References

Anda RF, Dong M, Brown DW The relationship of adverse childhood experiences to a history of premature death of family members. BMC Public Health. 2009; 9:(1) https://doi.org/10.1186/1471-2458-9-106

Bethell CD, Carle A, Hudziak J Methods to assess adverse childhood experiences of children and families: toward approaches to promote child well-being in policy and practice. Academic pediatrics. 2017; 17:(7)S51-S69 https://doi.org/10.1016/j.acap.2017.04.161

Bryant DJ, Oo M, Damian AJ. The rise of adverse childhood experiences during the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy. 2020; 12:(1)S193-S194 https://doi.org/10.1037/tra0000711

Bryce I. Responding to the accumulation of adverse childhood experiences in the wake of the COVID-19 pandemic: Implications for practice. Children Australia. 2020; 45:(2)80-87 https://doi.org/10.1017/cha.2020.27

Buheji M, Hassani A, Ebrahim A Children and coping during COVID-19: a scoping review of bio-psycho-social factors. Int J Appl. 2020; 10:8-15 https://doi.org/10.5923/j.ijap.20201001.02

Campbell AM. An increasing risk of family violence during the COVID-19 pandemic: Strengthening community collaborations to save lives. Forensic Science International: Reports. 2020; 2 https://doi.org/10.1016/j.fsir.2020.100089

Clark H, Coll-Seck AM, Banerjee A A future for the world's children? A WHO–UNICEF–Lancet Commission. Lancet. 2020; 395:605-658 https://doi.org/10.1016/S0140-6736(19)32540-1

Crouch E, Probst JC, Radcliff E, Bennett KJ, McKinney SH. Prevalence of adverse childhood experiences (ACEs) among US children. Child Abuse and Neglect. 2019; 92:209-218 https://doi.org/10.1016/j.chiabu.2019.04.010

Douglas PK, Douglas DB, Harrigan DC, Douglas KM. Preparing for pandemic influenza and its aftermath: mental health issues considered. International Journal of Emergency Mental Health. 2009; 11:(3)

Duke NN, Pettingell SL, McMorris BJ, Borowsky IW. Adolescent violence perpetration: associations with multiple types of adverse childhood experiences. Pediatrics. 2010; 125:(4)e778-e786 https://doi.org/10.1542/peds.2009-0597

Edwards VJ, Holden GW, Felitti VJ, Anda RF. Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: Results from the adverse childhood experiences study. American Journal of Psychiatry. 2003; 160:(8)1453-1460 https://doi.org/10.1176/appi.ajp.160.8.1453

Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child and Adolescent Psychiatry and Mental Health. 2020; 14:1-11 https://doi.org/10.1186/s13034-020-00329-3

Felitti VJ, Anda RF, Nordenberg D Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventative Medicine. 1998; 14:(4)245-258 https://doi.org/10.1016/s0749-3797(98)00017-8

Finkelhor D. Trends in adverse childhood experiences (ACEs) in the United States. Child Abuse and Neglect. 2020; 108 https://doi.org/10.1016/j.chiabu.2020.104641

Coronavirus: Fear of family violence spike as COVID-19 impact hits households. 2020. https://lens.monash.edu/@politics-society/2020/03/18/1379841/coronavirus-fear-of-family-violence-spike-as-covid-19-impact-hits-households (accessed 29 March 2021)

Fowler K, Wholeben M. COVID-19: Outcomes for trauma-impacted nurses and nursing students. Nurse Education Today. 2020; 93 https://doi.org/10.1016/j.nedt.2020.104525

Children are at risk from COVID-19. Journal of Pediatric Nursing. 2020; 53:A10-A12 https://doi.org/10.1016/j.pedn.2020.04.026

Golberstein E, Wen H, Miller BF. Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents. Journal of the American Medical Association Pediatrics. 2020; 174:(9)819-820 https://doi.org/10.1001/jamapediatrics.2020.1456

Guo J, Fu M, Liu D, Zhang B, Wang X, van Ijzendoorn MH. Is the psychological impact of exposure to COVID-19 stronger in adolescents with pre-pandemic maltreatment experiences? A survey of rural Chinese adolescents. Child Abuse and Neglect. 2020; 110 https://doi.org/10.1016/j.chiabu.2020.104667

Imran N, Zeshan M, Pervaiz Z. Mental health considerations for children & adolescents in COVID-19 Pandemic. Pakistan Journal of Medical Sciences. 2020; 36:(COVID19-S4)S67-S72 https://doi.org/10.12669/pjms.36.COVID19-S4.2759

Jensen TK, Holt T, Ormhaug SM A randomized effectiveness study comparing trauma-focused cognitive behavioral therapy with therapy as usual for youth. J Clin Child Adolesc Psychol. 2014; 43:(3)356-369 https://doi.org/10.1080/15374416.2013.822307

Kalia V, Knauft K. Emotion regulation strategies modulate the effect of adverse childhood experiences on perceived chronic stress with implications for cognitive flexibility. PLoS One. 2020; 15:(6) https://doi.org/10.1371/journal.pone.0235412

Karatekin C, Hill M. Expanding the original definition of adverse childhood experiences (ACEs). Journal of Child and Adolescent Trauma. 2019; 12:(3)289-306 https://doi.org/10.1007/s40653-018-0237-5

Lau JT, Griffiths S, Choi KC, Tsui HY. Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. BMC Infectious Diseases. 2010; 10:(1) https://doi.org/10.1186/1471-2334-10-139

Lee J. Mental health effects of school closures during COVID-19. Lancet Child Adolesc Health. 2020; 4:(6) https://doi.org/10.1016/S2352-4642(20)30109-7

McLennan JD, MacMillan HL, Afifi TO. Questioning the use of adverse childhood experiences (ACEs) questionnaires. Child Abuse and Neglect. 2020; 101 https://doi.org/10.1016/j.chiabu.2019.104331

McManus MA, Ball E. COVID-19 should be considered an Adverse Childhood Experience (ACE). Journal of Community, Safety and Well-Being. 2020; 5:(4)164-167 https://doi.org/10.35502/jcswb.166

Moser DA, Glaus J, Frangou S, Schechter DS. Years of life lost due to the psychosocial consequences of COVID-19 mitigation strategies based on Swiss data. European Psychiatry. 2020; 63:(1) https://doi.org/10.1192/j.eurpsy.2020.56

Murphy A, Steele M, Dube SR Adverse childhood experiences (ACEs) questionnaire and adult attachment interview (AAI): Implications for parent child relationships. Child Abuse and Neglect. 2014; 38:(2)224-233 https://doi.org/10.1016/j.chiabu.2013.09.004

Newman T, Blackburn S.Livingston, Scotland: Scottish Executive Education Department; 2002

Nurius PS, Green S, Logan-Greene P, Borja S. Life course pathways of adverse childhood experiences toward adult psychological well-being: A stress process analysis. Child Abuse and Neglect. 2015; 45:143-53 https://doi.org/10.1016/j.chiabu.2015.03.008

Phelps C, Sperry LL. Children and the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy. 2020; 12:(S1)S73-S75 https://doi.org/10.1037/tra0000861

Public Health Scotland. Adverse childhood experiences (ACEs). 2020. http://www.healthscotland.scot/population-groups/children/adverse-childhood-experiences-aces/overview-of-aces (accessed 14 February 2021)

Sanders LM. Is COVID-19 an adverse childhood experience (ACE): Implications for screening for primary care. The Journal of Pediatrics. 2020; 222:4-6 https://doi.org/10.1016/j.jpeds.2020.05.064

Seddighi H, Salmani I, Javadi MH, Seddighi S. Child abuse in natural disasters and conflicts: a systematic review. Trauma, Violence, Abuse. 2021; 22:(1)176-185 https://doi.org/10.1177/1524838019835973

Schilling EA, Aseltine RH, Gore S. Adverse childhood experiences and mental health in young adults: a longitudinal survey. BMC Public Health. 2007; 7:(1)1-10 https://doi.org/10.1186/1471-2458-7-30

Shreffler KM, Joachims CN, Tiemeyer S, Simmons WK, Teague TK, Hays-Grudo J. Childhood Adversity and Perceived Distress from the COVID-19 Pandemic. Adversity and Resilience Science. 2021; 2:1-4 https://doi.org/10.1007/s42844-021-00030-0

Taylor MR, Agho KE, Stevens GJ, Raphael B. Factors influencing psychological distress during a disease epidemic: data from Australia's first outbreak of equine influenza. BMC Public Health. 2008; 8 https://doi.org/10.1186/1471-2458-8-347

Van Lancker W, Parolin Z. COVID-19, school closures, and child poverty: a social crisis in the making. The Lancet Public Health. 2020; 5:(5)e243-e244 https://doi.org/10.1016/S2468-2667(20)30084-0

Verger NB, Urbanowicz A, Shankland R, McAloney-Kocaman K. Coping in isolation: Predictors of individual and household risks and resilience against the COVID-19 pandemic. Social Sciences and Humanities Open. 2021; 3:(1) https://doi.org/10.1016/j.ssaho.2021.100123

Walsh D, McCartney G, Smith M, Armour G. Relationship between childhood socioeconomic position and adverse childhood experiences (ACEs): a systematic review. J Epidemiol Community Health. 2019; 73:(12)1087-1093 https://doi.org/10.1136/jech-2019-212738

Wang G, Zhang Y, Zhao J, Zhang J, Jiang F. Mitigate the effects of home confinement on children during the COVID-19 outbreak. The Lancet. 2020; 395:(10228)945-947 https://doi.org/10.1016/S0140-6736(20)30547-X

World Health Organization. Rolling updates on coronavirus disease (COVID-19). 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (accessed 14 February 2021)

Wu P, Fang Y, Guan Z The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry. 2009; 54:(5)302-311 https://doi.org/10.1177/070674370905400504

Should COVID-19 be considered an adverse child experience?

02 April 2021
Volume 2 · Issue 2

Abstract

The term adverse childhood experience (ACE) covers a number of different traumatic events, including various forms of abuse, neglect, and household dysfunction, that occur before the age of 18 years. ACEs are recognised as predictors of future poor health outcomes, increased risk of mental illness and chronic diseases and reduced life expectancy. The current COVID-19 pandemic may be amplifying some ACEs in individuals by increasing social isolation or financial pressures and as a result of job loss, school closures, and exposure to the morbidity and mortality of the disease. This article considers the literature and asks the question ‘Can COVID-19 be considered an ACE itself?’ Ultimately, the long-term implications of an accumulation of risk and harm need to be considered and embedded in practice, to effectively respond to the future needs of vulnerable children.

Children are vulnerable to a range of experiences that can affect their physical health, mental health, and productivity in adult life (Clark et al, 2020). Adverse childhood experiences (ACEs) is a term that refers to traumatic events, including various forms of abuse, neglect, and household dysfunction, that occur before the age of 18 years, (Bryant et al, 2020; McLennan et al, 2020). ACEs were first identified by Felitti et al (1998), when researching the relationships between experiences of trauma in childhood and detrimental effects on health outcomes later in life.

Felitti et al (1998) originally defined ACEs as ‘childhood abuse and household dysfunction’. The original experiences identified included sexual and other forms of abuse, and a ‘dysfunctional family life’, which included drug use and criminal activity by parents, and domestic violence (Felitti et al, 1998). Karatekin and Hill (2019) suggest expanding the original definition of ACEs from maltreatment and household dysfunction. There are now 10 main categories of ACEs (Public Health Scotland, 2020):

Register now to continue reading

Thank you for visiting Journal of Child Health and reading some of our peer-reviewed resources for children’s health professionals. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month