Prevalence and measurement of adverse childhood experiences (ACE) among children and adolescents in the U.S. A scoping review

Purpose: The study objectives were to 1) examine what methodological approaches have been used to determine adverse childhood experiences (ACE) prevalence and 2) determine the prevalence of different ACEs. Methods: A scoping review was conducted on 2009–2020 articles focused on persons 17 years and younger, highlighting screening and surveillance of ACEs, and evaluating the psychometrics of ACE screening tools. Results: A descriptive analysis categorized results of 27 articles into key methodological themes (i.e., study design, self vs. caregiver reporting, location/setting). Majority of the studies were cross-sectional (81.5%), self-reporting (74.1%) and focused on neglect, bullying/victimization and violence. There were 26 unique instruments used to assess ACEs. The prevalence for ACEs reported in the literature varied widely based on factors such as the type of ACEs examined, instrument, self vs. caregiver reporting, age group, and setting. Conclusion: Synthesis of our findings highlights the need for standardization in ACE measurement as they contribute to variations in ACE prevalence estimations and understanding the overall burden ACEs have on a population. Recommendations for improving ACE measurement among U.S. children and adolescents were provided.