The Burden of Adverse Childhood Experiences in Children and Those of Their Parents in a Burn Population

Abstract

Objective To determine the prevalence, type, and associations of parental and child adverse childhood experiences (ACEs) in children presenting with burn injuries. Methods Parents of burned children completed an ACE-18 survey, including questions on parent and child ACEs, needs, and resiliency. Demographics, burn injury, hospital course, and follow up data were collected. Family needs and burn outcomes of children with and without ACEs’ exposure (NO ACE vs. 1-2 ACE vs ≥ 3 ACE) was analyzed. P < 0.05 was considered significant. Results Seventy-five children were enrolled; 58.7% were male, 69.3% white. The average age was 6.0 ± 5.2 years. The average total burn surface area was 4.4 ± 5.7% (0.1 to 27%). Parent ACE exposure correlated with child ACE exposure (r = 0.57; p = 0.001) and this intensified by increasing child age (p = 0.004). Child ACE exposure showed a graded response to family needs, including food and housing insecurity and childcare needs. Stress and psychosocial distress of the parents was significantly associated with their children’s ACE burden. Conclusions The ACE burden of parents of burned children can affect the ACE load of their children. Burned children with more ACEs tend to have significantly more needs and more family distress. Awareness of past trauma can help identify a vulnerable population to ensure successful burn recovery.

Associations between Adverse Childhood Experiences (ACEs) and Lifetime Experience of Car Crashes and Burns: A Cross-Sectional Study

“…However, even when adjusting for demographic confounders, individuals with 4+ ACEs were over two times more likely to report having ever had a burn and over four times more likely to report having had a burn multiple times. Such findings align with other research indicating that individuals who have experienced ACEs are at increased risk of burns [ 21 , 23 ]. ACEs have also been associated with increased risk of a more complicated recovery following a burn, with burn patients with higher ACE counts having been found to be less resilient and more likely to have depression and post traumatic stress disorder (PTSD) symptoms [ 23 ].…”

“…Further, in young adults, specific ACEs have been associated with past year serious injury (physical and sexual abuse, emotional neglect) and being in a motor vehicle collision (physical abuse, emotional neglect) [ 20 ]. Other research on ACEs and unintentional injury has predominately been conducted within populations affected by injury [ 21 , 22 ]. For example, a US study of burn patients identified a higher prevalence of ACEs (17.0% reporting 4+) compared to the general population (14.5%) [ 23 ].…”