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Paediatr Child Health. 2019 Feb;24(1):30-37. doi: 10.1093/pch/pxy043. Epub 2018 Apr 5.

Adverse childhood experiences: Basics for the paediatrician.

Author information

1
Faculty of Medicine, University of Toronto.
2
Department of Paediatrics, Hospital for Sick Children.
3
Division of Paediatric Medicine, Department of Paediatrics, Faculty of Medicine, University of Toronto.
4
Division of Neonatology, Department of Paediatrics, Faculty of Medicine, University of Toronto.
5
Social Paediatrics, Hospital for Sick Children.
6
SickKids Research Institute.

Abstract

In 1998, the Centers for Disease Control and Prevention Adverse Childhood Experiences study established the profound effects of early childhood adversity on life course health. The burden of cumulative adversities can affect gene expression, immune system development and condition stress response. A scientific framework provides explanation for numerous childhood and adult health problems and high-risk behaviours that originate in early life. In our review, we discuss adverse childhood experiences, toxic stress, the neurobiological basis and multigenerational and epigenetic transmission of trauma and recognized health implications. Further, we outline building resilience, screening in the clinical setting, primary care interventions, applying trauma-informed care and future directions. We foresee that enhancing knowledge of the far-reaching effects of adverse childhood events will facilitate mitigation of toxic stress, promote child and family resilience and optimize life course health trajectories.

KEYWORDS:

Adverse childhood experiences; Childhood adversities; Life course; Social paediatrics

PMID:
30792598
PMCID:
PMC6376298
[Available on 2020-02-01]
DOI:
10.1093/pch/pxy043

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