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Should COVID-19 be considered an adverse child experience?

02 April 2021
Volume 2 · Issue 2


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):

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