Skip to main content
SpringerLink
Log in

Supporting Families Exposed to Adverse Childhood Experiences Within Child Care Settings: A Feasibility Pilot

  • Published:
Early Childhood Education Journal Aims and scope Submit manuscript

Abstract

Childhood adversity is strongly associated with poor health and well-being in childhood and adulthood. Young children are at greatest risk during their developmental years. Child care providers can participate in preventing the impact of adversity on children by becoming communities of support for families in need. This project aimed to explore the feasibility and acceptability of identifying childhood adversity and strengthening family protective factors by incorporating professional development and both universal and targeted interventions that included screening, motivational interviewing, parent cafés, and parenting workshops within ten family and center-based child care programs. A total of 159 caregivers completed the screen about their experiences of adversity, with 60% disclosing adversity during their childhood and 53% disclosing current risk for adversity for their child. An intergenerational association was found between caregivers’ past exposure to adversity and their child’s current risk (p = 0.023). However, this association was no longer significant (p = 0.14) when accounting for their current protective factors (p = 0.002). Most families (77%) who disclosed moderate to high adversity or risk on the screen participated in a brief interview with their child care provider. Eleven parent events were also conducted with an attendance of 91. Child care providers reported that these interventions were both feasible and beneficial. Caregivers showed significant improvements in protective factors (p = 0.013) over the course of the project.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bartlett, J. D., Smith, S., & Bringewatt, E. (2017). Helping young children who have experienced trauma: Policies and strategies for early care and education. Resource Document. Child Trends. Accessed May 30, 2019, from https://www.childtrends.org/publications/ecetrauma.

  • Bellis, M. A., Hughes, K., Ford, K., Hardcastle, K. A., Sharp, C. A., Wood, S., et al. (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.

    Article  Google Scholar 

  • Bethell, C. D., Gombojav, N., & Whitaker, R. C. (2019). Family resilience and connection promote flourishing among US children, even amid adversity. Health Affairs,38(5), 729–737.

    Article  Google Scholar 

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology,3, 77–101.

    Article  Google Scholar 

  • Cook, A., Balustein, M., Spinazzola, J., & van der Kolk, B. (2003). Complex trauma in children and adolescents. Resource Document. National Child Traumatic Stress Network. Accessed May 30, 2019, from http://www.NCTSNet.org.

  • Counts, J. M., Buffington, E. S., Chang-Rios, K., Rasmussen, H. N., & Preacher, K. J. (2010). The development and validation of the protective factors survey: A self-report measure of protective factors against child maltreatment. Child Abuse and Neglect,34(10), 762–772.

    Article  Google Scholar 

  • Donahue, P. J., Falk, B., & Provet, A. G. (2007). Promoting social-emotional development in young children: Mental health supports in early childhood centers. In D. F. Perry, R. K. Kaufmann, & J. Knitzer (Eds.), Social and emotional health in early childhood: Building bridges between services and systems (pp. 281–312). Baltimore: Paul H Brookes Publishing.

    Google Scholar 

  • Dong, M., Giles, W. H., Felitti, V. J., Dube, S. R., Williams, J. E., Chapman, D. P., et al. (2004). Insights into causal pathways for ischemic heart disease: Adverse childhood experiences study. Circulation,110, 1761–1766.

    Article  Google Scholar 

  • Dube, S. R., Williamson, D. F., Thompson, T., Felitti, V. J., & Anda, R. F. (2004). Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse and Neglect,28, 729–737.

    Article  Google Scholar 

  • Dubowitz, H., Feigelman, S., Lane, W., & Kim, J. (2009). Pediatric primary care to help prevent child maltreatment: The Safe Environment for Every Kid (SEEK) Model. Pediatrics,123(3), 858–864.

    Article  Google Scholar 

  • Dubowitz, H., Lane, W. G., Semiatin, J. N., & Magder, L. S. (2012). The SEEK model of pediatric primary care: Can child maltreatment be prevented in a low-risk population? Academic Pediatrics,12(4), 259–268.

    Article  Google Scholar 

  • Eismann, E. A., Theuerling, J., Maguire, S., Hente, E. A., & Shapiro, R. A. (2019). Integration of the Safe Environment for Every Kid (SEEK) model across primary care settings. Clinical Pediatrics,58(2), 166–176.

    Article  Google Scholar 

  • Enlow, M. B., Devick, K. L., Brunst, K. J., Lipton, L. R., Coull, B. A., & Wright, R. J. (2017). Maternal lifetime trauma exposure, prenatal cortisol, and infant negative affectivity. Infancy,22, 492–513.

    Article  Google Scholar 

  • Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine,14, 245–258.

    Article  Google Scholar 

  • Flaherty, E. G., Thompson, R., Dubowitz, H., Harvey, E. M., English, D. J., Proctor, L. J., et al. (2013). Adverse childhood experiences and child health in early adolescence. JAMA Pediatrics,167, 622–629.

    Article  Google Scholar 

  • Flanagan, T., Alabaster, A., McCaw, B., Stoller, N., Watson, C., & Young-Wolff, K. C. (2018). Feasibility and acceptability of screening for adverse childhood experiences in prenatal care. Journal of Women’s Health,27(7), 903–911.

    Article  Google Scholar 

  • Folger, A. T., Eismann, E. A., Stephenson, N. B., Shapiro, R. A., Macaluso, M., Brownrigg, M. E., et al. (2018). Parental adverse childhood experiences and offspring development at 2 years of age. Pediatrics,141, e20172826.

    Article  Google Scholar 

  • Folger, A. T., Putnam, K. T., Putnam, F. W., Peugh, J. L., Eismann, E. A., Sa, T., et al. (2017). Maternal interpersonal trauma and child social–emotional development: An intergenerational effect. Paediatric and Perinatal Epidemiology,31, 99–107.

    Article  Google Scholar 

  • García, J. L., Heckman, J. J., Leaf, D. E., & Prados, M. J. (2017). Quantifying the life-cycle benefits of a prototypical early childhood program. Resource Document. The National Bureau of Economic Research. Accessed July 15, 2019, from https://www.nber.org/papers/w23479.

  • Glowa, P. T., Olson, A. L., & Johnson, D. J. (2016). Screening for adverse childhood experiences in a family medicine setting: A feasibility study. Journal of the American Board of Family Medicine,29, 303–307.

    Article  Google Scholar 

  • Harper Browne, C. (2014). The strengthening families approach and protective factors framework: Branching out and reaching deeper. Washington, DC: Center for the Study of Social Policy.

    Google Scholar 

  • 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, e20151839.

    Article  Google Scholar 

  • Johnson, K., Woodward, A., Swenson, S., Weis, C., Gunderson, M., Deling, M., et al. (2017). Parents’ adverse childhood experiences and mental health screening using home visiting programs: A pilot study. Public Health Nursing,34, 522–530.

    Article  Google Scholar 

  • Kalmakis, K. A., Meyer, J. S., Chiodo, L., & Leung, K. (2015). Adverse childhood experiences and chronic hypothalamic-pituitary-adrenal activity. Stress,18, 446–450.

    Article  Google Scholar 

  • Karageorge, K., & Kendall, R. (2008). The role of professional child care providers in preventing and responding to child abuse and neglect. Resource Document. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau, Office on Child Abuse and Neglect. Accessed May 30, 2019, from https://www.childwelfare.gov/pubs/usermanuals/childcare/.

  • Kerker, B. D., Zhang, J., Nadeem, E., Stein, R. E. K., Hurlburt, M. S., Heneghan, A., et al. (2015). Adverse childhood experiences and mental health, chronic medical conditions, and development in young children. Academic Pediatrics,15, 510–517.

    Article  Google Scholar 

  • Madigan, S., Wade, M., Plamondon, A., Maguire, J. L., & Jenkins, J. M. (2017). Maternal adverse childhood experience and infant health: Biomedical and psychosocial risks as intermediary mechanisms. The Journal of Pediatrics,187, 282–289.

    Article  Google Scholar 

  • Marie-Mitchell, A., & O’Connor, T. G. (2013). Adverse childhood experiences: Translating knowledge into identification of children at risk for poor outcomes. Academic Pediatrics,13, 14–19.

    Article  Google Scholar 

  • McDonnell, C. G., & Valentino, K. (2016). Intergenerational effects of childhood trauma: Evaluating pathways among maternal ACEs, perinatal depressive symptoms, and infant outcomes. Child Maltreatment,21, 317–326.

    Article  Google Scholar 

  • Merrick, M. T., Ford, D. C., Ports, K. A., & Guinn, A. S. (2018). Prevalence of adverse childhood experiences from the 2011–2014 Behavioral Risk Factor Surveillance System in 23 states. JAMA Pediatrics,172, 1038–1044.

    Article  Google Scholar 

  • Middlebrooks, J. S., & Audage, N. C. (2008). The effects of childhood stress on health across the lifespan. Atlanta: National Center for Injury Prevention and Control. Centers for Disease Control and Prevention.

    Google Scholar 

  • Mortensen, J. A., & Barnett, M. A. (2016). The role of child care in supporting the emotion regulatory needs of maltreated infants and toddlers. Children and Youth Services Review,64, 73–81.

    Article  Google Scholar 

  • Murphy, A., Steele, M., Dube, S. R., Bate, J., Bonuck, K., Meissner, P., et al. (2014). Adverse childhood experiences (ACEs) questionnaire and adult attachment interview (AAI): Implications for parent child relationships. Child Abuse and Neglect,38, 224–233.

    Article  Google Scholar 

  • Robles, A., Gjelsvik, A., Hirway, P., Vivier, P. M., & High, P. (2019). Adverse childhood experiences and protective factors with school engagement. Pediatrics,144, e20182945.

    Article  Google Scholar 

  • Schickedanz, A., Halfon, N., Sastry, N., & Chung, P. J. (2018). Parents’ adverse childhood experiences and their children’s behavioral health problems. Pediatrics,142, e20180023.

    Article  Google Scholar 

  • Shonkoff, J. P., & Garner, A. S. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics,129(1), e232–e246.

    Article  Google Scholar 

  • Shonkoff, J. P., & Phillips, D. A. (2000). From neurons to neighborhoods: The science of early childhood development. Washington, DC: National Academies Press.

    Google Scholar 

  • Stepleton, K., Bosk, E. A., Duron, J. F., Greenfield, B., Ocasio, K., & MacKenzie, M. J. (2018). Exploring associations between maternal adverse childhood experiences and child behavior. Children and Youth Services Review,95, 80–87.

    Article  Google Scholar 

  • Sun, J., Patel, F., Rose-Jacobs, R., Frank, D. A., Black, M. M., & Chilton, M. (2017). Mothers’ adverse childhood experiences and their young children’s development. American Journal of Preventive Medicine,53, 882–891.

    Article  Google Scholar 

  • U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2019). Child Maltreatment 2017. Resource document. U.S. Department of Health & Human Services. Accessed May 30, 2019, from https://www.acf.hhs.gov/cb/research-data-technology/statistics-research/child-maltreatment.

  • Voellmin, A., Winzeler, K., Hug, E., Wilhelm, F. H., Schaefer, V., Gaab, J., et al. (2015). Blunted endocrine and cardiovascular reactivity in young health women reporting a history of childhood adversity. Psychoneuroendocrinology,51, 58–67.

    Article  Google Scholar 

  • Yamaoka, Y., & Bard, E. (2019). Positive parenting matters in the face of early adversity. American Journal of Preventive Medicine,56, 530–539.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the Helen G., Henry F. & Louise Tuechter Dornette Foundation for their generous financial support of this project as well as each of the participating child care programs for their time, effort, and dedication to the project.

Funding

This study was funded by the Helen G., Henry F., & Louise Tuechter Dornette Foundation, Fifth Third Bank, Trustee.

Author information

Authors and Affiliations

  1. Mayerson Center for Safe and Healthy Children, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Emily A. Eismann, Jack Theuerling & Robert A. Shapiro

  2. The Children’s Home of Cincinnati, 5050 Madison Road, Cincinnati, OH, 45227, USA

    Carolyn Brinkmann

  3. Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, 45267, USA

    Robert A. Shapiro

Authors
  1. Emily A. Eismann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carolyn Brinkmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jack Theuerling
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert A. Shapiro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert A. Shapiro.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Eismann, E.A., Brinkmann, C., Theuerling, J. et al. Supporting Families Exposed to Adverse Childhood Experiences Within Child Care Settings: A Feasibility Pilot. Early Childhood Educ J 48, 451–462 (2020). https://doi.org/10.1007/s10643-019-01012-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10643-019-01012-9

Keywords

Search

Navigation