Adverse Childhood Experiences and Behavioral and Emotional Problems in Adolescents With and Without Autism.

This study followed children with autism and other disabilities from early childhood into their teens. Families of children with autism or other disabilities were more likely to experience financial hardship and parental divorce. Different stressful life events affected behavior differently depending on the child's disability. Mental health problems in the household were linked to behavioral and emotional difficulties in all children, regardless of disability status.

This longitudinal study examined adverse childhood experiences (ACEs) in 858 adolescents with autism, other developmental disabilities, or typical development from the SEED study. Researchers followed children initially assessed at ages 2-5 years through adolescence (12-16 years), collecting caregiver reports on ACEs and behavioral/emotional problems. Adolescents with autism and other developmental disabilities experienced higher rates of income insufficiency and parental divorce compared to typically developing peers. Specific ACEs showed differential associations with behavioral problems across groups - household substance abuse linked to conduct problems only in autism, while financial assistance receipt correlated with hyperactivity only in other developmental disabilities.

Household mental illness consistently predicted conduct and emotional problems across all groups.

Findings support implementing targeted financial and family support programs for families of children with disabilities. Universal screening for household mental health problems and substance abuse is warranted. Autism-specific behavioral interventions may be needed when household substance abuse is present.

Study relies on caregiver reports which may introduce bias. Sample size details for specific analyses not provided. Cross-sectional analysis of ACEs limits causal inferences. Potential confounding variables and effect sizes not clearly specified in the abstract.

We sought to examine differences in caregiver-reported adverse childhood experiences (ACEs) in adolescents with and without autism and explore associations between ACEs and behavioral and emotional problems in those with ACEs. Children were classified as having autism, another developmental disability (DD), or population comparison (POP) after a comprehensive evaluation in the Study to Explore Early Development (SEED) between 2 to 5 years of age. Caregivers of these same children completed the SEED Teen survey and answered questions about ACEs and current behavioral and emotional problems at 12 to 16 years of age. Adolescents with autism (n = 198) and other DD (n = 330) were more likely than POP (n = 330) to experience income insufficiency (29.8%, 25.2%, and 12.2%, respectively) and parental divorce (29.3%, 25.7%, and 18.4%, respectively) (all p < 0.05).

Living with someone with an alcohol or drug problem was associated with conduct problems only in adolescents with autism; living in a family that received financial assistance was associated with hyperactivity problems only in adolescents with other DD. Living with anyone experiencing mental illness, suicidality, or severe depression was associated with conduct and emotional problems in all 3 study groups. Families of children with atypical development may need more financial and emotional/marital support than others. Moreover, adolescents with autism and other DD could benefit from behavioral supports in response to a few specific ACEs while addressing household mental health problems could have widespread benefits that improve pediatric health.

These findings can be used to encourage evidence-based programs and practices to prevent ACEs and offer supports when needed.