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Matern Child Health J. 2016 Apr;20(4):843-53. doi: 10.1007/s10995-015-1915-7.

The Comorbidity of Physical, Mental, and Developmental Conditions Associated with Childhood Adversity: A Population Based Study.

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Institute for Child Health Policy, University of Florida, 1329 SW 16th ST, Gainesville, FL, 32611, USA.
Department of Health Policy and Administration, The Pennsylvania State University, State College, PA, USA.
Department of Sociology, University of Central Florida, Orlando, FL, USA.
Institute for Child Health Policy, University of Florida, 1329 SW 16th ST, Gainesville, FL, 32611, USA.



Adverse childhood experiences (ACEs) are associated with myriad health conditions and risk behaviors in both adolescents and adults. In this study we examine the association between ACEs and specific physical, mental, and developmental conditions, as well as their comorbidity, in a nationally representative sample of children 0-17 years.


Data from the 2011-2012 National Survey for Child Health (NSCH) were used. A total of 95,677 random-digit-dial interviews with parents of children 0-17 years were conducted across all 50 states and the District of Columbia. Outcomes included singular condition domains (physical, mental, and developmental) as well as combinations of condition domains (e.g., physical plus mental, mental plus developmental, etc.).


Twenty-three percent of parents reported that their child experienced 1 ACE; 9.2 % experienced 2 ACEs, and 10.3 % experienced three or more. Across all three condition domains and combinations of domains, children who experienced at least one ACE were more likely than children who experienced 0 ACEs to have at least one condition. Additionally, greater ACEs was associated with increased likelihood of at least one condition in each domain and in multiple domains.


for practice These findings support the extension of existing family environment screening tools in pediatric practices as well as the establishment of a system for monitoring ACEs in families with multiple or complex conditions.


Adverse childhood experiences; Comorbidity; Pediatrics; Public health

[Indexed for MEDLINE]

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