Adverse Childhood Experiences: Assessing the Impact on Health and School Engagement and the Mitigating Role of Resilience, 2014
Bethell et al (2014) found that children with higher ACE scores were less likely to demonstrate resilience, live in a protective home environment, have a mother who was healthy, and live in safe and supportive neighborhoods. However, almost half of the children who had experienced ACEs also demonstrated resilience, and “resilience mitigated the impact of adverse childhood experiences on grade repetition and school engagement.”
[Bethell, C., Newacheck, P., Hawes, E., & Halfon, N. Adverse childhood experiences: Assessing the impact on health and school engagement and the mitigating role of resilience. Health Affairs, 33(12). https://doi.org/10.1377/hlthaff.2014.0914]
Adverse Childhood Experiences, Resilience and Mindfulness-Based Approaches: Common Denominator Issues for Children with Emotional, Mental, or Behavioral Problems, 2016
This study examined ACEs, resilience, family protective factors, and emotional, mental or behavioral conditions (EMB) in children and youth in the U.S. The authors found that children with ACEs had higher EMB than children without ACEs, but the presence of resilience was significantly associated with lower amounts of EMB for both children with and without ACEs. In addition, the prevalence of EMB was lower when family protective factors were present, even if the child had ACEs, although the presence of two or more ACEs decreased the effect.
[Bethell, C., Gombojav, N., Solloway, M., & Wissow, L. (2016). Adverse childhood experiences, resilience and mindfulness-based approaches: Common denominator issues for children with emotional, mental, or behavioral problems. Child Adolesc Psychiatr Clin N Am, 25(2), 139-156. https://doi.org/10.1016/j.chc.2015.12.001]
Balancing Adverse Childhood Experiences with HOPE, 2017
This report presents evidence for HOPE (Health Outcomes of Positive Experiences) based on newly released, compelling data that reinforce the need to promote positive experiences for children and families in order to foster healthy childhood development despite the adversity common in so many families... This report contributes to a growing body of work – the Science of Thriving – that encourages us to better understand and support optimal child health and development.
Childhood Family Connection and Adult Flourishing: Associations Across Levels of Childhood Adversity, 2021
Greater childhood family connection was associated with greater flourishing in US adults across levels of childhood adversity. Supporting family connection in childhood may influence flourishing decades later, even with early adversity.
[Whitaker, R., Dearth-Wesley, T., & Herman, A. (2021). Childhood family connection and adult flourishing: Associations across levels of childhood adversity. Academic Pediatrics. https://doi.org/10.1016/j.acap.2021.03.002]
Effects of Positive and Negative Childhood Experiences on Adult Family Health, 2021
Childhood experiences affect family health in adulthood in the expected direction. Even in the presence of early adversity, positive experiences in childhood can provide a foundation for creating better family health in adulthood.
[Daines, C.L., Hansen, D., Novilla, M.L.B. & Crandall, A. (2021). Effects of positive and negative childhood experiences on adult family health. BMC Public Health, 21, 651. https://doi.org/10.1186/s12889-021-10732-w]
Examining the influence of positive childhood experiences on childhood overweight and obesity using a national sample, 2022
Compared to children who were underweight or had a healthy weight, children who were overweight or obese were less likely to: participate after school activities, volunteer in their community, school, or church, have a mentor they feel comfortable going to for guidance, live in a safe neighborhood, live in a supportive neighborhood, and to live with a resilient family. In adjusted analysis, among children exposed to two or more ACEs, children residing in a supportive neighborhood were less likely to be overweight or obese. Our findings suggest that certain PCEs may mitigate overweight and obesity when children have experienced at least some childhood trauma.[Crouch, E., Radcliff, E., Kelly, K., et al., (2022). Preventive Medicine. https://doi.org/10.1016/j.ypmed.2021.106907]
Family Resilience and Connection Promote Flourishing Among US Children, Even Amid Adversity, 2019
The presence of flourishing increased in a graded fashion with increasing levels of family resilience and connection.
[Bethell, C., Gombojav, N., & Whitaker, R. (2019). Family resilience and connection promote flourishing among US children, even amid adversity. Health Affairs 38(5). https://doi.org/10.1377/hlthaff.2018.05425]
Influence of Race/Ethnicity and Income on the Link between Adverse Childhood Experiences and Child Flourishing, 2021
The researchers conducted a secondary data analysis using the 2016–17 National Survey of Children’s Health data reported by parents/guardians for 44,686 children age 6–17 years. The data showed that family resilience partially mediated the ACEs-flourishing association. Although White and socioeconomically advantaged families were more likely to maintain family resilience, their children functioned more poorly at high-risk levels relative to Black and Hispanic children and across income groups.
[Goldstein, E., Topitzes, J., Miller-Cribbs, J. et al. (2021). Influence of race/ethnicity and income on the link between adverse childhood experiences and child flourishing. Pediatr Res 89, 1861–1869. https://doi.org/10.1038/s41390-020-01188-6]
Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels, 2019
Positive childhood experiences (PCEs) show dose-response associations with adult depression and/or poor mental health (D/PMH) and adult-reported social and emotional support (ARSES) after accounting for exposure to ACEs. The proactive promotion of PCEs for children may reduce risk for adult D/PMH and promote adult relational health. Findings support prioritizing possibilities to foster safe, stable nurturing relationships for children that consider the health outcomes of positive experiences.
[Bethell, C., Jones J., Gombojav, N., Linkenbach, J., & Sege R. (2019). Positive childhood experiences and adult mental and relational health in a statewide sample: Associations across adverse childhood experiences levels. JAMA Pediatr., 173(11), e193007. https://www.doi.org/10.1001/jamapediatrics.2019.3007]
Resilience, 2016
Every child is a unique individual. This individuality is evident in children exposed to psychosocial trauma or adverse childhood experiences. There exists wide variation in the way children respond to toxic stressors in their lives. Some children appear to be relatively unaffected, while others develop a variety of psychological, behavioral, and physical consequences. What is the explanation for this phenomenon? Resiliency has been suggested to explain this variation in pathology expressions in trauma-exposed children. It is vital for pediatric nurse practitioners to understand the concept of resilience. This continuing education offering will define concepts of resilience and stress, explore the neurobiology of resilience, and examine interventions that promote resilience in children.
[Hornor G. (2017). Resilience. J Pediatr Health Care, 31(3), 384-390. https://www.doi.org/10.1016/j.pedhc.2016.09.005]
Resilience Resources from The Harvard University Center on the Developing Child
Reducing the effects of significant adversity on young children’s healthy development is critical to the progress and prosperity of any society. Yet not all children experience lasting harm as a result of adverse early experiences. Some may demonstrate “resilience,” or an adaptive response to serious hardship. A better understanding of why some children do well despite early adversity is important because it can help us design policies and programs that help more children reach their full potential. The Harvard University Center on the Developing Child has developed many resources related to resilience:
Three videos provide an overview of why resilience matters, how it develops, and how to strengthen it in children.
A working paper entitled Supportive Relationships and Active Skill-Building Strengthen the Foundations of Resilience from the National Scientific Council on the Developing Child explains how supportive relationships with adults help children develop “resilience,” or the set of skills needed to respond to adversity and thrive.