Indicator: Childhood experiences

Definition

Individuals have not experienced repeated traumatic events within home environments.

Recommended Metric(s)

Percentage of individuals with fewer than three adverse childhood experiences (ACEs)

Example Instruments

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Type(s) of Data Needed

Survey data

Why it matters

Childhood experiences such as maltreatment, interparental violence, family disruption, poverty, and stress all have a negative impact on children’s development and lifelong outcomes.1, 2 The Adverse Childhood Experiences (ACEs) scale is a widely used, evidence-based tool that measures exposure to 10 potentially traumatic events that have been linked to short- and long-term well-being. High scores on the ACEs scale are positively related to chronic disease; suicide attempts; obesity; and leading causes of death, such as heart disease, stroke, and cancer.3 High scores are also negatively related to educational attainment, employment, and income,4, 5 and research shows that the percentage of single-family households in an area is negatively correlated with upward mobility.6 Nationally, 61 percent of Black children and 51 percent of Latino children have experienced at least one ACE, compared with 40 percent of White children and 23 percent of Asian children.7 On average, Black and Latino children, and children from low-income households, are also exposed to a higher number of adversities than their peers.8, 9, 10 Overall, 1 in 10 children in the United States have experienced three or more ACEs.11

What to know about measurement

Because of the sensitive nature of ACEs, data are collected only at scale through anonymous surveys, such as the Center for Disease Control and Prevention’s national Behavioral Risk Factor Surveillance System (BRFSS).12 Several states include ACEs questions in statewide youth risk behavior surveys. (For example, the Connecticut and Georgia Youth Risk Behavior Surveys each include questions related to ACEs.) All these surveys are anonymous and based on a random sample of respondents. For example, Connecticut and Georgia randomly select classrooms in public middle and high schools to field the surveys.

Individual ACEs screenings are often administered in clinical settings. Although school systems can administer these screenings, screeners should have training in mandated reporting requirements and expertise in trauma-informed care. Screeners should also have well-developed referral networks to help students connect with behavioral or trauma supports.13, 14 Some ACEs might be more difficult for respondents to disclose, leading to their underestimation.15, 16 Some research has found that respondents prefer reporting the number of ACEs rather than the specific experiences17 and that this may be an appropriate format for collecting sensitive information at the individual level. 18, 19, 20

Several alternatives to the ACEs survey exist that could be used to measure experiences within the home, such as the Family Support and Strain Scale (see Stanford University’s SPARQtools).21 Other alternatives are a measure of Family Structure and Stability (see Turner et al.)22 or the Conflict Tactics Scale to measure emotional and physical abuse.23 However, we recommend the ACEs scale because of its strong research base, which provides evidence for the scale’s predictive power; also, resources are widely available to support ACEs prevention and interventions.

Source frameworks

This indicator appeared in five source frameworks reviewed for this report. Our proposed definition and measure align with the Urban Institute’s Boosting Upward Mobility framework, which uses the ACEs scale to measure exposure to trauma.

References