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Updated: May 5, 2026
A Test Bed to Examine Helmet Fit and Retention and Biomechanical Measures of Head and Neck Injury in Simulated Impact
Published on: September 21, 2017
Research Letter: Childhood Adversity and Risk of Subsequent Head and Neck Injury: an ABCD Cohort Analysis
D Jain1, E Carlsson1, N L de Souza2
1Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY.
Objective:
This study examined whether baseline reports of adverse childhood experiences (ACEs) and early life adversity (ELA) were associated with subsequent head/neck injury or probable brain injury in the Adolescent Brain Cognitive Development (ABCD) Study® cohort.
Setting:
ABCD Study® cohort.
Participants:
ABCD Study® data release 5.0 provided baseline and partial longitudinal data through Year 4. Inclusion required at least one follow-up timepoint, data to compute the ACEs or ELA score, sex, and attention-deficit/hyperactivity disorder (ADHD) diagnosis status. The final sample included 10,853 participants for ACEs analyses and 10,850 ELA analyses.
Design:
Prospective observational design.
Main Measures:
Head and/or neck injuries and probable brain injuries were assessed using the caregiver-reported Ohio State University Traumatic Brain Injury Identification Method Short Form. We used previously published recommendations for the ABCD study to calculate a proxy ACEs score and a broader measure of ELA using both caregiver and youth report at baseline. Age, gender, race/ethnicity, primary caregiver education, child's history of ADHD, report of head/neck or probable brain injury at baseline, and broken bone injury at baseline or follow-up were covariates in logistic regression models examining the association between risk of head/neck injury or probable brain injury with ACEs or ELA.
Results:
Exposure to more adversity (ACES: Odds Ratio [95% Confidence Interval] OR[95%CI]=0.04[0.001,0.08]; ELA: OR[95%CI]=0.05[0.01,0.08]) was associated with higher odds of sustaining a head or neck injury at any of the follow-up time points but not of probable brain injury (ACES: OR[95%CI]=0.002[-0.08,0.08]; ELA: OR[95%CI]=0.01[-0.06,0.07]).
Conclusion:
Limited public knowledge of and reliance on caregiver report of head/neck injury increases misclassification bias and underscores the need for improved education and measurement strategies. We observed a stronger association between ELA and head/neck injury, potentially reflecting differences in disclosure and awareness rather than due to types of exposure.
