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Cumulative Adverse Childhood Experiences and Multiple Neurodevelopmental Disorders in Children and Adolescents: A

Jialing Lin1, James G Scott2,3,4, Valsamma Eapen5,6,7

  • 1International Centre for Future Health Systems, University of New South Wales, Sydney, New South Wales, Australia.

Stress and Health : Journal of the International Society for the Investigation of Stress
|July 7, 2026
PubMed

Insights

Adverse childhood experiences (ACEs) significantly increase the risk of multiple neurodevelopmental disorders (NDDs). Each additional ACE is linked to higher odds of developing two or more NDDs, highlighting the impact of cumulative adversity.

Area of Science:

  • Child Health
  • Neuroscience
  • Psychiatry

Background:

  • Adverse childhood experiences (ACEs) and neurodevelopmental disorders (NDDs) are prevalent in childhood.
  • The cumulative impact of ACEs on the development of multiple NDDs is not well understood.

Purpose of the Study:

  • To examine the association between cumulative ACEs and the presence of multiple NDDs in children.
  • To investigate specific ACEs and NDD combinations linked to increased risk.

Main Methods:

  • Utilized data from 120,629 children (aged 3-17) from the 2021-2023 US National Survey of Children's Health.
  • Employed logistic regression, analyzing ACEs as continuous and categorical variables, adjusted for covariates.
  • Assessed associations for common NDD combinations and individual ACEs.

Main Results:

  • The prevalence of multiple NDDs increased with the number of ACEs, from 4.5% with 0 ACEs to 17.8% with ≥3 ACEs.
  • Each additional ACE was associated with a 13% increased odds of multiple NDDs (aOR=1.13).
  • Specific ACEs like mistreatment, household mental illness, and economic hardship showed significant associations with multiple NDDs.

Conclusions:

  • Cumulative ACEs are significantly associated with a higher likelihood of developing multiple NDDs.
  • Findings underscore the need for coordinated health policies and services addressing cumulative adversity in children.
  • Future research should focus on integrated approaches to support children with multiple NDDs and a history of ACEs.

Keywords:
adolescentsadverse childhood experienceschildrenepidemiologyneurodevelopmental disorders

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