Wellbeing Outcomes for Children Exposed to Multiple Adverse Experiences in Early Childhood: A Systematic Review

This systematic review sought to examine and synthesize empirical research on the association between early childhood (0-83 months) exposure to multiple adverse childhood experiences (ACEs) and the child's social, behavioral, emotional, or physical developmental wellbeing. Guided by inclusion criteria and predefined search terms, articles were identified through electronic bibliographic databases, reference mining, hand searching, and gray literature. Two authors simultaneously conducted title and abstract reviews, and subsequently full-text reviews. Included studies examined early childhood exposure to two or more ACEs and the association between social, emotional, behavioral, physical, and/or overall wellbeing outcomes. Five studies met the predetermined inclusion criteria and were descriptive, secondary data analyses that utilized large, high-risk samples. Findings support a dose-response association between cumulative early childhood ACE exposure and behavioral issues and poor physical health outcomes. Results revealed between 12.3 and 70% of the early childhood samples were exposed to three or more ACEs. Among high-risk samples, exposure to multiple adversities is common although literature is scarce. Policy and practice implications include early assessments and interventions tailored to identifying the most vulnerable early childhood children.