Profiles of Early Childhood Adversity in an Urban Pediatric Clinic: Implications for Pediatric Primary Care

Author:

Ronis Sarah1ORCID,Guyon-Harris Katherine2,Burkhart Kimberly3,Gabriel Mary4,Cipolla Kristin5,Riggs Jessica6,Huth-Bocks Alissa27ORCID

Affiliation:

1. UH Rainbow Center for Child Health and Policy, Department of Pediatrics, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, OH 44106, USA

2. Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA

3. Department of Pediatrics, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, OH 44106, USA

4. Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA

5. Department of Pediatrics, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA

6. Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA

7. Merrill Palmer Skillman Institute, Division of Research, Wayne State University, Detroit, MI 48202, USA

Abstract

Pediatricians are well-positioned to screen for early childhood adversities, but effective responses to positive screens require an understanding of which adversities typically co-occur, and to what extent they are associated with other risk or protective factors. Among children seen at an urban academic pediatric practice, this study aimed to (1) examine the prevalence of different types of early adversity and protective experiences reported by primary caregivers, and (2) define latent classes of co-occurring adversities. Of 1434 children whose parents completed the Safe Environment for Every Kid (SEEK) at well-child visits during November 2019–January 2021, three classes of adverse experiences emerged, including those reporting low adversity (L; 73%), caregiver stress (CS; 17%), and both caregiver stress and depression (CSD; 10%). Among those who also completed the Adverse Childhood Experiences Questionnaire (ACE-Q, n = 1373) and the Protective and Compensatory Experiences Scale (PACES, n = 1377), belonging to the L class was associated with lower ACE-Q and higher PACES scores. For parent-respondents only, ACE-Q scores were significantly greater for the CSD class compared to the CS and L classes. Pediatricians should attend to the needs of caregivers reporting both stress and depression, as these families may face especially high levels of adversity and low levels of protective factors.

Publisher

MDPI AG

Subject

Pediatrics, Perinatology and Child Health

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