Study identifies factors that can help children thrive in the face of adversity

BALTIMORE, MD – Research shows that people who experience four or more adverse childhood experiences (ACEs), such as economic hardship, exposure to violence or the death of a loved one, are more likely to have lasting physical and mental health problems. But a new research abstract to be presented at the Pediatric Academic Societies 2016 Meeting suggests that certain family, social and community assets may boost a child's chances of flourishing in the face of adversity.

For the study, "The Relative Contributions of Adverse Childhood Experiences and Healthy Environments to Child Flourishing," researchers analyzed data from the 2011-2012 National Survey of Children's Health, conducted by the National Center for Health Statistics, to gauge children's health and well-being, physical, emotional and behavioral health indicators, family context and neighborhood environment.

"We focused on questions about ACEs exposure, but also family, social and community assets that could serve to moderate that risk or enhance resilience," said lead author Iman Sharif, MD, MPH, chief of the division of general pediatrics at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., and co-director of the Nemours Primary Care Research Collaborative. Her research team found that even when children were exposed to adverse childhood experiences, certain family and community strengths appeared to have a protective effect on health, social and behavioral outcomes. Among the most influential of these were having access to patient-centered, coordinated medical care, mothers who were in excellent mental health, and community supports. The latter was gauged by responses to statements such as, "I have adults I can trust, people to count on."

Additional protective factors identified in the study included fathers in excellent mental health, mothers and fathers who had completed at least some college, living in a neighborhood with amenities such as sidewalks, a library, a park and a recreation center, and mothers in good physical health.

"The research for the past 20 years has clearly demonstrated the relationship between ACEs exposure and adult physical and mental health outcomes. This study adds to the emerging literature on the impact of ACEs on child health outcomes, and goes further to identify the factors that can help children thrive even when exposed to ACEs," Dr. Sharif said.

The findings support earlier research showing that ACEs exposure does not render health systems and communities "helpless," she said. "This shows there are things we can do," she said. "With appropriate screening to identify children at risk we can support children and families through the patient-centered medical home, linking parents to mental health services, and building community social supports to help children succeed."


Dr. Sharif will present the abstract on Monday, May 2, at 4:15 p.m. in Exhibit Hall F of the Baltimore Convention Center. To view the abstract,

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal. Contact the researcher for more information.

The Pediatric Academic Societies (PAS) Meeting brings together thousands of individuals united by a common mission: to improve child health and wellbeing worldwide. This international gathering includes pediatric researchers, leaders in academic pediatrics, experts in child health, and practitioners. The PAS Meeting is produced through a partnership of four organizations leading the advancement of pediatric research and child advocacy: Academic Pediatric Association, American Academy of Pediatrics, American Pediatric Society, and Society for Pediatric Research. For more information, visit the PAS Meeting online at, follow us on Twitter @PASMeeting and #PASMeeting, or like us on Facebook.

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