Objective: The purpose of this paper is to examine the relationship between measured clinical outcomes and Adverse Childhood Experience (ACE) survey scores in a regional population of children and adolescents admitted to psychiatric services.Methods: ACE survey data collected between 2016 and 2020 was linked with demographic, clinical profile, clinical system variables (eg, repeated admissions), and outcome data for those admitted for treatment. Improved and deteriorated categories of clinical outcome were defined (dependent variable) and their association with demographic and clinical profile data (independent variables) was examined employing bivariate and multivariable logistic regression analysis.Results: Higher ACE scores were associated with the deteriorated categories of clinical outcome. Demographic, clinical profile and clinical system variables predicted 38% of the variance of the ACE survey total score. A subset of these variables predicted membership in the deteriorated clinical outcome category. There was a strong linear relationship between ACE survey total scores and sequential admissions to services. Poor outcomes were principally related to the following ACE items: Household substance abuse, Physical abuse, Psychotic symptoms, Significant biological family history of mental illness, Social/ friendships/community functioning. Conclusion:The risk for poor clinical outcomes is measurably associated with higher ACE survey scores.Based on the ability to measure this association, a framework is discussed for exploring the nature of effective therapies that take into account adversity child experiences such as Household substance abuse.
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