Adverse childhood experiences and dental health in children and adolescents

2014 ◽  
Vol 43 (3) ◽  
pp. 193-199 ◽  
Author(s):  
Melissa A. Bright ◽  
Shannon M. Alford ◽  
Melanie S. Hinojosa ◽  
Caprice Knapp ◽  
Daniel E. Fernandez-Baca
Keyword(s):  
Children And Adolescents ◽  
Adverse Childhood Experiences ◽  
Dental Health ◽  
Childhood Experiences ◽  
Adverse Childhood

scholarly journals Can the adverse childhood experiences (ACEs) checklist be utilized to predict emergency department visits among children and adolescents?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Asmita Bhattarai ◽  
Gina Dimitropoulos ◽  
Brian Marriott ◽  
Jaime Paget ◽  
Andrew G. M. Bulloch ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Children And Adolescents ◽  
Adverse Childhood Experiences ◽  
Emergency Department Visits ◽  
Validation Dataset ◽  
Extensive Literature ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Ed Visits

Abstract Background Extensive literature has shown an association of Adverse Childhood Experiences (ACEs) with adverse health outcomes; however, its ability to predict events or stratify risks is less known. Individuals with mental illness and ACE exposure have been shown to visit emergency departments (ED) more often than those in the general population. This study thus examined the ability of the ACEs checklist to predict ED visits within the subsequent year among children and adolescents presenting to mental health clinics with pre-existing mental health issues. Methods The study analyzed linked data (n = 6100) from two databases provided by Alberta Health Services (AHS). The Regional Access and Intake System (RAIS 2016–2018) database provided data on the predictors (ACE items, age, sex, residence, mental health program type, and primary diagnosis) regarding children and adolescents (aged 0–17 years) accessing addiction and mental health services within Calgary Zone, and the National Ambulatory Care Reporting System (NACRS 2016–2019) database provided data on ED visits. A 25% random sample of the data was reserved for validation purposes. Two Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression models, each employing a different method to tune the shrinkage parameter lambda (namely cross-validated and adaptive) and performing 10-fold cross-validation for a set of 100 lambdas in each model were examined. Results The adaptive LASSO model had a slightly better fit in the validation dataset than the cross-validated model; however, it still demonstrated poor discrimination (AUC 0.60, sensitivity 37.8%, PPV 49.6%) and poor calibration (over-triaged in low-risk and under-triaged in high-risk subgroups). The model’s poor performance was evident from an out-of-sample deviance ratio of − 0.044. Conclusion The ACEs checklist did not perform well in predicting ED visits among children and adolescents with existing mental health concerns. The diverse causes of ED visits may have hindered accurate predictions, requiring more advanced statistical procedures. Future studies exploring other machine learning approaches and including a more extensive set of childhood adversities and other important predictors may produce better predictions. Furthermore, despite highly significant associations being observed, ACEs may not be deterministic in predicting health-related events at the individual level, such as general ED use.

scholarly journals Adverse Childhood Experiences and Oral Health Outcomes in U.S. Children and Adolescents: A Cross-Sectional Study of the 2016 National Survey of Children’s Health

2021 ◽  
Vol 18 (23) ◽  
pp. 12313
Author(s):  
Alyssa Simon ◽  
Jamie Cage ◽  
Aderonke Akinkugbe
Keyword(s):  
Oral Health ◽  
Health Outcomes ◽  
Children And Adolescents ◽  
National Survey ◽  
Adverse Childhood Experiences ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Fair Poor ◽  
Oral Health Outcomes

This study investigated the cross-sectional associations between exposure to nine Adverse Childhood Experiences (ACEs) and U.S. children’s and adolescent’s oral health outcomes. Data from 41,294 participants of the 2016 National Survey of Children’s Health (NSCH) were analyzed. Past year exposure to ACE, oral health outcomes (decayed teeth, bleeding gums, and condition of the teeth), and child and caregiver sociodemographic factors were self-reported. Using SAS v. 9.4, propensity score weighted, multilevel survey-logistic regression estimated adjusted odds ratios (AORs) and 95% Confidence Intervals (CIs) of the proposed associations. The overall mean (SE) age was 8.9 (0.1) years with 51% being male. Fifty-four percent (54%) identified as non-Hispanic white, and 12% as non-Hispanic black. The prevalence of the nine ACE measures ranged from 3% for caregiver death to 25% for financial hardship and parental divorce. Children who experienced caregiver mental illness, when compared to those who did not, were more likely to report decayed teeth (AOR: 1.73 (95% CI: 1.24, 2.42)) and the condition of their teeth as fair/poor (AOR: 1.60, 95% CI: 0.61, 4.19). Children in households with financial hardship were about twice as likely to report dental caries (AOR: 1.85, 95% CI: 1.50, 2.29) and have fair/poor teeth (AOR: 1.87, 95% CI: 1.40, 2.51) and bleeding gums (AOR: 2.39, 95% CI: 1.48, 3.86). ACEs appear to be associated with worse oral health outcomes among children and adolescents. Nevertheless, the cross-sectional nature of this study precludes a causal interpretation of these findings and necessitates more research to elucidate the oral health impacts of exposure to ACEs in longitudinal follow-up studies.

scholarly journals Preparing for the COVID-19 paediatric mental health crisis: A focus on youth reactions to caretaker death

2021 ◽  
pp. 135910452110618
Author(s):  
Naomi Liang ◽  
Timothy D Becker ◽  
Timothy Rice
Keyword(s):  
Children And Adolescents ◽  
Adverse Childhood Experiences ◽  
Risk Behaviours ◽  
Mental Health Crisis ◽  
Childhood Experiences ◽  
Health Crisis ◽  
Paediatric Care ◽  
Effective Interventions ◽  
Adverse Childhood ◽  
Increased Risk

To promote clinician preparedness for working with children and adolescents who lost or will lose a parent or caretaker to COVID-19, findings from a review of the literature concerning youth reactions to parent and caretaker death and incapacitation were integrated with recent and emergent data concerning the COVID-19 pandemic. Children and adolescents who lose a parent or caretaker are at an increased risk of anxiety and depressive reactions and disorders, externalizing and health-risk behaviours, and substance use disorders. Particular aspects of the COVID-19 pandemic may influence these presentations and the risk of complicated grief. Youth with prior histories of adverse childhood experiences as well as boys and young men may require special considerations in formulation and planning. Tailored paediatric care based on the evidence advances accurate formulations and effective interventions for children and adolescents who suffer such a loss.

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