Emotional Support Seeking Among Immigrant Parents of Children with Adverse Childhood Experiences in the U.S

Background and Purpose: Adverse childhood experiences (ACEs) encompass a broad spectrum of potentially traumatic events in a child's life, including family instability, violence, discrimination, and economic hardship. Reliable emotional support is a well-established protective factor that can buffer the negative outcomes associated with these experiences. However, children from marginalized backgrounds, particularly those in immigrant families, often encounter significant barriers in accessing such support systems. While the detrimental health impacts of ACEs on children have been extensively studied, there is limited understanding of how children's exposure to ACEs affects their parents' emotional well-being and help-seeking behaviors. This study explores how cumulative ACE exposure and household sociodemographic factors influence parents' access to emotional support in the United States (U.S.).

Methods: This study used data from the 2022 National Survey of Children’s Health (NSCH), a nationally representative dataset based on caregiver reports. The final analytic sample included 7,510 parents of children aged 0-17. The primary outcome variable was parental emotional support, categorized dichotomously (presence vs. absence of support). The key independent variable was a continuous Adverse Childhood Experiences (ACE) index (range: 0-9), derived from binary indicators of exposure to parental separation/divorce, incarceration, death, household mental illness or substance use, domestic violence, neighborhood violence, financial hardship, and discrimination. Multivariate linear regression models were employed to examine associations between ACE exposure and parental emotional support, adjusting for child age, sex, race/ethnicity, household language, family structure, caregiver education and employment status, and household income. All analyses considered survey weights to ensure generalizability. Stata 17 was used for data analysis, and the p-value was set at .05.

Results: Regression analysis demonstrated a small but significant positive relationship between children’s ACE exposure and parents’ access to emotional support (β = 0.02, SE=0.007, p <.05). This suggests that parents of children with higher ACE exposure are marginally more likely to seek emotional support, possibly due to increased interaction with service providers, community resources, or informal support networks. However, significant disparities were observed across sociodemographic factors. Parents in non-English-speaking households were less likely to access emotional support (β=-0.22, SE= 0.012, p<.001), as were parents of children from racially minoritized groups (β= -0.04, SE=0.006, p<.001) and parents of older children (β=-0.01, SE= 0.001, p<.001). Conversely, higher parental education (β=0.05, SE=0.008, p<.001), stronger family closeness (β=0.01, SE= 0.005, p<.01), and higher household income (β=0.03, SE = 0.004, p < .001) were positively associated with emotional support seeking for parents.

Conclusion and Implications: The findings indicate that parents of children with higher ACE exposure are slightly more likely to seek emotional support, suggesting increased engagement with support systems in response to adversities. However, significant disparities exist, particularly among non-English-speaking and racially marginalized families, highlighting systemic barriers to accessing social support. Culturally and linguistically responsive care is essential to ensure equitable emotional support for all families. Trauma-informed, relational, and community-based interventions can help mitigate long-term negative impacts of ACEs and promote resilience for families in immigrant households in the U.S.