Children Exposed to Domestic Violence: Using Adverse Childhood Experience Scores to Inform Service Response

Abstract

 

Background: This study examined the prevalence of Adverse Childhood Experiences (ACEs) in a university population and was the first of its kind in the United Kingdom. ACE scores are associated with health and welfare outcomes across the life course, with probability of negative outcomes increasing exponentially with each additional score. The researchers were interested in testing for associations between ACE scores and likelihood of receiving welfare services prior to enrolling in university, hypothesising that elevated scores would be associated with higher levels of contact. They also sought to ascertain what particular adversities, if any, might be markers for elevated ACE scores?

Methods: First year students at Queen’s University Belfast, Northern Ireland took part in an online survey, self-reporting ACEs and measures of prior contact with welfare agencies. The ACE questionnaire measures abuse, neglect and household dysfunction. The study received a response rate of 18.6% (N = 765), 522 (72.7%) female and 212 (27.2%) male.

Results: The profile of ACE scores was comparable with college-educated populations in the USA: 0 – 44%, 1 – 21.2%, 2 – 13.6%, 3 – 8.8% and 4+ - 12.4%. Respondents with ACE scores of 4+ were twenty-three times more likely to have had previous contact with welfare agencies than those with ACE scores of zero. This confirms the hypothesis. Witnessing domestic violence was the strongest maker for higher ACE scores, with 86% of respondents reporting mother directed violence having at least three additional ACEs (i.e. an ACE score of 4 or more).

Implications: The results indicate that children with elevated ACE scores are more likely to come into contact with welfare agencies than are peers with lower scores. Moreover, the finding that the experience of witnessing domestic violence is a proxy indicator for elevated ACE scores is in line with research in this field. Child welfare agencies, however, in their assessment practices, have not generally taken such findings on board. For example, in the United Kingdom, Stanley and colleagues (2012) found that 83% of children referred to child welfare agencies for reason of exposure to domestic violence, did not receive a follow-up visit from social workers. With a UK prevalence rate of 14.2% for exposure to domestic violence before the age of 18 (Radford et al., 2011), it is incumbent on policy makers, service providers and practitioners to develop and promote assessments and interventions that recognise that incidences of domestic violence may signal that children in such families may be exposed to a greater number of adversities, with consequences for their immediate safety and future welfare.