The Effects of Adverse Childhood Experiences on Behavioral Problems of Children in Kinship Care

Background and Purpose: Children in kinship care not only experience child maltreatment, but also have exposure to other types of adversities. The negative influence of adverse childhood experiences (ACEs) on behavioral health is well documented; however, less research has examined the effect of ACEs on behavioral problems of children in kinship care. This study aims to examine the (1) prevalence of ACEs among children in kinship care and (2) relationships between the number and type of ACEs and children’s internalizing and externalizing problems.

Methods: Data for children in kinship care (N=900) were from the National Survey of Child and Adolescent Well-being II study. ACEs were captured by five maltreatment indicators: physical abuse, sexual abuse, emotional maltreatment, physical neglect, abandonment; and four household dysfunction indicators: parental/current caregiver’s substance abuse, mental illness, domestic violence, and incarceration (Felitti et al., 1998; Stambaugh et al., 2013). Children’s behavioral problems were measured by the Child Behavior Checklist, including internalizing and externalizing problems. Other covariates included the child’s age, sex, race, and health status, caregiver’s age, education, and physical health condition, and family’s poverty status. Descriptive, bivariate, and Ordinary Least Squares regression models were conducted using STATA 15.0.

Results: Among kinship children, 25% experienced at least one type of abuse (13% physical abuse, 8% sexual abuse, 4% emotional abuse), 29% at least one type of neglect (27% physical neglect, 2% abandonment), and 89% were expose to at least one type of household dysfunction (84% substance abuse, 28% mental illness, 22% incarceration, 6% domestic violence). Approximately 31% of children had one childhood adversity in comparison to 3% with no exposure, and 46% and 20% being exposed to two and ≥3 ACEs, respectively. The cumulative effect of ACEs on behavioral problems indicated that those with two ACEs had fewer internalizing problems (b= -3.92, p = .004) compared to those with ≥3 adversities. Similarly, children who experienced none or one (b= -5.09, p = .017), or two ACEs (b= -5.54, p = .004) had fewer externalizing problems compared to those who had ≥3 ACEs. The cumulative impacts of household dysfunction (internalizing: b = -6.93, p = .001; externalizing: b = -4.90, p = .017) and neglect (internalizing: b= -4.87, p =.048; externalizing: b= -8.45, p = .037) were weaker than that of abuse. Finally, only parental/caregivers’ mental illness was a significant predictor of children’s internalizing (b= 6.54, p =.003) and externalizing problems (b= 9.72, p < .001) while controlling for other types of ACEs.

Conclusions and Implications: The results showed that a large proportion of children in kinship experienced both household dysfunction and maltreatment. Also, ACEs negatively impact children’s behavioral problems with the effects of abuse being more severe than neglect and household dysfunction. More importantly, this study highlights the effects of parental/caregiver’s mental illness on children’s behavioral problems. Findings indicate the importance of addressing ACEs in kinship care, including provisions of mental health treatments to parents/caregivers.