Effects of childhood adversity are seen early in life

According to a new report, abuse and other household dysfunction correlates with more than adverse health outcomes later in life. Such dysfunction also increases both the risk of poor overall health early in childhood, and of illness requiring medical attention.

Investigators collected data at five sites across the country for more than 1,000 children at high risk for child abuse and neglect, using parental (primarily maternal) interviews and questionnaires when the children were 4 and 6 years old. They asked caregivers about their child's exposure to three types of child abuse: physical, sexual, and psychological. Using standardized measures, investigators also assessed the presence of four categories of household dysfunction: caregiver problem drinking, caregiver depression, physical abuse of the caregiver, and criminal behavior in the household.

Two thirds of the children had at least one of these seven exposures. About one quarter of the children had experienced psychological maltreatment, the most common of the three indicators of child abuse. Caregiver depression was the most prevalent household dysfunction, present in about one third of maternal caregivers. Domestic violence was the least prevalent of the seven indicators of childhood adversity, experienced by about 8% of caregivers.

Commentary

This study confirms that the children we care for are the products of their surroundings. It offers evidence that a stressful environment at home can have a negative impact on a child's health, not just in later years, but in childhood. So what do we do with this information? Be alert to high-risk conditions in the home and be ready to mobilize available community resources to help. This is not an easy task.