Resilience and Mental Health Outcomes Among Children that Experienced Multiple Adverse Childhood Experiences

Format

Individual Presentation

Presenters

Kevin Keane, University of Alabama, BirminghamFollow
Retta Evans, University of Alabama, BirminghamFollow

First Presenter's Institution

University of Alabama at Birmingham

First Presenter’s Email Address

keane@uab.edu

First Presenter's Brief Biography

Kevin Keane is a doctoral student in the Health Education/Health Promotion Ph.D. program at the University of Alabama at Birmingham. He also has a Master’s of Arts in Marriage and Family Counseling and a Master’s in Business Administration. Kevin currently works as a data analyst at the University of Alabama at Birmingham, where he conducts academic and clinical program evaluation. Kevin previously worked as a program director and administrator at nonprofit organizations that served youth involved with the foster care and juvenile justice systems. As a result of these experiences, Kevin developed research interests in adverse childhood experiences, resilience, teacher-student relationships, and mental health outcomes to advocate and improve outcomes for these populations.

Second Presenter's Institution

University of Alabama at Birmingham

Second Presenter’s Email Address

rrevans@uab.edu

Second Presenter's Brief Biography

Dr. Evans has a PhD in health sciences with an emphasis in nutrition. For over 15 years she has worked with K-12 school systems to implement programs and policies to improve health, physical activity, and wellness among students. She has also worked with the state department of education in the development of state policies outlining improvements in school nutrition. As a result, Dr. Evans’ presentations and publications have focused primarily on youth and schools related to nutrition, and obesity prevention initiatives. Dr. Evans also co-authored a textbook in 2016 and 2020 focused on training elementary education majors to implement health and wellness in the classroom. Dr. Evans is currently a professor in the School of Education, Community Health Program at the University of Alabama at Birmingham, where she teaches, mentors and conducts health-related research.

Location

Session Six Breakouts

Strand #1

Health: Mental & Physical Health

Strand #2

Home: Family & Community Engagement

Relevance

The presentation addresses two conference strands: health (mental and physical health) and home (family and community engagement). The study explored whether modifiable protective factors identified in a resilience framework reduced the likelihood of children who had experienced multiple adverse childhood experiences ever having a mental health issue. The implication is that targeting these modifiable protective factors could build resilience in children to overcome ACEs. The two strongest protective factors in the study were self-regulation and a strong parent/caregiver relationship. School-based interventions that target self-regulation and parent/caregiver relationships can potentially reduce the risk of mental health issues.

Brief Program Description

Adverse childhood experiences (ACEs) are associated with poorer child and adult outcomes. Research has identified protective factors that may mitigate ACEs. This program presents research that explored whether protective factors identified by a resiliency framework were associated with a lower likelihood of mental health issues in children experiencing multiple ACEs. The presenters will discuss potential strategies to target the most salient factors.

Summary

The proposed program will present the results of secondary data analysis of the 2019 National Survey of Children’s Health (NSCH) that explored whether the presence of protective factors identified by the National Scientific Council on the Developing Child (NSCDC) was associated with a lower likelihood of ever having a mental health issue among children who experienced 4 or more adverse childhood experiences (ACEs). Approximately 21.7% of all children in the United States have experienced multiple ACEs. Children who have experienced multiple adverse childhood experiences (ACEs) are more likely to have mental health issues. The National Scientific Council on the Developing Child (NSCDC) has identified four modifiable resilience factors to mitigate ACEs: 1) a supportive, caring, stable relationship with at least one adult, 2) strong executive functioning/self-regulation, 3) mastery in some area of their life, and 4) a supportive/affirming cultural or faith tradition. No known studies have explored whether these NSCDC constructs are associated with a lower likelihood of mental health issues among children experiencing ACEs. Logistic regression explored whether NSCDC resilience factors were associated with a lower likelihood of mental health issues in school-aged children utilizing the 2019 National Survey of Children’s Health. The NSCDC constructs and demographic variables significantly predicted whether children with 4 or more ACEs ever had a mental health issue with self-regulation and supportive parent relationships significantly contributing to the model. Based upon these results, presenters will discuss the potential to utilize the WSCC model to promote resilience factors in schools and to empower parents/other adults to develop resilience-building relationships to mitigate ACEs. The presentation will then discuss future research needed based upon this study and relevant aspects of the CDC’s recently released Adverse Childhood Experiences Prevention Strategy.

Evidence

The 2016 National Survey of Children’s Health (NSCH) found 46.3% of all children experiencing at least one adverse childhood experience (ACE) with 21.7% experiencing multiple ACEs (Bethell et al., 2017). Research has demonstrated that children that have experienced multiple ACEs are at increased risk for various risky health behaviors, mental health issues, behavioral issues, negative health outcomes, and poorer educational outcomes (Bellis et al., 2018; Burke et al., 2011; Choi et al., 2019; Dube et al., 2006; Jimenez et al., 2016; Porche et al., 2016; Song & Qian, 2020; Stempel et al., 2017). One study found that adolescents who experienced 4 or more ACEs were between 4 and 15 times more likely to have specific mental health issues like anxiety, behavior issues, depression, or substance use disorder (Bomysoad & Francis, 2020). Fortunately, resilience research has identified protective factors that can potentially help children adapt and succeed despite early childhood adversity (Ortiz, 2019). The National Scientific Council on the Developing Child [NSCDC] (2015) has identified a framework in which four modifiable factors build resilience to overcome ACEs: a supportive, caring, stable relationship with at least one adult, strong executive functioning/self-regulation, mastery in some area of their life, and a supportive/affirming cultural or faith tradition. While historical resilience research not specific to ACEs had validated these factors (Masten, 2018), no known studies have explored whether these factors reduce negative outcomes like mental health issues among children experiencing multiple ACEs.

Thus, this presentation presents results of research that explored whether the presence of these four NSCDC factors was associated with lower levels of mental health issues ever (depression, anxiety, ADHD, or conduct/behavior issues) among children experiencing 4 or more ACEs using data from the 2019 NSCH. The study found that NSCDC constructs and demographic variables significantly predicted whether children with 4 or more ACEs ever had a mental health issue with self-regulation and parent/caregiver relationships significantly contributing to the relationship. Based upon these findings, the presentation will discuss potential school-based strategies utilizing the Whole School, Whole Community, Whole Child (WSCC) model of school health to increase self-regulation and promote supportive adult relationships in trauma-sensitive schools based upon the literature (Centers for Disease Control and Prevention, 2021a; Gaias et al., 2020; Kolbe, 2019; Kuperminc et al., 2020; Lewallen et al., 2015; Temkin et al., 2020). The presenters will also discuss the recently released Center for Disease Control and Prevention’s (2021b) Adverse Childhood Experience Prevention Strategy and implications for future ACEs research based upon the study results

References

Bellis, M. A., Hughes, K., Ford, K., Hardcastle, K. A., Sharp, C. A., Wood, S., Homolova, L., & Davies, A. (2018). Adverse childhood experiences and sources of childhood resilience: A retrospective study of their combined relationships with child health and educational attendance. BMC Public Health, 18(1), 792. https://doi.org/10.1186/s12889-018-5699-8

Bethell, C. D., Davis, M. B., Gombojav, N., Stumbo, S., & Powers, K. (2017). A national and across-state profile on adverse childhood experiences among u.S. Children and possibilities to heal and thrive. Johns Hopkins Bloomberg School of Public Health.

Bomysoad, R. N., & Francis, L. A. (2020). Adverse childhood experiences and mental health conditions among adolescents. J Adolesc Health, 67(6), 868-870. https://doi.org/10.1016/j.jadohealth.2020.04.013

Burke, N. J., Hellman, J. L., Scott, B. G., Weems, C. F., & Carrion, V. G. (2011). The impact of adverse childhood experiences on an urban pediatric population. Child Abuse Negl, 35(6), 408-413. https://doi.org/10.1016/j.chiabu.2011.02.006

Centers for Disease Control and Prevention (2021a). Whole School, Whole Community, Whole Child (WSCC). https://www.cdc.gov/healthyschools/wscc/index.htm

Centers for Disease Control and Prevention (2021b). Adverse childhood experiences prevention strategy. https://www.cdc.gov/injury/pdfs/priority/ACEs-Strategic-Plan_Final_508.pdf

Choi, J. K., Wang, D., & Jackson, A. P. (2019). Adverse experiences in early childhood and their longitudinal impact on later behavioral problems of children living in poverty. Child Abuse Negl, 98, 104181. https://doi.org/10.1016/j.chiabu.2019.104181

Dube, S. R., Miller, J. W., Brown, D. W., Giles, W. H., Felitti, V. J., Dong, M., & Anda, R. F. (2006). Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescence. J Adolesc Health, 38(4), 444 e441-410. https://doi.org/10.1016/j.jadohealth.2005.06.006

Gaias, L. M., Cook, C. R., Nguyen, L., Brewer, S. K., Brown, E. C., Kiche, S., Shi, J., Buntain-Ricklefs, J., & Duong, M. T. (2020). A mixed methods pilot study of an equity-explicit student-teacher relationship intervention for the ninth-grade transition. J Sch Health, 90(12), 1004-1018. https://doi.org/10.1111/josh.12968

Jimenez, M. E., Wade, R., Jr., Lin, Y., Morrow, L. M., & Reichman, N. E. (2016). Adverse experiences in early childhood and kindergarten outcomes. Pediatrics, 137(2), e20151839. https://doi.org/10.1542/peds.2015-1839

Kolbe, L. J. (2019). School health as a strategy to improve both public health and education. Annu Rev Public Health, 40, 443-463. https://doi.org/10.1146/annurev-publhealth-040218-043727

Kuperminc, G. P., Chan, W. Y., Hale, K. E., Joseph, H. L., & Delbasso, C. A. (2020). The role of school-based group mentoring in promoting resilience among vulnerable high school students. Am J Community Psychol, 65(1-2), 136-148. https://doi.org/10.1002/ajcp.12347

Lewallen, T. C., Hunt, H., Potts-Datema, W., Zaza, S., & Giles, W. (2015). The whole school, whole community, whole child model: A new approach for improving educational attainment and healthy development for students. J Sch Health, 85(11), 729-739. https://doi.org/10.1111/josh.12310

Masten, A. S. (2018). Resilience theory and research on children and families: Past, present, and promise. Journal of Family Theory & Review, 10(1), 12-31. https://doi.org/10.1111/jftr.12255

National Scientific Council on the Developing Child. (2015). Supportive relationships and active skill-building strengthen the foundations of resilience. https://developingchild.harvard.edu/resources/supportive-relationships-and-active-skill-building-strengthen-the-foundations-of-resilience

Ortiz, R. (2019). Building resilience against the sequelae of adverse childhood experiences: Rise up, change your life, and reform health care. Am J Lifestyle Med, 13(5), 470-479. https://doi.org/10.1177/1559827619839997

Porche, M. V., Costello, D. M., & Rosen-Reynoso, M. (2016). Adverse family experiences, child mental health, and educational outcomes for a national sample of students. School Mental Health, 8(1), 44-60. https://doi.org/10.1007/s12310-016-9174-3

Song, W., & Qian, X. (2020). Adverse childhood experiences and teen sexual behaviors: The role of self-regulation and school-related factors. J Sch Health, 90(11), 830-841. https://doi.org/10.1111/josh.12947

Stempel, H., Cox-Martin, M., Bronsert, M., Dickinson, L. M., & Allison, M. A. (2017). Chronic school absenteeism and the role of adverse childhood experiences. Acad Pediatr, 17(8), 837-843. https://doi.org/10.1016/j.acap.2017.09.013

Temkin, D., Harper, K., Stratford, B., Sacks, V., Rodriguez, Y., & Bartlett, J. D. (2020). Moving policy toward a whole school, whole community, whole child approach to support children who have experienced trauma. J Sch Health, 90(12), 940-947. https://doi.org/10.1111/josh.12957

Learning Objective 1

Participants will be able to describe what adverse childhood experiences are and how they impact children and adults.

Learning Objective 2

Participants will be able to explain the four resilience factors identified by the National Scientific Council on the Developing Child (NSCDC) framework.

Learning Objective 3

Participants will be able to identify strategies to increase self-regulation and strengthen adult-child relationships to build resilience

Keyword Descriptors

Adverse childhood experiences, resilience, modifiable protective factors, mental health, self-regulation, parent-child relationships, mastery, supportive cultural/faith tradition, WSCC model

Presentation Year

2022

Start Date

3-8-2022 1:00 PM

End Date

3-8-2022 2:15 PM

Recommended Citation

Keane, Kevin and Evans, Retta, "Resilience and Mental Health Outcomes Among Children that Experienced Multiple Adverse Childhood Experiences" (2022). National Youth Advocacy and Resilience Conference. 65.
https://digitalcommons.georgiasouthern.edu/nyar_savannah/2022/2022/65