ArticleStress and health : journal of the International Society for the Investigation of Stress2026
Cumulative Adverse Childhood Experiences and Multiple Neurodevelopmental Disorders in Children and Adolescents: A Population-Based Study.
Article in Stress and health : journal of the International Society for the Investigation of Stress, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Adverse childhood experiences (ACEs) and neurodevelopmental disorders (NDDs) are frequent yet the relationship between cumulative ACEs and multiple NDDs remains poorly understood. Using data from 120,629 children aged 3-17 years in the 2021-2023 US National Survey of Children's Health, we examined associations between ACEs and multiple NDDs, defined as the presence of ≥ 2 NDDs. Logistic regression, adjusted for sociodemographic and health covariates, estimated associations for ACEs treated as a continuous variable and as categorical groups (0, 1, 2, and ≥ 3 ACEs). We also assessed associations for common NDD combinations and individual ACE. The prevalence of multiple NDDs increased with the number of ACEs: 4.5% (95% confidence interval [CI]: 4.2-4.8) for 0 ACE, 8.4% (95% CI: 7.7-9.1) for 1 ACE, 11.9% (95% CI: 10.7-13.2) for 2 ACEs, and 17.8% (95% CI: 16.5-19.2) for ≥ 3 ACEs. Each additional ACE was associated with 13% higher odds of multiple NDDs (adjusted odds ratio [aOR] = 1.13, 95% CI: 1.09-1.17). Compared with no ACE, the odds of multiple NDDs were higher for 1 ACE (aOR = 1.48, 95% CI: 1.30-1.68), 2 ACEs (aOR = 1.78, 95% CI: 1.52-2.09), and ≥ 3 ACEs (aOR = 1.91, 95% CI: 1.62-2.26). Associations were consistent across three NDD combinations. Individually, health- or disability-related mistreatment, household mental illness, and economic hardship showed significant associations. Cumulative ACEs are associated with a greater likelihood of multiple NDDs, suggesting future research, health policy, system and service planning require coordinated responses that account for the diverse adversities experienced by many families and children.
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