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Adverse Childhood Experiences and Developmental Delay in Young US Children

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Abstract

Purpose of Study: Adverse childhood experiences (ACEs) have been associated with developmental delay and poor health outcomes in late childhood and adolescence. Health promoting practices such as breastfeeding and daily reading have been associated with lower rates of developmental delay. This study aims to investigate the association between early ACE exposure, protective health behaviors, and the diagnosis of developmental delay in early childhood.

Methods Used: In this cross-sectional analysis of population-representative date from the 2017-2018 National Survey of Children’s Health, we examined the relationship between ACEs, prior breastfeeding, daily reading, and diagnosis of developmental delay among 7837 children aged 3-5 years, using multivariate logistic regression to adjust for family, personal (i.e. premature birth, or low birth weight), and sociodemographic characteristics.

Summary of Results: We found a dose-dependent relationship between ACEs and developmental delay; compared to those with no ACE, developmental delay was more common among those with either 1 ACE (aOR=1.57, 95% CI 1.03-2.40) or 2 or more ACEs (aOR=3.22, 95% CI 2.0-5.19). Developmental delay in this age group was also associated with very low birth weight (aOR 3.98, 95% CI 1.62-9.77) and premature birth (aOR 2.21, 95% CI 1.34-3.65). Neither breastfeeding (breastfed for 6 months versus none aOR=0.70, 95% CI 0.36-1.36) nor daily reading (no reading versus daily reading aOR=1.10, 95% CI 0.47-2.60) were associated with reduced incidence of developmental delay in study participants.

Conclusions: Children with early ACEs are  at risk of developmental delay, regardless of whether they are breastfed or read to on a daily basis.

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