eprintid: 10205535 rev_number: 19 eprint_status: archive userid: 699 dir: disk0/10/20/55/35 datestamp: 2025-03-04 09:18:02 lastmod: 2025-03-04 09:18:02 status_changed: 2025-03-04 09:18:02 type: article metadata_visibility: show sword_depositor: 699 creators_name: Madigan, Sheri creators_name: Thiemann, Raela creators_name: Deneault, Audrey-Ann creators_name: Fearon, RM Pasco creators_name: Racine, Nicole creators_name: Park, Julianna creators_name: Lunney, Carole A creators_name: Dimitropoulos, Gina creators_name: Jenkins, Serena creators_name: Williamson, Tyler creators_name: Neville, Ross D title: Prevalence of Adverse Childhood Experiences in Child Population Samples: A Systematic Review and Meta-Analysis ispublished: pub divisions: UCL divisions: B02 divisions: C07 divisions: D05 divisions: F66 note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Importance: Exposure to adverse childhood experiences (ACEs) before the age of 18 years is a major contributor to the global burden of disease and disability. // Objective: To meta-analyze data from samples with children 18 years or younger to estimate the average prevalence of ACEs, identify characteristics and contexts associated with higher or lower ACE exposure, and explore methodological factors that might influence these prevalence estimates. // Design, Setting, and Participants: Studies that were published between January 1, 1998 and February 19, 2024, were sourced from MEDLINE, PsycINFO, CINHAL, and Embase. Inclusion criteria required studies to report the prevalence of 0, 1, 2, 3, or 4 or more ACEs using an 8- or 10-item ACEs questionnaire (plus or minus 2 items), include population samples of children 18 years or younger, and be published in English. Data from 65 studies, representing 490 423 children from 18 countries, were extracted and synthesized using a multicategory prevalence meta-analysis. These data were analyzed from February 20, 2024, through May 17, 2024. // Main Outcomes and Measures: ACEs. // Results: The mean age of children across studies was 11.9 (SD, 4.3) years, the age range across samples was 0 to 18 years, and 50.5% were female. The estimated mean prevalences were 42.3% for 0 ACEs (95% CI, 25.3%-52.7%), 22.0% for 1 ACE (95% CI, 9.9%-32.7%), 12.7% for 2 ACEs (95% CI, 3.8%-22.3%), 8.1% for 3 ACEs (95% CI, 1.4%-16.8%), and 14.8% for 4 or more ACEs (95% CI, 5.1%-24.8%). The prevalence of 4 or more ACEs was higher among adolescents vs children (prevalence ratio, 1.16; 95% CI, 1.04-1.30), children in residential care (1.26; 95% CI, 1.10-1.43), with a history of juvenile offending (95% CI, 1.29; 1.24-1.34), and in Indigenous peoples (1.63; 95% CI, 1.28-2.08), as well as in studies where file review was the primary assessment method (1.29; 95% CI, 1.23-1.34). The prevalence of 0 ACEs was lower in questionnaire-based studies where children vs parents were informants (0.85; 95% CI, 0.80-0.90). // Conclusions: In this study, ACEs were prevalent among children with notable disparities across participant demographic characteristics and contexts. As principal antecedent threats to child and adolescent well-being that can affect later life prospects, ACEs represent a pressing global social issue. Effective early identification and prevention strategies, including targeted codesigned community interventions, can reduce the prevalence of ACEs and mitigate their severe effects, thereby minimizing the harmful health consequences of childhood adversity in future generations. date: 2025-01 date_type: published publisher: AMER MEDICAL ASSOC official_url: https://doi.org/10.1001/jamapediatrics.2024.4385 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2351174 doi: 10.1001/jamapediatrics.2024.4385 lyricists_name: Fearon, Richard lyricists_id: RMPFE61 actors_name: Fearon, Richard actors_id: RMPFE61 actors_role: owner funding_acknowledgements: [Calgary Health Foundation]; [Alberta Children's Hospital Research Foundation through the Alberta Children's Hospital Research Institute]; [Owerko Centre for Neuro development and Child Mental Health]; [University of Calgary's Cumming School of Medicine, Faculty of Arts]; [Office of the Vice-President (Research)] full_text_status: public publication: JAMA Pediatrics volume: 179 number: 1 pagerange: 19-33 pages: 15 issn: 2168-6203 citation: Madigan, Sheri; Thiemann, Raela; Deneault, Audrey-Ann; Fearon, RM Pasco; Racine, Nicole; Park, Julianna; Lunney, Carole A; ... Neville, Ross D; + view all <#> Madigan, Sheri; Thiemann, Raela; Deneault, Audrey-Ann; Fearon, RM Pasco; Racine, Nicole; Park, Julianna; Lunney, Carole A; Dimitropoulos, Gina; Jenkins, Serena; Williamson, Tyler; Neville, Ross D; - view fewer <#> (2025) Prevalence of Adverse Childhood Experiences in Child Population Samples: A Systematic Review and Meta-Analysis. JAMA Pediatrics , 179 (1) pp. 19-33. 10.1001/jamapediatrics.2024.4385 <https://doi.org/10.1001/jamapediatrics.2024.4385>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10205535/2/Figure%201_R%26R.pdf document_url: https://discovery.ucl.ac.uk/id/eprint/10205535/3/FIgure%202_R%26R.pdf document_url: https://discovery.ucl.ac.uk/id/eprint/10205535/17/Fearon_Appendix_R%26R_RN_30%20July.pdf document_url: https://discovery.ucl.ac.uk/id/eprint/10205535/18/Fearon_JAMA%20Child%20ACEs%20Manuscript_R%26R_Aug2_clean.pdf