Adverse childhood experiences during childhood and academic attainment at age 7 and 11 years: an electronic birth cohort study. (December 2020)

• Record Type: Journal Article
• Authors: Evans, A.; Hardcastle, K.; Bandyopadhyay, A.; Farewell, D.; John, A.; Lyons, R.A.; Long, S.; Bellis, M.A.; Paranjothy, S.
• Is Part Of: Public health. Volume 189(2020)
• Page Start: 37
• Page End: 47
• Publication Date: 2020-12
• Subjects: Adverse childhood experiences -- Education outcomes -- Social inequalities; Public health -- Periodicals; Public health -- Periodicals; Electronic journals; 362.1
• DOI: 10.1016/j.puhe.2020.08.027
• Languages: English
• ISSNs: 0033-3506

Abstract

Abstract: Objectives: Adverse childhood experiences (ACEs) have a negative impact on childhood health, but their impact on education outcomes is less well known. We investigated whether or not ACEs were associated with reduced educational attainment at age 7 and 11 years. Study design: The study design used in the study is a population-based electronic cohort study. Methods: We analysed data from a total population electronic child cohort in Wales, UK. ACEs (exposures) were living with an adult household member with any of (i) serious mental illness, (ii) common mental disorder (CMD), (iii) an alcohol problem; (iv) child victimisation, (v) death of a household member and (vi) low family income. We used multilevel logistic regression to model exposure to these ACEs and not attaining the expected level at statutory education assessments, Key Stage (KS) 1 and KS2 separately, adjusted for known confounders including perinatal, socio-economic and school factors. Results: There were 107, 479 and 43, 648 children included in the analysis, with follow-up to 6–7 years (KS1) and 10–11 years (KS2), respectively. An increased risk of not attaining the expected level at KS1 was associated with living with adult household members with CMD (adjusted odds ratio [aOR]: 1.13 [95% confidence interval [CI]: 1.09–1.17]) or an alcohol problem (adjusted odds ratio [aOR]: 1.16 [95% confidence interval [CI]: 1.10–1.22]), childhood victimisation (adjusted odds ratio [aOR]: 1.58 [95% confidence interval [CI]: 1.37–1.82]), death of a household member (adjusted odds ratio [aOR]: 1.14 [95% confidence interval [CI]: 1.04–1.25]) and low family income (adjusted odds ratio [aOR]: 1.92 [95% confidence interval [CI]: 1.84–2.01]). Similar results were observed for KS2. Children with multiple adversities had substantially increased odds of not attaining the expected level at each educational assessment. Conclusion: The educational potential of many children may not be achieved due to exposure to adversity in childhood. Affected children who come in to contact with services should have relevant information shared between health and care services, and schools to initiate and facilitate a coordinated approach towards providing additional support and help for them to fulfil their educational potential, and subsequent economic and social participation. Highlights: This is the first UK study to use routinely available healthcare data record-linked to education outcome data in a total population electronic child cohort to examine the cumulative impact of multiple forms of childhood and household adversity on early educational attainment. Children exposed to adverse experiences during childhood were less likely, compared with non-exposed peers, to attain the expected level of education at age 6–7 years (Key Stage 1) and age 10–11 years (Key Stage 2). Exposure to adverse childhood experiences increases the chances that children develop into adults with poor economic prospects, contributing to a cycle of hardship that fuels inequalities and potentially locks families into deprivation and ill health across generations.