The Effects of Adverse Childhood Experiences and Resilience on Child Development: Future Directions in Research, Practice, and Policy

In past decades, adverse childhood experiences (ACEs) rapidly gained attentionas a public health crisis due to dose-response relationships with a range of health and social problems, and early mortality. Converging studies show that ACEs are a pandemic in the general population of the United States—even in middle to upper-middle class families that are considered to be ‘better off’. There have been collaborative efforts in public health to target root-causes of childhood adversity and increase resilient adaptation in individuals and families at risk. Due to the importance of fostering positive adaptation in the midst of adversity, this dissertation sought to examine both vulnerability and protective factors in children’s proximal ecology—e.g., parents and caring adults at school. A population-based study in this dissertation revealed that parents’ emotional well-being, measured as negative feelings toward parenting, greatly influences developing children, so as support and resources for parenting. The presence of caring adults as a protective factor in teens with highly competitive settings—a newly identified at-risk group due to high pressure to achieve and internalizing/externalizing problems. Lastly, this dissertation discusses conceptual and methodological limitations in current ways of measuring ACEs and provide future directions for research, practice, and policy. Suggestions include frequent assessments on reaching consensus on how to define ACEs, expanding the concept of ACEs, considering the duration, timing, and severity of the event. Healthcare professionals have important roles in public health; they incorporate frequent assessments on parents’ emotional wellbeing and needs for parenting as a part of care. Ongoing support from multiple disciplines is necessary to reduce the impact of ACEs and strengthen resilience development of children and families.