Can the Cumulative Adverse Childhood Experiences (ACE) Score Actually Identify the Victims of Intrafamilial Childhood Maltreatment? Findings from a Study in the Child Welfare System

Int J Environ Res Public Health. 2021 Jun 27;18(13):6886. doi: 10.3390/ijerph18136886.

Abstract

Studies show that a significant proportion of children in the Child Welfare System (CWS) have suffered adverse childhood experiences (ACEs), which have led to well documented serious consequences. This study assessed and compared the ACE status of adolescents aged 12 to 17 placed in a family style group care (FGC) setting (n = 240) to the ACE status of adolescents living with their biological parents (n = 516). The ACE Score Calculator was employed. The populational differences in ACE scores and in the prevalence of ACEs were assessed using generalized linear and logistic regression models. Adolescents living in FGC settings reported more than five times as many multiple adverse experiences (≥4 types of ACEs) as those living with their biological parents. Adolescents living in FGC settings seem to be more willing to report family dysfunction rather than their maltreatment history and are less willing to report maltreatment. In the FGC group, a surprisingly high proportion of adolescents reported having experienced no maltreatment, which is probably highly underreported and/or unrecognised in the CWS. In fact, a high ACE score will not identify the children who have experienced direct maltreatment but will highlight the consequences of the unfavourable factors inherent in disadvantaged social situation instead.

Keywords: adolescence; adverse childhood experiences; child welfare system; family dysfunction; maltreatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adverse Childhood Experiences*
  • Child
  • Child Abuse*
  • Child Welfare
  • Humans
  • Logistic Models
  • Prevalence