Relationship of Adverse Family Experiences of Vermont Youth to Resilience and School Engagement

BACKGROUND:  Adverse childhood experiences (ACEs) have been found to be associated with a wide range of behavioral, mental, and physical health outcomes, risk behaviors, and premature death.  Studies indicate that as the number of ACEs increases, the risk of adverse health outcomes also increases.  In 2011-12, the National Survey of Children’s Health (NSCH) included questions about adverse family experiences (AFEs) of survey subject children.  The AFE module is similar to ACE questions, but differs in two important ways: there are no questions about emotional, physical, or sexual trauma; and, questions are asked of the parent responder rather than the subject child.  Although the relationship between ACEs and work/school absenteeism has been studied, the relationship between AFEs of school-aged children and their school performance and buffering behaviors has not been explored in depth.

METHODS:  We examined AFEs and measures of resilience (i.e., how quickly the child bounces back when things don’t go his/her way) and school engagement on 1,330 Vermont children included in the 2011-12 National Survey of Children’s Health using descriptive, bivariate and multivariable analytic techniques.  Potential confounders (child’s sex, age, special health care need, family poverty level, maternal education level and physical/mental health status) were identified through a review of the literature.

RESULTS:  The most prevalent AFEs among Vermont children were:  divorce/separation of parents (1 in 3); family income hardship (1 in 5); family members with substance use problems (1 in 6); and family members with mental illness/suicidality/severe depression (1 in 8).  In addition, 1 in 6 Vermont children had 4+ moves since birth. After adjusting for sex, age, special health care need, poverty level, maternal education level and physical/mental health status, children who had ≥3 AFEs had higher odds of failing to exhibit resilience (AOR 6.0, 95% CI:2.2-15.8; 1-2 AFEs: AOR 1.6 [95% CI:1.0-2.6]) and lower odds of completing all required homework (AOR 3.9, 95% CI:1.9-8.0; 1-2 AFEs: AOR 2.5 [95% CI:1.4-4.3]), compared to children who had fewer or no AFEs.

CONCLUSIONS:  Children with ≥3 AFEs may have additional obstacles in attaining developmental milestones associated with flourishing and engaging in school. Parents, school-based mental health professionals, and teachers could use simple measures of identifying children who may be less resilient and have difficulties completing homework assignments.  Practical approaches that promote family health, prevent development of emotional problems, and, when present, treat emotional/behavioral problems using a family-based approach are available and could be applied in school or community settings.