Adverse Childhood Experiences in Children with Intellectual Disabilities: An Exploratory Case-File Study in Dutch Residential Care

Abstract

Adverse Childhood Experiences (ACEs) are negative childhood events occurring in a child’s family or social environment, that may cause harm or distress. Children with intellectual disabilities (ID) and their families are underrepresented in international ACEs research, while current insights can also contribute to the improvement of their health and well-being. Deficiencies in intellectual and adaptive functioning and living circumstances can increase their vulnerability to adversities. In the present exploratory study 69 case-files of children referred to a Dutch national center for residential youth care for children with ID were analyzed to assess the prevalence and associations of ACEs. It was found that almost half (49.3%) of the children experienced 2 ACEs from the original ACEs framework or more (M (mean) = 2.1; SD (standard deviation) = 1.8) and that the number of ACEs in children was related to the presence of ACEs in parents. Both child and parental ACEs were also related to attachment- and trauma- and stressor-related disorders. Finally, living circumstances and multiple ACEs from the expanded ACEs framework, especially related to parental characteristics, were found to be related to ACEs in children with ID. This implicates the importance of a transgenerational approach when further investigating the impact of ACEs on mental and physical health in children with ID (intellectual disabilities).

Feasibility and potential effectiveness of an intensive trauma-focused treatment programme for families with PTSD and mild intellectual disability

“…These findings are in line with studies among parents without MID-BIF, suggesting that parents, who have been abused (physically, sexually, emotionally) or neglected themselves during their own childhood, have an enhanced risk for maltreatment of their offspring by showing less warmth, a lack of involvement and more verbal or physical aggression (Assink et al, 2018 ; Berlin, Appleyard, & Dodge, 2011 ). The transgenerational aspect of trauma has also been exhibited by a recent analysis of case-files of children referred to a Dutch national centre for residential youth care for children with MID-BIF (Vervoort-Schel et al, 2018 ). It was found that almost half (49.3%) of the 69 children experienced at least 2 ACEs from the original ACEs framework and that the number of ACEs in children was related to the presence of ACEs in parents.…”

“…Seven parents and seven children fulfilled DSM-5 PTSD criteria at baseline. For each child and parent, adverse childhood experiences from the original ACEs (Adverse Childhood Experiences) framework were taken from the DITS-ID event section, using the definition of ACEs as used in the study of Vervoort-Schel et al ( 2018 ) among out of home placed children with ID. ACEs as established by the children were emotional neglect ( n = 10), having a parent with mental health problems ( n = 10), having witnessed violence against a parent ( n = 8), parental divorce ( n = 8), sexual abuse ( n = 5), physical neglect ( n = 5), emotional abuse ( n = 4), physical abuse ( n = 3), parental substance abuse ( n = 3) and parental incarnation ( n = 1).…”

Resilience in the face of adversity in adults with an intellectual disability: A literature review

“…However, research on resilience in people with intellectual disability can only be found from 2006 to date. This finding is striking since people with intellectual disability are at a higher risk of experiencing adversity (Focht‐New et al, ; Reiter et al, ; Vervoort‐Schel et al, ) but resilience can be a buffer to diminish negative effects. In our study, a distinction is made between internal and external sources of resilience.…”

“…People with an intellectual disability are at a higher risk of experiencing adversity throughout their entire life (Focht‐New, Clements, Barol, Faulkner, & Service, ; Reiter, Bryen, & Shachar, ; Vervoort‐Schel et al, ). Vervoort‐Schel et al () found that in children with intellectual disability in residential care, the three most named adverse childhood experiences (ACEs) were as follows: parental separation, the mental health problems of a parent and being a witness of violence between parents. To date, it remains unclear whether these ACEs are truly specific for children with intellectual disability or for children referred to institutional care.…”

Toward Actionable Practice Parameters for “Dual Diagnosis”: Principles of Assessment and Management for Co-Occurring Psychiatric and Intellectual/Developmental Disability

“…Children and youth with IDD are up to 4 times more likely to witness family domestic violence in comparison to controls [18]. According to a study on the prevalence of various types of ACEs experienced by children with IDD, the most frequent were parental separation/divorce (63.8%), parental mental health problems (33.3%) and to have witnessed violence against a parent (28.9%) [19].…”