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

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.