95 - Resiliency Factors Associated with Lower Odds of Mental, Emotional, Developmental, Learning Disability and Behavioral Outcomes among Children Experiencing ACEs

Poster Number: 95
Publication Number: 95.211

Wynton Sims, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Matthew S. Pantell, University of California, San Francisco, School of Medicine, San Francisco, CA, United States

Background: Exposure to adverse childhood experiences (ACEs) is associated with an increased odds of poor childhood health outcomes. There is increasing interest in understanding the influence of positive childhood experiences (PCEs) and resilience on health because of their potential protective role against ACEs.

Objective: We sought to understand 1) whether PCEs are protective against developing learning disabilities and mental, emotional, developmental, and behavioral conditions (MEDBC); 2) whether this relationship is similar among those with many vs. few ACEs.

Design/Methods: We analyzed the 2018-2019 combined National Survey of Children’s Health (NSCH). We constructed a variable for “high ACEs” (vs. “low”) for children with 4 or more of the following: financial strain, parental divorce, caregiver death, caregiver history of incarceration, exposure to domestic violence, exposure to neighborhood violence, caregiver with mental illness, caregiver with an alcohol/drug problem, and discrimination. PCEs used in our analysis included after school activity participation (ages 6-17), community service participation (ages 6-17), family shares ideas well, family reads to children daily (ages 0-5), family sings/tells stories to children daily (ages 0-5), and family eats meals together daily (all ages). Our outcomes were whether the child has a 1) MEDBC (ages 3-17); 2) learning disability (all ages). We used the following logistic regression models to predict each outcome: 1) using high ACEs and each individual PCE as predictors; and 2) Model 1 + an interaction term for high ACEs x each PCE. All models were nationally weighted using survey-provided sampling weights and controlled for the following covariates: age, sex, race/ethnicity, and family income. Significance was set using a P-value < 0.05.

Results: The sample consisted of 59,963 children ages 0-17. In Model 1, each PCE except reading together and singing/sharing stories daily was associated with a significantly lower odds of having MEDBC compared to not having the PCE, regardless of ACEs score (Figure 1). Each PCE except reading together was associated with a significantly lower odds of having a learning disability compared to not having the PCE, regardless ACEs score (Figure 2). In Model 2, there was no significant interaction between high ACEs and any of the individual PCEs.Conclusion(s): Regardless of whether children had high or low ACEs, PCEs were associated with a lower odds of both having a MEDBC and having a learning disability. As the enthusiasm for screening for ACEs continues, clinicians should also consider screening for resiliency factors.
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