Impact of Early Childhood Exposure to Multiple Adverse Childhood Experiences and Poor Maternal Mental Health on Developmental, Behavioral, and Social Delays

Background and Purpose: Enhancing the well-being of vulnerable children and families is paramount to the social work profession. Research has revealed exposure to multiple adverse childhood experiences (ACEs) significantly predicts risky health behaviors, leadings causes of death, diseases, and poorer health status later in life. Young children exposed to multiple ACEs are at increased risk for social development delays, poor mental health, and chronic medical conditions. Aligning closely with the 2017 SSWR Conference theme of ensuring health development for all youth, this study applied the Ecological-Transactional Model of Child Maltreatment and examined the relationship between poor maternal mental health, early childhood exposure to multiple ACEs, and the risk for developmental, behavioral, and social delays among young children  

Methods: Secondary data analysis was conducted using the nationally representative 2011-2012 National Survey of Children’s Health (NSCH) consisting of a total sample of 95,677 caregiver interviews regarding child health, well-being, and developmental domains. For the purposes of this analysis, the sample was restricted to mother-respondents with young children between 4 months and 5 years old, who answered all questions pertaining to their child’s early development, which was used to derive the developmental outcome variable. This yielded a final sample size of 19,479 cases. 

Variables of interest included poor self-reported maternal mental health, early childhood exposure to two or more ACEs and the derived ‘child’s risk for developmental, behavioral, and social delays. Control variables included: child’s gender; child’s age; child’s race; mother’s level of education; mother’s physical health; mother’s current marital status; and derived poverty level of household. 

Data Analysis: Logistic regression was conducted for three subgroups based on risk for developmental delay (low/no risk, moderate and high risk, high risk only) to examine the predictive relationship between maternal mental health, ACE exposure in early childhood, and risk for negative child developmental outcomes. Due to high poverty within the sample, two additional models were created for poverty and extreme poverty households (at or below 100% of the poverty guidelines; or above 100% of the poverty guidelines). In total, nine logistic regression tests were conducted across the three models for each of the three risk groups.

Results: Findings revealed that poor maternal mental health and early exposure to two or more ACEs significantly predicted increased risk for developmental, behavioral, and social delays among young children. Young children in the high-risk group who lived in extreme poverty households were most likely to have a caregiver mother with both poor physical and mental health and have exposure to multiple ACEs.

Conclusions/Implications: These findings suggest that the intergenerational impact of ACEs may occur early in the child’s life, emphasizing the critical need for early interventions. This exposes the need for practitioners to address co-occurring issues within the family system, such as poor caregiver mental health and early childhood exposure to ACEs, as well as the urgent need for policy development to support this multiple-domain approach.