Adverse childhood experiences (ACEs) and child behaviour problems in KwaZulu-Natal, South Africa.
Meaghan L Nazareth, Jane D Kvalsvig, Claude A Mellins and 3 others
PMID 34913192WHAT IT FOUND
In South African children, more adverse childhood experiences were associated with higher-risk behaviour scores, especially emotional and conduct problems.
The link remained after household chaos was adjusted, but hyperactivity was not associated.
Key findings
01Children with four or more ACEs had a mean total SDQ score of 16.4, compared with 12.8 for children with no ACEs.
02A higher total ACE score was associated with high-risk SDQ total, emotional, and conduct scores, but not hyperactivity.
03After adjusting for household chaos, the ACE associations with high-risk SDQ total, emotional, and conduct scores remained.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was observational, so it measured associations over time rather than effects of changing ACEs. The paper did not know timing, duration, or severity of several ACE exposures. It did not know whether the child witnessed caregiver drinking or experienced the reported intimate partner violence. The main analysis excluded caregivers not in a current romantic or sexual relationship because they were not asked about intimate partner violence. The analysed sample differed from the wider cohort on several ACE components and caregiver/child characteristics, though SDQ total score did not differ. The SDQ is a screening measure, not a diagnosis. There is no agreed LMIC ACE definition, and the study team selected the components.
Declared interests
The supplied text does not include a conflicts-of-interest declaration; the publication metadata lists NIH extramural research support.
The easy way to misread this
Do not read this as proof that adverse childhood experiences caused behaviour problems, or that reducing them will improve behaviour. The study measured associations over time, not treatment effects.