Introducing the Adverse Life Events Inventory for Children (ALEIC): An examination of adverse experiences and related impacts in a large clinical sample of children and youth.

Abstract

Adverse childhood experiences (ACEs) investigators report a dose-response relation between the number of negative experiences in childhood and physical and emotional well-being in adulthood. Measures of ACEs have been developed for clinical use; however, some instruments focus only on specific types of negative events and/or conflate trauma symptoms. We present the development of the Adverse Life Events Inventory for Children (ALEIC), a measure of childhood adversity exposure that enhances the comprehensive interRAI Child and Youth Mental Health intake instrument already in use at children's mental health agencies. ALEIC development was aided by an external Delphi panel of trauma experts. These efforts resulted in 28 items across 16 categories, covering a wide range of negative life events. Archival data analyzed from 13,645 children and youth who had initial Child and Youth Mental Health assessments completed at 40 children's mental health agencies in Ontario, Canada, found a positive relation between ALEIC total scores of adversity history and trauma mental health symptoms. As a benchmark for researchers and clinicians, we include prevalence rates reported by sex and age for each type of adversity in this extremely large and diverse clinical sample. Remarkably, 40% of children and 51% of youth referred to mental health clinics experienced 4 or more (of 16) different types of adversity. Given these base rates, routine, structured screening of adversity exposure at clinic intake ("What happened to this child?") is recommended to mitigate the reoccurrence of future stressors and to minimize the long-term effects of adverse life events.