Objective

To examine associations between adverse childhood experiences (ACEs) and teen behavior outcomes and whether the presence of disability moderates this relationship.

Methods

We conducted a secondary analysis of population-based data from the Fragile Families & Child Wellbeing Study urban birth cohort. Disability status included physical/developmental/behavioral conditions (ages 1–5) using mother-reported child health conditions and cognitive disability (age 9), measured by the Peabody Picture Vocabulary Test (PPVT), an assessment of receptive vocabulary. We investigated whether either disability type moderates the relationship between ACEs occurring between ages 5 to 9 and behavior outcomes at age 15, specifically, standardized scales of caregiver-reported externalizing and youth-reported internalizing and delinquent behaviors. Associations were examined using multivariate linear regression models, including interaction effects of ACEs with low PPVT score and disability conditions to assess for potential moderation.

Results

Of the 3038 children included, 15% had a cognitive disability and 24% had a disabling health condition. The presence of 2 or more ACEs (compared to none) is associated with more externalizing (by 0.34 standard deviations [SD]), internalizing (0.18 SD), and delinquent (0.18 SD) behaviors. Cognitive disability exacerbates this association for externalizing behaviors and delinquent behaviors while other disabling health conditions do not.

Conclusions

ACEs were associated with more behavior problems among urban youth. Cognitive disability, but not other disabling health conditions, compounded this association for externalizing and delinquent behaviors, indicating these children may be particularly vulnerable to the effects of trauma and adversity. Targeted assessment and resources for youth with cognitive disability are critical.

中文翻译：

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不良童年经历和青少年行为结果：残疾的作用

客观的

研究不良童年经历 (ACE) 与青少年行为结果之间的关联，以及残疾的存在是否会缓和这种关系。

方法

我们对来自脆弱家庭和儿童福利研究城市出生队列的人口数据进行了二次分析。残疾状况包括身体/发育/行为状况（1-5 岁），使用母亲报告的儿童健康状况和认知障碍（9 岁），通过皮博迪图片词汇测试 (PPVT) 测量，接受词汇评估。我们调查了任何一种残疾类型是否可以调节 5 至 9 岁之间发生的 ACE 与 15 岁行为结果之间的关系，特别是照料者报告的外化和青年报告的内化和犯罪行为的标准化量表。使用多元线性回归模型检查关联，

结果

在包括的 3038 名儿童中，15% 有认知障碍，24% 有致残的健康状况。2 个或更多 ACE（与没有相比）的存在与更多的外化（0.34 标准差 [SD]）、内化（0.18 SD）和违法（0.18 SD）行为相关。认知障碍加剧了这种外化行为和违法行为的关联，而其他致残的健康状况则不会。

结论

ACE 与城市青年中更多的行为问题有关。认知障碍，而不是其他致残的健康状况，加剧了这种外化和犯罪行为的关联，表明这些儿童可能特别容易受到创伤和逆境的影响。为有认知障碍的青少年提供有针对性的评估和资源至关重要。