particular testing and validation for individual tools is included in Table 1, in the Technical Appendix (http://www.cahmi.org/wp-content/uploads/2015/01/ACEs-Measurement-paper-Technical-Appendix.pdf), and references included in Table 1. We used latent class analysis (LCA) to further investigate the suitability of using item response patterns to create typologies. Although the covariance matrix of the NSCH-ACEs items is consistent with a single constructs covariance matrix, some of the items do not relate as strongly to the overall adversity construct as others. How do you want to teach your child? PACES Connection (Positive & Adverse Childhood Experiences, formerly ACES Connection). Shonkoff JP, Boyce WT, McEwen BS. Learn how to develop a calming strategy to use when things get stressful. When the difficult to get by on income, parental death, or treated unfairly due to race/ethnicity topics were removed from the NSCH-ACEs, prevalence of ACEs among US children decreased from 48.7% to 35.6%, 47.1%, and 46.7%, respectively. So how do you parent or care for a child who has experienced ACEs? The ACE International Questionnaire (ACE-IQ) is intended to measure ACEs in all countries, and the association between them and risk behaviours in later life. The .gov means its official. If you live it, they will learn it! For instance, if different responses were to be observed across administration intervals of the NSCH-ACEs, it could be explained by changes in awareness brought about by the self-reflection that can occur when first asked about ACEs, or subsequent learning. Even though these occurred in the past, they may still impact you and your parenting. This raises questions about individual differences in sensitivity to ACEs and discerning appropriate approaches to discussing ACEs and interventions with families. Clinical adverse childhood experiences questionnaire: Child and adult versions. Behavioral risk factor surveillance system. Finally, to further examine use of cumulative versus categorical or topic-specific scoring, we assessed whether specific NSCH-ACEs items have a unique explanatory effect on key outcomes. Comparison of Items in Philadelphia (PHL) and Kaiser ACE Surveys Indicator PHL ACE Survey Kaiser ACE Survey Conventional ACE Emotional Abuse While you were growing up how often did a parent, step-parent, or Validity of an expanded assessment of adverse childhood experiences: A official website and that any information you provide is encrypted Anda RF, Dong M, Brown DW, et al. This study adds to existing early reports from the NSCH and other more narrowly focused US studies on childhood trauma19,23,5658 by evaluating the measurement properties and validity of the NSCH-ACEs as it relates to its possible use in research, policy, and practice contexts. PDF ACEs Resource Packet: Adverse Childhood Experiences (ACEs) Basics This measure is included in the 2016 NSCH and is expected to continue to be included on a yearly basis through the NSCH. Specific objectives for this study were to: 1) characterize and compare, using a standardized framework, existing and emerging measures of ACEs in adult and child populations (part 1); and 2) evaluate psychometric properties and internal and external validity of the new childhood ACEs measure included in the National Survey of Childrens Health (NSCH)-ACEs,55 which provides data on ACEs nationally, for all US states and, potentially, counties and cities (part 2). ACES: The Challenge. Don't give up. Construct validity in health behavior research: interpreting latent variable models involving self-report and objective measures. NSCH-ACEs Structural Equation Model Assessing Validity With 5 Key Child Health and School Outcomes. These advances especially highlight the central role of social determinants of health and the importance of fostering safe, stable, nurturing relationships in infancy, childhood, and throughout life.14 It is now well known that the stress and trauma associated with disruptions in safe, stable, nurturing relationships affect childrens development, health, and well-being into adulthood.510 These advances inspire and require us to evolve models of care and use new measurement instruments to guide the design, delivery, and evaluation of health and human services, such as well-child care, early learning, social services, and other medical, public health, and social services.1115. Look for the good, and also show your child how to seek positive feelings and experiences. Epidemiological approaches to measure childhood stress. Think of what you want to do each day, to give a positive message to your child. Harvard University. Philadelphia ACE Survey | ACES Philadelphia | What ACEs/PCEs do you have? Some tools have multiple versions with slightly varying construct and item counts. From April 2013 to October 2017, 322 women completed the MBDH and 272 agreed to be contacted for research purposes. PDF Adverse Childhood Experiences ("ACEs") Questionnaire Inclusion in an NLM database does not imply endorsement of, or agreement with, To identify ACEs measurement tools for adults and children, we conducted a structured search of published research literature and reviewed online resources from federal, state, local, academic, and community-based health programs recognized as being engaged in activities related to ACEs. NSCAW II Baseline Report: Introduction to NSCAW II. National Library of Medicine If you dont know where to get started, most communities provide Parent Education Programs through your county or city health services, and through the local public school program. Usable Knowledge. Trauma-Informed Care Implementation Resource Center is a Center for Health Care Strategies website developed with support from the Robert Wood Johnson Foundation. Class 1 appears to correspond to a group of children who have not experienced ACEs. Last, rather than seeking to create a single continuous score, one might wish to categorize children into nominally different groups on the basis of the types and patterns of ACEs children have experienced. The Childhood Experiences Survey (CES) is a second-generation ACE questionnaire that measures 17 major childhood adversities that can occur in a child's home, neighborhood, or school environment. Of 14 ACEs assessment methods identified, 5 have been used in clinical settings (vs public health assessment or research) and all but 1 require self or parent report (3 allow child report). Several other versions of the ACE Questionnaire exist, including the ACEIQ, the ACE from the Center for Youth Wellness, the Philadelphia ACEs, the National Survey of Child and Adolescent Wellbeing, the National Survey of Children's HealthACEs, and the Behavioral Risk Factor Surveillance SystemACEs. Much my of Adverse Infancy Feels (ACEs) relies on data predominantly collected from water, middle- / upper-middle-class participants and focuses on experiences within the home. They provide a flexible method for evaluating internal validity. : 20 questions; 20 topics each (4 different versions), DH: Adapted from original CDC/Kaiser questions, additional questions added on the basis of common other responses in initial draft, The Institute for Safe Families/ACE Task Force Philadelphia Urban ACE Study; Sponsored by Robert Wood Johnson Foundation, DH: Used original CDC/Kaiser questions, added questions to make applicable to an urban population, Past/current health conditions, sexual history, drug use, NSCAW; Sponsored by the Office of Planning, Research, and Evaluation, Administration for Children and Families, DH: Mapped CDC/Kaiser ACEs constructs to questions that already existed in NSCAW, Physical, mental, and emotional well-being and functioning, family characteristics, community environment, and service needs and use, Marie-Mitchell and OConnor Child ACE tool; Sponsored by the Commonwealth Fund via the Academic Pediatric Association Young Investigator Award, DH: Developed from risk factors described in the literature on ACEs, Developmental screening, child health status, and health care use, AQ: OI (could include PA, PN, EA, EN, SA), MontefioreClinical ACE questionnaire Adult/Child, TP: Adults about child and adults about self, DH: Modified slightly from original CDC/Kaiser questions, None in ACEs questionnaire, study also includes items on body mass index and stressors, WSU ACEs tool for schools; Sponsored by the Spokane County Community Network with funds awarded by the Washington State Family Policy Council, DH: Modified from original CDC/Kaiser questions, Demographic characteristics, academic problems, health concerns, AQ: CPS report (including PA, EA, SA), PN, OI, WSU ACEs tool for Head Start; Sponsored by Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, US Department of Justice, Demographic characteristics, child development, child adjustment, AQ: EA, EN, CPS report (including PA, SA), OI, Childrens Hospital of Philadelphia CAQ (under development); Sponsored by the Stoneleigh Foundation, TP: Adults about child and older children about self, DH: Questions created from statements from interviews with children and youth impacted by ACEs, Demographic characteristics, protective factors (eg, positive relationship and coping skills), The National Crittenton Foundations ACEs Survey; Aided by Dr. Roy Wade for development and implementation, Demographic characteristics, well-being assessment (stress, coping, and connection to adults), Lived with someone with alcohol or drug problem, Victim or witnessed neighborhood violence, Lived with someone mentally ill or suicidal, Treated or judged unfairly due to race/ethnicity. Click here for plans to do with younger children. Learn about four parenting strategies to help you be a better parent. Ford DC, Merrick MT, Parks SE, et al. Not surprisingly, because the Bollen83 approach constrains the residual variances to 0 (unrealistic but necessary for statistical identification), the size of the b coefficients that result from the Bollen83 approach are smaller than the coefficients from the other 2 approaches. Although 5 were specified for use in clinical and/ or service delivery contexts, they nonetheless share many similarities with the other 9 tools in terms of topics included and administration methods used, including methods to assist respondents who might request resources on ACEs (Table 1). The 2011/12 NSCH included the list of ACEs used in the original CDC/Kaiser adult ACEs study, with modifications overseen by a technical expert panel and evaluated using standard cognitive interviewing-based survey item testing through the CDCs National Center for Health Statistics (NCHS).
