Adverse Childhood Experiences: A Focus for Pediatric Practice

The association between adverse childhood experiences (ACEs) and risk for serious physical and mental conditions in adulthood was demonstrated 2 decades ago (Am J Prev Med 1998; 14:245). An estimated 12% of children experience four or more ACEs, including emotional, physical, or sexual abuse and neglect; witnessing violence against a mother; experiencing parental separation or divorce; and living with household members who were substance users, mentally ill, or suicidal, or who had been imprisoned. Subsequent studies have documented the importance of other common adversities, including community violence, poverty, and peer victimization.

In a viewpoint article, the author proposes that pediatricians focus on “ACEs” — the smaller, and more fr…